{"_id": "WikiPedia_Orthopedics$$$corpus_1", "text": "Redirect to:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_2", "text": "Acta Orthopaedica et Traumatologica Turcica  is a  peer-reviewed   medical journal  published bi-monthly by the  Turkish Association of Orthopaedics and Traumatology . It is also the official journal of the  Turkish Society of Orthopaedics and Traumatology . The journal is included in the  Science Citation Index Expanded ,  Index Medicus , and  TUBITAK-ULAKBIM ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_3", "text": "Acta Orthopaedica et Traumatologica Turcica  was established in 1962 and published semi-annually until 1974 after which publication was quarterly. The journal has been published 6 times a year since 1988. Articles have been peer-reviewed since 1991."}
{"_id": "WikiPedia_Orthopedics$$$corpus_4", "text": "The journal publishes articles pertaining to  diagnostic , treatment, and prevention methods as well as studies in basic sciences related to  orthopedics  and  traumatology . Article types published are:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_5", "text": "This article about a  surgery   journal  is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_6", "text": "See tips for writing articles about academic journals . Further suggestions might be found on the article's  talk page ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_7", "text": "Archives of Osteoporosis   is a  peer-reviewed   medical journal  published by  Springer Science+Business Media . [ 1 ]  It was established in 2006 and is an official journal of the  International Osteoporosis Foundation  and the United States'  National Osteoporosis Foundation . [ 1 ]  The journal is published yearly and covers the specificities of regions around the world concerning  epidemiology , including reference values for  bone density  and  bone metabolism , as well as clinical aspects of  osteoporosis  and other bone diseases. The current  co-editors-in-chief  are John Kanis and Felicia Cosman."}
{"_id": "WikiPedia_Orthopedics$$$corpus_8", "text": "The  Australasian Journal of Bone & Joint Medicine  (originally titled the  Australasian Journal of Musculoskeletal Medicine [ 1 ] ) was a periodical presented in the style of a  scientific journal , published by  Elsevier  but established and funded by pharmaceutical company  Merck . Publication began in 2002, [ 1 ]  and the last issue appeared in 2005. [ 2 ] [ 3 ]  According to  The Scientist :"}
{"_id": "WikiPedia_Orthopedics$$$corpus_9", "text": "Merck paid an undisclosed sum to Elsevier to produce several volumes of [ Australasian Journal of Bone and Joint Medicine ], a publication that had the look of a peer-reviewed medical journal, but contained only reprinted or summarized articles\u2014most of which presented data favorable to Merck products\u2014that appeared to act solely as marketing tools with no disclosure of company sponsorship. [ 4 ] [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_10", "text": "The publication was not included in the  MEDLINE  literature database and did not have its own website. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_11", "text": "In May 2009, Elsevier admitted that a series of similar industry sponsored publications had been produced, and that \"high standards for disclosure were not followed in this instance\". [ 3 ]  In a formal statement, the CEO of Elsevier's Health Sciences Division, Michael Hansen, admitted that the practice was \"unacceptable\", and expressed regret for the publications. [ 7 ]  Merck has denied claims that articles within it were  ghost written  by Merck and has stated that the articles were all  reprinted  from  peer-reviewed   medical journals . [ 8 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_12", "text": "Several medical experts stated that their names were included in the Honorary Editorial Board of the  Australasian Journal of Bone and Joint Medicine  without their knowledge and consent. [ 9 ] [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_13", "text": "There were six such \"industry-sponsored\" publications brought out by Elsevier without proper disclosure of their nature, and which had the superficial appearance of a legitimate independent journal. [ 11 ] [ 12 ]  The six publications involved were:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_14", "text": "Bone  is a bimonthly  peer-reviewed   medical journal  covering the study of  bone biology  and mineral  metabolism . It absorbed two journals,  Metabolic Bone Disease and Related Research  and  Mineral and Bone , during its history. It was once the official journal of the  International Bone and Mineral Society  (IBMS), but has been an independently-published journal since 2012."}
{"_id": "WikiPedia_Orthopedics$$$corpus_15", "text": "The journal has its origins in several journals which merged."}
{"_id": "WikiPedia_Orthopedics$$$corpus_16", "text": "Metabolic Bone Disease and Related Research  was established in 1978, with a different  ISSN . [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_17", "text": "According to the IBMS website, two scientific journals,  Bone [ 3 ]  (with the same ISSN as this journal; 1985 onwards) [ 4 ]  and  Bone and Mineral [ 5 ] [ 6 ] [ a ]  merged under the title  Bone , which became the official journal of IBMS, published monthly, until the relationship between the journal and IBMS ended on 31 December 2012. The website notes that  Bone  went on to become a leading journal in the field, \"publishing top-notch, peer-reviewed content on both the basic science and clinical sides\". [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_18", "text": "As of 2024 [update]   Bone  is published by  Elsevier  and the  editor-in-chief  is Peter Ebeling of  Monash University  in  Melbourne , Australia. [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_19", "text": "According to the  Journal Citation Reports , the journal had an  impact factor  of 4.147 in 2019. [ 8 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_20", "text": "This article about a  medical journal  is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_21", "text": "The Bone & Joint Journal , formerly known as  The Journal of Bone & Joint Surgery (British Volume) , is a monthly  peer-reviewed   medical journal  published by The British Editorial Society of Bone & Joint Surgery. [ 1 ]  It is the flagship journal within the society's 'Bone & Joint Publishing' imprint, which also includes  Bone & Joint Research ,  Bone & Joint Open , and  Bone & Joint 360 ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_22", "text": "The journal is the official publication of the  British Orthopaedic Association , Canadian Orthopaedic Association, New Zealand Orthopaedic Association and  Australian Orthopaedic Association ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_23", "text": "The journal is indexed in  MEDLINE . According to the  Journal Citation Reports , it has a 2022  Impact Factor  of 4.6. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_24", "text": "Bone & Joint Research  (BJR) is an orthopaedic journal covering the whole spectrum of the musculoskeletal sciences, published by The British Editorial Society of Bone & Joint Surgery, a registered charity in the UK (No. 209299). BJR is a gold open access journal and hence articles published in the journal are available online to anyone, free of charge. Articles are published in a continuous publication model, and collated into monthly issues. First published in 2012, BJR is part of the Bone & Joint series of journals, which also includes  Bone & Joint 360  and the flagship journal  The Bone & Joint Journal  (first published in 1948 as  The Journal of Bone & Joint Surgery (British Volume) ). [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_25", "text": "According to the  Journal Citation Reports , BJR received achieved a 2022  Impact Factor  Impact Factor of 4.6. [ 3 ]  The journal is also indexed in  MEDLINE ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_26", "text": "Cartilage  is a quarterly  peer-reviewed   academic journal  that covers research in the field of  sports medicine , especially the  musculoskeletal  system with particular attention to  cartilage  repair, function, and degeneration. The  editor-in-chief  is Roy D. Altman. It was established in 2010 and is currently published by  SAGE Publications  on behalf of the  International Cartilage Repair Society ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_27", "text": "Cartilage  is abstracted and indexed in  Chemical Abstracts  and  Scopus ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_28", "text": "The Cleft Palate-Craniofacial Journal  is a monthly  peer-reviewed   medical journal . It was established in 1964 as the  Cleft Palate Journal , obtaining its current title in 1991. [ 1 ]  The journal is published by  SAGE Publishing  on behalf of the  American Cleft Palate-Craniofacial Association . It covers research on the  etiology , prevention,  diagnosis , and treatment of  cleft palate  and other  craniofacial  anomalies. The  editor-in-chief  is Jamie Perry."}
{"_id": "WikiPedia_Orthopedics$$$corpus_29", "text": "The journal is abstracted and indexed in:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_30", "text": "According to the  Journal Citation Reports , the journal has a 2019  impact factor  of 1.347. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_31", "text": "Clinical Orthopaedics and Related Research  is a  peer-reviewed   medical journal . It was established in 1953 as  Clinical Orthopaedics  by the Association of Bone and Joint Surgeons as an alternative to the  Journal of Bone and Joint Surgery , which was the only American orthopaedic journal at the time. The journal obtained its current title in 1963 and its mission is to disseminate knowledge about all aspects of  musculoskeletal  research, diagnoses, and treatment. The journal was established by  Anthony F. DePalma , who was also its  editor-in-chief  from 1953 to 1966. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_32", "text": "In conjunction with  Clinical Orthopaedics and Related Research , the Association of Bone and Joint Surgeons presents three awards annually including the  Nicolas Andry Award . [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_33", "text": "EFORT Open Reviews  is a monthly  peer-reviewed   medical journal , which was first published in January 2016. [ 1 ]   EFORT Open Reviews  is the official journal of the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) and is published in partnership with Bioscientifica. [ 2 ] [ 3 ]   EFORT Open Reviews  is a gold open access journal and hence articles published in the journal are available online to anyone, free of charge. Full-text content can also be accessed via  PubMed Central . [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_34", "text": "The journal is indexed in  PubMed Central , which hosts full-text content of the complete archive."}
{"_id": "WikiPedia_Orthopedics$$$corpus_35", "text": "EAO asbl , operating as the  European Association for Osseointegration  (EAO) is a non-profit organisation founded in  Munich  in 1991  (34\u00a0years ago) \u00a0( 1991 )  to serve as an international, interdisciplinary and independent science-based forum for all professionals interested in the art and science of  Osseointegration . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_36", "text": "Its headquarters are in  Ixelles ,  Brussels ,  Belgium . [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_37", "text": "This article about a medical organization or association is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_38", "text": "The  European Spine Journal  is a  peer-reviewed   medical journal  dedicated to  orthopedics  as it relates to all aspects of the human  spine . It was established in 1992 and is published eight times per year by  Springer Science+Business Media . It is the official journal of  EuroSpine , the Spine Society of Europe. The  editor-in-chief  is Robert Gunzburg, a spinal surgeon in private practice in  Antwerp ,  Belgium . [ 1 ]  According to the  Journal Citation Reports , the journal has a 2022  impact factor  of 2.8. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_39", "text": "Foot & Ankle Specialist  is a bimonthly  peer-reviewed   medical journal  that covers the field of  orthopedics . The  editors-in-chief  are Gregory C. Berlet and Lowell Weil, Jr. ( Weil Foot & Ankle Institute ). It was established in 2008 and is currently published by  SAGE Publications ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_40", "text": "Foot & Ankle Specialist  is abstracted and indexed in  PubMed ,  Medline ,  EMBASE , and  Scopus ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_41", "text": "Geriatric Orthopaedic Surgery & Rehabilitation  is a bimonthly  peer-reviewed   medical journal  that covers the field of  Orthopedics . The journal's  editor-in-chief  is Stephen L. Kates ( University of Rochester Medical Center ). It has been in publication since 2010 and is currently published by  SAGE Publications ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_42", "text": "The  HSS Journal , the Musculoskeletal Journal of Hospital for Special Surgery  is a  peer-reviewed   medical journal  published by  Springer Science+Business Media . It covers  musculoskeletal  diseases and  orthopedic surgery . The journal offers free  continuing medical education  articles without registration. [ 1 ]  The  editor in chief  is Charles N. Cornell ( Weill Cornell Medical College of Cornell University )."}
{"_id": "WikiPedia_Orthopedics$$$corpus_43", "text": "The Journal of Bone and Joint Surgery  is a biweekly  peer reviewed   medical journal  in the field of  orthopedic surgery . It is published by the non-profit corporation The Journal of Bone and Joint Surgery, Inc. It was established as the  Transactions of the American Orthopedic Association  in 1889, published by the  American Orthopedic Association . In 1903, volume 16 of the  Transactions  became the first volume of the  American Journal of Orthopedic Surgery , which was renamed  Journal of Orthopaedic Surgery  in 1919 and also became the official journal of the  British Orthopaedic Association . The journal obtained its current name in 1921.  As of 2016, it had a  Journal Citation Reports  impact factor of 4.8 and ranking of 10/197 (surgery), 2/76 (orthopedics). [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_44", "text": "The journal became the organ of the newly founded  American Academy of Orthopaedic Surgeons  in 1933. A British volume was established in 1948, using the name under license from the American volume. In 1954, the American journal incorporated itself as a non-profit organization. The British volume was published by The British Editorial Society of Bone and Joint Surgery, a registered charity in the United Kingdom. The American and British volumes were completely independent of each other, and had completely different content. The British volume was renamed  The Bone & Joint Journal  in 2013."}
{"_id": "WikiPedia_Orthopedics$$$corpus_45", "text": "The journal is the official scientific journal of the American Academy of Orthopaedic Surgeons and is affiliated with the  American Orthopaedic Association ,  Eastern Orthopaedic Association ,  Mid-America Orthopaedic Association , and the  Western Orthopaedic Association . [ 2 ] \n The Journal of Bone and Joint Surgery, British volume  (now titled  The Bone and Joint Journal ) was the official journal of the  Australian Orthopaedic Association ,  British Orthopaedic Association ,  British Orthopaedic Research Society ,  Canadian Orthopaedic Association ,  Canadian Orthopaedic Research Society ,  European Federation of National Associations of Orthopaedics and Traumatology ,  European Orthopaedic Research Society ,  Irish Orthopaedic Association ,  New Zealand Orthopaedic Association , and the  South African Orthopaedic Association . [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_46", "text": "The  Journal of Cachexia, Sarcopenia and Muscle  is a quarterly  peer-reviewed   medical journal  that covers research relevant to changes in  body composition , especially  cachexia  and  sarcopenia , as consequences of chronic illnesses or of the aging process, respectively. It was established in 2010 and was originally published by  Springer Science+Business Media . As of January 2015, the journal is published by  Wiley-Blackwell  in association with the  Society on Sarcopenia, Cachexia and Wasting Disorders . The founding  editors-in-chief  are  Stefan D. Anker  ( Charit\u00e9 - Universit\u00e4tsmedizin Berlin ) and  Stephan von Haehling  ( University of G\u00f6ttingen ). As of November 2016, the journal has two daughter journals entitled  JCSM - Clinical Reports  and  JCSM - Rapid Communications , dedicated to clinical and basic science, respectively."}
{"_id": "WikiPedia_Orthopedics$$$corpus_47", "text": "The journal is abstracted and indexed in  Embase , [ 1 ]   Science Citation Index Expanded , [ 2 ]  and  Scopus . [ 3 ]  According to the  Journal Citation Reports , the journal has a 2017  impact factor  of 12.511. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_48", "text": "The  Journal of Children's Orthopaedics  is a bimonthly  peer-reviewed   medical journal , which was first published in March 2007. It is the official journal of the European Paediatric Orthopaedic Society (EPOS). The  Journal of Children's Orthopaedics  is a gold open access journal and hence articles published in the journal are available online to anyone, free of charge. Full-text content can also be accessed via  PubMed Central . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_49", "text": "The journal is indexed in  Scopus , the  Emerging Sources Citation Index  (via  Web of Science ) and also  PubMed Central , which hosts full-text content of the complete archive."}
{"_id": "WikiPedia_Orthopedics$$$corpus_50", "text": "According to the  Journal Citation Reports , it has a 2019  impact factor  of 1.075. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_51", "text": "The  Journal of Musculoskeletal Research  is a quarterly  peer-reviewed   medical journal  covering clinical and basic research in the  human musculoskeletal system . It was established in 1997 and is published by  World Scientific . The journal covers musculoskeletal disorders,  orthopedics ,  neurology ,  rheumatology , and rehabilitation. The  editors-in-chief  are  Po-Quang Chen ( National Taiwan University Hospital  ) and Li-Shan Chou ( University of Oregon )."}
{"_id": "WikiPedia_Orthopedics$$$corpus_52", "text": "The  Journal of Orthopaedic & Sports Physical Therapy  is a  peer-reviewed   medical journal  covering research about musculoskeletal rehabilitation,  orthopaedics ,  physical therapy , and  sports medicine . It was established in 1979, following the founding of the Orthopedic and Sports Medicine sections of the  American Physical Therapy Association  and resulted from a  merger of the  Bulletin of the Orthopaedic Section  and the  Bulletin of the Sports Medicine Section . Initially published quarterly, the journal is now monthly. It is abstracted and indexed by  PubMed / MEDLINE  and  CINAHL ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_53", "text": "The  Journal of Orthopaedic Research  is a  peer-reviewed   medical journal  of  orthopaedics  published by  Wiley-Liss  on behalf of the  Orthopaedic Research Society . It was established in 1983 and the  editor-in-chief  is Dr. Edward M. Schwarz, Ph.D.( University of Rochester ). According to the  Journal Citation Reports , the journal has a 2022  impact factor  of 2.8, ranking it 27th out of 86 journals in the category \"Orthopedics\". [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_54", "text": "The  Journal of Orthopaedic Science  ( ISSN \u00a0 0949-2658  (print version);  ISSN \u00a0 1436-2023  (electronic version)), based out of  Tokyo ,  Japan , and published by  Springer Science+Business Media , is the official journal of the  Japanese Orthopaedic Association .  The journal focuses primarily on research and topical debates impacting areas of clinical and experiential orthopedics, but often branches out to other areas of research that directly or indirectly impact orthopedics research.  The format of the journal includes original articles of research, instructional reviews, lectures, and editorials."}
{"_id": "WikiPedia_Orthopedics$$$corpus_55", "text": "Founded in 1926, the Japanese Orthopaedic Association (JOA) is an organization that primarily promotes research, partnerships, and the dissemination of information regarding orthopedics science to the public.  JOA currently has over 19,000 members worldwide.  The association itself conducts studies, holds an annual meeting full of presentations and lectures, as well as coordinates research among several organizations across the globe."}
{"_id": "WikiPedia_Orthopedics$$$corpus_56", "text": "The  Journal of Orthopaedic Surgery and Research  is a  peer-reviewed   open access   medical journal  covering  orthopedic surgery  and the general study of the  musculoskeletal system . It was established in 2006 and is published by  BioMed Central . The  editor-in-chief  is Nicola Maffulli ( Queen Mary University of London ). According to the  Journal Citation Reports , the journal has a 2018/2019  impact factor  of 1.907. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_57", "text": "The  Journal of Orthopaedic Trauma  is a monthly,  peer-reviewed ,  orthopaedic journal  published by  Lippincott Williams & Wilkins . It was established in 1987. The  editor in chief  is Roy W. Sanders. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_58", "text": "This journal is the official publication of the  Orthopaedic Trauma Association ,  International Society for Fracture Repair ,  Belgian Orthopaedic Trauma Association ,  Japan Fracture Society , and the  Canadian Orthopaedic Trauma Society . [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_59", "text": "Topical coverage includes  hard  and  soft tissue   trauma , pertaining to the following types of injuries: ligament, bone, muscle, spinal cord, and tendons. Diagnoses and management of these injuries is also covered. Furthermore, methods and tools are covered such as advancements in surgical instruments, effective diagnostics, and advancements in surgical procedures. Prostheses and implants are also covered by this journal, as well as  bioplastics  and biometals, physical therapy, and rehabilitation. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_60", "text": "The journal is abstracted and indexed in the following databases: [ 2 ] [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_61", "text": "The  Journal of Shoulder and Elbow Surgery  is a  peer-reviewed   medical journal  covering  orthopedic surgery  related to the shoulder, elbow, and upper extremities. It is the official journal of multiple shoulder and elbow societies, including the  American Shoulder and Elbow Surgeons , the  European Society for Surgery of Shoulder and Elbow , the  Japan Shoulder Society , the  Shoulder and Elbow Society of Australia , the  South American Shoulder and Elbow Society , the  South African Shoulder and Elbow Surgeons , the  Asian Shoulder Association , the  Korean Shoulder and Elbow Society , the  International Congress of Shoulder and Elbow Surgery , and the  American Society of Shoulder and Elbow Therapists ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_62", "text": "The journal was established in January 1991, with  Mosby , now an imprint of  Elsevier , as the publisher. The founding  editor-in-chief  was Robert Cofield ( Mayo Clinic ). In 1997, Robert Neviaser ( George Washington University Medical Center ) took over as editor-in-chief. In 2008,  Bill Mallon  (Triangle Orthopaedic Associates,  Durham, North Carolina ) was named as the third editor-in-chief. [ 1 ]  John E (Jed) Kuhn was named as the fourth editor-in-chief in 2025.  Originally the journal was published bimonthly. In 2010, it began publishing 8 issues per year, increased in 2012 to monthly."}
{"_id": "WikiPedia_Orthopedics$$$corpus_63", "text": "The journal is abstracted and indexed in  PubMed ,  MEDLINE ,  EMBASE , and  Scopus . According to the  Journal Citation Reports , the journal has a 2014  impact factor  of 2.289, ranking it 18th out of 72 journals in the category \"Orthopedics\", [ 2 ]  17th out of 81 journals in the category \"Sport Science\", [ 3 ]  and 60th out of 198 journals in the category \"Surgery\". [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_64", "text": "The  Journal of the American Podiatric Medical Association  is a bimonthly  peer-reviewed   academic journal  covering  podiatry , including foot and ankle surgery,  biomechanics , and  dermatology . It was established in 1907 and is the official journal of the  American Podiatric Medical Association . The  editor-in-chief  is Warren R. Joseph."}
{"_id": "WikiPedia_Orthopedics$$$corpus_65", "text": "According to the  Journal Citation Reports , the journal has a 2013  impact factor  of 0.574. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_66", "text": "The  Knee Surgery, Sports Traumatology, Arthroscopy  is a monthly  peer-reviewed   medical journal  published in English covering  orthopaedic surgery , especially related to sports trauma and surgeries, in particular  arthroscopies  and knee surgery."}
{"_id": "WikiPedia_Orthopedics$$$corpus_67", "text": "The journal is the official journal of the  European Society of Sports Traumatology, Knee Surgery and Arthroscopy  . It was established in 1992 with Ejnar Eriksson as founding  editor-in-chief  for the first 16 years. He was succeeded by Jon Karlsson ( Gothenburg University ) and Ren\u00e9 Verdonk ( Ghent University ) in 2008. In 2012, Verdonk became Senior Editor and Jon Karlsson the sole editor-in-chief. While the journal was originally published as three relatively thin issues in 1993, its publication frequency increased gradually to the current 12 issues per year with about 300 pages per issue. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_68", "text": "According to the  Journal Citation Reports , the journal has a 2014  impact factor  of 3.053, ranking it 7th out of 72 journals in the category \"Orthopaedics\", [ 2 ]  9th out of 81 journals in the category \"Sport Sciences\", [ 3 ]  and 31st out of 198 journals in the category \"Surgery\". [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_69", "text": "Neuromuscular Disorders  is a  peer-reviewed   medical journal  that focuses on  neuromuscular disease , including  muscular dystrophy ,  spinal muscular atrophy , and  myasthenia . It is the official journal of the  World Muscle Society . It was established in 1991 and is published by  Elsevier ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_70", "text": "This article about a  neurology   journal  is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_71", "text": "Orthopedics  is a monthly  peer-reviewed   medical journal  covering adult and pediatric  orthopedic surgery  and treatment. It was established in 1978 and is published by Slack."}
{"_id": "WikiPedia_Orthopedics$$$corpus_72", "text": "The journal was established as a bimonthly journal in 1978 with H. Andrew Wissinger as founding  editor-in-chief . [ 1 ]  The current editor-in-chief is Robert D'Ambrosia. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_73", "text": "According to the  Journal Citation Reports , the journal has a 2017  impact factor  of 1.463. [ 8 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_74", "text": "Osteoarthritis and Cartilage  is  monthly  peer-reviewed   medical journal  covering research in  orthopedics  and  rheumatology . It is an official journal of the  Osteoarthritis Research Society International , published on their behalf by  Elsevier ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_75", "text": "Scoliosis and Spinal Disorders  ( ISSN \u00a0 2397-1789 ) is an international, multidisciplinary  open-access ,  peer-reviewed , online-only  medical journal  addressing all  spine  conditions. The journal encompasses all aspects of research on prevention, diagnosis, treatment, outcomes and cost-analyses of conservative and surgical management of all spinal deformities, disorders and conditions (e.g.  low back pain ,  degenerative disc disease ,  trauma , etc.). Both clinical and basic science reports form the cornerstone of the journal in its endeavor to provide original, primary studies as well as narrative/systematic reviews and meta-analyses to the academic community and beyond. The journal aims to provide an integrated and balanced view of spine research to further enhance effective collaboration among clinical spine specialists and scientists, and to ultimately improve patient outcomes based on an evidence-based spine care approach.  [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_76", "text": "Published by  BioMed Central ,  Scoliosis and Spinal Disorders  is the official journal of the  Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT)  and is also affiliated with the  International Research Society of Spinal Deformities (IRSSD) ,  Hellenic Spine Society (HSS) ,  Italian Scoliosis and Spine Study Group (GSS) ,  Italian Physiotherapist Association (AIFI) ,  Study in Multidisciplinary Pain Research (SIMPAR) ,  Chinese Orthopaedic Research Society (CORS) , and the  International Spine and Pain Consortium (ISPC) . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_77", "text": "The journal was initially started in 2006 and was called \"Scoliosis\". [ 2 ]  In 2016, the journal changed its name to  Scoliosis and Spinal Disorders , and extended its scope to include all spine-related issues and themes. The journal is currently indexed in  PubMed ,  Scopus  and dozens of other search engines. Its editorial board is composed of spine experts located throughout the globe. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_78", "text": "As of 2016, the Editors-in-Chief are  Theodoros B. Grivas  from the Department of Traumatology and Orthopaedics at Tzaneio General Hospital in Piraeus,  Greece  and  Dino Samartzis  from the Department of Orthopaedics and Traumatology,  The University of Hong Kong  in  Hong Kong ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_79", "text": "Skeletal Radiology  is a  peer-reviewed   medical journal  published by  Springer Science+Business Media , covering disorders of the  musculoskeletal system , including the  spine . It is the official journal of  The International Skeletal Society . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_80", "text": "The journal is abstracted and indexed in  Current Contents /Clinical Medicine,  EMBASE ,  PASCAL ,  PubMed / Medline ,  Science Citation Index , and  Scopus . [ 2 ]  According to the  Journal Citation Reports , the journal has a 2016  impact factor  of 1.737. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_81", "text": "Spine  is a biweekly  peer-reviewed   medical journal  covering research in the field of  orthopaedics , especially concerning the  spine . It was established in 1976 and is published by   Lippincott Williams & Wilkins . The current  editor-in-chief  is Andrew J. Schoenfeld, M.D.. Spine is considered the leading orthopaedic journal covering cutting-edge spine research. Spine is available in print and online. Spine is considered the most cited journal in orthopaedics. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_82", "text": "The following societies are affiliated with  Spine : [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_83", "text": "The Spine Journal  is a  peer-reviewed   medical journal  covering research related to the  spine . It is the official journal of the  North American Spine Society . The journal was established in 2001 and is published by  Elsevier ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_84", "text": "According to the  Journal Citation Reports ,  The Spine Journal  has a 2020  impact factor  of 4.166. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_85", "text": "Sports Health : A Multidisciplinary Approach  is a bimonthly  peer-reviewed   medical journal  that covers research in the field of  sports medicine . Its  editor-in-chief  is  Edward M. Wojtys  ( University of Michigan ). The journal was established in 2009 and is currently published by  SAGE Publications  in association with the  American Orthopedic Society for Sports Medicine ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_86", "text": "Sports Health  is abstracted and indexed in  CAB International ,  SafetyLit , and  Scopus ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_87", "text": "Orthopedic surgery  or  orthopedics  ( alternative spelling   orthopaedics ) is the branch of  surgery  concerned with conditions involving the  musculoskeletal system . [ 1 ]  Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal  trauma ,  spine diseases ,  sports injuries ,  degenerative diseases , infections,  tumors , and  congenital disorders ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_88", "text": "Nicholas Andry  coined the word in French as  orthop\u00e9die , derived from the  Ancient Greek  words  \u1f40\u03c1\u03b8\u03cc\u03c2   orthos  (\"correct\", \"straight\") and  \u03c0\u03b1\u03b9\u03b4\u03af\u03bf\u03bd   paidion  (\"child\"), and published  Orthopedie  (translated as  Orthop\u00e6dia: Or the Art of Correcting and Preventing Deformities in Children [ 2 ] ) in 1741. The word was  assimilated  into English as  orthop\u00e6dics ; the  ligature   \u00e6  was common in that era for  ae  in Greek- and Latin-based words. As the name implies, the discipline was initially developed with attention to children, but the correction of spinal and bone deformities in all stages of life eventually became the cornerstone of orthopedic practice. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_89", "text": "As with many words derived with the  \"\u00e6\" ligature , simplification to either \"ae\" or just \"e\" is common, especially in North America. In the US, the majority of college, university, and residency programmes, and even the  American Academy of Orthopaedic Surgeons , still use the spelling with the digraph  ae , though hospitals usually use the shortened form. Elsewhere, usage is not uniform; in Canada, both spellings are acceptable; \"orthopaedics\" is the normal spelling in the UK in line with other fields which retain \"ae\". [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_90", "text": "Many developments in orthopedic surgery have resulted from experiences during wartime. [ 3 ]  On the battlefields of the  Middle Ages , the injured were treated with bandages soaked in horses' blood, which dried to form a stiff, if unsanitary, splint. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_91", "text": "Originally, the term orthopedics meant the correcting of musculoskeletal deformities in children. [ 4 ]   Nicolas Andry , a professor of medicine at the  University of Paris , coined the term in the first textbook written on the subject in 1741. He advocated the use of exercise, manipulation, and splinting to treat deformities in children. His book was directed towards parents, and while some topics would be familiar to orthopedists today, it also included 'excessive sweating of the palms' and freckles. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_92", "text": "Jean-Andr\u00e9 Venel  established the first orthopedic institute in 1780, which was the first hospital dedicated to the treatment of children's skeletal deformities. He developed the club-foot shoe for children born with foot deformities and various methods to treat curvature of the spine. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_93", "text": "Advances made in surgical technique during the 18th century, such as  John Hunter 's research on  tendon  healing and  Percival Pott 's work on  spinal deformity  steadily increased the range of new methods available for effective treatment.  Robert Chessher , a pioneering British orthopedist, invented the double-inclined plane, used to treat lower-body bone fractures, in 1790. [ 6 ]   Antonius Mathijsen , a Dutch military surgeon, invented the  plaster of Paris   cast  in 1851. Until the 1890s, though, orthopedics was still a study limited to the correction of deformity in children. One of the first surgical procedures developed was percutaneous tenotomy. This involved cutting a tendon, originally the Achilles tendon, to help treat deformities alongside bracing and exercises. In the late 1800s and first decades of the 1900s, significant controversy arose about whether orthopedics should include surgical procedures at all. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_94", "text": "Examples of people who aided the development of modern orthopedic surgery were  Hugh Owen Thomas , a surgeon from  Wales , and his nephew,  Robert Jones . [ 7 ]  Thomas became interested in orthopedics and  bone-setting  at a young age, and after establishing his own practice, went on to expand the field into the general treatment of fracture and other musculoskeletal problems. He advocated enforced rest as the best remedy for  fractures  and  tuberculosis , and created the so-called \"Thomas splint\" to stabilize a fractured femur and prevent infection. He is also responsible for numerous other medical innovations that all carry his name: Thomas's collar to treat tuberculosis of the cervical spine, Thomas's maneuvere, an orthopedic investigation for fracture of the hip joint, the  Thomas test , a method of detecting hip deformity by having the patient lying flat in bed, and Thomas's wrench for reducing fractures, as well as an  osteoclast  to break and reset bones. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_95", "text": "Thomas's work was not fully appreciated in his own lifetime. Only during the  First World War  did his techniques come to be used for injured soldiers on the  battlefield . His nephew, Sir Robert Jones, had already made great advances in orthopedics in his position as surgeon-superintendent for the construction of the  Manchester Ship Canal  in 1888. He was responsible for the injured among the 20,000 workers, and he organized the first comprehensive accident service in the world, dividing the 36-mile site into three sections, and establishing a hospital and a string of first-aid posts in each section. He had the medical personnel trained in fracture management. [ 8 ]  He personally managed 3,000 cases and performed 300 operations in his own hospital. This position enabled him to learn new techniques and improve the standard of fracture management. Physicians from around the world came to Jones' clinic to learn his techniques. Along with Alfred Tubby, Jones founded the British Orthopedic Society in 1894."}
{"_id": "WikiPedia_Orthopedics$$$corpus_96", "text": "During the First World War, Jones served as a  Territorial Army  surgeon. He observed that treatment of fractures both, at the front and in hospitals at home, was inadequate, and his efforts led to the introduction of military orthopedic hospitals. He was appointed Inspector of Military Orthopedics, with responsibility for 30,000 beds. The hospital in Ducane Road,  Hammersmith , became the model for both British and American military orthopedic hospitals. His advocacy of the use of  Thomas splint  for the initial treatment of  femoral  fractures reduced mortality of open fractures of the femur from 87% to less than 8% in the period from 1916 to 1918. [ 9 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_97", "text": "The use of  intramedullary rods  to treat fractures of the femur and  tibia  was pioneered by  Gerhard K\u00fcntscher  of Germany. This made a noticeable difference to the speed of recovery of injured German soldiers during  World War II  and led to more widespread adoption of intramedullary fixation of fractures in the rest of the world.  Traction  was the standard method of treating thigh bone fractures until the late 1970s, though, when the  Harborview Medical Center  group in Seattle popularized intramedullary fixation without opening up the fracture."}
{"_id": "WikiPedia_Orthopedics$$$corpus_98", "text": "The modern total  hip replacement  was pioneered by Sir  John Charnley , expert in  tribology  at  Wrightington Hospital , in England in the 1960s. [ 10 ]  He found that joint surfaces could be replaced by implants cemented to the bone. His design consisted of a  stainless steel , one-piece femoral stem and head, and a  polyethylene  acetabular component, both of which were fixed to the bone using  PMMA  (acrylic)  bone cement . For over two decades, the Charnley low-friction arthroplasty and its derivative designs were the most-used systems in the world. This formed the basis for all modern hip implants."}
{"_id": "WikiPedia_Orthopedics$$$corpus_99", "text": "The  Exeter  hip replacement system (with a slightly different stem geometry) was developed at the same time. Since Charnley, improvements have been continuous in the design and technique of  joint replacement  (arthroplasty) with many contributors, including W. H. Harris, the son of R. I. Harris, whose team at Harvard pioneered uncemented arthroplasty techniques with the bone bonding directly to the implant."}
{"_id": "WikiPedia_Orthopedics$$$corpus_100", "text": "Knee replacements, using similar technology, were started by McIntosh in  rheumatoid arthritis  patients and later by Gunston and Marmor for  osteoarthritis  in the 1970s, developed by  John Insall  in New York using a fixed bearing system, and by Frederick Buechel and Michael Pappas using a mobile bearing system. [ 11 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_101", "text": "External fixation of fractures was refined by American surgeons during the  Vietnam War , but a major contribution was made by  Gavril Abramovich Ilizarov  in the  USSR . He was sent, without much orthopedic training, to look after injured Russian soldiers in  Siberia  in the 1950s. With no equipment, he was confronted with crippling conditions of unhealed, infected, and misaligned fractures. With the help of the local bicycle shop, he devised ring external  fixators  tensioned like the spokes of a bicycle. With this equipment, he achieved healing, realignment, and  lengthening  to a degree unheard of elsewhere. His  Ilizarov apparatus  is still used today as one of the distraction osteogenesis methods. [ 12 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_102", "text": "Modern orthopedic surgery and musculoskeletal research have sought to make surgery less invasive and to make implanted components better and more durable. On the other hand, since the emergence of the opioid epidemic, orthopedic surgeons have been identified as one of the highest prescribers of opioid medications. [ 13 ] [ 14 ]  Decreasing prescription of opioids while still providing adequate pain control is a development in orthopedic surgery. [ 14 ] [ 15 ] [ 16 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_103", "text": "In the United States, orthopedic surgeons have typically completed four years of undergraduate education and four years of medical school and earned either a  Doctor of Medicine  (MD) or  Doctor of Osteopathic Medicine  (DO) degree. Subsequently, these medical school graduates undergo  residency  training in orthopedic surgery. The five-year residency is a categorical orthopedic surgery training."}
{"_id": "WikiPedia_Orthopedics$$$corpus_104", "text": "Selection for residency training in orthopedic surgery is very competitive. Roughly 700 physicians complete orthopedic residency training per year in the United States. About 10% of current orthopedic surgery residents are women; about 20% are members of minority groups. Around 20,400 actively practicing orthopedic surgeons and residents are in the United States. [ 17 ]  According to the latest Occupational Outlook Handbook (2011\u20132012) published by the  United States Department of Labor , 3\u20134% of all practicing physicians are orthopedic surgeons."}
{"_id": "WikiPedia_Orthopedics$$$corpus_105", "text": "Many orthopedic surgeons elect to do further training, or fellowships, after completing their residency training. Fellowship training in an orthopedic sub-specialty is typically one year in duration (sometimes two) and sometimes has a research component involved with the clinical and operative training. Examples of orthopedic subspecialty training in the United States are:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_106", "text": "These specialized areas of medicine are not exclusive to orthopedic surgery. For example,  hand surgery  is practiced by some  plastic surgeons , and spine surgery is practiced by most  neurosurgeons . Additionally,   foot and ankle surgery  is also practiced by doctors of  podiatric medicine  (DPM) in the United States. Some  family practice  physicians practice  sports medicine , but their scope of practice is nonoperative."}
{"_id": "WikiPedia_Orthopedics$$$corpus_107", "text": "After completion of specialty residency or  registrar  training, an orthopedic surgeon is then eligible for board certification by the  American Board of Medical Specialties  or the  American Osteopathic Association Bureau of Osteopathic Specialists . Certification by the American Board of Orthopedic Surgery or the  American Osteopathic Board of Orthopedic Surgery  means that the orthopedic surgeon has met the specified educational, evaluation, and examination requirements of the board. [ 18 ] [ 19 ]  The process requires successful completion of a standardized written examination followed by an oral examination focused on the surgeon's clinical and surgical performance over a 6-month period. In Canada, the certifying organization is the  Royal College of Physicians and Surgeons of Canada ; in Australia and New Zealand, it is the  Royal Australasian College of Surgeons ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_108", "text": "In the United States, specialists in hand surgery and orthopedic sports medicine may obtain a certificate of added qualifications  in addition to their board primary certification by successfully completing a separate standardized examination. No additional certification process exists for the other subspecialties."}
{"_id": "WikiPedia_Orthopedics$$$corpus_109", "text": "According to applications for board certification from 1999 to 2003, the top 25 most common procedures (in order) performed by orthopedic surgeons are: [ 20 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_110", "text": "A typical schedule for a practicing orthopedic surgeon involves 50\u201355 hours of work per week divided among clinic, surgery, various administrative duties, and possibly teaching and/or research if in an academic setting. According to the  American Association of Medical Colleges  in 2021, the average work week of an orthopedic surgeon was 57 hours. [ 21 ] [ 22 ]  This is a very low estimation however, as research derived from a 2013 survey of orthopedic surgeons who self identified as \"highly successful\" due to their prominent positions in the field indicated average work weeks of 70 hours or more. [ 23 ] [ 21 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_111", "text": "The use of arthroscopic techniques has been particularly important for injured patients.  Arthroscopy  was pioneered in the early 1950s by  Masaki Watanabe  of Japan to perform minimally invasive cartilage surgery and reconstructions of torn ligaments. Arthroscopy allows patients to recover from the surgery in a matter of days, rather than the weeks to months required by conventional, \"open\" surgery; it is a very popular technique. Knee arthroscopy is one of the most common operations performed by orthopedic surgeons today, and is often combined with meniscectomy or chondroplasty. The majority of upper-extremity outpatient orthopedic procedures are now performed arthroscopically. [ 24 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_112", "text": "Arthroplasty is an orthopedic surgery where the articular surface of a musculoskeletal joint is replaced, remodeled, or realigned by  osteotomy  or some other procedure. [ 25 ]  It is an elective procedure that is done to relieve pain and restore function to the joint after damage by arthritis ( rheumasurgery ) or some other type of trauma. [ 25 ]  As well as the standard total knee replacement surgery, the unicompartmental knee replacement, in which only one weight-bearing surface of an arthritic knee is replaced, may be performed, [ 25 ]  but it bears a significant risk of revision surgery. [ 26 ]  Joint replacements are used for other joints, most commonly the  hip [ 27 ]  or  shoulder . [ 28 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_113", "text": "A post-surgical concern with joint replacements is wear of the bearing surfaces of components. [ 29 ]  This can lead to damage to the surrounding bone and contribute to eventual failure of the implant. [ 29 ]  The plastic chosen is usually ultra-high-molecular-weight  polyethylene , which can also be altered in ways that may improve wear characteristics. [ 29 ]  The risk of revision surgery has also been shown to be associated with surgeon volume. [ 28 ] [ 30 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_114", "text": "Between 2001 and 2016, the prevalence of musculoskeletal procedures drastically increased in the U.S, from 17.9% to 24.2% of all operating-room (OR) procedures performed during hospital stays. [ 31 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_115", "text": "In a study of hospitalizations in the United States in 2012, spine and joint procedures were common among all age groups except infants. Spinal fusion was one of the five most common OR procedures performed in every age group except infants younger than 1 year and adults 85 years and older. Laminectomy was common among adults aged 18\u201384 years. Knee arthroplasty and hip replacement were in the top five OR procedures for adults aged 45 years and older. [ 32 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_116", "text": "[ 33 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_117", "text": "Artificial ligaments  are devices used to replace damaged  ligaments . Today, the most common use of artificial ligaments is in  anterior cruciate ligament reconstruction . [ 1 ]  Although  autotransplantation  remains the most common method of ligament reconstruction, numerous materials and structures were developed to optimize the artificial ligament since its creation in the  World War I  era. [ 2 ]  Many modern artificial ligaments are made of synthetic polymers, such as  polyethylene terephthalate . [ 3 ]  Various coatings have been added to improve the biocompatibility of the synthetic polymers. [ 3 ]  Early artificial ligaments developed in the 1980s were ineffective due to material deterioration. [ 4 ]  Currently, the Ligament Advanced Reinforcement System (LARS) artificial ligament has been utilized extensively in clinical applications. [ 5 ]   Tissue engineering  is a growing area of research which aims to regenerate and restore ligament function. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_118", "text": "Artificial ligament research began in the  World War I  era. [ 2 ]  In the first documented case of an artificial ligament in 1914, Dr. Corner utilized a piece of silver filament as synthetic graft to reconstruct a ruptured  anterior cruciate ligament  ( ACL ). [ 2 ]  A ligament made of silk was used to replace an ACL in 1918. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_119", "text": "In the early 1980s, technological progress in chemistry and materials science promoted the development of medically suitable materials. Doctors utilized these synthetic materials in clinical applications. The  Food and Drug Administration  (FDA) approved an artificial ligament made of  Gore-Tex  for use in ACL reconstruction in 1986. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_120", "text": "The design of artificial ligaments in the 1980s consisted of two major parts: a relatively stiff cable or tape, and silicone rubber cylinders on one or both ends. [ 2 ]  The cable or tape was usually made of  polyethylene ,  nylon  or  carbon fiber . The  silicone rubber  cylinder varied in size to fit different sized patients. [ 2 ] [ 7 ] [ 1 ]  Theoretically, the flexibility of the  silicone rubber  would allow some deformation under relatively low loads, and the artificial ligament would stiffen to maintain its shape under higher loads. [ 7 ] [ 1 ]  Practically, this design never achieved its goal to mimic the property of a natural ligament. [ 8 ]  The mechanical performance of the artificial ligaments was inadequate for widespread clinical application. In the long term, performance loss, complications, and failure occurred. [ 8 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_121", "text": "Material deterioration contributed to the ineffectiveness of early artificial ligaments. [ 4 ]  Issues would occur in the months and years following treatment. [ 2 ] [ 4 ]  J.E. Paulos indicated in a report about  Gore-Tex  usage in  ACL  reconstruction: \"Early results of the  Gore-Tex  prosthesis used for  ACL  reconstruction showed low rates of failure. Unfortunately, with extended follow-up, our rate of complications continues to increase. Mechanical failure, effusions, and infections continue to occur\". [ 2 ]  At the time, the materials used in artificial ligaments could not sustain adequate mechanical performance. [ 2 ] [ 4 ]  For many of these materials, their mechanical performance diminished in the long-term. [ 1 ] [ 8 ] [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_122", "text": "The primary usage of modern artificial ligaments is in  anterior cruciate ligament reconstruction . Many artificial ligaments seek to mimic or exceed the performance of the native  ACL . [ 5 ]  The mechanical performance of an artificial ligament can be characterized by  abrasion  resistance, withstanding flexural and rotational  fatigue , [ 2 ]  and preventing graft slippage or rupture. [ 9 ]  Biocompatibility is important to the performance of the artificial ligament in vivo. [ 3 ]  Biocompatibility is related to new tissue ingrowth, [ 10 ]  fibroblast migration,  osseointegration  of bone, reduction of  inflammation , preventing scar tissue infiltration, and improving hydrophilicity. [ 3 ]  Tissue ingrowth and fibroblast migration have been shown to improve the mechanical strength of the artificial ligament, [ 10 ]  and osseointegration with the surrounding bone can reduce the likelihood of graft slippage. [ 9 ]  Many artificial ligaments are designed to minimize inflammation and scar tissue infiltration because they can hinder the mechanical strength and can cause graft rupture. [ 3 ]  Artificial ligament design strives to improve hydrophilicity because hydrophobicity can trigger the host's natural response to foreign bodies. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_123", "text": "The Ligament Advanced Reinforcement (LARS) is a leading artificial ligament in ACL repair surgery. They are made of  polyethylene terephthalate  (PET). [ 3 ]  They consist of an intraosseous and an intra-articular portion. The intraosseous section consists of longitudinal fibers bounded by a knitted transverse structure. This knitted structure can help prevent deformation and abrasion. [ 5 ] [ 11 ]  The intra-articular portion is made of longitudinal fibers pretwisted at a 90\u00a0degree angle. This section is designed to resist fatigue and promote tissue ingrowth. [ 5 ]  Leeds Keio ligaments consist of a  polyester  mesh structure. It seeks to mimic the mechanical properties of the native ACL. The porous nature of the ligament can promote tissue ingrowth which has been shown to improve mechanical properties. [ 5 ]  The PGA Dacron artificial graft consists of 75% braided biodegradable  polyglycolic acid  and 25% permanent  Dacron  thread. [ 11 ]  The Kennedy LAD artificial ligament is made of  polypropylene  ribbons. It is designed to promote tissue ingrowth and the progressive transfer of load onto the new ligament. [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_124", "text": "The native ACL of a human has a  tensile strength  on the order of kilonewtons, [ 3 ]  and an elongation at failure of approximately 10%. [ 10 ]  The mechanical properties of the native ACL vary throughout the human population. The strength of a child's ACL tends to be greater than that of an adult. [ 10 ]  PGA Dacron artificial ligaments have an ultimate tensile strength near 3500 N and a mean ultimate elongation of approximately 20%. [ 10 ]  Kennedy LAD ligaments have a tensile strength at failure of approximately 1500 N and an approximate stiffness of 50 N/mm. [ 10 ]  Leeds-Keio artificial ligaments have an ultimate tensile strength near 2000 N and a stiffness around 250 N/mm after tissue ingrowth. [ 10 ]  LARS artificial ligaments have varying mechanical properties depending on the amount of fibers used. A higher gauged ligament will have a greater tensile strength. During testing, a 60 gauge LARS ligament exhibited an ultimate tensile strength of 2500 N while a 120 gauge ligament exhibited a tensile strength of 5600 N. [ 5 ] [ 12 ]  The ingrown tissue has been shown to improve viscoelastic properties and reduce friction. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_125", "text": "Coatings have been added to artificial ligaments to improve their biocompatibility. 58S bioglass and  hydroxyapatite  coatings have been shown to improve osseointegration and cellular activity in vitro and in animal studies [ 3 ]  when deposited onto PET ligaments using the soaking method. [ 2 ] [ 3 ]  Hydroxypropyl cellulose surface treatments have been shown to improve osseointegration for PET ligaments in animal studies. [ 2 ]  Uncoated PET is hydrophobic, so coatings are designed to improve hydrophilicity. [ 3 ]   Hyaluronic acid  coatings can reduce hydrophobicity and have been shown to reduce scar tissue formation and inflammation in vivo. [ 3 ]  Hyaluronic acid and  chitosan  composite coatings can be deposited onto artificial ligament surfaces by the layer-by-layer technique, and they have been shown to enhance new bone formation at the ligament interface in mice. [ 9 ]  The chitosan is used to reduce hydrophobicity and improve osseointegration and mineral deposition, while the hyaluronic acid promotes cell differentiation and growth. [ 9 ]   Poly(sodium styrene sulfonate)  coatings have been shown in animal studies to improve knee functionality and mimicry of the native ACL. [ 2 ] [ 13 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_126", "text": "The  anterior cruciate ligament  (ACL) is a frequently injured human body structure that may cause secondary damages to the knees, such as meniscal tears and articular cartilage degeneration, without medical treatment.  ACL reconstruction  is a commonly practiced technique for ACL injury, conducted on 30% of patients, which manages to restore stability to the knee structure. [ 2 ] [ 14 ]  Traditional ACL reconstructions uses autografts or allografts which demand a long rehabilitation time and in most cases, develop donor morbidity in the long term. [ 11 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_127", "text": "The early interests in artificial ligaments led to the implementation of non-human tissue, such as Proplast ligaments made of  Teflon  and carbon fibers and Polyflex made of  polypropylene . [ 10 ] [ 15 ]  The results demonstrated poor resistance to torsion forces. [ 11 ]  Approved by FDA in 1986 and adopted in clinics later,  Gore-Tex  cruciate ligament prosthesis demonstrated low rates of mechanical failure but high rates of rupture in follow-up. [ 16 ]  Gore-Tex was then abandoned in ACL surgery and  Leeds-Keio  (LK) ligament was then adopted. In the later long term follow-up research, LK ligament demonstrated promising performance at first but still showed low stability rates in 2 years and increased degenerative changes compared with their opposite joint in one decade. [ 17 ] [ 18 ]  In the 21st century, the  Ligament Advanced Reinforcement  (LARS) ligament became the most popular artificial ligament on the market.  LARS ligaments not only provide satisfactory outcomes initially but also do not perform differently in at least 2 years. [ 19 ]  LARS ligaments demonstrate higher stability and lower morbidity rate compared to autograft in short-term research and in a 9-year study, LARS ligament showed a 100% survival rate. [ 5 ]  Synthetic ACL grafts always develop creep, fatigue and failure so the demand for synthetic grafts with sufficient supply, satisfactory mechanical properties, and low morbidity rate is essentially high. [ 5 ]  Currently, the LARS ligament is the most comparable to both autografts and other synthetic grafts. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_128", "text": "Complications that commonly occur in the artificial ligaments after the first ten years are breakage, wear debris, synovitis, recurrent instability, osteolysis and chronic effusions. [ 10 ]  Complications do not commonly surface right after the surgery or after a relatively short term, and in a few cases, start to show up after the first ten years. Follow-up research is required to study the performance of certain synthetic materials for artificial ligament and to monitor the health of patients. [ 10 ]  Rupture rates are usually recorded in 2 to 5 years. [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_129", "text": "While the future of artificial ligaments is unknown, leading researchers in  tissue engineering  aim to regenerate and repair the ligament to restore normal function. [ 2 ] \u00a0 ACL tissue engineering will be based on the healing of the  medial collateral ligament  (MCL), since the ACL does not heal naturally. [ 2 ]  \u00a0A seed cell will be used in tissue engineering for the repair of ACL ligaments. The seed cell must have qualifications such as: easily available, potent to proliferate, and efficient in elaborating a mature extracellular matrix.\u00a0 Stem cells such as bone marrow-derived  mesenchymal stem cells , adipose-derived stem cells, perivascular stem cells, and human foreskin  fibroblasts  are commonly used in tissue engineering. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_130", "text": "Bone malrotation  refers to the situation that results when a  bone  heals out of rotational alignment from another bone, or part of bone. It often occurs as the result of a  surgical  complication after a  fracture  where  intramedullary nailing (IMN)  occurs, [ 1 ]  especially in the femur and tibial bones, but can also occur genetically at birth. The severity of this complication is often neglected due to its complexity to detect and treat, [ 1 ]  yet if left untreated, bone malrotation can significantly impact regular bodily functioning, and even lead to severe  arthritis . Detection throughout history has become more advanced and accurate, ranging from clinical assessment to  ultrasounds  to CT ( computed tomography ) scans. Treatment can include an  osteotomy , a major surgical procedure where bones are cut and realigned correctly, or compensatory methods, where individuals learn to externally or internally rotate their limb to compensate for the rotation. Further research is currently being examined in this area to reduce occurrences of malrotation, including detailed computer navigation to improve visual accuracy during surgery. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_131", "text": "Bone malrotation predominantly occurs after an injury where a bone is fractured, however malrotation can genetically occur during  foetal development . It usually occurs during a surgery which involves  intramedullary nailing , which is the insertion of metal rods and nails to stabilise bones. Nailing is used as it requires minimal surgical dissection, less disruption of the fracture  hematoma  and allows faster functionality to a patient post-surgery. [ 1 ] [ 3 ]  However, due to the semi-closed nature of IM, it is impossible to correct under direct vision, so there is less rotational control compared to traditional open methods such as plate fixation. [ 3 ]  As a result, in many cases of intramedullary nailing, the bone is misaligned which causes malrotated regrowth. This torsional error is a major problem for femoral and tibial fractures, and occurs in 17 to 35% of patients who receive these surgeries, [ 4 ]  and up to 40% of femur fracture patients. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_132", "text": "Femoral malrotation is the most significant bone malrotation issue, and these errors cause cosmetic problems but can also cause drastic physical problems. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_133", "text": "Historically, bone malrotation occurred due to a lack of adequate treatment measures, where fixation methods such as  traction ,  casting  and non-locked nails provided poor torsional stability. Currently, the utilisation of locked intramedullary nailing, has reduced the occurrence of rotational malalignment during fracture healing, yet femoral malrotation continues to remain very prevalent due to surgeon's inability to reliably restore the pre-injury alignment during operation. [ 1 ]  A high attention to detail is necessary intra-operatively to avoid this complication when locking the intramedullary device. [ 5 ]  The utilisation of both radiological and clinical assessment techniques to compare with an injured limb would also help prevent bone malrotation, however these can be difficult and inexact methods of assessment, which is why complications are so common. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_134", "text": "It is difficult to assess and diagnose the rotational malalignment of a bone after an operation, and many methodologies have been developed."}
{"_id": "WikiPedia_Orthopedics$$$corpus_135", "text": "Clinical assessment and observation  is one methodology, however it is unreliable, and can lead to complications. For femoral or tibial malrotation, many surgeons use the patient's ankle or patella to symmetrically align them with the injured side or to the floor but this method does not consider the position of the proximal fragment and could be moved during reduction attempts. [ 5 ]  In order to measure femoral malalignment, many doctors will compare the internal and external rotation of both hips, while the patient is supine or prone, and a change in a patient's range of movement indicates malrotation. However, while clinical assessment can indicate the direction of malrotation, it often reports inaccurate measurements of the degree of malalignment, so it is unreliable in determining the potential impacts and necessary treatment methods. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_136", "text": "Another diagnosis methodology sometimes utilised are  radiographs ; however, they are unreliable as they require difficult patient positioning to quantify the rotational deformity. [ 5 ]   This difficulty is due to a patient's restriction in movement, as they may exhibit post-traumatic deformities and severe pain. To determine the level of femoral malrotation, with this method, two radiographs of the pelvis and upper legs must be made. Firstly, an anteroposterior (AP) perspective which shows the degree of difference between the femoral neck and femur, and another view where the hips and knees are both flexed to a right angle, which determines antetorsion. Both of these radiographs are utilised to calculate the angle of anteversion of the femoral neck. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_137", "text": "Ultrasounds  can also be used to measure bone malrotation, and are considered highly reliable. The main issue with utilising ultrasound measurement is that it relies largely on the skills of an ultrasound technician, and consequently is not widely used. When measuring femoral malrotation with ultrasounds, a patient's thighs are fixed symmetrically while the degree of rotation of the femoral shaft is measured. This methodology requires exact positioning of a patient to correctly measure any deformity. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_138", "text": "MRI scans  can be utilised and are proven to be reliable and effective at determining malrotation of bones. However, they are not as readily available as CT scanners, and are also time consuming and very expensive. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_139", "text": "The standard bone malrotation detection practice utilised are  computed tomography scans , which are able to exactly quantify the amount of rotational malalignment. [ 5 ]  It is also considered highly reliable and utilised because of its reproducibility. For femoral malrotation, the scan involves doctors measuring the angle between a line through the axis of the femoral neck and a line tangential to the femoral condyles. The angle difference between the uninjured and injured sides determines the degree of malrotation.  An increase in the anteversion of the femoral neck of the injured side denotes internal rotation, and a decrease means external rotation has occurred. Another advantage of CT scans is that patient positioning does not impact the measurement accuracy of femoral torsion, which is unlike radiographs and ultrasounds.  However, inaccurate measurements of malrotation can still occur in CT scans, but are mostly related difficulty in drawing clear and accurate lines along the femoral neck within the image. To avoid this inaccuracy, there needs to be improved accuracy of the line drawn, and this can be fixed by the utilisation of multi-image superimposed projection of the CT images so a more accurate measurement can be drawn. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_140", "text": "Whilst malrotation of a bone can be tolerated for most cases, it can still cause severe impacts on functional outcome for some patients. Whilst tibial fractures are the most common long bone fractures, it is malrotation of the femur which can cause the most significant impacts on regular functioning. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_141", "text": "If untreated, femoral malrotation can cause considerable gait disturbance and abnormal hip joint pressures. [ 2 ]  Malrotation of the femur in the setting of a mid-shaft fracture has an impact on the axis of the entire leg, which shifts the centre of force in the knee away from its neutral position. Consequently, femoral malrotation has significant impacts on the mechanical axis and force vectors within the knee. This can cause pain in the hip and knee, and patients may be limited in their movement, which can impair their function, especially in physically demanding activities such as walking up stairs and running. [ 3 ]  This can impact a person's satisfaction in life, as they may be physically unable to do things they want and need to, such as for laborious work, leisure activities, or raising a family, which can have significant impacts on their psychological health. Femoral malrotation can also cause an abnormally rotated foot, as the angle of a person's foot is directly related to the angle of the femur. [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_142", "text": "Another significant long term consequence of femoral malrotation if untreated is  degenerative arthritis  of the hip and knee. [ 3 ]  This joint arthrosis occurs as there is a proven correlation between rotational error, axis deviation and  arthrosis  of the knee and hip joints. However, the severity of the arthrosis is dependent on the percentage of malrotation. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_143", "text": "Whilst most malrotation problems occurred during surgery, patients with 10\u00b0 or less difference of malrotation compared with the uninjured side rarely complained of any issues. [ 8 ]  However, patients with differences greater than 15\u00b0 found noticeable issues, and above 30\u00b0 malrotation difference resulted in serious complaints. [ 5 ]  External femoral malrotation is usually much better tolerated than internal malrotation. [ 1 ]  However, older studies have found that external rotational deformities are more poorly tolerated, [ 9 ]  which shows the need for more research in this area."}
{"_id": "WikiPedia_Orthopedics$$$corpus_144", "text": "There are two main treatment methods; corrective surgery to fix the malrotation, or compensatory methods where patients learn to compensate for any malrotation when walking."}
{"_id": "WikiPedia_Orthopedics$$$corpus_145", "text": "Many people with bone malrotation, such as femoral malrotation are able to functionally tolerate and learn  compensatory methods , such as externally or internally adjusting their limb. Patients will compensate for even considerable rotational malalignment when they are active.  However, femoral malrotation is more difficult to compensate for and maintain with non-operative treatment methods. [ 5 ]  Patients with femoral malrotation of less than 15 degrees give less complaints than those with higher amounts of malalignment, yet many patients are able to tolerate the deformity well. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_146", "text": "In extreme cases, the malalignment can be treated by means of a derotational  osteotomy  which is a major surgical procedure. [ 3 ]  It can be conducted around the existing intramedullary fixtures, but it usually requires a subtrochanteric osteotomy, which is an invasive surgical approach where bone is cut and realigned. As this is a major procedure, it is beneficial if discovered early, before callus has set, and consequently, patients should be assessed for malrotation in the early post-operative period and a CT scan should occur if abnormalities are found. [ 5 ]  Correct measurement of bone malalignment with a CT scan is vital when considering an osteotomies in fixing rotational deformities, as torsional differences below 15 degrees are often easily compensated for with non surgical treatment. [ 3 ]  Revision surgery should be avoided, if not necessary, as implementing femoral nails for a second time leads to higher rates of problems such as infection, nonunion, or nail destabilisation due to overlapping holes for the interlocking screws. [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_147", "text": "There is currently limited clinical attention in the area of bone malrotation and research into more accurate methods, likely due to the complexity of the issue. [ 1 ]  Whilst computed tomography scans are useful in determining the degree of bone malrotation after a surgery has occurred, research is being conducted into how to prevent this deformity occurring at all during surgery. CT scans are impractical intraoperatively due to high cost, lack of equipment portability and increased exposure to radiation. [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_148", "text": "Consequently, one area being researched is that of  computer navigation,  which could be utilised during these surgeries to avoid malalignment issues.  Computer assisted surgery  (CAS) matches a patient's anatomy with pre or intraoperatively generated fluoroscopic image data, by using camera detected infrared signals. The computer then calculates the positioning of each component and creates a visual of their position on the monitor. As a result, the surgeon can monitor in real time the position of the surgical instruments in relation to the patient's anatomy and conducts the procedure accordingly. [ 11 ]  The surgeon can plan the torsional adjustment and control the fracture reduction and nail insertion on a touchscreen of the navigation module."}
{"_id": "WikiPedia_Orthopedics$$$corpus_149", "text": "Currently, this navigation may add extra time during surgery, so it is sometimes considered unnecessary in an urgent surgery. However, without computer navigation, the risk of bone malrotation is significantly increased. The benefit of computer navigation means that surgeons are able to view more clearly and restore axial alignment, but also ensure the injured limb and matches the alignment and length of the uninjured limb. [ 2 ]  CAS provides increased surgical accuracy and safety for both patients and surgeons, radiation time is reduced, and it utilises minimally invasive techniques which means less tissue damage, improved wound healing, and reduced infections and scarring for patients. [ 11 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_150", "text": "Dorsal intercalated segment instability  ( DISI ) is a deformity of the  wrist  where the  lunate bone  angulates to the dorsal side of the hand. [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_151", "text": "The main cause of DISI is [ 4 ]  wrist trauma, with or without a fracture:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_152", "text": "This  human musculoskeletal system  article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_153", "text": "The  Drehmann sign  describes a clinical test of examining orthopedic patients and is widely used in the functional check of the  hip  joint. \nIt was first described by Gustav Drehmann (Breslau, 1869\u20131932). [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_154", "text": "The Drehmann sign is positive if an unavoidable passive external rotation of the hip occurs when performing a hip flexion. In addition, an internal rotation of the respective hip joint is either not possible or accompanied by  pain  when forcefully induced. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_155", "text": "The positive Drehmann sign is a typical clinical feature in slipped capital femoral  epiphysis  (SCFE), the  impingement syndrome of the acetabulum-hip ,  or in  osteoarthritis  of the hip joint. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_156", "text": "EOS imaging  is a medical device company based in  Paris, France , that designs, develops, and markets EOSedge and the EOS system, innovative, orthopedic medical imaging systems, associated with several orthopedic solutions along the patient care pathway \u2013 from  diagnosis  to post-operative treatments. The EOS platform targets  musculoskeletal disorders  and  orthopedic surgical care  through 2D  X-ray  scans and 3D skeletal models from stereo-radiographic images of patients in a seated or standing position."}
{"_id": "WikiPedia_Orthopedics$$$corpus_157", "text": "The philosophy of EOS imaging surrounds three main principles: reduction of the  radiation  dose emitted by the technology, relevance and manipulability of calculated clinical parameters, and optimization of the patient care workflow. Currently, over 300 EOS systems are installed in medical centers in 51 different countries, including the United States, Japan, Korea, China, and throughout the European Union."}
{"_id": "WikiPedia_Orthopedics$$$corpus_158", "text": "The EOS imaging technology stems from the scientific findings of  Georges Charpak  ( Nobel Prize in Physics , 1992) concerning radiation detection and  particle physics , especially the  multi-wire chamber . [ 1 ]  Since then, physicists, engineers, radiologists, and surgeons have collaborated to transform these findings into a new technology called the EOS system."}
{"_id": "WikiPedia_Orthopedics$$$corpus_159", "text": "EOS imaging began in 1989 as Biospace Med, a medical company founded by Georges Charpak for the development of his detection technology. In 1999, Marie Meynadier became the CEO of Biospace Med; she developed the company's first subsidiary dedicated to imaging solutions for pre-clinical research \u2013 the EOS system."}
{"_id": "WikiPedia_Orthopedics$$$corpus_160", "text": "In 2004, hospitals in Paris, France and Brussels, Belgium finished running clinical tests on the EOS prototype, and in 2005, the first fundraising efforts commenced with the company's first venture capital round."}
{"_id": "WikiPedia_Orthopedics$$$corpus_161", "text": "From 2007 to 2011, the company obtained  CE marking  in Europe and  FDA  approval to market the EOS system and the sterEOS 2D/3D workstation in the United States."}
{"_id": "WikiPedia_Orthopedics$$$corpus_162", "text": "The first installations of EOS in European and North American hospitals and clinics occurred from 2008 to 2010. In 2011, the EOS system was being integrated into clinical routines of medical centers in 10 countries, including the United States, Canada, and Australia."}
{"_id": "WikiPedia_Orthopedics$$$corpus_163", "text": "In 2010, Biospace Med changed its name to EOS imaging."}
{"_id": "WikiPedia_Orthopedics$$$corpus_164", "text": "In 2012, EOS imaging entered the  Euronext Paris  stock exchange (name: EOSI) and had its first installation in Asia."}
{"_id": "WikiPedia_Orthopedics$$$corpus_165", "text": "In 2013, EOS acquired the medical company oneFIT Medical (see Acquisition of oneFIT Medical).\nIn 2014, EOS provided the EOS system in the Vietnam market (Medic - Medic Hoa Hao) through Bluelight."}
{"_id": "WikiPedia_Orthopedics$$$corpus_166", "text": "In 2015, the CFDA certification in China and the NECA designation in Korea were obtained, allowing the company to further expand its market."}
{"_id": "WikiPedia_Orthopedics$$$corpus_167", "text": "In 2016, the company entered into the Latin American market with the signing of its first contract in Brazil."}
{"_id": "WikiPedia_Orthopedics$$$corpus_168", "text": "In 2019, the company launched EOSedge, its new generation imaging system powered by photon-counting technology."}
{"_id": "WikiPedia_Orthopedics$$$corpus_169", "text": "While based in Paris, France, EOS imaging has five other corporate locations in various regions around the world:  Besan\u00e7on, France ;  St. Paul, Minnesota , US;  Montreal, Quebec , Canada;  Frankfurt, Germany , and in  Singapore ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_170", "text": "In 2013, EOS imaging acquired oneFIT Medical (based in Besan\u00e7on, France), a  medical software  engineering and manufacturing company dedicated to the development of  surgical planning  software for spine, hip, and knee surgeries and patient-specific orthopedic surgical cutting guides. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_171", "text": "EOS imaging platforms\u2014EOSedge and EOS\u2014deliver unique and specific capabilities that are used in conjunction with EOS Advanced Orthopedic Solutions to generate highly accurate 3D representations of patient anatomy and enable a seamless surgical planning experience."}
{"_id": "WikiPedia_Orthopedics$$$corpus_172", "text": "The EOS examination takes place in an upright scanning cabin where the patient can either stand or sit. With a vertically traveling arm supporting two fine X-ray beams perpendicular to one another, the EOS system acquires frontal and lateral, weight-bearing images of the patient in a functional \u2013 standing or sitting \u2013 position. These biplanar images are then used to create a 3D model of the patient's skeleton."}
{"_id": "WikiPedia_Orthopedics$$$corpus_173", "text": "The ALARA principle (As Low As Reasonably Achievable) represents a movement to \u201cminimize radiation doses and releases of radioactive materials\u201d by minimizing the time of exposure to radiation, increasing the distance between the human body and the radiation source, and using absorber materials to shield the body from  beta particles , X-rays, and  gamma rays . [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_174", "text": "EOS imaging aligns itself with this principle, providing reduced exam times and amounts of radiation in comparison with conventional imaging systems. [ 4 ] [ 5 ]  Furthermore, EOS developed a Micro Dose option that further reduced the radiation exposure by 5.5 times compared to a typical low-dose EOS exam protocol, resulting in a nearly negligible radiation dose. [ 6 ]  Additionally, with Flex Dose technology, EOSedge can deliver up to an 80% overall radiation reduction compared to same acquisition without Flex Dose."}
{"_id": "WikiPedia_Orthopedics$$$corpus_175", "text": "Having reduced-radiation options available for patients has become critical in the world of medical imaging as radiation exposure from artificial sources, such as medical imaging, has increased over the last two decades, [ 7 ]  and many patients require multiple examinations throughout the course of their medical treatment."}
{"_id": "WikiPedia_Orthopedics$$$corpus_176", "text": "The sterEOS workstation enables the generation of patient-specific 3D models of the spine and/or lower limbs from weight-bearing low dose or Micro Dose EOS exams. Once the models are created, clinical parameters are automatically calculated and may be exported as a patient report including 2D images and 3D captures. This report is used by physicians for diagnosis, post-operative assessment, and patient follow-up. sterEOS also enables the exportation of 3D anatomical biomarkers for pre-operative planning."}
{"_id": "WikiPedia_Orthopedics$$$corpus_177", "text": "The EOSapps (kneeEOS, hipEOS, and spineEOS) are online, 3D surgical planning solutions based on the weight-bearing EOS images. Frontal and lateral EOS images are uploaded to the EOS Portal, where the EOS 3DServices team prepares the 3D models and dataset and makes the planning case available online. Surgeons can have access to the patient's anatomy information in 3D, with which they can plan and simulate the effect of different implant selections and positions in 3D. spineEOS is used to plan spine surgeries, hipEOS is used for the planning of  total hip arthroplasty , and kneeEOS is geared towards the planning of  total knee arthroplasty ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_178", "text": "Foot Levelers  is a foot care, footwear, and whole body health company based in Roanoke, Virginia, and owned by Kent S. Greenawalt."}
{"_id": "WikiPedia_Orthopedics$$$corpus_179", "text": "Foot Levelers began in Iowa, in 1952, by Chiropractor Monte H. Greenawalt. Greenawalt earned his degree from Lincoln Chiropractic College and began to notice a pattern in patients with foot problems\u2014his adjustments did not hold. Dr. Monte referred these patients to a podiatrist, but their problems persisted."}
{"_id": "WikiPedia_Orthopedics$$$corpus_180", "text": "Monte began to experiment with orthotics, and through trial and error, developed a formula based on 16 unique measurements of the foot. Unlike off-the-shelf orthotics or even those made by podiatrists, Monte\u2019s orthotic was designed to support all three arches of the foot, rather than just one. Through Greenawalt's orthotics invention, his patients began to show positive results and his adjustments held longer."}
{"_id": "WikiPedia_Orthopedics$$$corpus_181", "text": "In Foot Levelers multi-decade history, they have served tens of thousands of doctors and millions of patients [ 1 ]  through their patented orthotic technology. [ 2 ]  They have offices in the U.S., Europe, and Australia and serve customers in over 80 countries."}
{"_id": "WikiPedia_Orthopedics$$$corpus_182", "text": "Foot Levelers holds title sponsorship of \"America's Toughest Road Marathon\", the  Blue Ridge Marathon , since 2012."}
{"_id": "WikiPedia_Orthopedics$$$corpus_183", "text": "Halo-gravity traction  (HGT) is a type of  traction  device utilized to treat spinal deformities such as  scoliosis , [ 1 ] [ 2 ]   congenital  spine deformities,  cervical instability ,  basilar invagination , and  kyphosis . [ 3 ]  It is used prior to surgical treatment to reduce the difficulty of the following surgery and the need for a more dangerous surgery. [ 4 ] [ 5 ] [ 6 ]  The device works by applying weight to the spine in order to stretch and straighten it. Patients are capable of remaining somewhat active using a  wheelchair  or a walker whilst undergoing treatment. Most of the research suggests that HGT is a safe treatment, and it can even improve patients'  nutrition  or  respiratory functioning . However, some patients may experience side effects such as  headaches  or neurological complications.  The halo device itself was invented in the 1960s by doctors working at the  Rancho Los Amigos hospital . [ 7 ] [ 8 ] [ 9 ]  Their work was published in a paper entitled \"The Halo: A Spinal Skeletal Traction Fixation Device.\" [ 10 ]  The clinician  Pierre Stagnara  utilized the device to develop Halo-Gravity traction. [ 11 ] [ 12 ] [ 13 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_184", "text": "Halo-gravity traction works by straightening and stretching the compressed  spine . [ 14 ] [ 15 ]  It relies on the  viscoelastic  properties of  vertebrae . This means vertebrae can stretch over time. Doctors will apply weight to the spine, and gradually increase it over time, slowly straightening and stretching it. [ 16 ]  Patients undergoing the procedure will typically spend the entire course of the treatment, which is usually three to eight weeks, in a  hospital . Usually, halo-gravity traction is the first step in the treatment plan for a child with severe spinal deformity. Following the procedure, it is common for a surgical operation such as  spinal fusion surgery  to be performed afterward to permanently mend the issue. [ 14 ] [ 17 ]  It is utilized before the operation to reduce the need for a more dangerous surgery and to reduce the risk of damage to the soft  tissues  or  nerves  that surround the spine during the surgery. [ 15 ] [ 18 ] [ 19 ]  In addition, HGT has also been found to reduce the risk of complications during the following surgery. [ 20 ] [ 21 ] [ 22 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_185", "text": "To perform halo-traction therapy a surgeon will use six to ten small pins to attach a \"halo\" made of a metal ring to the patient's skull. [ 23 ] [ 24 ] [ 25 ]  Doctors will typically leave one to two centimeters of distance between the halo and the patient's head. It is common for older patients to be given eight pins while younger patients are given 10. Prior to pin placement, some patients may undergo hair removal. It is not required for successful treatment, but it can help to reduce the risk of pin infection from hair getting caught in a pin or  scalp necrosis . [ 7 ]  The pins will be placed into the  forehead   bones  to prevent the head from moving. Pin placement is determined using a  CT scan . The chosen area will be cleaned with  betadine  swabs. Usually, two to three pins are placed in the  frontal  and  occipital  areas. Pins placed on the occipital area will have to be placed one centimeter above and behind the  auricle  of the ear. Pins placed on the  anterior  of the head will likely be placed one centimeter to above the sides of the eyebrow to avert potential damage to the  supraorbital  and the  supratrochlear nerves , and potential  muscle  damage.  Parietal  placements are generally avoided as the skull around this area is generally softer, which risks the pins puncturing the  temporal artery . Typically, the pins will tightened to a  torque  equivalent to the age of the child using a  torque wrench . Adults can withstand tighter torques than children can. [ 26 ]  Whilst this operation is being performed the child will be given general  anesthesia . [ 7 ]  In  infant  children, significantly less torque is required to tighten the pins. This allows for the pins to be placed in more areas than they could be placed in older patients. [ 27 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_186", "text": "Afterward, the halo will be attached to a  pulley system  which is attached to the patient's bed,  walker , or  wheelchair . [ 28 ]  Spring-type pulleys are typically used as they allow for the patient to self-regulate the weight applied to the pulley, which improves the safety of the device. [ 29 ] :\u200a390\u200a  Spring-based HGT devices are also cheaper and easier to build than other methods of construction. [ 30 ]  It is common for patients to begin the procedure with 5-10 pounds of weight on the pulley system. [ 29 ] :\u200a387\u200a  Over the next few weeks, clinicians will add weight to the pulley, which will slowly straighten the patient's spine over time. Eventually, a weight greater than 50% of the patient's body weight may be achieved. [ 23 ] [ 31 ]  Doctors will monitor the movements and strength and will take  x-rays  of the patient to track their progress. They will adjust the amount of weight on the pulley system based on the results. All patients will undergo  cranial nerve  testing during the procedure. [ 23 ]  After the spine has reached its optimal position, spinal fusion surgery will be performed on the patient. [ 15 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_187", "text": "Whilst undergoing the procedure, patients are encouraged to remain as active as possible. Activities such as low-impact play, walking, or standing can all increase the benefits of halo-traction therapy. However, patients are limited to leaving the traction for only a short time span. They can leave for activities such as repositioning, changing clothes, daily medical care,  showering , or using the  toilet .  Baby shampoo  is required to be used for bathing purposes as other shampoos could contain chemicals that react negatively with the metal halo. Patients will be required to utilize a special bed for  sleeping  whilst in the traction. After ending treatment the patient is required to avoid strenuous activities for a few months as their spine and muscles will still need to recover. Some patients may wear an orthopedic vest or a  halo vest . [ 15 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_188", "text": "Halo-gravity traction has been found to be almost completely safe. [ 29 ] :\u200a385\u200a [ 32 ]  Patients who have undergone the procedure report that they have a greater ability to stand upright, an increased appetite, and an improved  body image . [ 33 ]  It can improve  respiratory  functioning by relieving pressure on the lungs caused by a deformed spine. [ 13 ] [ 34 ] [ 35 ]  Patients often  gain weight  and have improved  nutrition  following HGT. [ 36 ]  This may occur since HGT can correct issues associated with spinal deformities, such as  exercise ,  comorbid   metabolic disorders , and  gastrointestinal  malformations. These issues are associated with malnutrition and low weight, and HGT can lead to weight gain by correcting them. [ 37 ]  When in combination with surgical release, HGT may improve the  flexibility  of the spine and lead to more spinal correction. [ 38 ] [ 39 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_189", "text": "Patients may experience pain from the pins, which is usually caused by the loosening of the pins. This can be remedied by tightening them. Up to 20% of patients may experience  infections  at the site where the pins were applied. These infections are typically treated with  antibiotics . One rare, but serious complication of the procedure can be the development of intra-cranial  abscesses  due to  septic  contamination of the pin site. [ 13 ]  Some patients experience  headaches  around the area where the pins were applied for a short while after the halo is attached. It is common for patients to recover from this pain in less than 24 hours. [ 29 ] :\u200a384\u200a  Halo therapy will leave small  lesions  in the skin when the pins are first removed. Typically, they will turn into  scabs  after a few days. Patients who have undergone the procedure will also have small  scars  on their foreheads. These scars will typically fade over time. [ 15 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_190", "text": "If the traction that is applied is greater than the tolerable amount, the patient may feel  cervical pain ,  cranial nerve lesions ,  nausea ,  vertigo , [ 40 ]  or  dizziness . These side effects are treated by lowering the level of weight applied. [ 41 ]  Some patients may suffer from  motor paresis  after the application of the device. Typically it is present in patients with preexisting spinal cord abnormalities. [ 29 ] :\u200a389\u200a  Generally, HGT does not cause neurological side effects due to the slow progression of traction. The spine adjusts slowly over time, and as a result, consequences are generally limited. Children are less likely than adolescents or adults to experience neurological side effects, due to the softness and flexibility of their spine, as well as their low weight. [ 42 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_191", "text": "Erb's palsy  has been identified as a rare neurological side effect of HGT. [ 43 ]  One 2006 study published in the journal \"Studies in Health Technology and Informatics\" found that in extremely rare cases HGT could induce  Erb's palsy , ulnar nerve paralysis, and  median nerve palsy  in cases. In the seven cases identified by the study, all patients had fully recovered within a few months of treatment. The likelihood of developing Erb's palsy due to HGT is associated with the weight of the traction. [ 44 ]  Another study published in the  Journal of Spinal Disorders & Techniques  found that patients may experience Erb's palsy or  sensory loss  during or after treatment. However, none of the patients who had experienced these side effects reported in this study had permanent neurological loss. [ 45 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_192", "text": "One 2016 clinical study published in  BioMed Research International  found that HGT resulted in reduced bone density among patients with kyphoscoliosis. [ 46 ]  However, little other research has investigated this potential side effect or found any evidence to support this claim. [ 37 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_193", "text": "Patients with bone conditions such as  fibrous dysplasia  or  osteogenesis imperfecta  may be unsuitable for treatment if the pins are not capable of safely being applied to the bone. [ 29 ] :\u200a385\u200a   Osteoporosis  is considered a contraindication that sometimes may prevent treatment,  however, doctors may avert complications by utilizing more pins with a lower torque. [ 40 ]   Absolute contraindications  for halo-gravity traction include the presence of a  stenotic segment , an  intradural or extradural lesion , lesions in the skull by the sites of pin application, [ 12 ]  any lesion or  tumor  by the spine cord, [ 23 ]  severe skull deformity, and  spine instability . [ 12 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_194", "text": "Most of the research conducted on HGT found that it is mostly a safe, [ 47 ]  reliable, [ 47 ]  and effective treatment. [ 48 ] [ 49 ] [ 50 ]  The average correction rate of HGT has been shown to be 19.4% for  sagittal curves  and 24.1%  coronal  curvature. [ 12 ]  One 2013 study on 33 patients published in the journal  Spine Deformity  found an average correction rate of 33% for coronal curves and 35% for sagittal. [ 51 ]  According to a  cohort study  conducted on 75 subjects investigating the efficacy of Halo traction therapy found an improvement rate of 31% to 66% for the spine. They found a  coronal  curvature improvement of 19.6% for adolescents, and 12% for adults. Kyphosis had improved at a rate of 23.9% for adolescents. Afterward, spinal surgery performed on people who had undergone the procedure had a greater than 50% chance of success. [ 52 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_195", "text": "One study conducted on 20 patients with either scoliosis, kyphosis, or kyphoscoliosis found that the most improvement occurred within the first 3 weeks of treatment. According to this study, the spinal curve had improved by 63.7% during the first two weeks, which decreased to 24.3% at 3 weeks, and to 15.9% at 4 weeks. [ 38 ]  Other studies have found similar results. One study conducted on 21 patients found that 45% of improvement occurred within the first 3 weeks. [ 53 ]  Another study on 24 patients found that a mean improvement of 82% occurred during the first three weeks. [ 54 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_196", "text": "Much of the research utilized as evidence of the efficacy of HGT has been criticized for a lack of a  control group  and a small  sample size . [ 55 ]  Some research has suggested that HGT leads to  statistically insignificant  improvement. [ 56 ]   Paul Sponseller, an  Orthopedic surgeon  at  Johns Hopkins University , claims in his study \"The use of traction in the treatment of severe spinal deformity\" that his research found \"no statistically significant difference in main coronal curve correction (62% vs. 59%), operative time, blood loss, and total complication rate (27% vs. 52%).\" However, his data did showcase that people who had not undergone HGT required  surgical resection  30% more often. [ 55 ]  In a study on 25 patients with severe spinal deformities who had been treated with spinal surgery, a mean correction of 44 degrees was found in patients who had not undergone HGT prior to the operation, and a mean correction of 52 was found in patients who had been treated with HGT. The researchers concluded that this difference was not statistically significant, and therefore HGT should not be used as the general treatment for these issues, and should be reserved for specific cases. [ 57 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_197", "text": "Some research suggests that HGT may be less effective than other forms of traction, such as Halo-femoral traction or Halo-pelvic traction. [ 58 ] [ 59 ]  HGT also has been found to require lengthy hospital stays, which many patients dislike about the treatment. [ 60 ]  In the study by Paul Sponsellor, he found that patients who had undergone HGT spent almost twice the amount of time hospitalized as those who had not received the treatment. [ 55 ]  HGT is significantly safer than other forms of traction. It is less likely to produce significant complications such as  blood loss , [ 59 ] [ 61 ]  neurological side effects, and spine stiffness or degeneration. [ 62 ]  HGT also allows patients to remain social and active, whilst other forms of traction severely restrict movement. [ 63 ]  These reasons have led to HGT becoming the standard preoperative treatment for patients with severe spinal deformities. [ 64 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_198", "text": "The treatment of broken bones and dislocated joints can be traced as far back as the  Ancient Greeks .  Hippocrates  is credited with a method of reduction of a  dislocated shoulder . 16th century Spanish texts talk about the  Aztecs  use of  reduction  of fractures using fir branches. The modern discipline of orthopaedics in trauma care developed during the course of World War I, but it was not until after World War II that orthopaedics became the dominant field treating fractures in much of the world. Today, the discipline encompasses conditions such as bone fractures and bone loss, as well as spinal pathology and joint disease. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_199", "text": "Several volumes of the  Hippocratic Corpus ,  Articulations or On Joints, On Fractures, On the Instruments of Reduction  discuss  Ancient Greek medicine  relating to orthopaedics, [ 2 ]  and  Hippocrates  is credited with a method of reduction of a  dislocated shoulder ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_200", "text": "16th century Spanish texts talk about the  Aztecs  use of  reduction  of fractures, as well  intramedullary  fixation using fir branches. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_201", "text": "Peter Lowe  was the first surgeon to use the term  amputation  in his 1597 book  A discourse of the Whole Art of Chirurgerie . [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_202", "text": "Nicolas Andry  has been credited with the term 'orthopaedics', taken from the title of his 1741 book  Orthop\u00e9die  on childhood deformity correction. [ 5 ]   The frontispiece of the book bore an engraving of a sapling being splinted with a stake, a symbol now referred to as the  Tree of Andry  and adopted by many orthopaedic associations internationally."}
{"_id": "WikiPedia_Orthopedics$$$corpus_203", "text": "In 1768,  Percivall Pott  published his book  Some Few Remarks upon Fractures and Dislocations  following his compound femoral fracture on the use of  splinting  to avoid  amputation . [ 6 ]   Pott's student,  John Hunter , expanded on the knowledge of bone healing."}
{"_id": "WikiPedia_Orthopedics$$$corpus_204", "text": "Around the same time,  Jean-Andr\u00e9 Venel  published his work  Orthopaedia, or the Art of Preventing and Correcting Deformities in Children , one of the first surgeons to discuss the practical application for treating  congenital deformities ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_205", "text": "Even after the  Medical Act 1858 ,  bonesetters  continued to practice unlicensed within England, with one of the last being Evan Thomas. His son,  Hugh Owen Thomas , is considered by many to be the father of modern orthopaedics in the UK, [ 7 ]  with many published works such as  Diseases of the hip, knee and ankle joints (1876), Principles of the treatment of diseased joints (1883), The principles of the treatment of fractures and dislocations (1886), Fractures, dislocations, diseases and deformities of the bones of the trunk and upper extremities (1887) and Fractures, dislocations, deformities and diseases of the lower extremities (1890)' . The use of his  traction splint  during the  First World War  lead to a dramatic reduction in the mortality following  femoral fractures ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_206", "text": "Thomas' nephew,  Robert Jones  continued his work, and was the first person to publish on the use of  radiography  in orthopaedics. [ 8 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_207", "text": "The developing field of orthopaedics was originally focused on deformities in children, and subsequently adults. The involvement of orthopaedics in trauma care developed in the course of World War I, the interwar period, and World War II. [ 9 ]  It was not until after World War II that orthopaedics became the dominant field treating fractures in much of the world."}
{"_id": "WikiPedia_Orthopedics$$$corpus_208", "text": "Later in the 20th century,  John Charnley  pioneered  hip replacement , [ 10 ]  as well as published on the conservative treatment of fractures."}
{"_id": "WikiPedia_Orthopedics$$$corpus_209", "text": "Orthopedic surgery  is the branch of  surgery  concerned with conditions involving the  musculoskeletal system .  Orthopedic surgeons  use both surgical and nonsurgical means to treat  musculoskeletal injuries ,  sports injuries , degenerative diseases, infections,  bone tumours , and  congenital limb deformities .   Trauma surgery  and  traumatology  is a sub-specialty dealing with the operative management of  fractures ,  major trauma  and the multiply-injured patient."}
{"_id": "WikiPedia_Orthopedics$$$corpus_210", "text": "List excludes anatomical terminology covered in  index of anatomy articles ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_211", "text": "Abbreviated Injury Scale \n-  Acetabular fracture \n-  Acheiropodia \n-  Achilles tendon rupture \n-  Acromioplasty \n-  Adamantinoma \n-  Adhesive capsulitis of shoulder \n-  Advanced trauma life support \n-  Ainhum \n-  Akin osteotomy \n-  Albers-Schonberg disease \n-  Albright's hereditary osteodystrophy \n-  Allis test \n-  ALPSA lesion \n-  Amelia (birth defect) \n-  American Joint Replacement Registry \n-  Amphiarthrosis \n-  Andersson lesion \n-  Aneurysmal bone cyst \n-  Ankle replacement \n-  Anterior cruciate ligament injury \n-  Anterior cruciate ligament reconstruction \n-  Antley\u2013Bixler syndrome \n-  Apert syndrome \n-  Apley grind test \n-  Apley scratch test \n-  Apprehension test \n-  Arachnodactyly \n-  Arm fracture \n-  Arthralgia \n-  Arthritis \n-  Arthrocentesis \n-  Arthrodesis \n-  Arthrogram \n-  Arthrogryposis \n-  Arthroplasty \n-  Arthroscopy \n-  Arthrotomy \n-  Articular capsule \n-  Articular cartilage repair \n-  Astragalectomy \n-  Autologous chondrocyte implantation \n-  Avascular necrosis \n-  Avulsion fracture"}
{"_id": "WikiPedia_Orthopedics$$$corpus_212", "text": "Baastrup's sign \n-  Baker's cyst \n-  Baksi's prosthesis \n-  Ballottement \n-  Bankart lesion \n-  Bankart's fracture \n-  Barlow maneuver \n-  Barr\u00e9\u2013Li\u00e9ou syndrome \n-  Barton's fracture \n-  Baumann's angle \n-  Beals syndrome \n-  Bechterew's \n-  Bennett's fracture \n-  Bifid rib \n-  Bimalleolar fracture \n-  Blount's disease \n-  Blumensaat's line \n-  Blunt trauma \n-  Bohler's angle \n-  Bone cutter \n-  Bone cyst \n-  Bone density \n-  Bone disease \n-  Bone fracture \n-  Bone fracture healing \n-  Bone grafting \n-  Bone healing \n-  Bone metastases \n-  Bone mineral \n-  Bone pathology \n-  Bone remodeling \n-  Bone resorption \n-  Bone tumor \n-  Bone \n-  Bosworth fracture \n-  Bouchard's nodes \n-  Boutonniere deformity \n-  Boxer's fracture \n-  Brachydactyly \n-  British Orthopaedic Association \n-  Brodie abscess \n-  Brostr\u00f6m procedure \n-  Brown tumor \n-  Bruck syndrome \n-  Brunelli procedure \n-  Bryant's traction \n-  Buddy wrapping \n-  Bumper fracture \n-  Bunion \n-  Burst fracture"}
{"_id": "WikiPedia_Orthopedics$$$corpus_213", "text": "Calcaneal fracture \n-  Camurati\u2013Engelmann disease \n-  Cancellous bone \n-  Cartilage \n-  Cartilaginous joint \n-  Catel\u2013Manzke syndrome \n-  Cenani\u2013Lenz syndactylism \n-  Cervical dislocation \n-  Cervical fracture \n-  Cervical rib \n-  Chalkstick fracture \n-  Chance fracture \n-  Chandler's disease \n-  Charnley prosthesis \n-  Charnley retractor \n-  Chauffeur's fracture \n-  Child bone fracture \n-  Chondroblast \n-  Chondroblastoma \n-  Chondrocyte \n-  Chondrogenesis \n-  Chondromalacia patellae \n-  Chondromyxoid fibroma \n-  Chondrosarcoma \n-  Chopart's fracture-dislocation \n-  Clarke's test \n-  Clavicle fracture \n-  Clay-shoveler fracture \n-  Cleidocranial dysostosis \n-  Clinodactyly \n-  Club foot \n-  Clubbed thumb \n-  Cobb angle \n-  Codman triangle \n-  Cole carpenter syndrome \n-  Colles' fracture \n-  Combined tibia and fibula fracture \n-  Compartment syndrome \n-  Complex regional pain syndrome \n-  Compression fracture \n-  Computer-assisted orthopedic surgery \n-  Congenital knee dislocation \n-  Congenital limb deformities \n-  Congenital patellar dislocation \n-  Conradi\u2013H\u00fcnermann syndrome \n-  Coopernail's sign \n-  Cortical bone \n-  Cotrel\u2013Dubousset instrumentation \n-  Coxa valga \n-  Coxa vara \n-  Cozen's test \n-  Crus fracture \n-  Crush injury \n-  Crush syndrome \n-  Cubitus valgus \n-  Cubitus varus \n-  Cunningham shoulder reduction \n-  Currarino syndrome"}
{"_id": "WikiPedia_Orthopedics$$$corpus_214", "text": "Danis\u2013Weber classification \n-  Darrach's procedure \n-  Darrah procedure \n-  De Quervain syndrome \n-  Denis Browne bar \n-  Denis classification \n-  Destot's sign \n-  Diaphysis \n-  Diffuse idiopathic skeletal hyperostosis \n-  Discectomy \n-  Discoid meniscus \n-  Dislocated shoulder \n-  Dislocation of hip \n-  Displacement (orthopedic surgery) \n-  Distal radius fracture \n-  Distraction osteogenesis \n-  Drawer test \n-  Dupuytren's contracture \n-  Durkan's test \n-  Duverney fracture \n-  Dynamic compression plate \n-  Dynamic hip screw \n-  Dysplasia epiphysealis hemimelica"}
{"_id": "WikiPedia_Orthopedics$$$corpus_215", "text": "Early appropriate care \n-  Ecchondroma \n-  Ectrodactyly \n-  Ectromelia \n-  Ehlers\u2013Danlos syndrome \n-  Eiken syndrome \n-  Elbow examination \n-  Elbow extension test \n-  Ellis\u2013van Creveld syndrome \n-  Enchondroma \n-  Enchondromatosis \n-  Ender's nail \n-  Endochondral ossification \n-  Endosteum \n-  Enthesis \n-  Epiphyseal plate \n-  Epiphysiodesis \n-  Epiphysis \n-  Erlenmeyer flask deformity \n-  Essex-Lopresti fracture \n-  Evans technique \n-  Evans-Jensen classification \n-  Ewing's sarcoma \n-  Exostosis \n-  External fixation \n-  Extraskeletal chondroma"}
{"_id": "WikiPedia_Orthopedics$$$corpus_216", "text": "Fairbank's changes \n-  Fairbanks disease \n-  Fat embolism \n-  Femoral fracture \n-  Femoral head ostectomy \n-  Fibrocartilage callus \n-  Fibrocartilage \n-  Fibrosarcoma \n-  Fibrous dysplasia of bone \n-  Fibrous joint \n-  Fibular fracture \n-  Ficat classification \n-  Finkelstein's test \n-  Fixation (surgical) \n-  Flat bone \n-  Flat feet \n-  Flexion teardrop fracture \n-  Foot drop \n-  Foot fracture \n-  Forearm fracture \n-  Frankel's sign \n-  Freiberg disease \n-  Froment's sign \n-  Frykman classification"}
{"_id": "WikiPedia_Orthopedics$$$corpus_217", "text": "Gaenslen's test \n-  Galeazzi fracture \n-  Galeazzi test \n-  Gamekeeper's thumb \n-  Garden classification \n-  Garre's sclerosing osteomyelitis \n-  Gartland classification \n-  Genu recurvatum \n-  Genu valgum \n-  Genu varum \n-  Gerber's test \n-  Gerdy's tubercle \n-  Geriatric trauma \n-  Giant-cell tumor of bone \n-  Gigli saw \n-  Gilula's Lines \n-  Girdlestone's Procedure \n-  Gorham's disease \n-  Gosselin fracture \n-  Greenstick fracture \n-  Grosse-Kempf nail \n-  Gruen zone \n-  Gustilo open fracture classification \n-  Guyon's Canal"}
{"_id": "WikiPedia_Orthopedics$$$corpus_218", "text": "Haglund's deformity \n-  Hajdu\u2013Cheney syndrome \n-  Hallux rigidus \n-  Hallux valgus \n-  Hallux varus \n-  Hammer toe \n-  Hand deformity \n-  Hand fracture \n-  Hand of benediction \n-  Hand surgery \n-  Hangman's fracture \n-  Haruguchi classification \n-  Hardinge lateral approach to the hip \n-  Harrington rod \n-  Harris Hip Score \n-  Harris lines \n-  Harrison's groove \n-  Haversian canal \n-  Hawkin's classification \n-  Hawkins-Kennedy test \n-  Heberden's node \n-  Hemarthrosis \n-  Hematoma \n-  Hemimelia \n-  Herbert classification \n-  Herbert screw \n-  Herscovici classification \n-  High ankle sprain \n-  High tibial osteotomy \n-  Hilgenreiner's line \n-  Hill\u2013Sachs lesion \n-  Hip dysplasia (human) \n-  Hip examination \n-  Hip fracture \n-  Hip replacement \n-  Hip resurfacing \n-  Hip spica cast \n-  Hoffa fracture \n-  Holdsworth fracture \n-  Holstein\u2013Lewis fracture \n-  Hubscher's maneuver \n-  Hueter-Volkmann law \n-  Human musculoskeletal system \n-  Hume fracture \n-  Hume fracture \n-  Humerus fracture \n-  Humphrey's ligament \n-  Hyaline cartilage \n-  Hydroxylapatite \n-  Hyperostosis \n-  Hypertrophic pulmonary osteoarthropathy"}
{"_id": "WikiPedia_Orthopedics$$$corpus_219", "text": "Ideberg classification \n-  Ilizarov apparatus \n-  Infantile cortical hyperostosis \n-  Injury Severity Score \n-  Internal fixation \n-  Intervertebral disc annuloplasty \n-  Intervertebral disc arthroplasty \n-  Intramedullary rod \n-  Intramembranous ossification \n-  Involucrum \n-  Irregular bone \n-  Iselin's disease"}
{"_id": "WikiPedia_Orthopedics$$$corpus_220", "text": "Jansen's metaphyseal chondrodysplasia \n-  Jefferson fracture \n-  Jobe's test \n-  Joint dislocation \n-  Joint locking (symptom) \n-  Joint replacement \n-  Joint replacement registry \n-  Joint stiffness \n-  Joint \n-  Jones fracture \n-  Juvenile osteoporosis"}
{"_id": "WikiPedia_Orthopedics$$$corpus_221", "text": "Kanavel's cardinal signs \n-  Kapandji score \n-  Kashin\u2013Beck disease \n-  Keller procedure \n-  Kellgren-Lawrence grading scale \n-  Khyphoplasty \n-  Kienbock's disease \n-  Kirschner wire \n-  Klein's line \n-  Klippel\u2013Feil syndrome \n-  Klippel\u2013Tr\u00e9naunay\u2013Weber syndrome \n-  Knee cartilage replacement therapy \n-  Knee examination \n-  Knee replacement \n-  Kniest dysplasia \n-  Kocher criteria \n-  Kocher manoeuvre \n-  K\u00f6hler disease \n-  Krukenberg procedure \n-  Kuntscher nail"}
{"_id": "WikiPedia_Orthopedics$$$corpus_222", "text": "Lachman test \n-  Larrey's sign \n-  Larsen syndrome \n-  Las\u00e8gue's sign \n-  Latarjet procedure \n-  Lauge-Hansen classification \n-  Legg\u2013Calv\u00e9\u2013Perthes syndrome \n-  Ligamentous laxity \n-  Limb lengthening methods \n-  Lisfranc fracture \n-  Lisfranc joint \n-  Lisfranc ligament \n-  List of orthopedic implants \n-  Lister's tubercle \n-  Lobstein syndrome \n-  Loder classification \n-  Long bone \n-  Loosers zone \n-  Lunotriquetral shear test \n-  Luxating patella"}
{"_id": "WikiPedia_Orthopedics$$$corpus_223", "text": "Madelung's deformity \n-  Maffucci syndrome \n-  Maisonneuve fracture \n-  Major trauma \n-  Malgaigne's fracture \n-  Malunion \n-  March fracture \n-  Marfan syndrome \n-  Marie-Str\u00fcmpell disease \n-  Marshall syndrome \n-  Marshall\u2013Smith syndrome \n-  Martin-Gruber Anastomosis \n-  Mayfield classification \n-  McCune\u2013Albright syndrome \n-  McMurray test \n-  Medullary cavity \n-  Melnick\u2013Needles syndrome \n-  Melorheostosis \n-  Mesenchymal chondrosarcoma \n-  Metaphysis \n-  Metatarsophalangeal joint sprain \n-  Microfracture surgery \n-  Milch classification \n-  Mirel's Score \n-  Monostotic fibrous dysplasia \n-  Monteggia fracture \n-  Moore or Southern posterior approach to the hip \n-  Moore's fracture \n-  Moore's pin \n-  Morton's neuroma \n-  Morton's toe \n-  Mulder's sign \n-  M\u00fcller AO Classification of fractures \n-  Multiple epiphyseal dysplasia \n-  Mumford procedure \n-  Musculoskeletal injury \n-  Myxoid chondrosarcoma"}
{"_id": "WikiPedia_Orthopedics$$$corpus_224", "text": "National hip fracture database \n-  Neer classification \n-  Neer impingement sign \n-  Neer's prosthesis \n-  Nonossifying fibroma \n-  Nonunion \n-  Nonunion of fracture \n-  Nursemaid's elbow"}
{"_id": "WikiPedia_Orthopedics$$$corpus_225", "text": "O'Brien's test \n-  Ober's test \n-  Oligodactyly \n-  Ollier disease \n-  Orthopaedic pathology \n-  Orthopaedic procedure \n-  Orthopedic cast \n-  Orthopedic plaster casts \n-  Orthopedic plates \n-  Orthopedic surgery \n-  Orthotics \n-  Ortolani test \n-  Ortolani test \n-  Osgood\u2013Schlatter disease \n-  Osseointegration \n-  Osseous tissue \n-  Ossification center \n-  Ossification \n-  Ostectomy \n-  Osteitis fibrosa cystica \n-  Osteitis \n-  Osteoarthritis \n-  Osteoblast \n-  Osteoblastoma \n-  Osteochondritis dissecans \n-  Osteochondritis \n-  Osteochondrodysplasia \n-  Osteochondroma \n-  Osteochondromatosis \n-  Osteochondrosis \n-  Osteoclast \n-  Osteocyte \n-  Osteofibrous dysplasia \n-  Osteogenesis imperfecta \n-  Osteoid osteoma \n-  Osteoid \n-  Osteolysis \n-  Osteoma \n-  Osteomalacia \n-  Osteomyelitis \n-  Osteon \n-  Osteopetrosis \n-  Osteophyte \n-  Osteoporosis \n-  Osteosarcoma \n-  Osteosclerosis \n-  Osteostimulation \n-  Osteotomy"}
{"_id": "WikiPedia_Orthopedics$$$corpus_226", "text": "Paget's disease of bone \n-  Panner disease \n-  Patella alta \n-  Patella baja \n-  Patella fracture \n-  Patellar dislocation \n-  Patellar tendon rupture \n-  Pathologic fracture \n-  Patrick's test \n-  Patrick's test \n-  Pauwel's angle \n-  Pauwel's classification \n-  Pectus carinatum \n-  Pectus excavatum \n-  Pediatric trauma \n-  Pelvic fracture \n-  Penetrating trauma \n-  Perichondrium \n-  Periosteal reaction \n-  Periosteum \n-  Periostitis \n-  Perkin's line \n-  Perthes Lesion \n-  Pes cavus \n-  Phalen maneuver \n-  Phocomelia \n-  Physical therapy \n-  Pigeon toe \n-  Pigmented villonodular synovitis \n-  Pilon fracture \n-  Pipkin classification \n-  Pipkin fracture-dislocation \n-  Pivot-shift test \n-  Plafond fracture \n-  Polydactyly \n-  Polyostotic fibrous dysplasia \n-  Polytrauma \n-  Ponseti method \n-  Porotic hyperostosis \n-  Pott's fracture \n-  Preiser disease \n-  Proteus syndrome \n-  Protrusio acetabuli \n-  Pseudarthrosis \n-  Pulled hamstring \n-  Pycnodysostosis \n-  Pyogenic osteomyelitis"}
{"_id": "WikiPedia_Orthopedics$$$corpus_227", "text": "Quadriceps tendon rupture"}
{"_id": "WikiPedia_Orthopedics$$$corpus_228", "text": "Radius fracture \n-  Rapadilino syndrome \n-  Reduction (orthopedic surgery) \n-  Resuscitation \n-  Resuscitative thoracotomy \n-  Rett syndrome \n-  Revised Trauma Score \n-  Rib fracture \n-  Rickets \n-  Rocker bottom foot \n-  Rolando fracture \n-  Rotationplasty \n-  Rotator cuff tear \n-  Rowe Score \n-  Rubinstein\u2013Taybi syndrome \n-  Ruedi-Allgower classification \n-  Rush nail"}
{"_id": "WikiPedia_Orthopedics$$$corpus_229", "text": "Sacralization of the fifth lumbar vertebra \n-  Salter\u2013Harris fracture \n-  Sanders classification \n-  Sarcoma \n-  Scaphoid fracture \n-  Scapular fracture \n-  Schenck classification \n-  Scheuermann's disease \n-  Schmorl's nodes \n-  Schober's test \n-  Schwartz\u2013Jampel syndrome \n-  Scoliosis \n-  Seddon classification \n-  Segond fracture \n-  Seidel nail \n-  Seinsheimer classification \n-  Separated shoulder \n-  Sequestrum \n-  Sesamoid bone \n-  Sesamoiditis \n-  Sever's disease \n-  Shenton's Line \n-  Shepherd's fracture \n-  Shin splints \n-  Short bone \n-  Shoulder examination \n-  Shoulder fracture \n-  Shoulder replacement \n-  Shoulder surgery \n-  Silver\u2013Russell syndrome \n-  Simmonds' test \n-  Skeletal fluorosis \n-  SLAP tear \n-  Slipped capital femoral epiphysis \n-  Slipped Upper Femoral Epiphysis \n-  Smith Peterson nail \n-  Smith-Petersen anterior approach to the hip \n-  Smith's fracture \n-  Soft tissue injury \n-  Southwick angle \n-  Speed's test \n-  Spina bifida occulta \n-  Spinal curvature \n-  Spinal fracture \n-  Spinal fusion \n-  Spiral fracture \n-  Splint (medicine) \n-  Spondylolisthesis \n-  Sports injury \n-  Sprained ankle \n-  Sprengel's deformity \n-  Steinmann pin \n-  Stener lesion \n-  Sternal fracture \n-  Stieda fracture \n-  Straight leg raise \n-  Stress fracture \n-  Subacromial bursitis \n-  Sudeck's atrophy \n-  Sulcoplasty \n-  Supracondylar fracture \n-  Swan neck deformity \n-  Swanson prosthesis \n-  Swanson's arthroplasty \n-  Symphysis \n-  Synchondrosis \n-  Syndactyly \n-  Syndesmosis \n-  Synovectomy \n-  Synovial fluid \n-  Synovial joint"}
{"_id": "WikiPedia_Orthopedics$$$corpus_230", "text": "Talipes equinovarus \n-  Talwalkar nail \n-  Taylor Spatial Frame \n-  Tear of meniscus \n-  Teisen classification \n-  Tendon transfer \n-  Tension band wiring \n-  Teunissen\u2013Cremers syndrome \n-  Thomas test \n-  Thompson and Epstein classification \n-  Thompson test \n-  Thurstan Holland sign \n-  Tibia fracture \n-  Tibial plateau fracture \n-  Tietze syndrome \n-  Tile classification \n-  Tillaux-Chaput avulsion fracture \n-  Tinel sign \n-  Toddler's fracture \n-  Tommy John surgery \n-  Trabecula \n-  Traction (orthopedics) \n-  Traction splint \n-  Trauma center \n-  Trauma surgery \n-  Trauma team \n-  Traumatology \n-  Trendelenburg gait \n-  Trendelenburg's sign \n-  Trethowan's sign \n-  Trevor's disease \n-  Triage \n-  Trimalleolar fracture \n-  Triple arthrodesis \n-  Tscherne classification \n-  Tumoral calcinosis"}
{"_id": "WikiPedia_Orthopedics$$$corpus_231", "text": "Ulnar fracture \n-  Unhappy triad \n-  Unicompartmental knee arthroplasty \n-  Upington disease"}
{"_id": "WikiPedia_Orthopedics$$$corpus_232", "text": "Valgus deformity \n-  Valgus stress test \n-  Vancouver classification \n-  Varus deformity \n-  Vertebral osteomyelitis \n-  Villonodular synovitis \n-  Volkmann's canals \n-  Volkmann's contracture \n-  Volkmann avulsion fracture"}
{"_id": "WikiPedia_Orthopedics$$$corpus_233", "text": "Waddell's signs \n-  Wagstaffe-Le Fort avulsion fracture \n-  Wallis\u2013Zieff\u2013Goldblatt syndrome \n-  Wassel classification \n-  Watson-Jones anterolateral approach to the hip \n-  Watson's test \n-  Weaver\u2013Dunn procedure \n-  Webbed toes \n-  Wedge fracture \n-  Weil's osteotomy \n-  Wilson test \n-  Winged scapula \n-  Wolff's law \n-  WOMAC \n-  Wound healing \n-  Wrist drop \n-  Wrist osteoarthritis"}
{"_id": "WikiPedia_Orthopedics$$$corpus_234", "text": "Yergason's test \n-  Young-Burgess classification"}
{"_id": "WikiPedia_Orthopedics$$$corpus_235", "text": "Zadek's procedure"}
{"_id": "WikiPedia_Orthopedics$$$corpus_236", "text": "James H-C. Wang  is a Chinese American orthopedic biomechanist and  academic . Currently, he is a  Professor  at the Departments of  Orthopaedic Surgery ,  Bioengineering , and PM&R at the  University of Pittsburgh . [ 1 ]  In addition, he is a Faculty Member at the  McGowan Institute for Regenerative Medicine . [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_237", "text": "Wang is most known for his work on tissue biomechanics,  tissue engineering , and cell  mechanobiology . [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_238", "text": "Wang is a Fellow of the International Orthopaedic Research (FIOR), and  American Institute for Medical and Biological Engineering  (AIMBE). [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_239", "text": "Wang completed his  Bachelor of Science  in Engineering Mechanics in 1982 and  Master of Science  in Experimental Biomechanics in 1989 from  Tongji University . Later in 1996, he obtained  PhD  in  Bioengineering  from the  University of Cincinnati  in the US. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_240", "text": "In 1982, Wang joined Tongji University as an Assistant Instructor in the Department of Engineering Mechanics. After moving to USA, he finished his PhD at the University of Cincinnati and later completed postdoctoral training in  Biomedical Engineering  at  Johns Hopkins School of Medicine  and  Washington University in St. Louis . After his postdoctoral training, he joined the  University of Pittsburgh  in 1998, where he was  Assistant Professor  at the Department of Orthopaedic Surgery from 1998 to 2005. Subsequently, he held the position of tenured  Associate Professor  at the Department of Orthopaedic Surgery and associate professor at the Departments of Bioengineering,  Mechanical Engineering  and  Materials Science , and PM&R between 2005 and 2012. Since 2012, he has been serving as Professor at the Department of Orthopaedic Surgery and also Professor at the Departments of Bioengineering and PM&R. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_241", "text": "In 2017, he was appointed  Vice Chair  of Research at the Department of Orthopaedic Surgery at the University of Pittsburgh. Since 2004, he has been the Director of the MechanoBiology Laboratory in the same department. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_242", "text": "At the University of Pittsburgh, Wang has developed a research program in cell mechanobiology, which particularly focuses on the role of tendon cells in the development of  tendinopathy . He has been consistently receiving substantial funding support from  NIH  and  NSF . Additionally, he has been awarded research grants from DOD for several projects that aim to develop practical and clinically actionable strategies for the prevention and treatment of tendinopathy. He has authored numerous publications spanning the areas of tissue biomechanics, tissue engineering, and cell mechanobiology. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_243", "text": "To understand the inflammatory and degenerative responses of tendon due to overuse injury, Wang's group has established a validated animal model of tendinopathy by using mouse treadmill running that mimic human tendinopathy development. Additionally, his work emphasized the role of HMGB1 as a pivotal molecule in mechanically induced tendinopathy and proposed glycyrrhizin and metformin as potential therapeutic agents to inhibit HMGB1 activity, thereby offering preventive and treatment options for tendinopathy. [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_244", "text": "Wang's research team has also worked on the identification and characterization of tendon stem cells (TSCs) in humans, mice, rats, and rabbits. [ 7 ]  Wang's tendon stem cell research has focused on the effects of different mechanical loading conditions on TSC growth and differentiation. [ 8 ]  Focusing on TSCs, his work highlighted the role of  TSC mechanobiology in tendon homeostasis as well as the development of degenerative tendinopathy. [ 8 ] [ 9 ]  His group showed that in normal conditions, the multi-differentiation potential of TSCs allows these stem cells to differentiate into tenocytes; however, under high stress and injurious conditions TSCs can undergo aberrant differentiation into adipocytes, chondrocytes, and osteocytes. Wang's team has established the beneficial effects of modest exercise on tendons via moderate treadmill running by the virtue of its effect in enhancing the function of TSCs resulting in the formation of normal-like tendon tissue at the site of injury. [ 10 ] [ 11 ]  In their examination of treatment options for tendon injuries, [ 12 ]  his group has provided insights into the application of biologics such as PRP [ 13 ]  for the effective treatment of tendon injuries. [ 14 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_245", "text": "Wang also focuses his research on tissue engineering. His approach to regenerate tendons after injury includes the use of PRP. His group showed that PRP with minimal leukocytes, known as pure-PRP (P-PRP), induces TSC differentiation into active tenocytes. These tenocytes produce abundant collagens, enabling P-PRP to effectively repair tendon injuries. His team demonstrated that the combined application of kartogenin and PRP effectively enhanced the formation of a fibrocartilage region connecting the tendon graft and bone interface, thereby improving the biomechanical strength of the tendon-bone junction. [ 15 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_246", "text": "The  management of scoliosis  is complex and is determined primarily by the type of scoliosis encountered: syndromic, congenital, neuromuscular, or idiopathic. [ 1 ]  Treatment options for idiopathic scoliosis are determined in part by the severity of the curvature and  skeletal maturity , which together help predict the likelihood of progression. Non-surgical treatment (conservative treatment) should be pro-active with intervention performed early as \"Best results were obtained in 10-25 degrees scoliosis which is a good indication to start therapy before more structural changes within the spine establish.\" [ 2 ]  Treatment options have historically been categorized under the following types:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_247", "text": "For adults, treatment usually focuses on relieving any pain, [ 3 ] [ 4 ]  while physiotherapy and braces usually play only a minor role. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_248", "text": "Treatment for idiopathic  scoliosis  also depends upon the severity of the curvature, the spine\u2019s potential for further growth, and the risk that the curvature will progress."}
{"_id": "WikiPedia_Orthopedics$$$corpus_249", "text": "Mild scoliosis (less than 30 degrees deviation) has traditionally been treated through observation only. [ 7 ]  However, the progression of adolescent idiopathic scoliosis has been linked to rapid growth, [ 8 ]  suggesting that observation alone is inadequate as progression can rapidly occur during the pubertal growth spurt. Another study has further shown that the peak rate of growth during puberty can actually be higher in individuals with scoliosis than those without, further exacerbating the issue of rapid worsening of the scoliosis curves. [ 8 ]  Moderately severe scoliosis (30\u201345 degrees) in a child who is still growing requires bracing. A 2013 study by Weinstein et al. [ 9 ]  found that rigid bracing significantly reduces worsening of curves in the 20-45 degree range and found that 58% of children receiving \"observation only\" progressed to surgical range. Recent guidelines [ 10 ]  published by the Scientific Society of Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) in 2016 state that \u201cthe use of a brace is recommended in patients with evolutive idiopathic scoliosis above 25\u00ba during growth\u201d based on a review of current scientific literature. Severe curvatures that rapidly progress may be treated surgically with spinal rod placement. Thus, early detection and early intervention prior to the pubertal growth spurt provides the greatest correction and prevention of progression to surgical range. [ 11 ]  In all cases, early intervention offers the best results. A growing body of scientific research testifies to the efficacy of specialized treatment programs of physical therapy, which may include bracing. [ 12 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_250", "text": "Physical therapists  and  occupational therapists  help those who have experienced an injury or illness regain or maintain the ability to participate in everyday activities. For those with scoliosis, a physical therapist and/or occupational therapist can provide assistance through assessment, intervention, and ongoing evaluation of the condition. This helps them manage physical symptoms and/or use compensatory techniques so that they can participate in  daily activities  like self-care, productivity, and leisure."}
{"_id": "WikiPedia_Orthopedics$$$corpus_251", "text": "One intervention involves bracing. During the past several decades, a large variety of bracing devices have been developed for the treatment of scoliosis. [ 13 ]  Studies demonstrate that preventing force sideways across a joint by bracing prevents further curvature of the spine in idiopathic scoliosis, [ 14 ]  while other studies have also shown that braces can be used by individuals with scoliosis during physical activities. [ 15 ]  It is important to note that scoliosis is not merely a lateral or sideways deformity, but occurs in three dimensions [ 16 ]  as a rotational component is often present."}
{"_id": "WikiPedia_Orthopedics$$$corpus_252", "text": "Other interventions include postural strategies, such as posture training in sitting, standing, and sleeping positions, and in using positioning supports such as pillows, wedges, rolls, and corsets. [ 17 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_253", "text": "Adaptive and compensatory strategies are also employed to help facilitate individuals to returning daily activities."}
{"_id": "WikiPedia_Orthopedics$$$corpus_254", "text": "Scoliosis specific exercises have been found to improve treatment outcomes when utilized in addition to bracing and other standards of care. [ 18 ]  Scoliosis specific exercises include methods such as Schroth [ 19 ]  which specifically aim to correct aesthetic differences and strengthened muscles and connective tissue that may have atrophied as a result of scoliosis and asymmetric posture. Schroth exercises and other scoliosis specific exercises should be utilized in conjunction with bracing and other standards of care, [ 20 ]  and be performed under the guidance of a trained professional to ensure the exercises are effective and target the individual's curve pattern so that the correct muscles are strengthened. Strengthening spinal  muscles  is a crucial preventive measure. This is because the muscles in the back are essential when it comes to supporting the  spinal column  and maintaining the spine's proper shape.  Exercises  that will help improve the strength of the muscles in the back include rows and leg and arm extensions. [ 21 ]  Elastic  resistance exercise  may also be able to sustain the progression of  spinal curvature . [ 22 ]  This type of exercise is able to sustain progression by equalizing the strength of the torso muscles found on each side of the body."}
{"_id": "WikiPedia_Orthopedics$$$corpus_255", "text": "Disability caused by scoliosis, as well as physical limitations during recovery from treatment-related surgery, often affects an individual\u2019s ability to perform  self-care  activities. [ 23 ]  One of the first treatments of scoliosis is the attempt to prevent further curvature of the spine. Depending on the size of the curvature, this is typically done in one of three ways: bracing, surgery, or postural positioning through customized cushioning. [ 23 ] [ 24 ] [ 25 ]  Stopping the progression of the scoliosis can prevent the loss of function in many  activities of daily living  by maintaining range of motion, preventing deformity of the rib cage, and reducing pain during activities such as bending or lifting."}
{"_id": "WikiPedia_Orthopedics$$$corpus_256", "text": "Occupational therapists  are often involved in the process of selection and fabrication of customized cushions. These individualized postural supports are used to maintain the current spinal curvature, or they can be adjusted to assist in the correction of the curvature. This type of treatment can help to maintain mobility for a wheelchair user by preventing the deformity of the rib cage and maintaining an active range of motion in the arms. [ 23 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_257", "text": "For other self-care activities (such as dressing, bathing, grooming, personal hygiene, and feeding), several strategies can be used as a part of  occupational therapy  treatment. Environmental adaptations for bathing could include a bath bench, grab bars installed in the shower area, or a handheld shower nozzle. [ 26 ]   For activities such as dressing and grooming, various assistive devices and strategies can be used to promote independence. An occupational therapist may recommend a long-handled reacher that can be used to assist self-dressing by allowing a person to avoid painful movements such as bending over; a long-handled shoehorn can be used for putting on and removing shoes. Problems with activities such as cutting meat and eating can be addressed by using specialized cutlery, kitchen utensils, or dishes."}
{"_id": "WikiPedia_Orthopedics$$$corpus_258", "text": "Productive activities include paid or  unpaid work , household chores, school, and play. [ 27 ]  Recent studies in healthcare have led to the development of a variety of treatments to assist in the management of scoliosis thereby maximizing productivity for people of all ages.  Assistive technology  has undergone dramatic changes over the past 20 years; the availability and quality of the technology has improved greatly. [ 28 ]  As a result of using assistive technology, functional changes may range from improvements in abilities, performance in daily activities, participation levels, and quality of life. [ 27 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_259", "text": "A common assistive technology intervention is specialized seating and postural control. For children with poor postural control, a comfortable seating system that provides them with the support needed to maintain a sitting position can be essential for raising their overall level of well-being. [ 29 ]  A child's well-being in a productive sense involves the ability to participate in classroom and play activities. [ 27 ]  Specialized wheelchair seating has been identified as the most common prescription in the management of scoliosis in teenagers with  muscular dystrophy . [ 30 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_260", "text": "With comfortable wheelchair seating, teenagers are able to participate in classroom activities for longer periods with less fatigue. By tilting the seating position 20\u00b0 forward (toward the thighs), seating pressure is significantly redistributed, so sitting is more comfortable. If an office worker with scoliosis can sit for longer periods, increased work output is likely to occur and could improve quality of life. Tall, forward-sloping seats or front parts of seats, and when possible with tall desk with the opposite slope, can, in general, reduce pains and the need of bending significantly while working or studying, and that is particularly important with braced, fragile, or tender backs. An open hip angle can benefit the used lung volume and respiration. [ 31 ] [ 32 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_261", "text": "For those not using a wheelchair, bracing may be used to treat scoliosis. Lifestyle changes are made to compensate for the proper use of spine braces."}
{"_id": "WikiPedia_Orthopedics$$$corpus_262", "text": "Physical symptoms such as chest pains, back pains, shortness of breath, and limited spinal movement can hamper or preclude participation in leisure activities of a physical nature. The occupational therapist's role is to facilitate participation by helping the patient manage these symptoms."}
{"_id": "WikiPedia_Orthopedics$$$corpus_263", "text": "Bracing is a common strategy recommended by an occupational therapist, in particular, for individuals engaging in sports and exercise. [ 15 ]  An OT is responsible for educating an individual on the advantages and disadvantages of different braces, proper ways to wear the brace, and the day-to-day care of the brace."}
{"_id": "WikiPedia_Orthopedics$$$corpus_264", "text": "To help a person manage heart and lung symptoms, such as shortness of breath or chest pains, an occupational therapist can teach the individual energy conservation techniques. [ 26 ]  This includes scheduling routine breaks during the activity, as suitable for the individual. For example, an occupational therapist can recommend that a swimmer take breaks between laps to conserve energy.  Adapting or modifying the exercise or sport is another way a person with scoliosis can do it. [ 26 ]  Adapting the activity may change the difficulty of the sport or exercise. For example, it might mean taking breaks throughout an exercise. If a person with scoliosis is unable to participate in a sport or exercise, an OT can help the individual explore other physical activities that are suitable to his/her interests and capabilities. An occupational therapist and the person with scoliosis can explore enjoyable and meaningful participation in the sport/exercise in another capacity, such as coaching or refereeing."}
{"_id": "WikiPedia_Orthopedics$$$corpus_265", "text": "Bracing is most effective when the patient has bone growth remaining (is skeletally immature) and should aim to both prevent progression of the curve (prevent progression to surgery), as well as reduce the scoliosis curve. Reduction of the curve is important as the natural history of idiopathic scoliosis suggests it can continue to progress at a rate ~1 degree per year in adulthood, [ 33 ]  while the treatment results of bracing have been shown to hold over >15 years. [ 34 ]  In some cases with juveniles, bracing has reduced curves significantly, going from a 40 degrees (of the curve, mentioned in length above.) out of the brace to 18 degrees in it. Braces are sometimes prescribed for adults to relieve pain related to scoliosis. Bracing involves fitting the patient with a device that covers the torso; in some cases, it extends to the neck. The most commonly used brace is a  TLSO , such as a  Cheneau type brace , a  corset -like appliance that fits from armpits to hips and is custom-made from fiberglass or plastic. It is worn upwards of 18\u201323 hours a day, depending on the doctor's prescription, and applies pressure on the curves in the spine. The effectiveness of the brace depends not only on brace design and  orthotist  skill; patient compliance; and amount of wear per day, but also the \"stiffness\" of the spine resulting from a shortened spinal cord [ 35 ] [ 36 ]  and/or nerve tension. [ 37 ]  as evidence by the force necessary (mean force ~121 lbs) to physically correct scoliosis during spinal surgery [ 38 ] \nThe typical use of braces for idiopathic scoliosis is to prevent progression to surgical range as well as reduce the scoliotic curve of the spine as spinal fusion surgery can reduce mobility due to fusion of the vertebrate while potentially increasing pain long term. [ 39 ]  For non-idiopathic scoliosis (ie. neuromuscular, congenital, etc.) and those with additional comorbidities (ie.  Marfans Syndrome ) spinal surgery may be required due to structural changes in the spine."}
{"_id": "WikiPedia_Orthopedics$$$corpus_266", "text": "Indications for Scoliosis Bracing:  Scoliosis professionals determine the proper bracing method for a patient after a complete clinical evaluation. The patient\u2019s growth potential, age, maturity, and scoliosis (Cobb angle, rotation, and sagittal profile) are also considered. Immature patients who present with Cobb angles less than 20 degrees should be closely monitored and proactively treated based on their risk of progression [ 40 ]  as surgery can be prevented with early intervention of conservative treatment. [ 41 ]  Immature patients who present with Cobb angles of 20 degrees to 29 degrees should be braced according to the risk of progression by considering age, Cobb angle increase over a six-month period, Risser sign, and clinical presentation. Immature patients who present with Cobb angles greater than 30 degrees should be braced. However, these are guidelines and not every patient will fit into this table. For example, an immature patient with a 17-degree Cobb angle and significant thoracic rotation or flatback could be considered for nighttime bracing. On the opposite end of the growth spectrum, a 29-degree Cobb angle and a Risser sign three or four might not need to be braced because there is reduced potential for progression. [ 42 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_267", "text": "Surgery is indicated by the Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) at 45 degrees to 50 degrees [ 10 ]  and by the Scoliosis Research Society (SRS) at a Cobb angle of 45 degrees. [ 43 ]  SOSORT uses the 45-degree to 50-degree threshold as a result of the well-documented, plus or minus five degrees measurement error that can occur while measuring Cobb angles."}
{"_id": "WikiPedia_Orthopedics$$$corpus_268", "text": "Scoliosis braces are usually comfortable for the patient, especially when it is well designed and fit; also after the 7- to 10-day break-in period.  A well fit and functioning scoliosis brace provides comfort when it is supporting the deformity and redirecting the body into a more corrected and normal physiological position. [ 44 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_269", "text": "The Scoliosis Research Society's recommendations for bracing include curves progressing to larger than 25\u00b0, curves presenting between 30 and 45\u00b0,  Risser sign  0, 1, or 2 (an X-ray measurement of a pelvic growth area), and less than six months from the onset of menses in girls. [ 45 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_270", "text": "Progressive scolioses exceeding 25\u00b0 Cobb angle in the pubertal growth spurt should be treated with a pattern-specific brace like the Ch\u00eaneau brace and its derivatives, with an average brace-wearing time of 16 hours/day (23 hours/day assures the best possible result)."}
{"_id": "WikiPedia_Orthopedics$$$corpus_271", "text": "The latest standard of brace construction is with CAD/CAM technology. With the help of this technology, it has been possible to standardize the pattern-specific brace treatment. Severe mistakes in brace construction are largely ruled out with the help of these systems. This technology also eliminates the need to make a plaster cast for brace construction. The measurements can be taken in any place and are simple (and not comparable to plastering). Available CAD/CAM braces include the Regnier-Ch\u00eaneau brace, the Rigo-System-Ch\u00eaneau-brace (RSC brace), the Silicon Valley Brace, and the Gensingen brace; braces can and should be customized to fit the individual's curve pattern and reduce the curve as much as possible as immediate in-brace correction has been shown to be associated with better treatment outcomes. [ 46 ] [ 47 ]  Many patients prefer the \"Ch\u00eaneau light\" brace as it has good in-brace corrections reported in international literature and is easier to wear than other braces in use today. [ 48 ] [ 49 ]  However, this brace is not available for all curve patterns."}
{"_id": "WikiPedia_Orthopedics$$$corpus_272", "text": "Prior to 2013 the efficacy of bracing has not been definitively demonstrated in randomised clinical studies, with more limited studies giving inconsistent conclusions. [ 50 ]  In 2013 the Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST) published results establishing benefits of bracing in adolescents with idiopathic scoliosis. In the randomized cohort, 72% in the group instructed to wear a brace for 18 hours per day against 48% in the observation group sustained curve progression to under 50 degrees, the proxy used for not requiring surgery. Additionally results suggested that the more a patient wore the brace, the better the result. [ 51 ] [ 52 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_273", "text": "In progressive infantile and sometimes juvenile scoliosis, a plaster jacket applied early may be used instead of a brace. It has been proven possible [ 53 ]  to permanently correct cases of infantile idiopathic scoliosis by applying a series of plaster casts (EDF: elongation, derotation, flexion) on a specialized frame under corrective traction, which helps to \"mould\" the infant's soft bones and work with their growth spurts. This method was pioneered by UK scoliosis specialist Min Mehta. [ 54 ]  EDF casting is now the only clinically known nonsurgical method of complete correction in progressive infantile scoliosis. Complete correction may be obtained for curves less than 50\u00b0 if the treatment begins before the second year of life. [ 55 ] [ 56 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_274", "text": "Surgery is usually recommended by orthopedists for curves with a high likelihood of progression (i.e., greater than 45 to 50\u00b0 of magnitude), curves that would be cosmetically unacceptable as an adult, curves in patients with  spina bifida  and  cerebral palsy  that interfere with sitting and care, and curves that affect physiological functions such as breathing. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_275", "text": "Surgery for scoliosis is performed by a  surgeon  specializing in spine surgery. For various reasons, [ specify ]  it is usually impossible to completely straighten a scoliotic spine, but in most cases, significant corrections are achieved. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_276", "text": "The two main types of surgery are:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_277", "text": "One or both of these surgical procedures may be needed. The surgery may be done in one or two stages and, on average, takes four to eight hours. A Cochrane review could not draw conclusions on how effective surgical interventions were when compared to non-surgical interventions in patients with adolescent idiopathic scoliosis. [ 57 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_278", "text": "Spinal fusion  is the most widely performed surgery for scoliosis. In this procedure, bone [either harvested from elsewhere in the body ( autograft ) or from a donor ( allograft )] is  grafted  to the vertebrae so when they heal, they form one solid bone mass and the  vertebral column  becomes rigid. This prevents worsening of the curve, at the expense of some spinal movement. This can be performed from the anterior (front) aspect of the spine by entering the  thoracic  or  abdominal  cavities, or more commonly, performed from the back (posterior). A combination may be used in more severe cases, though the modern pedicle screw system has largely negated the need for this. [ 50 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_279", "text": "In recent years all-screw systems have become the gold-standard technique for adolescent idiopathic scoliosis.  Pedicle  screws achieve better fixation of the  vertebral column  and have better biomechanical properties than previous techniques, so enabling greater correction of the curve in all planes. [ 50 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_280", "text": "Pedicle screw-only  posterior spinal fusion  may improve major curve correction at two years among patients with adolescent idiopathic scoliosis (AIS) [ 50 ]  as compared to hybrid instrumentation (proximal hooks with distal pedicle screws) (65% versus 46%) according to a  retrospective, matched-cohort study . [ 58 ]  The prospective cohorts were matched to the retrospective cohorts according to patient age, fusion levels, Lenke curve type, and operative method. The two groups were not significantly different in regard to age, Lenke AIS curve type, or Riser grade. The numbers of fused vertebrae were significantly different (11.7\u00b11.6 for pedicle screw versus 13.0\u00b11.2 for hybrid group). This study's results may be biased due to the pedicle screw group's being analyzed prospectively versus retrospective analysis of the hybrid instrumentation group."}
{"_id": "WikiPedia_Orthopedics$$$corpus_281", "text": "In general, modern spinal fusions have good outcomes with high degrees of correction and low rates of failure and infection. However a systematic review of  PubMed  papers in 2008 concluded \"Scoliosis surgery has a varying but high rate of complications\", although the non-standardised data on complications was difficult to assess and was incomplete. [ 59 ]  Patients with fused spines and permanent implants tend to have normal lives with unrestricted activities when they are younger; it remains to be seen whether those that have been treated with the newer surgical techniques develop problems as they age. [ 60 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_282", "text": "A complementary surgical procedure a surgeon may recommend is called thoracoplasty (also called costoplasty). This is a procedure to reduce the rib hump that affects most scoliosis patients with a thoracic curve. A rib hump is evidence of some rotational deformity to the spine. Thoracoplasty may also be performed to obtain bone grafts from the ribs instead of the pelvis, regardless of whether a rib hump is present. Thoracoplasty can be performed as part of a spinal fusion or as a separate surgery, entirely."}
{"_id": "WikiPedia_Orthopedics$$$corpus_283", "text": "Thoracoplasty is the removal (or resection) of typically four to six segments of adjacent ribs that protrude. Each segment is one to two inches long. The surgeon decides which ribs to resect based on either their prominence or their likelihood to be realigned by correction of the curvature alone. The ribs grow back straight."}
{"_id": "WikiPedia_Orthopedics$$$corpus_284", "text": "Thoracoplasty has risks, such as increased pain in the rib area during recovery or reduced pulmonary function (10\u201315% is typical) following surgery. This impairment can last anywhere from a few months to two years. Because thoracoplasty may lengthen the duration of surgery, patients may also lose more blood or develop complications from the prolonged anesthesia. A more significant, though far less common, risk is the surgeon might inadvertently puncture the pleura, a protective coating over the lungs. This could cause blood or air to drain into the chest cavity,  hemothorax  or  pneumothorax , respectively. [ 61 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_285", "text": "Implants that aim to delay spinal fusion and to allow more spinal growth in young children is the gold standard for surgical treatment of early onset scoliosis. Surgery without fusion can be divided into three principles: distraction of the entire spine, compression of the short segment of spine, and guided-growth techniques. Distraction-based systems include Vertical, Expandable Prosthetic Titanium Ribs (VEPTR) & growing rods. The concept uses distraction to create additional soft-tissue space in-between the vertebrae, for the bone to later grow into. Its universal application was thrusted through the use of traditional growth rods which required repeated invasive surgeries every 6\u201312 months for the sustenance of growth, via distraction. Nowadays developed countries only use MAGEC (MAGnetic Expansion Control) rods to non-invasively lengthen the spine. In contrast, developing and under-developed countries still use traditional growing rods, which require invasive surgery every 6\u201312 months, because of high initial cost associated with procurement of MAGEC rods. Compression-based system include tethering using a flexible rope-like implant and are relatively new to receive FDA approval. Guided-growth technique include SHILLA (named after a hotel in Korea, where the concept was initiated). SHILLA has the advantage of being one-time surgery and is technologically less demanding compared with MAGEC rod. However, there are still two major disadvantages of using SHILLA: loss of correction and need for osteotomies. [ 62 ] [ 63 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_286", "text": "The failure of most of these standalone techniques has shown that the concept of \u201cone size fits all\u201d is not applicable for the surgical management of EOS. Therefore, newer concepts employing two or more of the above philosophies, i.e. various combinations of distraction-based, guided-growth, and compression-based approaches might be more suitable and biomechanically-speaking, a more optimal surgical intervention. One such combination currently used for surgery includes  active apex correction (APC) . It is a hybrid of guided-growth and compression-based management of deformity. The technique simply consists of replacing the apical fusion (of traditional SHILLA) with unilateral compression (via pedicle screws or any other means) on the convex side. The latest clinical results presented by spine researchers  Aakash Agarwal  and Alaaedldin Azmi Ahmad on APC shows good clinical results with no economic barrier to use the technology. [ 62 ] [ 64 ] [ 65 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_287", "text": "The risk of undergoing surgery for scoliosis was estimated in 2008 to be varying, but with a high rate of complications. Possible complications may be inflammation of the soft tissue or deep inflammatory processes, breathing impairments, bleeding and nerve injuries. It is not yet clear what to expect from spine surgery in the long term. [ 66 ] [ 67 ]  Taking into account that signs and symptoms of spinal deformity cannot be changed by surgical intervention, surgery remains primarily a cosmetic indication [ dubious  \u2013  discuss ] , only especially in patients with adolescent idiopathic scoliosis, the most common form of scoliosis never exceeding 80\u00b0. [ 66 ] [ 68 ]  However, the cosmetic effects of surgery are not necessarily stable. [ 66 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_288", "text": "For spinal fusion surgery on AIS cases, with instrumentation attached using pedicle screws, complication rates were reported in 2011 as transient neurological injuries between 0% to 1.5%, a pedicle fracture rate of 0.24%, screw malposition assessed by radiography at 1.5%, 6% when assessed by CT scans though these patients were asymptomatic not requiring screw revision, and screw loosening noted in 0.76% of patients. [ 50 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_289", "text": "For surgery without fusion in growing children, substantial percentage of patients undergoing SHILLA technique experience loss of correction via crankshafting or adding-on (eg, distal migration). In addition, the need for osteotomies on the concave side has the potential of severe complications. For MAGEC rods, higher distraction magnitude resulted in the generation of higher distraction forces, and this in combination with off-axis loading (exemplified by \u201cgrowth marks\u201d) result in wear and breakage of MAGEC rod\u2019s components. [ 69 ] [ 70 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_290", "text": "In the event of surgery to correct scoliosis, pain medications and  anesthesia  will be administered. Before the surgery, the patient will receive anesthesia. With adults, the anesthesia will be administered through an IV in the antecubital region of the arm. With young children, however, the child will be asked to breathe in  nitrous oxide , or laughing gas. Because needles can be frightening for a young child, the nitrous oxide will put them to sleep so the  anesthesiologist  can then insert the IV in order to give them the anesthesia. After the surgery, the patient will most likely be given  morphine . Until the patient is ready to take the medicine by mouth, an IV will be giving them their medication. Morphine is the most common pain medicine used after scoliosis surgery, and is often administered through a  patient-controlled analgesia  (PCA) system.  The PCA system allows the patient to push a button when they are feeling pain, and the PCA will emit the drugs into the IV and then into the body.  To prevent overdoses, there is a limit on the number of times a patient can push the button. If a patient pushes the button too much at once, the PCA will reject the request. [ 71 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_291", "text": "For the patient's bladder control, a  catheter  will be inserted so that a patient can urinate without having to move. A catheter is inserted because the patient will not have much free movement to be able to get up and walk to the bathroom. The most common type of catheter used after major surgeries is an indwelling  Foley catheter . The indwelling Foley catheter is most often put in the  urethra , with a tube leading into a drainage bag. Once the catheter is inserted into the urethra, a balloon is blown up inside the bladder in order to keep it from falling out. The balloon allows the catheter to remain inside the urethra until the patient is able to get up and go to the bathroom on their own. [ 72 ]  The drainage bag is connected to the side of the bed, and must be changed or emptied out once it is full."}
{"_id": "WikiPedia_Orthopedics$$$corpus_292", "text": "Bowel control can vary from patient to patient. The combination of no food, very little fluids, and a lot of  prescription drugs  has the potential to cause many patients to become constipated. The body is used to a normal diet, and used to excreting waste in a system. Interrupting the system can cause bowel problems. This  constipation  can be resolved in a couple of ways. The first way, and the most common way, is to administer a  rectal suppository . A rectal suppository is administered through the  anus , and into the  rectum . They are bullet-shaped and contain medicine that will help the patient's bowels get back on track. Once the suppository is inserted, it is designed to melt off the wax-like case, and put the medicine in the body. [ 73 ]  If the suppository does not work, a laxative may be continued at home to keep the bowels in full function."}
{"_id": "WikiPedia_Orthopedics$$$corpus_293", "text": "When first returning home after surgery, a nutritional diet is necessary in order to keep the body operating correctly. Junk food is not a good idea, as the grease and sugar can irregulate the bowels. Fruit, vegetables, and juices will be a vital part in the diet. [ 74 ]  Food and drink will be limited for the patient after surgery. Because the bowels are not fully active because of anesthetic, clear water and ice may be the only acceptable thing to ingest. After the digestive tract is back up to speed, soft food and drink like pudding, soup broth, and orange juice are acceptable. [ 75 ]  Very dark urine with a strong odor means that the person is most likely dehydrated and needs more fluids. In order for the urine to become a pale or clear color, the patient will need to drink a lot of water. Juices such as prune juice are a healthy option and prune juice also helps with constipation, a common factor after surgery. When it comes to food, whole grains should be added into the diet. Whole grains can be broken down easily by the body whereas processed grains and flour cannot be broken down easily. Processed grains and flour also add to  constipation . [ 76 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_294", "text": "In 1962,  Paul Harrington  introduced a metal spinal system of instrumentation that assisted with straightening the spine, as well as holding it rigid while fusion took place. The original (now obsolete)  Harrington rod  operated on a ratchet system, attached by hooks to the spine at the top and bottom of the curvature that when cranked would distract, or straighten, the curve. The Harrington rod represented a major advance in the field, as it obviated the need for prolonged casting, allowing patients greater mobility in the postoperative period and significantly reducing the quality of life burden of fusion surgery. Additionally, as the first system to apply instrumentation directly to the spine, the Harrington rod was the precursor to most modern spinal instrumentation systems. A major shortcoming of the Harrington method was it failed to produce a posture wherein the skull would be in proper alignment with the pelvis, and it did not address rotational deformity. As a result, unfused parts of the spine would try to compensate for this in the effort to stand up straight. As the person aged, there would be increased wear and tear, early-onset arthritis, disc degeneration, muscular stiffness, and pain with eventual reliance on painkillers, further surgery, inability to work full-time, and disability.  \"Flatback\"  became the medical name for a related complication, especially for those who had lumbar scoliosis. [ 77 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_295", "text": "In the 1960s, the gold standard for idiopathic scoliosis was a posterior approach using a single Harrington rod. Post-operative recovery involved bed rest, casts, and braces. Poor results became apparent over time. [ 78 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_296", "text": "In the 1970s, an improved technique was developed using two rods and wires attached at each level of the spine. This segmented instrumentation system allowed patients to become mobile soon after surgery. [ 78 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_297", "text": "In the 1980s,  Cotrel-Dubousset instrumentation  improved fixation and addressed  sagittal  imbalance and rotational defects unresolved by the Harrington rod system. This technique used multiple hooks with rods to give stronger fixation in three dimensions, usually eliminating the need for post-operative bracing. [ 78 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_298", "text": "Orthopaedic Nurse, Certified  (ONC) is the designation for an  orthopaedic nurse  who has earned  nursing board certification  from the Orthopaedic Nurses Certification Board (ONCB)"}
{"_id": "WikiPedia_Orthopedics$$$corpus_299", "text": "ONBC supports the advancement of health of orthopaedic patients by administering a certificate to the Orthopaedic nurse that improves their knowledge and practice to support patients with orthopaedic conditions or injuries. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_300", "text": "An Orthopaedic nurse is responsible for assessing new patients, monitoring the condition of their current patients, and providing treatments and medication. As part of this role, the nurse also monitors vital signs, assess the surgical sight, provide dressing changes, and notifies the doctor of any changes in the patient's condition. Finally, the Orthopaedic nurse also performs general nursing techniques, such as changing bedpans, assisting the patient with ambulation, maintaining care plans, providing IV medication, and informing and supporting the patient and their families."}
{"_id": "WikiPedia_Orthopedics$$$corpus_301", "text": "The optimal goal for the Orthopaedic nurse is to keep the patient comfortable, which may require turning the patient and providing pain relievers as needed."}
{"_id": "WikiPedia_Orthopedics$$$corpus_302", "text": "The Orthopaedic certification exam contains 150 questions, 135 of which are scored while the other 15 do not affect the test score. 97/135 is needed to pass the exam. Results are hosted by AMP, which is ONCB's test vendor. The ONCB then distributes the results directly to the new certified holder. The ONCB does not distribute the results to individual agencies. [ 2 ]  The exam is usually given in the Fall and Spring and is offered around the United States. To take the certification exam the nurse has to be licensed and have at least 2 years experience but doesn't need a bachelor's degree. Nurses must have 1000 hours of Orthopaedic patient care within the last 3 years. Certification lasts for 5 years, after which recertification or continuing education is required. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_303", "text": "Recertification in Orthopeadic Nursing requires 1000 practice hours logged in an applicant's past 5 years and 100 hours of education: 70 hours in Orthopaedics and 30 hours in general nursing. The application can take 8 weeks to process. Paper applications should be mailed with a return receipt. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_304", "text": "This  nursing -related article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_305", "text": "The  Orthopaedic Research Society  ( ORS ) is a professional, scientific, and medical organization focused on  orthopaedic  research. [ 1 ] [ 2 ]  The stated mission of the ORS is to advance orthopaedic research through education, collaboration, communication, and advocacy. [ 3 ] [ 4 ]  The ORS aims to raise resources for orthopaedic research and increase the awareness of the impact of such research on patients and the public. Annual meetings are held across the US to discuss current research, with a number of  awards  available to further career trajectories of members."}
{"_id": "WikiPedia_Orthopedics$$$corpus_306", "text": "In 1940, the Research Committee of the  American Academy of Orthopaedic Surgeons , chaired by  Alfred R. Shands , [ 5 ]  conducted a survey of its members which indicated that over 180 members were conducting some type of research. [ 6 ]  This finding prompted several  musculoskeletal  investigators to express the desire for having a forum to present and share their work. [ 7 ]   Philip D. Wilson Jr. , a member of the Academy, along with several others, met in San Francisco and proposed the idea of starting an organization focused solely on musculoskeletal research. This idea gained unanimous support from the  American Academy of Orthopaedic Surgeons  at their Annual Meeting in 1951. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_307", "text": "In 1952, the first meeting of the founding members of the ORS took place. At this first meeting,  Philip D. Wilson Jr.  created a draft constitution and set of by-laws for the fledgling society. [ 8 ]   It was determined that the purpose of the society was to \"encourage and coordinate investigation and research in basic principles or clinical problems related to the special field of Orthopaedic Surgery.\" [ 7 ]    Due to the unexpected death of  Dallas B. Phemister , who had agreed to take on the role of chairman, the formal organization of the society was delayed. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_308", "text": "1954 marked the first official meeting of the group at the Palmer House in Chicago under the Chairmanship of Wilson. [ 8 ]   At this first meeting there were twenty-nine people in attendance.  Cultivating the relationship between clinicians and scientists while providing them with opportunities to come together and share ideas was the driving factor in establishing the society. \"The close relationship of between clinicians and basic scientists would help ensure the prominent role of orthopaedic surgeons in delivering care to patients with injuries and diseases of the  musculoskeletal system ,\" explained Eugene R. Mindell, [ 9 ]  MD who served as president of the ORS from 1972\u20131973. [ 8 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_309", "text": "As of June\u00a02018 [update] , membership had grown to more than 4,100 members from across the globe. [ 10 ]   Once a role only held by surgeons, in 1982 the ORS elected  Van C. Mow  as the first PhD president.  Currently, Presidents are elected from each of the three disciplines represented in the membership: clinicians, biologists, and engineers."}
{"_id": "WikiPedia_Orthopedics$$$corpus_310", "text": "Past presidents of the ORS have included  Farshid Guilak  and  Marjolein C. van der Meulen ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_311", "text": "Members of the ORS conduct cutting-edge research on the full range of musculoskeletal tissues\u00a0:  bone ,  tendon ,  cartilage  &  synovium ,  meniscus ,  skeletal muscle , and the  intervertebral disc . Researchers focus on all aspects of these tissues, including  development , structure and function, mechanics, diagnostics, injury and healing, and potential therapeutics. Special emphasis is given to pathologies that cause significant morbidity in patients, such as  osteoarthritis ,  osteoporosis ,  osteopenia ,  rheumatoid arthritis ,  fracture healing ,  ACL tears ,  tendinopathies , and  meniscus tears ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_312", "text": "More recently a number of research subsections have been formed, starting with the Spine Section in 2015. These small communities bring together like-minded researchers with a focus on a specific topic of research. Since then, the number of sections has expanded to include: International Section of Fracture Repair, Meniscus Section, Orthopaedic Implants Section, Preclinical Models Section, Strategies in Clinical Research Section, and the Tendon Section. Each of these meets annually at the regular meeting, and some have added satellite meetings to create more opportunity for collaboration in their respective field."}
{"_id": "WikiPedia_Orthopedics$$$corpus_313", "text": "The  Journal of Orthopaedic Research  is a peer-reviewed journal that is published in cooperation with  John Wiley & Sons, Inc . [ 11 ]  The journal provides an essential forum for the orthopaedic community to share and communicate new information in the different research areas of orthopaedics, including  life sciences ,  engineering ,  translational  and  clinical studies . [ 11 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_314", "text": "JOR Spine  is a fully open access and peer-reviewed journal that was established by the ORS. [ 12 ]  The journal provides a platform to share original and innovative information focusing on basic and translational research of the spine. Publications in this journal include the following topics in spine research:  ageing ,  biomaterials ,  biomechanics ,  bioreactors ,  degeneration ,  genetics ,  inflammation ,  pain , remodeling,  tissue engineering , etc."}
{"_id": "WikiPedia_Orthopedics$$$corpus_315", "text": "Coordinated by the ORS Basic Science Education Committee,  On the Horizon  presents brief articles discussing current scientific investigations that may have future orthopaedic clinical applications.\nThis feature was previously presented quarterly in the  Journal of the American Academy of Orthopaedic Surgeons  (January, April, July, and October), where archived articles remain available."}
{"_id": "WikiPedia_Orthopedics$$$corpus_316", "text": "The ORS is invested in developing partnerships and collaborations dedicated to research, outreach and education worldwide:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_317", "text": "LearnORS  is an online platform that offers courses suited for PhD candidates, medical students, postdoctoral fellows, orthopaedic residents, orthopaedic fellows, and industry researchers interested in learning more about orthopaedic research. Courses include those geared towards improving grant writing, basic musculoskeletal science, and clinical research, among others. [ 13 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_318", "text": "The  Musculoskeletal Knowledge Portal (MSK-KP)  is currently in development by a team of scientists and software engineers at the  Broad Institute  in collaboration with the International Federation of Musculoskeletal Research Societies (IFMRS). The site enables browsing, searching, and analysis of human genomic information associated with musculoskeletal traits and pathology."}
{"_id": "WikiPedia_Orthopedics$$$corpus_319", "text": "ORS Open Door is an outreach activity aimed at communicating orthopaedic/musculoskeletal science to the general public, and takes place during the annual meeting in the local community. Open Door 2023\u2019s target audience was middle school- and high school-aged students from the Dallas area, with the goal of sharing potential careers and topics in musculoskeletal science to under-represented minorities and first-generation students in STEM (science, technology, engineering, mathematics) fields."}
{"_id": "WikiPedia_Orthopedics$$$corpus_320", "text": "Open Door 2024 will be held in Long Beach CA just prior to the annual meeting."}
{"_id": "WikiPedia_Orthopedics$$$corpus_321", "text": ")"}
{"_id": "WikiPedia_Orthopedics$$$corpus_322", "text": "Orthopaedic Studio  is an application designed to help  orthopaedic  specialists perform several common quantitative hip examinations that are based on standard  x-ray images ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_323", "text": "The application is implemented as a plugin for the medical image viewer  OsiriX  and thereby only runs on  Mac OS X ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_324", "text": "Orthopaedic Studio evaluates four different types of hip  radiographs  (standing anteroposterior, Von Rosen, false profile and frog). On such images a number of standardized angles, offsets and ratios can be measured, including: [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_325", "text": "The following visual scores can also be registered:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_326", "text": "This article related to  health software  is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_327", "text": "This article about  orthopedic surgery  is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_328", "text": "OrthoPediatrics  is an American  bio-science  company engaged in designing, developing, manufacturing, and distributing orthopedic  implants  and  instruments  for  pediatric  issues. [ 1 ]  It is based in  Warsaw, Indiana . [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_329", "text": "Founded in 2006, OrthoPediatrics is an orthopedic company focused on providing  product offerings to the pediatric  orthopedic  market to improve the lives of children with  orthopedic conditions . [ 3 ] [ 4 ]  They currently market 24 surgical systems spanning trauma and deformity,  scoliosis  and sports medicine among others. [ 3 ] [ 4 ] [ 5 ]  They hold exclusive rights to the Hamann-Todd Human Osteological Collection at the  Cleveland Museum of Natural History . [ 6 ]  The company is dedicated to clinical research and education and licensed its name to establish a  501(c)(3)  public charity focused on advancements in the field of pediatric orthopedics. [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_330", "text": "In October 2017, they went public with a common stock of 4,000,000 shares and raised $52 M with $13 per share. [ 8 ] [ 9 ] [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_331", "text": "OrthoPediatrics has partnerships with 31 independent distributors selling products to children's hospital in the United States and 34 countries globally."}
{"_id": "WikiPedia_Orthopedics$$$corpus_332", "text": "They signed a license agreement with the Sydney Children's Hospitals Network in 2016 and a partnership agreement with Mighty Oak Medical for FIREFLY Technology in 2017. [ 11 ] [ 12 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_333", "text": "OrthoPediatrics holds nine patents for bottom loaded pedicle screw, bone screw, graft fixation, bone screw, surgical connectors and instrumentation, pediatric long bone support or fixation plate, pediatric intramedullary nail, compression bone fragment wire, convertible threaded compression device and its method of use. [ 13 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_334", "text": "This United States corporation or company article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_335", "text": "Orthotics  ( Greek :  \u039f\u03c1\u03b8\u03cc\u03c2 ,  romanized :\u00a0 ortho ,  lit. \u2009 'to straighten, to align') is a  medical specialty  that focuses on the design and application of  orthoses , sometimes known as braces, calipers, or splints. [ 1 ]  An  orthosis  is \"an externally applied device used to influence the structural and functional characteristics of the  neuromuscular  and  skeletal systems .\" [ 2 ]   Orthotists  are medical professionals who specialize in designing orthotic devices such as braces or foot orthoses."}
{"_id": "WikiPedia_Orthopedics$$$corpus_336", "text": "Orthotic devices are classified into four areas of the body according to the international classification system (ICS): [ 2 ]  orthotics of the  lower extremities , orthotics of the  upper extremities , orthotics for the  trunk , and orthotics for the head. Orthoses are also classified by function: paralysis orthoses and relief orthoses. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_337", "text": "Under the  International Standard  terminology, orthoses are classified by an acronym describing the anatomical joints they support. [ 2 ]  Some examples include KAFO, or knee-ankle-foot orthoses, which span the knee, ankle, and foot; TLSO, or thoracic-lumbar-sacral orthoses, supporting the  thoracic ,  lumbar  and   sacral  regions of the  spine . The use of the International Standard is promoted to reduce the widespread variation in the description of orthoses, which is often a barrier to interpreting research studies. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_338", "text": "The transition from an orthosis to a  prosthesis  can be fluid. An example is compensating for a leg length discrepancy, equivalent to replacing a missing part of a limb. Another example is the replacement of the forefoot after a forefoot  amputation . This treatment is often made from a combination of a prosthesis to replace the forefoot and an orthosis to replace the lost muscular function (ortho prosthesis). [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_339", "text": "An orthotist is a specialist responsible for the customising, manufacture, and repair of orthotic devices (orthoses). [ 5 ]  The manufacture of modern orthoses requires both artistic skills in modeling body shapes and manual skills in processing traditional and innovative materials\u2014  CAD / CAM ,  CNC machines  and  3D printing  are involved in orthotic manufacture. [ 6 ]  Orthotics also combines knowledge of anatomy and physiology,  pathophysiology ,  biomechanics  and engineering. [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_340", "text": "In the United States, while orthotists require a prescription from a licensed healthcare provider, physical therapists are not legally authorized to prescribe orthoses. In the U.K., orthotists will often accept referrals from doctors or other healthcare professionals for orthotic assessment without requiring a prescription. [ 8 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_341", "text": "Orthoses are offered as:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_342", "text": "Both custom-fabricated products and semi-finished products are used in long-term care and are manufactured or adapted by the orthotist or by trained orthopedic technicians according to the prescription. In many countries the physician or clinician defines the functional deviations in his prescription, e.g. paralysis ( paresis ) of the calf muscles ( M. Triceps Surae ) and derives the indication from this, e.g. orthotic to restore safety when standing and walking after a  stroke . The orthotist creates another detailed physical examination and compares it with the prescription from the physician. The orthotist describes the configuration of the orthosis, which shows which orthotic functions are required to compensate for the functional deviation of the neuromuscular or skeletal system and which functional elements must be integrated into the orthosis for this. Ideally, the necessary orthotic functions and the functional elements to be integrated are discussed in an interdisciplinary team between physician,  physical therapist , orthotist and patient."}
{"_id": "WikiPedia_Orthopedics$$$corpus_343", "text": "All orthoses that affect the foot, the ankle joint, the lower leg, the knee joint, the thigh or the hip joint belong to the category of orthoses for the lower extremities. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_344", "text": "Paralysis  orthoses are used for partial or complete paralysis, as well as complete functional failure of muscles or muscle groups, or incomplete paralysis ( paresis ). They are intended to correct or improve functional limitations or to replace functions that have been lost as a result of the paralysis. Functional leg length differences caused by paralysis can be compensated for by using orthosis. [ 9 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_345", "text": "For the quality and function of a paralysis orthosis, it is important that the orthotic shell is in total-contact  with the patient's leg to create an optimal fit, which is why a custom-made orthotic is often preferred. As reducing the weight of an orthosis significantly lessens the energy needed to walk with it, the use of light weight and highly resilient materials such as  carbon fiber ,  titanium  and  aluminum  is indispensable for the manufacture of a custom-made orthosis. [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_346", "text": "The production of a custom-made orthotic also allows the integration of orthotic joints, which means the dynamics of the orthotic can be matched exactly with the pivot points of the patient's anatomical joints. As a result, the dynamics of the orthosis take place exactly where dictated by the patient's anatomy. Since the dynamics of the orthosis are executed via the orthotic joints, it is possible to manufacture the orthotic shells as stable and torsion-resistant, which is necessary for the quality and function of the orthosis. The orthosis thus offers the necessary stability to regain the security that has been lost due to paralysis when standing and walking. [ 11 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_347", "text": "In addition, an orthosis can be individually configured through the use of orthosis joints. In this way, the combination of the orthotic joints and the adjustability of the functional elements can be adjusted to compensate for any existing functional deviations that have resulted from the muscle weakness. [ 12 ] [ 13 ] [ 14 ] [ 15 ] [ 16 ] [ 17 ]  The goal of a high-quality orthotic fitting is to adjust the functional elements so precisely that the orthosis provides the necessary support while restricting the dynamics of the lower extremities as little as possible to preserve the remaining functionality of the muscles. [ 11 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_348", "text": "In the case of paralysis due to disease or injury to the spinal/peripheral nervous system, a  physical examination  is needed to determine the strength levels of the affected leg's six major muscle groups and the orthosis's necessary functions."}
{"_id": "WikiPedia_Orthopedics$$$corpus_349", "text": "According to Vladimir Janda, a muscle function test is carried out to determine strength levels. [ 18 ]  The degree of paralysis is given for each muscle group on a scale from 0 to 5, with the value 0 indicating complete paralysis (0%) and the value 5 indicating normal strength (100%). The values between 0 and 5 indicate a percentage reduction in muscle function. All strength levels below five are called  muscle weakness ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_350", "text": "The combination of strength levels of the muscle groups determines the type of orthosis (AFO or KAFO) and the functional elements necessary to compensate for restrictions caused by the reduced muscular strength levels. [ medical citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_351", "text": "Paralysis may be caused by injury to the spinal or peripheral nervous system after  spinal cord injury , or by diseases such as  spina bifida ,  poliomyelitis  and  Charcot-Marie-Tooth disease . In these patients, knowledge of the strength levels of the large muscle groups is necessary to configure the orthotic  for the necessary functions. [ medical citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_352", "text": "Paralysis caused by diseases or injuries to the central nervous system (e.g.  cerebral palsy ,  traumatic brain injury ,  stroke , and  multiple sclerosis ) can cause incorrect motor impulses that often result in clearly visible deviations in gait. [ 19 ] [ 20 ]  The usefulness of muscle strength tests is therefore limited, as even with high degrees of strength, disturbances to the gait pattern can occur due to the incorrect control of the central nervous system."}
{"_id": "WikiPedia_Orthopedics$$$corpus_353", "text": "In  ambulatory  patients with paralysis due to  cerebral palsy  or  traumatic brain injury ,  the gait pattern is analysed as part of the  physical examination  in order to determine the necessary functions of an orthosis. [ 21 ] [ 22 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_354", "text": "One way of classifying gait is according to the \"Amsterdam Gait Classification\", which describes five gait types. To assess the gait pattern, the patient is viewed directly, or via a video recording, from the side of the leg being assessed. At the point when the leg is   mid-stance  the knee angle and the contact of the foot with the ground are assessed. [ 21 ]  The five gait types are:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_355", "text": "Patients with paralysis due to cerebral palsy or traumatic brain injury are usually treated with an ankle-foot orthosis (AFO). Although in these patients the muscles are not paralyzed but being sent the wrong impulses from the brain, the functional elements used in the orthotics are the same for both groups. The compensatory gait is an unconscious reaction to the lack of security when standing or walking that usually worsens with increasing age; [ 20 ]  if the right functional elements are integrated into the orthosis to counter this, and maintain physiological mobility, the right motor impulses are sent to create new cerebral connections. [ 23 ]  The goal of an orthotic is the best possible approximation of the physiological gait pattern. [ 24 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_356", "text": "In the case of paralysis after a  stroke , rapid care with an orthosis is necessary. Often areas of the brain are affected that contain \"programs\" for controlling the musculoskeletal system. [ 25 ] [ 26 ] [ 27 ]  With the help of an orthosis, physiological standing and walking can be relearned, preventing long term health consequences caused by an abnormal gait pattern. [ 28 ]  According to Vladimir Janda, when configuring the orthotic it is important to understand that the muscle groups are not paralyzed, but are controlled by the brain with wrong impulses, and this is why a muscle function test can lead to incorrect results when assessing the ability to stand and walk. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_357", "text": "An important basic requirement for regaining the ability to walk is that the patient trains early on to stand on both legs safely and well balanced. An orthosis with functional elements to support balance and safety when standing and walking can be integrated into physical therapy from the first standing exercises, and this makes the work of mobilizing the patient at an early stage easier. With the right functional elements that maintain physiological mobility and provide security when standing and walking, the necessary motor impulses to create new cerebral connections can occur. [ 23 ]  Clinical studies confirm the importance of orthoses in stroke rehabilitation. [ 29 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_358", "text": "Patients with paralysis after a stroke are often treated with an ankle-foot orthosis (AFO), as after a stroke stumbling can occur if only the  dorsiflexors  are supplied with incorrect impulses from the central nervous system. This can lead to insufficient foot lifting during swing phase of walking, and in these cases, an orthosis that only has functional elements to support the dorsiflexors can be helpful. Such an orthosis is also called drop foot orthosis. When configuring a foot lifter orthosis, adjustable functional elements for setting the resistance can be included, which make it possible to adapt the passive lowering of the forefoot (plantar flexion) to the  eccentric work  of the dorsal flexors during loading response. [ 12 ] [ 13 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_359", "text": "In cases where the muscle group of the  plantar flexors  is supplied with wrong impulses from the central nervous system, which leads to uncertainty when standing and walking, an unconscious compensatory gait can occur. [ 20 ]  When configuring an orthosis functional elements that can restore safety when standing and walking must be used in these cases; a foot lifter orthosis is not suitable as it only compensates for the functional deviations caused by weakness of the dorsiflexors."}
{"_id": "WikiPedia_Orthopedics$$$corpus_360", "text": "Patients with paralysis after stroke who are able to walk have the option of analysing the gait pattern in order to determine the optimal function of an orthosis. One way of assessing is the classification according to the \"N.A.P. Gait Classification\", which is a physiotherapeutic treatment concept. [ 30 ]  According to this classification, the gait pattern is assessed in the mid-stance phase and described as one of four possible gait types."}
{"_id": "WikiPedia_Orthopedics$$$corpus_361", "text": "This assessment is a two step process; in the first step, the patient is viewed from the side of the leg to be assessed, either directly or via a video recording. In gait type 1 the knee angle is hyperextended, while in type 2, the knee angle is flexed. In the second step, the patient is viewed from the front to determine if the foot is  inverted , if it is the letter \"a\" is added to the gait. This is associated with a  varus deformity  of the knee. If instead the patient stands on the inner edge of the foot (eversion), which is associated with a  valgus deformity  of the knee, the letter \"b\" is added to the gait type. Patients are thus classified as gait types 1a, 1b, 2a or 2b. The goal of orthotic fitting for patients who are able to walk is the best possible approximation of the physiological gait pattern. [ medical citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_362", "text": "In the case of paralysis due to  multiple sclerosis , the degree of strength of the six major muscle groups of the affected leg should be determined as part of the  physical examination  in order to determine the necessary functions of an orthosis, just as in the case of diseases or injuries to the spinal/peripheral nervous system. However, patients with multiple sclerosis may experience muscular fatigue as well. The fatigue can be more or less pronounced and, depending on the severity, can lead to considerable restrictions in everyday life. Persistent stress, such as from walking, causes a deterioration in muscle function and has a significant effect on the spatial and temporal parameters of walking, for example by significantly reducing the cadence and walking speed. [ 31 ] [ 32 ] [ 33 ]  Fatigue can be measured as  muscle weakness . When determining the strength levels of the six major muscle groups as part of the patient's medical history, fatigue can be taken into account by using a standardized six-minute walking test. [ 34 ]  According to Vladimir Janda the muscle function test is carried out in combination with the six-minute walk test in the following steps:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_363", "text": "This sequence of muscle function test and six-minute walk test is used to determine whether muscular fatigue can be induced. If the test reveals muscular fatigue, the strength levels and measured fatigue should be included in the planning of an orthosis, and when determining the functional elements. [ medical citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_364", "text": "Paralysis of the dorsiflexors \u00a0\u2013  weakness  of the  dorsiflexors  results in a  drop foot . The patient's foot cannot be sufficiently lifted during the swing phase while walking, as the necessary concentric work of the dorsiflexors can not be activated. [ 35 ]  There is a risk of stumbling, and the patient cannot influence the shock absorption when walking (gait phase, loading response), as the  eccentric work  of the dorsiflexors is limited. [ 35 ]  After initial heel contact the forefoot either slaps too quickly on the floor via the heel rocker, which creates an audible noise, or the foot does touch the floor with forefoot first, which disrupts gait development. [ 36 ] :\u200a178\u2013181\u200a [ 37 ] :\u200a44\u201345,\u200a50\u201354 and 126\u200a [ 38 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_365", "text": "Paralysis of the plantar flexors \u00a0\u2013 If the  plantar flexors  are weak, the muscles of the forefoot lever are either inadequately activated or not activated at all. The patient has no balance when standing and has to support themself with aids such as  crutches . The forefoot lever required for energy-saving walking in the gait phases from mid-stance to pre-swing cannot be activated by the plantar flexors. This leads to excessive dorsiflexion in the ankle joint in terminal stance and a loss of energy while walking. The center of gravity of the body lowers towards the end of the stance phase and the knee of the contralateral leg is flexed excessively. With each step, the center of gravity must be raised above the leg by straightening the excessively flexed knee. Since the plantar flexors originate above the knee joint, they also have a knee-extension effect in the stance phase. [ 36 ] :\u200a177\u2013210\u200a [ 37 ] :\u200a72\u200a [ 38 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_366", "text": "Paralysis of the knee extensors \u00a0\u2013 if the  knee extensors  are weak, there is an increased risk of falling when walking, as between loading response to the mid-stance the knee extensors control knee flexion inadequately, or not at all. To control the knee, the patient develops compensatory mechanisms that lead to an incorrect gait pattern, for example by exaggerated activation of the plantar flexors, leading into hyperextension of the knee, or when initial contact is with the forefoot and not the heel in order to prevent the knee-flexing effect of the heel rocker. [ 36 ] :\u200a222,\u200a226\u200a [ 37 ] :\u200a132,\u200a143,\u200a148\u2013149\u200a [ 38 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_367", "text": "Paralysis of the knee flexors \u00a0\u2013 if the knee flexors are weak, it is more difficult to flex the knee in pre-swing. [ 36 ] :\u200a220\u200a [ 37 ] :\u200a154\u200a [ 38 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_368", "text": "Paralysis of the hip flexors \u00a0\u2013 if the hip flexors are weak, it is more difficult to flex the knee in pre-swing. [ 36 ] :\u200a221\u200a [ 37 ] :\u200a154\u200a [ 38 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_369", "text": "Paralysis of the hip extensors \u00a0\u2013 the  hip extensors  help control of the knee against unwanted flexion when walking between loading response and mid-stance. [ 36 ] :\u200a216\u201317\u200a [ 37 ] :\u200a45\u201346\u200a [ 38 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_370", "text": "The functional elements of an orthosis ensure the flexion and extension movements of the ankle, knee and  hip joints. They correct and control the movements and secure the joints against undesired incorrect movements, and help avoid falls when standing or walking. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_371", "text": "Functional elements in paralysis of the dorsiflexors \u00a0\u2013 if the  dorsiflexors  are weak, an orthosis should lift the forefoot during the swing phase in order to reduce the risk of the patient stumbling. An orthosis that has only one functional element for lifting the forefoot in order to compensate for a weakness in the dorsiflexors is also known as a drop foot orthosis. An AFO of the drop foot orthosis type is therefore not suitable for the care of patients with weakness in other muscle groups, as these patients require additional functional elements to be taken into account. Initial contact with the heel should be achieved by lifting the foot through the orthosis, and if the dorsiflexors are very weak, control of the rapid drop of the forefoot should be taken over by dynamic functional elements that allow for adjustable resistance of  plantar flexion . Orthoses should be adapted to the functional deviation of the dorsiflexors in order to correct the shock absorption of the heel rocker lever during loading response, but should not block plantar flexion of the ankle joint as this leads to excessive flexion in the knee and hip and an increase in the energy needed for walking. This is why static functional elements are not recommended when there are newer technical alternatives. [ 12 ] [ 36 ] :\u200a105\u200a [ 37 ] :\u200a134\u200a [ 38 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_372", "text": "Functional elements in paralysis of the plantar flexors \u00a0\u2013 in order to compensate for a  weakness  of the  plantar flexors , the orthosis has to transfer large forces that the strong muscle group would otherwise take over. These forces are transmitted in a similar way to a ski boot during downhill skiing via the functional elements of the foot part, ankle joint and lower leg shell. Dynamic functional elements are preferable for the ankle joint as static functional elements would completely block the dorsiflexion, which would have to be compensated for by the upper body, resulting in an increased energy cost when walking. [ 15 ]  The functional element's resistance to protect against unwanted dorsiflexion should be able to be adapted according to the weakness of the plantar flexors. In the case of very weak plantar flexors, the functional element's resistance against undesired dorsiflexion must be very high in order to compensate for the functional deviations this causes. [ 39 ] [ 16 ]  Adjustable functional elements allow the resistance to be adjusted exactly to the weakness of the muscle, and scientific studies recommend adjustable resistance in patients with paralysis or weakness of the plantar flexors. [ 13 ] [ 14 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_373", "text": "Functional elements in paralysis of knee extensors and hip extensors \u00a0\u2013 in the case of weak  knee extensors  or  hip extensors , the orthosis must take over the stability and stance phase control when walking. Different knee-securing functional elements are needed depending on the weakness of these muscles. In order to compensate for functional deviations with slightly weakness of these muscle groups, a free moving mechanical knee joint with the mechanical pivot point behind the anatomical knee pivot point can be sufficient. In the case of significant weakness, knee flexion when walking must be controlled by functional elements that mechanically secure the knee joint during the early stance phases between loading response and mid stance. Stance phase control knee joints which lock the knee in the early stance phases and release it for knee flexion during the swing phase can be used here, with these joints, a natural gait pattern can be achieved despite mechanically securing against unwanted knee flexion. In these cases, locked knee joints are often used, and while they have a good safety function, the knee joint remains mechanically locked during the swing phase while walking. Patients with locked knee joints have to manage the swing phase with a stiff leg, which only works if the patient develops compensatory mechanisms, such as by raising the body's center of gravity in the swing phase ( Duchenne  limping) or by swinging the orthotic leg to the side ( circumduction ). Stance phase control knee joints and locked joints can both be mechanically \"unlocked\" so the knee can be flexed to sit down. [ 17 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_374", "text": "AFO is the abbreviation for ankle-foot orthoses, which is the English name for an orthosis that spans the ankle and foot. [ 2 ]  In the treatment of paralyzed patients, they are mainly used when there is a  weakness  of the  dorsiflexors  or  plantar flexors . [ 40 ] [ 41 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_375", "text": "Through the use of modern materials, such as carbon fibers and  aramid  fibers, and new knowledge about processing these materials into composite materials, the weight of orthotics has been reduced significantly. In addition to the weight reduction, these materials and technologies have created the possibility of making some areas of an orthosis so rigid that it can take over the forces of the weakened muscles (e.g. the connection from the ankle joint to the frontal contact surface on the shin), while at the same time leaving areas requiring less support very flexible (e.g. the flexible part of the forefoot). [ 42 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_376", "text": "It is now possible to combine the required rigidity of the orthotic shells with the dynamics in the ankle, [ 43 ]  with this, other new technologies, and the possibility of producing lightweight but rigid orthoses, new demands have been made of orthotics: [ 44 ] [ 45 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_377", "text": "A custom-made AFO can compensate for functional deviations of muscle groups, it should be configured according to the patient data through a function and load calculation so that it meets the functional and load requirements. In calculating or configuring an AFO, variants are optimally matched to individual requirements for the functional elements of the ankle joint, for the stiffness of the foot shell, and for the shape of the lower leg shell. The size of these components is selected by matching their resilience to the load data. [ medical citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_378", "text": "An ankle joint based on new technology is the connection between the foot shell and the lower leg shell and at the same time contains all the necessary adjustable functional elements of an AFO. [ clarification needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_379", "text": "Depending on the combination of the degree of paralysis of the  dorsiflexors  or  plantar flexors , different functional elements to compensate for their weakness can be integrated into the ankle joint; if both muscle groups are affected, the elements should be integrated into one orthotic joint. The necessary dynamics and resistance to movements in the ankle can be adapted via adjustable functional elements in the ankle joint of the orthosis, which allows it to compensate for muscle weaknesses, provide safety when standing and walking, and still allow as much mobility as possible. For example, adjustable spring units with pre-compression can enable an exact adaptation of both static and dynamic resistance to the measured degree of muscle weakness. Studies show the positive effects of these new technologies. [ 12 ] [ 14 ] [ 15 ] [ 39 ] [ 16 ]  It is of great advantage if the resistances for these two functional elements can be set separately. [ 13 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_380", "text": "An AFO with functional elements to compensate for a weakness of the  plantar flexors  can also be used for slight weakness of the knee-securing muscle groups, the  knee extensors  and the  hip extensors . [ medical citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_381", "text": "A drop foot orthosis is an AFO that only has one functional element for lifting the forefoot in order to compensate for a weakness in the dorsiflexors. [ 46 ]  If other muscle groups, such as the plantar flexors, are weak, additional functional elements must be taken into account, making a drop foot orthosis unsuitable for patients with weakness in other muscle groups."}
{"_id": "WikiPedia_Orthopedics$$$corpus_382", "text": "In 2006, before these new technologies were available, the  International Committee of the Red Cross  published in its 2006 Manufacturing Guidelines for Ankle-Foot Orthoses, with the aim of providing people with disabilities worldwide standardized processes for the production of high-quality, modern, durable and economical devices. [ 47 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_383", "text": "Because new technologies are not widely used, AFOs are often made from polypropylene-based plastic, mostly in the shape of a continuous \"L\" shape, with the upright part behind the calf and the lower part under the foot, however, this only offers the rigidity of the material. AFOs made of polypropylene are still called \"DAFO\" (dynamic ankle-foot orthosis), \"SAFO\" (solid ankle-foot orthosis) or \"Hinged AFO\". DAFOs are not stable enough to transfer the high forces required to balance the weak plantar flexors when standing and walking, and SAFOs block the mobility of the ankle joint. A \"Hinged AFO\"  only allowed for the compensation that could be achieved with the orthotic joints of the time, for example, they commonly block plantar flexion, as the joints cannot simultaneously transmit the large forces that are required to compensate for muscle deviations while also  offering the necessary dynamics. [ medical citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_384", "text": "While there was a multitude of AFOs with differing designs in clinical practice, there was also a clear lack of details regarding the design and the materials used for manufacture, leading Eddison and  Chockalingam  to call for a new standardization of the terminology. [ 48 ] [ 49 ]  With a focus on caring for children with cerebral palsy there is a recommendation to investigate the potential for gait pattern improvement via the design and manufacture of orthotics made of polypropylene. [ 50 ]  On the other hand, integrating orthotic joints with modern functional elements into the  production of older technologies using polypropylene is unusual because the orthotic shells made of polypropylene either could not transfer the high forces or would be too soft. [ medical citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_385", "text": "New studies now show the better possibilities for improving the gait pattern through the new technologies. [ 12 ] [ 15 ] [ 39 ] [ 16 ] [ 13 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_386", "text": "The International Committee of the Red Cross published its manufacturing guidelines for ankle\u2013foot orthoses in 2006, and, unfortunately, today's terminologies are still based those guidelines and therefore require a particularly high level of explanation. [ 47 ]  The intent was to provide standardized procedures for the manufacture of high-quality modern, durable and economical devices to people with disabilities throughout the world. However, with the new technologies available, the main types mentioned are in need of revision today."}
{"_id": "WikiPedia_Orthopedics$$$corpus_387", "text": "plus the body parts included in the orthosis fitting: ankle and foot, English abbreviation: AFO for ankle-foot orthoses"}
{"_id": "WikiPedia_Orthopedics$$$corpus_388", "text": "\"SAFO\""}
{"_id": "WikiPedia_Orthopedics$$$corpus_389", "text": "Rigid AFO [ 47 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_390", "text": "\"DAFO\""}
{"_id": "WikiPedia_Orthopedics$$$corpus_391", "text": "Flexible AFO [ 47 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_392", "text": "\"Hinged-AFO\""}
{"_id": "WikiPedia_Orthopedics$$$corpus_393", "text": "\"Hinged\" simply means a flexible connection between the two parts of the orthosis. The joint itself does not offer any further functional elements."}
{"_id": "WikiPedia_Orthopedics$$$corpus_394", "text": "AFO with Tamarack Flexure Joint"}
{"_id": "WikiPedia_Orthopedics$$$corpus_395", "text": "\"Posterior Leaf Spring\""}
{"_id": "WikiPedia_Orthopedics$$$corpus_396", "text": "Spring made from flexible material behind (posterior) the ankle"}
{"_id": "WikiPedia_Orthopedics$$$corpus_397", "text": "A DAFO often also known as \"Posterior Leaf Spring\""}
{"_id": "WikiPedia_Orthopedics$$$corpus_398", "text": "FR for Floor reaction"}
{"_id": "WikiPedia_Orthopedics$$$corpus_399", "text": "\"FRAFO\""}
{"_id": "WikiPedia_Orthopedics$$$corpus_400", "text": "Designation is misleading as other orthoses also have this function"}
{"_id": "WikiPedia_Orthopedics$$$corpus_401", "text": "Plus further descriptions, such as:\n - ventral shell with torsionally rigid reinforcement to focus the dynamics on the ankle joint\n - dynamic ankle joint with precompressed spring elements to control plantarflexion and dorsiflexion"}
{"_id": "WikiPedia_Orthopedics$$$corpus_402", "text": "KAFO is the abbreviation for knee-ankle-foot orthoses, which spans the knee, ankle and foot. [ 51 ]  In the treatment of paralyzed patients, a KAFO is used when there is a  weakness  of the knee  or hip extensors. [ 17 ] [ 40 ] [ 41 ]  They have two orthotic joints: an ankle joint between the foot and lower leg shells and a knee joint between the lower leg and thigh shells. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_403", "text": "KAFOs can be roughly divided into three variants, depending on whether the mechanical knee joint is: locked, unlocked or locked and unlocked. [ medical citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_404", "text": "KAFO with locked knee joint -  The mechanical knee joint is locked both when standing and also when walking (in both the stance and swing phases) in order to achieve the necessary stability. To sit, the user can unlock the knee joint. When walking with a locked knee joint it is difficult for the user to swing the leg forward and, in order to not stumble, the leg must be swung forward and out in a circular arc (circumduction) or the hip must be raised unnaturally to swing the stiff leg. Each of these incorrect gait patterns can lead to secondary diseases in the bone and muscle system, and such compensatory movement patterns lead to increased energy consumption when walking. The film  Forrest Gump  impressively shows how the main character  Forrest Gump  is additionally hindered in his urge to move by such orthoses. [ relevant? ]  For centuries, KAFOs were built with mechanical knee joints that stiffened the knee of the paralyzed leg, and even today, such orthotic fittings are still common. Typical designations for a KAFO with a locked knee joint include \"KAFO with Swiss lock\" or \"KAFO with drop lock lock\". [ medical citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_405", "text": "KAFO with unlocked knee joint -  An unlocked knee joint can move freely both when standing and when walking, both in the stance phase and in the swing phase. In order for the leg to swing through without stumbling, knee flexion of approximately 60\u00b0 is allowed; the user does not need to unlock the knee joint to sit. As a KAFO with an unlocked knee joint can provide only minor compensation for paralysis-related issues while standing and walking, an orthotic knee joint with a rearward displacement of the pivot point can be installed in order to increase safety. However, even with this, a KAFO with a non-locked knee joint should only be used in cases of minor paralysis of the knee and hip extensors. With more severe paralysis and low levels of strength in these muscle groups, there is a significant risk of falling. A typical designation for a KAFO with a unlocked knee joint is, among other things, \"KAFO with knee joint for movement control\". [ medical citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_406", "text": "KAFO with locked and unlocked knee joint -  The mechanical knee joint of a KAFO with locked and unlocked knee joint is locked when walking in the stance phase, [ 52 ]  providing the necessary stability and security for the user. The knee joint is then automatically unlocked in the swing phase, allowing the leg to be swung through without stumbling. In order to be able to walk efficiently, without stumbling, and without compensating mechanisms, the joint should allow  knee flexion of approximately 60\u00b0 in the swing phase. The first promising developments of automatic knee joints, or stance phase locking knee joints, emerged in the 1990s. In the beginning there were automatic mechanical constructions that took over the locking and unlocking, now [ when? ]  automatic electromechanical and automatic  electrohydraulic  systems are available that make standing and walking safer and more comfortable. Various terms are used for a KAFO with a locked and unlocked knee joint. Typical designations are \"KAFO with automatic knee joint\" or \"KAFO with stance phase control knee joint\". In scientific articles, the English term Stance Control Orthoses SCO is often used, but as this term differs from the ICS classification, one of the first two terms is preferable."}
{"_id": "WikiPedia_Orthopedics$$$corpus_407", "text": "Different functional elements to compensate for weakness of the  dorsiflexors  or  plantar flexors  can be integrated into the ankle joint of the orthosis depending on the degree of paralysis of the two muscle groups. It is of great advantage if the resistances for these two functional elements can be set separately. [ 13 ]  The functional elements to compensate for paralysis of the knee-securing muscle groups of the  knee  and  hip extensors  are integrated into the knee joint of the orthosis via knee-securing functional elements. A KAFO can use a variety of combinations of different variants in the stiffness of the foot shell, the different variants of the functional elements of a dynamic ankle joint, the variants in the shape of the lower leg shell, and the functional elements of a knee joint to compensate for the user's limitations. [ 41 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_408", "text": "HKAFO is the abbreviation for hip-knee-ankle-foot orthoses; which is the English name for an orthosis that spans the hip, the knee, the ankle and the foot. [ 51 ]  In the treatment of paralyzed patients, a HKAFO is used when there is a  weakness  of the pelvic stabilizing trunk muscles. [ 41 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_409", "text": "Relief Orthoses are used when there is degeneration to a joint (from \"wear and tear\" for example) or after an injury such as a torn ligament. [ 53 ]  Relief orthoses are also used after operations such as operations on the joint ligaments, other bony, muscular structures, or after a complete replacement of a joint. [ 54 ] [ 55 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_410", "text": "Relief orthosis may also be used to: [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_411", "text": "A custom-made ankle/foot orthosis can be used for the treatment of patients with foot ulcers, it is a rigid L-shaped support member with a rigid anterior support shell on an articulated hinge. The plantar portion of the L-shaped member has at least one ulcer-protecting hollow to allow the user to transfer their weight away from the ulcer to facilitate treatment. The anterior support shell is designed with a lateral hinged attachment to take advantage of the medial tibial flare structure to enhance the weight-bearing properties of the orthosis. A flexible, polyethylene hinge attaches the support shell to the L-shaped member and straps securely attach the anterior support shell to the user's lower leg. [ 56 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_412", "text": "Foot orthoses (commonly called  orthotics ) are devices inserted into shoes to provide support for the foot by redistributing  ground reaction forces  acting on the foot joints while standing, walking or running. They may be either pre-moulded (also called pre-fabricated) or custom made according to a cast or impression of the foot. They are used by everyone from athletes to the elderly to accommodate biomechanical deformities and a variety of soft tissue conditions. Foot orthoses are effective at reducing pain for people with painful  high-arched feet , and may be effective for people with  rheumatoid arthritis ,  plantar fasciitis , first  metatarsophalangeal  (MTP) joint pain [ 57 ]  or  hallux valgus  (bunions). For children with  juvenile idiopathic arthritis  (JIA) custom-made and pre-fabricated foot orthoses may also reduce foot pain. [ 58 ]  Foot orthoses may also be used in conjunction with properly fitted orthopedic footwear in the prevention of  diabetic foot ulcers . [ 59 ] [ 60 ]  A real-time weight bearing orthotic can be created using a neutral position casting device and the Vertical Foot Alignment System VFAS. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_413", "text": "An AFO can also be used to immobilize the ankle and lower leg in the presence of arthritis or a fracture. Ankle\u2013foot orthoses are the most commonly used orthoses, making up about 26% of all orthoses provided in the United States. [ 61 ]  According to a review of Medicare payments from 2001 to 2006, the base cost of an AFO was about $500 to $700. [ 62 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_414", "text": "A knee orthosis (KO) or knee brace extends above and below the knee joint and is generally worn to support or align the knee. In the case of diseases causing neurological or muscular impairment of muscles surrounding the knee, a KO can prevent flexion, extension, or instability of the knee. If the ligaments or cartilage of the knee are affected, a KO can provide stabilization to the knee by replacing their functions. For instance, knee braces can be used to relieve pressure from diseases such as  arthritis  or  osteoarthritis  by realigning the knee joint. In this way a KO may help reduce osteoarthritis pain, [ 63 ]  however, there is no clear evidence about the most effective orthosis or the best approach to rehabilitation. [ 64 ]  A knee brace is not meant to treat an injury or disease on its own, but is used as a component of treatment along with drugs, physical therapy and possibly surgery. When used properly, a knee brace may help an individual to stay active by enhancing the position and movement of the knee or reducing pain. [ medical citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_415", "text": "Prophylactic braces are used primarily by athletes participating in contact sports. Evidence indicates that prophylactic knee braces, like the ones football linemen wear that are often rigid with a knee hinge, are ineffective in reducing anterior cruciate ligament tears, but may be helpful in resisting medial and lateral collateral ligament tears. [ 65 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_416", "text": "Functional braces are designed for use by people who have already experienced a knee injury and need support while recovering from it, or to help people who have pain associated with arthritis. They are intended to reduce the rotation of the knee, support stability, reduce the chance of hyperextension, and increase the agility and strength of the knee. The majority of these are made of elastic. They are the least expensive of all braces and are easily found in a variety of sizes. [ medical citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_417", "text": "Rehabilitation braces are used to limit the movement of the knee in both medial and lateral directions, these braces often have an adjustable range of motion, and can be used to limit flexion and extension following ACL reconstruction. They are primarily used after injury or surgery to immobilize the leg and are larger in size than other braces, due to their function."}
{"_id": "WikiPedia_Orthopedics$$$corpus_418", "text": "A soft brace, sometimes called soft support or a bandage, belong to the field of orthoses and are supposed to protect the joints from excessive loads.\nSoft braces are also classified according to regions of the body. In sport, bandages are used to protect bones and joints, and prevent and protect injuries. [ 66 ]  Bandages should also allow  proprioception . They mostly consist of textiles, some of which have supportive elements. The supporting functions are low compared to paralysis and relief orthoses, though they are sometimes used  prophylactically  or to optimize performance in sport. [ 67 ]  At present, the scientific literature does not provide sufficient high quality research to allow for strong conclusions on their effectiveness and cost-effectiveness. [ 68 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_419", "text": "Upper-limb (or upper extremity) orthoses are mechanical or electromechanical devices applied externally to the arm, or segments of it, in order to restore or improve function or structural characteristics of the arm segments enclosed in the device. In general, musculoskeletal problems that may be alleviated by the use of upper limb orthoses include those resulting from trauma [ 69 ]  or disease (arthritis for example). They may also benefit individuals who have a neurological impairment from a stroke, spinal cord injury, or peripheral neuropathy. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_420", "text": "Scoliosis , a condition describing an abnormal curvature of the spine, may in certain cases be treated with spinal orthoses, [ 70 ]  such as the  Milwaukee brace ,  Boston brace ,  Charleston bending brace , or  Providence brace . As scoliosis most commonly develops in adolescent females who are undergoing their  adolescent growth spurt , compliance is hampered by patient concerns about appearance and movement restrictions caused by the brace. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_421", "text": "Spinal orthoses may also be used in the treatment of spinal fractures. A Jewett brace, for instance, may be used to aid healing of an anterior  wedge fracture  involving the T10 to L3 vertebrae, and a body jacket may be used to stabilize more involved fractures of the spine. There are several types of orthoses for managing cervical spine pathology. [ 71 ]  The halo brace is the most restrictive cervical thoracic orthosis in use; it is used to immobilize the cervical spine, usually following fracture, and was developed by Vernon L. Nickel at  Rancho Los Amigos National Rehabilitation Center  in 1955. [ 72 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_422", "text": "Helmets  such as a cranial molding orthoses is an example of orthoses for the head. [ 73 ]  These devices are often suggested for infants with  positional plagiocephaly . [ 74 ] [ 75 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_423", "text": "An  orthotist  is a healthcare professional who specializes in the provision of  orthoses . An orthotist has an overall responsibly of  orthotics  treatment, who can supervise and mentor the practice of other personnel. [ 1 ]  They are clinicians trained to assess the needs of the user, prescribe treatment, determine the precise technical specifications of orthotic devices, take measurements and image of body segments, prepare model of the evaluation, fit devices and evaluate treatment outcome. [ 1 ]  In the United States, orthotists work by prescription from a licensed healthcare provider. Physical therapists are not legally authorized to prescribe orthoses in the U.S. In the U.K., orthotists will often accept open referrals for orthotic assessment without a specific prescription from doctors or other healthcare professionals. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_424", "text": "The scope of an orthotist includes the design and application of  orthoses  (braces or  orthotic devices ). The definition of an orthosis is an \u201cexternally applied device used to modify the structural and functional characteristics of the neuromuscular and skeletal system\u201d. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_425", "text": "In Canada, a Certified Orthotist CO(c) provides clinical assessment, treatment plan development, patient management, technical design, and fabrication of custom orthoses to maximize patient outcomes. To become CBCPO certified through Orthotics Prosthetics Canada (OPC) an applicant must successfully meet the following requirements:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_426", "text": "Upon successful completion of the national certification exams, candidates are conferred the designation of Canadian Certified Orthotist CO(c). [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_427", "text": "In the UK orthotists assess patients, and where appropriate design and fit orthoses for any part of the body. Registration is with the  Health and Care Professions Council  and BAPO - the British Association of Prosthetists and Orthotists. The training is a B.Sc.(Hons) in Prosthetics and Orthotics at either the  University of Salford  or  University of Strathclyde . New graduates are therefore eligible to work as an orthotist and/or  prosthetist ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_428", "text": "Podiatrists are the other profession involved with foot orthotic provision. [ 5 ]  They are also registered with the  Health and Care Professions Council  . Podiatrists assess gait to provide orthotics to improve foot function and alignment or may use orthoses to redistribute stress on pressure areas for those with diabetes or rheumatoid arthritis."}
{"_id": "WikiPedia_Orthopedics$$$corpus_429", "text": "A licensed orthotist is an orthotist who is recognized by the particular state in which they are licensed to have met basic standards of proficiency, as determined by examination and experience to adequately and safely contribute to the health of the residents of that state. An American Board of Certification certified orthotist has met certain standards; these include a degree in orthotics, completion of a one-year residency at an approved clinical site, and passing a rigorous three-part exam. [ 6 ]  A certified orthotist (CO) is an orthotist who has passed the certification standards of the American Board of Certification in Orthotics, Prosthetics and Pedorthics. Other credentialing bodies who are involved in orthotics include the Board for Orthotic Certification, the pharmaceutical industry, the Pedorthic Footcare Association, and various of the professional associations who work with athletic trainers, physical and occupational therapists, and orthopedic technologists/cast technicians."}
{"_id": "WikiPedia_Orthopedics$$$corpus_430", "text": "Four universities including the  Iran University of Medical Science ,  Isfahan University of Medical Science ,  University of Social Welfare and Rehabilitation Sciences  and Iran Red Crescent University confer bachelor of science in the Prosthetics and Orthotics. Three universities including Isfahan University of Medical Science, the Iran University of Medical Science and University of Social Welfare and Rehabilitation Science also confer  M.Sc.  and  Ph.D . New bachelor graduates are eligible to work as an orthotist and  prosthetist  after registration in the  Medical Council of Iran . [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_431", "text": "Lars Peterson  (born 1936 in  Vansbro ,  Sweden ) is an  orthopedist , known as \"the father of autologous cell implantation\". [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_432", "text": "Beginning in 1987, Peterson co-pioneered, with colleague  Mats Brittberg  and others,  autologous chondrocyte implantation , a method of repairing  cartilage  using a patient's own cartilage cells. [ 2 ]  He was honored for his work at  Genzyme  in 2009. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_433", "text": "He is also a professor and sports physician, and has been a Swedish national league football and ice hockey player, active in both  \u00d6rgryte IS  and  Fr\u00f6lunda HC ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_434", "text": "Peterson's sports career started early in most sports, ending up playing in the Swedish National League in both soccer and hockey with \u00d6rgryte IS, ending on fourth place and  V\u00e4stra Fr\u00f6lunda IF , ending first place, respectively. Along with playing soccer and football, he studied medicine at the  University of Gothenburg  and graduated in 1966.\nHe served his Residency in General Surgery in Kung\u00e4lvs Hospital, his orthopaedic residency in  Sahlgrenska University Hospital  from 1967 to 1974, and became specialist in General Surgery 1972 and in Orthopaedic Surgery 1974. In 1974, Peterson defended his doctoral thesis: Fracture of the Neck of the Talus, An Experimental and Clinical Study."}
{"_id": "WikiPedia_Orthopedics$$$corpus_435", "text": "In 1980, Peterson was approved associate professor of Orthopaedic Surgery at the University of Gothenburg and in 2000, appointed professor of Orthopaedic Surgery. Peterson had a long and broad experience in treating athletes in his University practice and as team physician in soccer and ice hockey and since 1987 in his clinic, Gothenburg Medical Center. He has served as head physician of the Swedish National Team in ice hockey and in soccer"}
{"_id": "WikiPedia_Orthopedics$$$corpus_436", "text": "For over 25 years, Peterson has been a member of the Sports Medical Committee of  FIFA , The International Football Federation and a founding member of F-Marc (FIFA Medical Assessment and Research Center). He has served as a Medical Officer at six World Cups in Football.\nPeterson has been President of the  Swedish Society of Sports Medicine  and is an honorary member. He was president and one of the founding members of the  International Society of Cartilage Repair  (ICRS). He has served as Godfather for ICRS Traveling Fellows in 2001. He also has served as Goodfather in the Herodicus Society."}
{"_id": "WikiPedia_Orthopedics$$$corpus_437", "text": "In 2010, Peterson received \u201cThe Duke of Edinburgh Prize\u201c for \u201cOutstanding contribution to international education in Sports Medicine\u201d. In 2010 awarded \u201cDoctor Honoris Causa\u201d at the  University of Helsinki , Finland. In 2011, he was awarded \u201cDoctor Honoris Causa\u201d at  Universidad Cat\u00f3lica San Antonio de Murcia , Spain."}
{"_id": "WikiPedia_Orthopedics$$$corpus_438", "text": "Peterson has lectured extensively, nationally and internationally and served as visiting professor several times. His publication list includes more than 200 originals, reviews books, book chapters in the fields of Orthopaedic Surgery, Sports Traumatology and Sports Medicine, Biomechanics, and Rehabilitation."}
{"_id": "WikiPedia_Orthopedics$$$corpus_439", "text": "This Swedish biographical article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_440", "text": "This biographical article related to medicine is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_441", "text": "Prosthetic joint infection  (PJI), also known as  peri-prosthetic joint infection , is an acute, sub-acute or chronic infection of a  prosthetic joint . It may occur in the period after the joint replacement or many years later. It usually presents as joint pain,  erythema  (redness of the joint or adjacent area),  joint swelling  and sometimes formation of a  sinus tract  ( a tract connecting the joint space to the outer environment). PJI is estimated to occur in approximately 2% of hip and knee replacements, and up to 4% of revision hip or knee replacements. Other estimates indicate that 1.4-2.5% of all joint replacements worldwide are complicated by PJIs. [ 1 ]  The incidence is expected to rise significantly in the future as  hip replacements  and  knee replacements  become more common. It is usually caused by  aerobic   gram positive  bacteria, such as  Staph epidermidis  or  Staphylococcus aureus  but  enterococcus  species,  gram negative  organisms and  Cutibacterium  are also known causes with  fungal  infections being a rare culprit. The definitive diagnosis is isolation of the causative organism from the  synovial fluid  (joint fluid), but signs of inflammation in the joint fluid and imaging may also aid in the diagnosis. The treatment is a combination of systemic  antibiotics ,  debridement  of infectious and  necrotic  tissue and local antibiotics applied to the joint space. The bacteria that usually cause prosthetic joint infections commonly form a  biofilm , or a thick slime that is adherent to the artificial joint surface, thus making treatment challenging."}
{"_id": "WikiPedia_Orthopedics$$$corpus_442", "text": "The most common symptom of periprosthetic joint infections is  joint pain . [ 2 ]  Other local symptoms are also present, including  erythema  (redness of the joint),  joint swelling , warmth of the joint, and loosening of the prosthetic joint. [ 2 ]  A  sinus tract , or a tract connecting the joint space to the external environment, is more common in chronic PJI, and is definitively diagnostic of PJI. [ 3 ]  Fever may be present in PJI, but is uncommon. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_443", "text": "Prosthetic joint infections can occur any time after a joint replacement. Early infections (occurring within 4 weeks of a joint replacement) are usually due to Staph aureus,  streptococci  or  enterococci . [ 4 ]  Whereas late infections (occurring 3 months or later after the joint replacement) are usually due to coagulase negative staphylococcus or  cutibacterium . [ 4 ]  The highest risk of PJI is in the immediate post-operative period, when direct inoculation of bacteria into the joint space may occur during surgery. [ 4 ]  The risk of PJI is highest in this early period; within 2 years of the joint replacement. [ 1 ]   Hematogenous spread , or infection of a prosthetic joint via direct seeding from a bloodstream infection, may occur at any time after a joint replacement, with the risk being as high as 34% in staph aureus  bacteremia . [ 4 ]  An additional possible cause of PJI is from direct spread to the joint from a nearby skin or soft tissue infection, a bone infection ( osteomyelitis ), or from more distal spread to the joint from a respiratory tract infection,  gastroenteritis ,or  urinary tract infection . [ 4 ]  Dental procedures may cause a transient bacteremia which can lead to inoculation of the artificial joint and PJI, with  strep viridans  being the most common causative organism. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_444", "text": "The most common causes of PJIs are aerobic, gram positive bacteria, including staph aureus and coagulase negative staphylococcus (such as  staph epidermidis ), which make up greater than 50% of all causes of hip and knee PJIs. [ 3 ]  With regards to acute PJIs, the most common causative organism is staph aureus (comprising 38% of acute infections) followed by aerobic gram negative bacilli (making up 24% of acute infections). [ 3 ]  70% of PJIs are monomicrobial (with a single causative organism identified), whereas 25% of cases are polymicrobial (with multiple causative organisms identified). [ 2 ]  3% of PJIs are due to fungal organisms. [ 2 ]   Propionibacterium acnes  is the most common cause of shoulder PJIs. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_445", "text": "Risk factors for PJI include  diabetes ,  immunosuppression ,  smoking ,  obesity ,  chronic kidney disease , the presence of a soft tissue infection, or an infection in another part of the body or increased fat tissue around the replaced joint. [ 1 ]  Surgical factors that may lead to an increased risk of PJIs include  wound dehiscence  (unplanned opening of the surgical wound after the surgery) and  hematoma  (collection of blood) formation. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_446", "text": "The presence of multiple artificial joints,  MRSA  PJIs,  rheumatoid arthritis  or bacteremia place people at risk for multiple PJIs (either concurrent or subsequent infections). [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_447", "text": "Prolonged operative times, in which the joint is left open to the external environment, determined as greater than 90 minutes in a single study, also increases the risk for PJIs. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_448", "text": "Prosthetic joint infections are generally difficult to treat as most causative organisms form a biofilm, or a thickly adherent membrane, against the artificial joint surface. The bacteria secrete  adhesion proteins  which help them attach to each other and to the joint surface. [ 1 ]  The bacteria then secrete  autoinducer  proteins that act as bacterial signals which facilitate the secretion of an intricate extracellular matrix, the biofilm. [ 1 ]  Biofilms greatly decrease antibiotic penetrance thereby shielding bacteria from the  bacteriocidal  effects of antibiotics. [ 2 ] [ 1 ]  Biofilms usually take 4 weeks to fully mature. [ 4 ]   Granulocytes  have decreased  phagocytic  activity encountering the biofilm, also allowing the bacteria to persist. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_449", "text": "The presence of a PJI is confirmed when one of the proposed major diagnostic criteria are met: [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_450", "text": "Polymerase chain reaction  testing of the joint fluid or sonification fluid may aid in the diagnosis. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_451", "text": "Skin swabs, sinus tract swabs, swabbing of the artificial joint surface during surgery is not recommended due to the high risk of contaminants and low diagnostic yield (including the risk of contaminants rather than the pathologic organism being cultured). [ 4 ] [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_452", "text": "Blood cultures are positive in approximately 25% of cases of PJIs, especially in acute PJI, however, the organism isolated from blood culture does not always correlate to the organisms isolated from the joint fluid, and therefore blood cultures are not diagnostic of PJIs. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_453", "text": "Routine blood work attempting to identify infection including elevated white blood cells on a  complete blood count , elevated inflammatory markers ( erythrocyte sedimentation rate  and  C-reactive protein ) or  procalcitonin  are not sensitive nor specific in diagnosis PJIs. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_454", "text": "Plain radiography  (X-ray) has a low sensitivity and specificity for diagnosing PJI but it may show radiolucent lines around the prosthetic joint, bone breakdown, loosening or migration of the prosthetic joint. [ 2 ] [ 4 ]   Functional imaging  tests such as white blood cell  Scintigraphy  or  PET scan  may help to identify hypermetabolic areas consistent with infection and aid with the diagnosis. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_455", "text": "Magnetic resonance imaging  is specific to soft tissue infections, with metal artifact reduction sequence (MARS) MRIs having great utility to aid in the diagnosis of PJIs. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_456", "text": "Antibiotic treatment alone, without surgical debridement, usually results in treatment failure. [ 2 ]  Acute infections (in which the biofilm is thought to be immature) are usually treated using the DAIR technique;  debridement , systemic and local antibiotics, and implant retention (the implant is not removed). [ 4 ] [ 2 ]  However, the mobile, easily interchangeable components of the implant are often replaced in the DAIR approach. [ 4 ]  DAIR is contraindicated if there is a sinus tract, loosening of the prosthesis, or the surgical wound cannot be closed. [ 2 ]  The microbial cure rate of DAIR is 74%, 49% and 44% in early, sub-acute and late infections respectively. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_457", "text": "Antibiotic loaded  polymethylmethacrylate  (PMMA) which are placed in the joint are helpful, however these non-resorbable beads may themselves be colonized by bacteria with an associated  biofilm , therefore bio-absorbable local antibiotic carriers (calcium sulfate beads, resorbable  gentamicin  sponges) are preferred. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_458", "text": "Chronic PJIs may be treated using 1 stage revisions, where the artificial joint is replaced with a new one during the same surgical procedure, or with a 2-stage revision; in which the infected joint is removed and an antibiotic spacer is placed, this is followed by a second surgery in which a new artificial joint is placed. [ 4 ]  Two step revisions are associated with increased morbidity, longer hospital stays, longer immobilization time, worse functional outcomes and higher costs. [ 4 ]  Therefore, for intact, or mostly intact bone and soft tissue, and without a history of joint replacement revisions; a 1 step exchange is the treatment of choice. [ 4 ]  In the case of hip PJIs both kinds of surgery are equally effective but one-stage surgery results in faster recovery. [ 5 ] [ 6 ] [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_459", "text": "Negative pressure wound therapy  is not recommended as the sponges used are often themselves colonized by the biofilm or by new organisms from the environment (including  multi-drug resistant organisms ). [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_460", "text": "An extended course of antibiotics is required in PJIs, usually 6\u201312 weeks of antibiotic therapy. [ 2 ] [ 4 ]  Intravenous antibiotics are initially used and then transitioned to oral antibiotics. A strategy of surgical debridement to decrease the bacterial load prior to starting systemic antibiotics is sometimes employed. [ 4 ]  Common practice involves switching to oral antibiotics after 14 days. [ 4 ]  Intravenous  ampicillin-sulbactam  or  amoxicillin with clavulanic acid  with  vancomycin  added in cases of MRSA is a commonly employed empiric antibiotic treatment strategy. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_461", "text": "If surgery fails or the PJI persists despite optimal antibiotic therapy, resection arthroplasty of the hip with a pseudarthrosis ( Femoral head ostectomy ) is sometimes done. [ 2 ]  Or in cases of knee PJIs failing treatment; an  arthrodesis  (artificial induction of ossification of the knee joint) is done. [ 2 ]  These are considered last line therapies due to significant disability. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_462", "text": "Antibiotic prophylaxis , or giving small doses of antibiotics as a preventative measure, during the perioperative period (usually less than 60 minutes prior to the start of joint replacements)(usually using second generation  cephalosporins ) is believed to reduce the risk of acute PJIs. [ 2 ] [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_463", "text": "Screening for and eradication of MRSA carriage and  chlorhexidine  wipes or soap and water skin cleansing prior to surgery may possibly decrease the risk of PJIs. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_464", "text": "According to the  American Dental Association : in patients with prosthetic joint implants, prophylactic antibiotics prior to routine dental procedures are generally not recommended in the prevention of PJI. However specific circumstances placing patients at higher risk, as determined by the dentist or other physicians, may warrant antibiotic prophylaxis. [ 8 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_465", "text": "The 5-year mortality after hip PJIs is 21%, which is 4 times that of age adjusted controls. [ 2 ]  And the 10 year mortality after hip PJIs was 45%, as compared to 29% in people with non-infected hip replacements. [ 2 ]  25% of people with PJIs have an unplanned re-operation within 1 year of PJI treatment. [ 2 ]  Hospital stays are longer in those with knee and hip PJIs as compared to un-infected knee and hip replacement controls; at 5.3 vs 3 days (knee) and 7.6 vs 3.3 days (hip). [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_466", "text": "PJIs are the most common cause of knee replacement failures, and the third most common cause of hip replacement failures. [ 1 ]  As of 2017, 2.1% of hip and 2.3% of knee replacements will at some time develop a PJI. [ 2 ]  The incidence of PJIs have more than tripled in the last 20 years, with the incidence expected to further increase in the future. This increase is believed to be due to the much greater number of hip and knee arthroplasties being performed presently. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_467", "text": "Shoulder reduction  is the process of returning the shoulder to its normal position following a  shoulder dislocation . Normally, closed reduction, in which the relationship of bone and  joint  is manipulated externally without surgical intervention, is used. A variety of techniques exist, but some are preferred due to fewer  complications  or easier execution. [ 1 ]  In cases where closed reduction is not  successful , open (surgical) reduction may be needed. [ 2 ]   X-rays  are often used to confirm success and absence of associated  fractures . The arm should be kept in a sling or immobilizer for several days, prior to supervised recovery of motion and strength."}
{"_id": "WikiPedia_Orthopedics$$$corpus_468", "text": "Various non-operative reduction techniques are employed. They have certain principles in common, including gentle in-line traction, reduction or abolition of muscle spasm, and gentle external rotation. They all strive to avoid inadvertent injury. Two of them, the Milch and Stimson techniques, have been compared in a randomized trial. [ 3 ]  Pain can be managed during the procedures either by  procedural sedation and analgesia  or by injecting  lidocaine  into the shoulder joint. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_469", "text": "The person's arm is brought against their side. [ 2 ]  The elbow is then bent to 90 degrees and the forearm is slowly and gently externally rotated. [ 2 ]  Any discomfort or spasm interrupts the process until the person is able to relax. Reduction usually takes place by the time full external rotation has been achieved. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_470", "text": "This is an extension of the external rotation technique. The externally rotated arm is gently abducted (brought away from the body into an overhead position) while external rotation is maintained. Gentle in-line traction is applied to the arm while some pressure is applied to the humeral head via the operator's thumb in the armpit to keep the head from moving inferiorly. [ 2 ] [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_471", "text": "In the Stimson technique, also known as prone technique, the person lies on their stomach on a bed or bench and the arm hangs off the side, being allowed to drop toward the ground. A 5\u201310\u00a0kg weight is suspended from the wrist to overcome spasm and to permit reduction by the force of gravity; [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_472", "text": "The person is on their back and gentle upward traction is applied to the extremity coupled with external rotation. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_473", "text": "The  Cunningham technique  was originally published in 2003 and is an anatomically based method of shoulder reduction that utilizes positioning (analgesic position), voluntary scapular retraction, and bicipital massage. [ 7 ]  If performed correctly most patients do not require analgesia for the performance of this technique. Inappropriate use of traction will result in pain for the patient with subsequent spasm and failure to reduce. If the patient is unable to adduct the humerus or unable to cooperate with positioning the technique should not be attempted. The patient may require analgesia or sedation if they are in pain or unable to relax spasming muscles."}
{"_id": "WikiPedia_Orthopedics$$$corpus_474", "text": "FARES stands for fast, reliable, and safe. With the person lying on their back, the operator holds the person's hand on the affected side while the arm is at the side and the elbow is fully extended. The forearm is in neutral position. Next, the operator gently applies longitudinal traction and slowly the arm is abducted. At the same time, continuous vertical oscillating movement at a rate of 2\u20133 \"cycles\" per second is applied throughout the whole reduction process. [ 8 ] [ 9 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_475", "text": "Traction countertraction involves pulling the dislocated arm down and outwards while an assistant pulls the body upwards. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_476", "text": "Kocher's method was described in 1870 and has been incorrectly associated with neuromuscular complications and humeral fractures due to the inappropriate addition of traction by later users. It was designed for subcoracoid dislocations.\n\"This method: Pressing the arm bent at the elbow towards the body, turning outward until resistance is felt, lifting of the outwardly rotated upper arm in the sagittal plane as far as possible, and finally slowly turning it inward.\" [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_477", "text": "A  sling , also known as  arm sling , is a device to limit movement of the shoulder or elbow while it heals. [ 1 ]  A sling can be created from a  triangular bandage . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_478", "text": "This  health -related article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_479", "text": "The  Spurling test  is a medical maneuver used to assess nerve root pain (also known as  radicular pain )."}
{"_id": "WikiPedia_Orthopedics$$$corpus_480", "text": "The patient rotates their head to the affected side and extends their neck, while the examiners applies downward pressure to the top of the patient's head."}
{"_id": "WikiPedia_Orthopedics$$$corpus_481", "text": "A positive  Spurling's sign  is when the pain arising in the neck radiates in the direction of the corresponding  dermatome  ipsilaterally. [ 1 ]  It is a type of cervical compression test."}
{"_id": "WikiPedia_Orthopedics$$$corpus_482", "text": "Patients with a positive Spurling's sign can present with a variety of symptoms, including pain, numbness and weakness. In addition to the clinical history, the neurological examination may show signs suggesting a cervical  radiculopathy ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_483", "text": "The Spurling test is used during a spinal or neck examination to aid in the diagnosis and assessment of cervical radiculopathy. It should be used to assess patients with radicular symptoms. The results of this test can guide a clinician when considering further imaging and necessary steps needed to make a proper diagnosis."}
{"_id": "WikiPedia_Orthopedics$$$corpus_484", "text": "However, caution should be used when assessing patients with acute cervical injuries, critically ill patients, and those with other neoplastic or infectious processes. Cervical instability is also a reason to avoid performing this medical maneuver."}
{"_id": "WikiPedia_Orthopedics$$$corpus_485", "text": "Spurling's test is somewhat specific when used for individuals with an abnormal  electromyogram study  and is a relatively sensitive physical examination maneuver in diagnosing  cervical spondylosis  or acute cervical radiculopathy. It is not a very sensitive test when used for individuals without classic radicular signs suggestive of cervical radiculopathy. [ citation needed ]   In 2011, one study evaluated 257 patients with clinical cervical radiculopathy and correlated  CT scan  findings with clinical exam findings using the Spurling's test. The Spurling's test was 95% sensitive and 94% specific for diagnosing nerve root pathology. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_486", "text": "In another study done in the late 1900s, 255 patients were examined using a Spurling test and afterwards received an electrodiagnostic examination. The study results showed the Spurling test was 30% sensitive, and 93% specific for finding cervical radiculopathy diagnosed by electrodiagnostic examination. The conclusions drawn from this study demonstrate clinical utility of the Spurling test to confirm cervical radiculopathy rather than for screening purposes. Overall, there continues to be limited data on the specificity and sensitivity of the Spurling test. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_487", "text": "The  sulcus sign  is an  orthopedic  evaluation test for  glenohumeral  instability of the shoulder.  With the arm straight and relaxed to the side of the patient, the elbow is grasped and traction is applied in an  inferior  direction.  With excessive inferior translation, a depression occurs just below the  acromion .  The appearance of this sulcus is a positive sign. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_488", "text": "This  medical sign  article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_489", "text": "Tenodesis grasp and release  is an  orthopedic  observation of a passive  hand grasp  and release mechanism, affected by  wrist extension  or  flexion , respectively.   It is caused by the manner of attachment of the finger tendons to the bones and the passive tension created by two-joint muscles used to produce a functional movement or task (tenodesis). [ 1 ]   Moving the wrist in extension or flexion will cause the fingers to curl or grip when the wrist is extended, and to straighten or release when the wrist is flexed. [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_490", "text": "The tenodesis grip and release mechanism is used in occupational therapy, [ 4 ]  physical therapy [ 5 ] [ 4 ]  and rehabilitation of fine motor impairment, typically various levels of spinal paralysis, [ 6 ] [ 7 ]  and in kinesiology and sports mechanics that are concerned with efficient grasp and release mechanics.  Wrist extension is noted for bat grip in baseball. [ 8 ]    Wrist extension is also noted in the form of grip used in most schools of Japanese swordsmanship or  kenjutsu ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_491", "text": "This particular function serves to enhance gripping capabilities for individuals with tetraplegia exhibiting wrist extension against gravity but lacking active finger functionality (C6 Motor Level). The active wrist extension, when initiated, draws the fingers and thumb into a flexed position passively. Acquiring tenodesis function is crucial for enabling task execution, as it allows for the passive holding of objects between the thumb and index finger or within the palm. [ 9 ]  People with tetraplegia devise adaptive approaches to optimize the utility of their hands. Many individuals create alternative techniques to carry out their daily activities. One such strategy involves leveraging the impact of gravity to enhance grasping capabilities. This adjustment is inherent in the tenodesis grasp, where the hand is often opened through wrist flexion assisted by gravity, reflecting a reliance on this natural force. [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_492", "text": "The tenodesis grasp entails extending the wrist (specifically the extensor carpi radialis longus and brevis), leading to two distinct types of grips: a passive whole hand grasp attributed to the shortening of finger flexors and a passive lateral grip resulting from the shortening of the flexor pollicis longus. [ 11 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_493", "text": "There are a number of ways that a patient in a rehabilitation or healthcare setting can optimize their tenodesis Grasp to boost their independence after a spinal cord injury. A physical therapy or occupational therapy professional may guide the patient in the following ways:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_494", "text": "The use of an effective tenodesis grasp after a spinal cord injury can have a substantial impact on the activities of daily living for a patient after suffering a spinal cord injury. The majority of individuals with tetraplegia opt against undergoing surgical reconstruction for hand function, relying instead on the inherent passive properties of their musculoskeletal system to carry out functional tasks. [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_495", "text": "The following  outline  is provided as an overview of and topical guide to trauma and orthopaedics:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_496", "text": "Orthopedic surgery  \u2013 branch of  surgery  concerned with conditions involving the  musculoskeletal system .  Orthopedic surgeons  use both surgical and nonsurgical means to treat  musculoskeletal injuries ,  sports injuries , degenerative diseases, infections,  bone tumours , and  congenital limb deformities .   Trauma surgery  and  traumatology  is a sub-specialty dealing with the operative management of  fractures ,  major trauma  and the multiply-injured patient."}
{"_id": "WikiPedia_Orthopedics$$$corpus_497", "text": "History of trauma and orthopaedics"}
{"_id": "WikiPedia_Orthopedics$$$corpus_498", "text": "Pet orthotics  refers to the use of  orthotics  for  pets .  Orthotics  is an allied health care field concerned with the design, development, fitting, and manufacture of orthoses. Orthoses, sometimes called braces or splints, are devices that support or correct musculoskeletal deformities and/or abnormalities of the body."}
{"_id": "WikiPedia_Orthopedics$$$corpus_499", "text": "Animals that might benefit from the use of an orthosis commonly have an injury to a lower limb or paw, such as a fracture, torn  meniscus , ruptured  Achilles tendon , or injured  cruciate ligament  (ACL or CCL). They may also have an orthopedic condition due to arthritis, spinal cord injury, or a  congenital abnormality . Animals that have used orthoses and  prostheses  (artificial limbs) include dogs, cats, horses, llamas, and an orangutan. Each animal's situation is unique and should be evaluated by a  veterinarian . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_500", "text": "Orthoses can decrease pain and increase stability in an  unstable joint , as well as prevent potential progression or development of a deformity or contracture. An orthosis will prevent, control or even assist the motion of a joint, depending upon how it is made. An orthosis can be made for short-term use during a post-operative healing period, for example, or for long-term chronic use. [ 2 ]  They can provide a good quality of life for an animal that might otherwise have to be euthanized. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_501", "text": "With a few exceptions, orthoses for animals are custom-made from a  cast . They are typically formed from lightweight plastic or carbon fiber material with a comfort liner inside and velcro to hold them in place. They may have solid joints or hinged joints. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_502", "text": "An orthotic differs from a prosthetic in that a prosthetic completely replaces a missing limb or body part, whereas an orthotic is an external device that is meant to help support or protect a limb or body part."}
{"_id": "WikiPedia_Orthopedics$$$corpus_503", "text": "The most common orthotic, especially for dogs, are  booties . They have a wide range of uses for the dog, including traction while getting up or walking on slippery surfaces such as hardwood or tile flooring. They can especially help dogs with hip issues and dogs with neurological conditions who are less aware of their self-movement ( proprioception ). [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_504", "text": "Another form of orthotic is a leg brace that can improve stabilization for issues caused by age, worn-out bones in the foot, or  ectrodactyly . This is the deficiency of one or more central digits of the foot, causing the animal's foot to become deformed. Proper support is necessary or more serious health issues can arise in the future. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_505", "text": "Malpositions should be corrected as early as possible. The sooner the problem is resolved, and the younger the animal, the easier and faster a correction using dog  braces  or other methods is possible since the bones are still remodeled due to the growth. The misaligned teeth are often congenital, i.e., the causes are genetic. They are already visible in the young dog, e.g., excess teeth,  deciduous teeth  that have not failed, or jaw malformations. As with humans, there are also braces or other appliances for orthodontic treatment in dogs. With the help of these methods, teeth in the jaw, for example, can be realigned and thus integrated into the healthy row of teeth. There are different systems of dog braces. [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_506", "text": "When looking at purchasing or constructing an orthotic for a pet, several factors must be taken into consideration to ensure the animal's health and wellness. These include how the orthotic sits on the body, the material being used, and the functionality of the product. The fit is also important for prosthetics for the area of attachment so it is comfortable and does not cause irritation to the skin. Material is also a consideration: if the skin is irritated or damaged, it can have a greater impact on the animal than if it were not wearing the orthotic at all, in some cases. The functionality of the orthotic affects both owner and pet. An orthotic or a prosthetic needs to be monitored regularly. Orthotics need to be removed several times daily to check the condition of the skin. For this reason, it is better if they are easier to take on and off, both in terms of ease and in avoiding irritation to the skin by removing or putting on the orthotic in a cumbersome way. It also helps the pet to stay calm if it is not such a laborious task. For functionality, the product itself and how it will serve the pet are important considerations. An orthotic that interferes with the pet's daily life and  range of motion  is problematic. Even if the pet wears it while standing, it might not function well enough when trying to get up from lying down. The orthotic must also be kept clean, both from dirt from everyday activities and sweat build-up, and if the pet gets dirty. [ 8 ] [ 9 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_507", "text": "Depending on the orthotic, they can be expensive.  3D printing  can be a cost-effective alternative. 3D printing is an additive manufacturing process where filament is layered on top of itself to create a three-dimensional object. This differs from more traditional subtractive manufacturing processes, like drilling, where the material is taken away to form a whole. Free online versions of different orthotics are available to print if a more general model is suitable; they can also be adapted to fit the owner and pet's needs. Libraries may be a source of complimentary or donation-based printing for the public. Custom orthotics can also be designed in  3D modeling  software. [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_508", "text": "Frykman classification  is a system of categorizing  Colles' fractures . In the Frykman classification system there are four types of  fractures . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_509", "text": "Though the Frykman classification system has traditionally been used, there is little value in its use because it does not help direct treatment. The classification is as follows: [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_510", "text": "Gartland & Werley classification  is a system of categorizing  Colles' fractures . In the Gartland & Werley classification system there are three types of  fractures . The classification system is based on  metaphysical comminution , intra-articular extension and displacement, and was first published in 1951. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_511", "text": "The  Gartland classification  is a system of categorizing  supracondylar humerus fractures , clinically useful as it predicts the likelihood of associated neurovascular injury, such as  anterior interosseous nerve   neurapraxia  or  brachial artery  disruption."}
{"_id": "WikiPedia_Orthopedics$$$corpus_512", "text": "The  Gustilo open fracture classification  system is the most commonly used classification system for  open fractures .  It was created by Ram\u00f3n Gustilo and Anderson, and then further expanded by Gustilo, Mendoza, and Williams. [ 1 ] [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_513", "text": "This system uses the amount of energy, the extent of soft-tissue injury and the extent of contamination for determination of fracture severity. Progression from grade 1 to 3C implies a higher degree of energy involved in the injury, higher soft tissue and bone damage and higher potential for complications. It is important to recognize that a Gustilo score of grade 3C implies vascular injury as well as bone and connective-tissue damage. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_514", "text": "There are many discussions regarding the inter-observer reliability of this classification system. Different studies have shown inter-observer reliability of approximately 60% (ranging from 42% to 92%), [ 7 ] [ 8 ]  representing poor-to-moderate agreement of scale grading between health-care professionals. This is due to much of the criteria being at risk of observer errors, and is a known liability of this scaling system. However, this classification is simple and hence easy to use, and is generally able to predict  prognostic  outcomes and guide treatment regimes. Generally, the higher the grading of Gustillo classification, the higher the rate of infection and complications; any Guistilo classification rating should still be interpreted with caution due to observer errors before any definite therapeutic plans are made. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_515", "text": "Although this classification system has a fairly good ability to predict fracture outcomes, it is not perfect. The Gustillo classification does not take into account the viability and death of soft tissues over time which can affect the outcome of the injury. Besides, the number of the underlying medical illnesses of the patient also affects the outcome. Whether the timing of wound debridement, soft tissue coverage, and bone have any benefits on the outcome is also questionable. Besides, different types of bones have different rates of infection because they are covered by different amounts of soft tissues. Gustilo initially does not recommend early wound closure and early fixation for Grade III fractures. However, newer studies have shown that early wound closure and early fixation reduces infection rates, promotes fracture healing and early restoration of function. Therefore, assessment of all open fractures should include the mechanism of injury, the appearance of soft tissues, the likely levels of bacterial contamination and the specific characteristics of the fractures. Accurate assessment of the fracture can only be performed inside an operating theatre. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_516", "text": "For more comprehensive prognosis purposes other classification systems, such as the Sickness Impact Profile (as a health status measure), [ 5 ]  Mangled Extremity Severity Score (MESS) and Limb Salvage Index (LSI) (decision to amputate or salvage a limb), have been devised by Dr  Shanmuganathan Rajasekaran . [ 9 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_517", "text": "In 1976, Gustilo and Anderson refined the early classification system proposed by Veliskasis in 1959. An early study conducted by Gustilo in 1976 showed that primary closures with prophylactic antibiotics of Type I and type II fractures reduced the risk of infection by 84.4%. Meanwhile, early  internal fixation  and primary closure of the wound in Type III fractures have a greater risk of getting  osteomyelitis . However, Type III fractures occur in 60% of all the open fracture cases. Infection of the Type III fractures is observed in 10% to 50% of the time. Therefore, in 1984, Gustilo subclassified Type III fractures into A, B, and C with the aim of guiding the treatment of open fractures, communication and research, and to predict outcomes. Based on the results of the previous studies, Gustilo initially recommended  therapeutic irrigation  and surgical  debridement  for all fractures with primary closure for Type I and II fractures; secondary closure without internal fixation for Type III fractures. However, soon after that, he recommended internal fixation devices for Type III fractures. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_518", "text": "The  Herbert classification  is a system of categorizing  scaphoid fractures . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_519", "text": "After  hip replacement ,  hip prosthesis zones  are regions in the interface between prosthesis material and the surrounding bone. These are used as reference regions when describing for example complications including  hip prosthesis loosening  on  medical imaging . Postoperative controls after hip replacement surgery is routinely done by  projectional radiography  in anteroposterior and lateral views."}
{"_id": "WikiPedia_Orthopedics$$$corpus_520", "text": "The DeLee and Charnley system applies to the acetabular cup on anteroposterior radiographs. It divides the acetabulum into three equally large zones. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_521", "text": "The  Gruen zones  is a system of dividing the interface between the bone and the stem of the hip prosthesis."}
{"_id": "WikiPedia_Orthopedics$$$corpus_522", "text": "The  Ideberg classification  is a system of categorizing  scapula fractures  involving the  glenoid fossa ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_523", "text": "The  Le Fort  (or  LeFort )  fractures  are a pattern of midface fractures originally described by the French surgeon,  Ren\u00e9 Le Fort , in the early 1900s. [ 1 ]  He described three distinct fracture patterns. Although not always applicable to modern-day facial fractures, the Le Fort type fracture classification is still utilized today by medical providers to aid in describing  facial trauma  for communication, documentation, and  surgical planning . [ 2 ]  Several surgical techniques have been established for facial reconstruction following Le Fort fractures, including  maxillomandibular fixation (MMF)  and  open reduction and internal fixation (ORIF) . The main goal of any surgical intervention is to re-establish  occlusion , or the alignment of upper and lower teeth, to ensure the patient is able to eat. [ 2 ]  Complications following Le Fort fractures rely on the anatomical structures affected by the inciding injury."}
{"_id": "WikiPedia_Orthopedics$$$corpus_524", "text": "When discussing the anatomy of the face, it is often divided into thirds. The lower third extends from the chin to approximately the level of the upper teeth. The middle third continues from the teeth to just below the brow line. Finally, the upper third stretches from the brow to the hairline. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_525", "text": "The middle third of the face, or the midface, is the anatomical location in which Le Fort fractures occur. It comprises the  maxillary bone ,  palatine bones ,  zygomas ,  zygomatic processes (of the temporal bone) ,  ethmoid bone ,  vomer ,  nasal concha ,  nasal bones , and  pterygoid processes (of the sphenoid bone) . [ 2 ] [ 3 ] [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_526", "text": "The maxillary bone contains important anatomical structures which are prone to injury during trauma. The  maxillary sinuses  are housed within the maxillary bone, and traumatic injury to these sinuses may cause  sinus infections , and changes in eye placement and movement. [ 4 ]  The  infraorbital nerve  (a terminal branch of  CNV2 ) courses through the maxillary bone and provides sensation to the central face. Additionally, the maxillary bone contains the upper row of teeth (maxillary dentition).  Occlusion , or the alignment of upper and lower teeth, is vital following midface trauma to ensure a patient is able to eat and speak. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_527", "text": "Facial  biomechanics , or the study of forces on the facial bones, plays an important role in midface reconstruction following trauma. Although the biomechanics of the face are not fully understood due to their complex nature, several vertical and horizontal buttresses, or pillars, have been established. These buttresses dissipate the powerful forces the skull endures during biting and chewing. [ 2 ] [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_528", "text": "The Le Fort fractures are a pattern of midface fractures originally described by the French surgeon,  Ren\u00e9 Le Fort , in the early 1900s. [ 1 ]  Le Fort studied the effect of  facial trauma  by dropping cadavers from various heights and recording the different fracture patterns observed. [ 2 ]  Today, with the evolution of high-speed  motor vehicle accidents  and advancements in  medical imaging  and surgical techniques, the low-speed fracture patterns originally described by Le Fort are not always applicable. [ 7 ]  Modern midface fractures typically do not neatly fit into one of the Le Fort classifications and often occur in combination with other  craniofacial trauma . [ 1 ]  Nevertheless, the Le Fort type fracture classification is still used today as a starting point for describing midface fractures for communication, documentation, and treatment planning. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_529", "text": "Traditionally, Le Fort described three types of fractures. All three fractures involve the  nasal septum  and the  pterygoid plates . [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_530", "text": "Every trauma patient presenting to the hospital should first be evaluated according to the  Advanced Trauma Life Support (ATLS) protocol , which follows the ABC's ( airway ,  breathing ,  circulation ) of trauma. This includes ensuring the patient is able to breathe, confirming that the patient is actively  breathing , and identifying and minimizing major bleeding. [ 1 ] [ 2 ] [ 6 ]  Le Fort fractures have the potential to obstruct a patient's  airway  for a variety of reasons, preventing him or her from being able to breathe. [ 1 ] [ 6 ]  Medical providers should be prepared for  emergency airway management  should the patient develop an obstructed airway due to bleeding or swelling. [ 6 ]  Other life-threatening injuries, including those to the  brain ,  spine , or  abdomen , should receive prompt evaluation by the appropriate  medical specialist . [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_531", "text": "After the initial evaluation is complete and the patient is  stable , the patient should be evaluated by a surgeon that specializes in facial trauma, such as a  plastic surgeon , an  otolaryngologist  (ear, nose, and throat surgeon), or an  oral and maxillofacial surgeon  (OMFS). The surgeon will perform a thorough facial exam, paying special attention to any new-onset facial asymmetry or distortion. [ 1 ]  Facial swelling and bruising is very common in Le Fort fractures and can make evaluation of facial changes challenging. [ 6 ]  It can be helpful to have a picture of the patient prior to his or her facial trauma as a comparison."}
{"_id": "WikiPedia_Orthopedics$$$corpus_532", "text": "If the surgeon suspects a Le Fort fracture, they may test for abnormal movement of the  maxillary bone  by planting one hand on the patient's forehead and using the other hand to press on the roof of the patient's mouth. [ 1 ]  Movement in the  maxillary bone  either in isolation or with the nose is suggestive of a Le Fort I or II fracture, respectively. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_533", "text": "The  cranial nerves (CNs)  should be  examined  if the patient is awake and able to participate in the exam process. [ 2 ]  The  CN exam  evaluates facial movement and sensation. Special attention should be made to the  fifth CN (CNV)  as one of its branches (the  infraorbital nerve ) courses through the  maxillary bone . [ 2 ]  If this nerve is injured during trauma, it can result in numbness or tingling around the nose or within the mouth. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_534", "text": "The surgeon will also examine the patient's mouth for bleeding, swelling, cuts, foreign objects, changes in bite, and newly lost teeth. Additionally, an eye exam assessing vision and  pupillary response  may be warranted, especially in Le Fort II and III fractures due to the involvement of the  orbit . [ 2 ]  If there is suspicion that the  skull base has been injured , such as during a Le Fort III fracture, the patient should be examined for clear drainage from the ear or nose which may be caused by a  cerebrospinal fluid (CSF) leak . [ 2 ] [ 6 ]  Abnormal findings during these mouth, eye, ear, or nose exams may require further evaluation."}
{"_id": "WikiPedia_Orthopedics$$$corpus_535", "text": "If it was determined that the patient lost a tooth during the inciting trauma, the tooth's location should be identified as it could have become lodged in the airway,  aspirated into the lungs , or swallowed. [ 1 ]  If there is concern for an  aspirated  tooth, an  x-ray  can confirm the tooth's location. [ 1 ] [ 6 ]  If the eye exam reveals abnormalities in either vision or the  pupillary response , prompt evaluation by a  neurosurgeon  and an  ophthalmologist  should occur. [ 2 ]   Skull base injuries  can result in a  cerebrospinal fluid (CSF) leak , which can present as a clear, metallic-tasting liquid draining from the  nose  or the ear. [ 2 ]  If a CSF leak is suspected, the patient should be evaluated by a  neurosurgeon . [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_536", "text": "Although diagnosis can be suspected by history and physical exam, imaging is required for an accurate diagnosis. A  computed tomography (CT)  of the face and skull is the imaging of choice for diagnosing Le Fort fractures. [ 5 ] [ 7 ]  CT imaging has greatly replaced the use of  plain x-ray  as CTs are significantly more likely to show when a fracture is present compared to an x-ray. [ 7 ]  Additionally, CT imaging is far more useful in visualizing the skeletal injuries in Le Fort fractures than  magnetic resonance imaging (MRI) . [ 7 ]  However, MRIs may be useful if there is extensive  soft tissue injuries . [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_537", "text": "Surgical  treatment of Le Fort fractures is almost always necessary, especially if the fractures are displaced or impact facial functions like eating and speaking. [ 6 ]  Fractures can be repaired through  maxillomandibular fixation (MMF)  and/or  open reduction and internal fixation (ORIF)  after life-threatening injuries have been addressed."}
{"_id": "WikiPedia_Orthopedics$$$corpus_538", "text": "The primary goal of any intervention is to ensure that a patient is able to eat and speak. This is done by re-establishing  occlusion  (alignment of upper and lower teeth) and stabilizing  facial biomechanics  (via the vertical and horizontal facial buttresses discussed previously) to support chewing. [ 1 ]  Other goals of intervention include restoring cosmetic deformities from the trauma, but this should never be prioritized over re-establishing occlusion. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_539", "text": "Maxillomandibular fixation (MMF) , also known as intermaxiallary fixation (IMF), is a surgical procedure to re-establish  occlusion  by fixating the upper and lower teeth in their correct position. It can be used in isolation or in combination with  open reduction and internal fixation (ORIF)  in treating Le Fort fractures. [ 6 ]  Several surgical techniques exist for establishing MMF, with selection relying on the individual patient injury and surgeon preference. [ 1 ] [ 2 ]  MMF involves fixation of the upper and lower teeth for 6-8 weeks, which limits a patient's ability to speak, eat, breathe through their mouth, and maintain adequate  oral hygiene . [ 1 ]  MMF patients should be provided with wire cutters or scissors for emergency situations. [ 1 ]  A patient in MMF will be placed on a liquid-only diet during the entirety of their treatment, which may result in weight changes. [ 1 ] [ 8 ]  MMF has some effect on a patient's ability to breathe through their mouth while in place, so patients with a history of  pulmonary disease  who rely on mouth breathing may not qualify for MMF. [ 8 ]   Additionally, patients with psychological or seizure disorders may not be good MMF candidates. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_540", "text": "Open reduction and internal fixation (ORIF)  is a surgical term that refers to open surgical repair of broken bones. It is required for correction of complex Le Fort fractures affecting facial function or involving neurological complications (visual changes,  CSF leak ). [ 6 ]  ORIF is especially important for repairing unstable facial buttresses in order to allow the patient to tolerate chewing. Plates and screws are often permanently fixated to facial bones to stabilize the lateral and medial vertical buttresses bilaterally. [ 2 ]  Bone grafts may also be required to stabilize the buttresses. [ 2 ]  ORIF can be used in isolation or in combination with  maxillomandibular fixation (MMF)  in treating Le Fort fractures. [ 6 ]  Following surgery, patients may require up to six weeks of rest before they are able to return to the demands of their daily life. [ 6 ]  As all patients heal slightly differently, ORIF may result in a less-than-ideal correction of facial bones, resulting in poor  occlusion  or facial asymmetries. Furthermore, as with any surgery, ORIF comes with risk of scarring, nerve injury, and infection. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_541", "text": "The role of  antibiotics  in midface trauma is a complex and highly patient-dependent topic. Facial trauma patients with  lacerations  (or wounds) to the inner lining ( mucosa ) of the  mouth  or the  nose  traditionally have been started on antibiotics as soon as they enter the hospital and have remained on antibiotics for a minimum of 24 hours after surgery. [ 2 ]  However, some preliminary studies on  preoperative  antibiotic use suggest that they may not be necessary to prevent  bacterial infections , though these are based on small patient populations and are not strong enough studies to set specific recommendations regarding preoperative antibiotic use. [ 9 ]  Therefore, patients are still often placed on antibiotics before surgery, especially if they are at an increased risk of developing infection (including, but not limited to, patients that are elderly,  tobacco users ,  diabetic , and/or  immunocompromised ). [ 9 ] [ 10 ]  If a patient is begun on antibiotics, it is difficult to determine how long they should remain on antibiotics  postoperatively . [ 10 ]  Although multiple studies have been performed examining postoperative antibiotic use, they have come to contradicting conclusions. [ 11 ]  The more recent studies have suggested that antibiotics may not have any advantage in preventing postoperative bacterial infections. [ 10 ] [ 11 ]  However, these studies acknowledge that their results are based predominantly on the young, healthy, male patients with non-specific  facial trauma  that make up the majority of the studies' participants and may not be applicable to the everyone experiencing midface trauma. [ 10 ]  With limited studies specifically on midface trauma, no standards for postoperative antibiotic use has been determined. The use of postoperative antibiotics relies on the surgeon's clinical recommendations and individual patient risk factors. [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_542", "text": "Longterm outcomes of Le Fort fractures depend on the severity and location of the fracture. The most common complication of Le Fort fractures include imperfect fracture reduction resulting in poor  dental occlusion . [ 2 ]  Other longterm effects of Le Fort fractures include various nerve injuries, either from the inciting injury or from surgical correction, resulting in facial movement and sensory deficits. [ 2 ]  If one or both of the  maxillary sinuses  are injured during the trauma, it can result in  chronic sinus infections  or injuries to the eye which may require further surgical correction. [ 2 ]  Le Fort III fractures that injure the  optic nerve  or the  extraocular muscles  that move the eye may result in visual defects. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_543", "text": "Lidstr\u00f6m classification  is a system of categorizing  fractures of the distal radius , one of the two bones of the  forearm . In the Lidstr\u00f6m classification system there are six types of  fractures . The classification system is based on fracture line, direction and degree of displacement, extent of articular involvement and involvement of the  distal radioulnar joint , and was first published in 1959. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_544", "text": "The  Mayfield classification  is a system of categorizing perilunate dislocations."}
{"_id": "WikiPedia_Orthopedics$$$corpus_545", "text": "The  Milch classification  is a system of categorizing single column ( AO  type B) distal  humerus fractures  based on the pattern of  epicondyle  involvement.  It is distinct from the  Jupiter classification  which is used for bicolumnar distal humerus fractures."}
{"_id": "WikiPedia_Orthopedics$$$corpus_546", "text": "The  M\u00fcller AO Classification of fractures  is a system for classifying bone fractures initially published in 1987 [ 1 ]  by the  AO Foundation  as a method of categorizing injuries according to therognosis of the patient's anatomical and functional outcome. \"AO\" is an initialism for the German \"Arbeitsgemeinschaft f\u00fcr Osteosynthesefragen\", the predecessor of the AO Foundation."}
{"_id": "WikiPedia_Orthopedics$$$corpus_547", "text": "It is one of the few complete fracture classification systems to remain in use today after validation. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_548", "text": "The English language version of the system [ 3 ]  allows consistent in detail description of a fracture in defined terminology by creating a 5-element alphanumeric code:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_549", "text": "First, each fracture is given 2 numbers to describe which bone it affects, and where in the bone:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_550", "text": "Each fracture is next given a letter (A, B or C) to describe the joint involvement of the fracture:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_551", "text": "The exceptions to this step include:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_552", "text": "Finally, the fracture is given 2 further numbers to denote the fracture pattern and geometry."}
{"_id": "WikiPedia_Orthopedics$$$corpus_553", "text": "For segment 2 (diaphyseal) fractures:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_554", "text": "For segment 1 and 3 (epiphyseal and metaphyseal) fractures:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_555", "text": "Subgroups are then used to describe the fractures in terms of displacement (versus apposition, which is the degree to which the parts are in contact with each other), rotation, angulation and shortening."}
{"_id": "WikiPedia_Orthopedics$$$corpus_556", "text": "A pediatric version of the long-bone classification was published in 2006 [ 4 ]  to further classify fractures of immature bone and so the effects on future growth:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_557", "text": "The Orthopaedic Trauma Association Committee for Coding and Classification initially published their classification system covering the whole skeleton in 1996. [ 5 ]   In 2006 [ 6 ]  they published a revision, unifying the Muller/AO and OTA systems into a single alphanumeric classification, which has been further updated in 2018: [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_558", "text": "Nissen-Lie classification  is a system of categorizing  Colles' fractures . In the Nissen-Lie classification system there are seven types of  fractures . The classification system was first published in 1939."}
{"_id": "WikiPedia_Orthopedics$$$corpus_559", "text": "Older's classification  is a system of categorizing  Colles' fractures , proposed in 1965. [ 1 ]  In the Older's classification system there are four types of  fractures . [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_560", "text": "A  Salter\u2013Harris fracture  is a fracture that involves the  epiphyseal plate  (growth plate) of a bone, specifically the zone of provisional  calcification . [ 2 ]  It is thus a form of  child bone fracture . It is a common injury found in children, occurring in 15% of childhood long bone fractures. [ 3 ]  This type of fracture and its classification system is named for  Robert B. Salter  and  William H. Harris  who created and published this classification system in the  Journal of Bone and Joint Surgery  in 1963. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_561", "text": "There are nine types of Salter\u2013Harris fractures; types I to V as described by Robert B. Salter and William H. Harris in 1963, [ 3 ]  and the rarer types VI to IX which have been added subsequently: [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_562", "text": "The mnemonic \"SALTER\" can be used to help remember the first five types. [ 14 ] > [ 15 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_563", "text": "N.B. : This mnemonic requires the reader to imagine the bones as long bones, with the epiphyses at the base."}
{"_id": "WikiPedia_Orthopedics$$$corpus_564", "text": "Alternatively, SALTER can be used for the first 6 types, as above but adding Type V \u2014 'E' for 'Everything' or 'Epiphysis' and Type VI \u2014 'R' for 'Ring'."}
{"_id": "WikiPedia_Orthopedics$$$corpus_565", "text": "Fractures in children generally heal relatively fast but may take several weeks to heal. [ 1 ]  Most growth plate fractures heal without any lasting effects. [ 1 ]  Rarely, bridging bone may form across the fracture, causing stunted growth and/or curving. [ 1 ]  In such cases, the bridging bone may need to be surgically removed. [ 1 ]  A growth plate fracture may also stimulate growth, causing a longer bone than the corresponding bone on the other side. [ 1 ]  Therefore, the  American Academy of Orthopaedic Surgeons  recommends regular follow-up for at least a year after a growth plate fracture. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_566", "text": "In  orthopedic medicine , the  Sanders classification  is a system of categorizing intra-articular  calcaneal fractures  based on the number of articular fragments seen on the  coronal   CT  image at the widest point of the posterior facet."}
{"_id": "WikiPedia_Orthopedics$$$corpus_567", "text": "The  Schenck classification  is a system of categorizing  knee   dislocations  based on the pattern of multiligamentous  injury .  It is limited clinically by not describing the risk of neurovascular involvement."}
{"_id": "WikiPedia_Orthopedics$$$corpus_568", "text": "Teisen classification  is a system of categorizing  fractures  of the  lunate bone , which is located in the hand. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_569", "text": "The  Tscherne classification  is a system of categorization of  soft tissue   injuries . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_570", "text": "The intraobserver (observations at two different times by the same person) agreement for Tscherne classification is 85%; while for inter-observer agreement is 65%. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_571", "text": "This classification system was developed by Harald Tscherne and Hans-J\u00f6rg Oestern in 1982 at the Hannover Medical School (Hanover, Germany) to classify both open and closed fractures. This classification system is based on the physiological concept that the higher the kinetic energy imparted on the bone, the higher the kinetic energy imparted on the soft tissue. It also serves as a tool to guide management and to predict clinical outcomes. It also serves as a communication tool in research and in clinical presentations. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_572", "text": "The  Vancouver classification  is a grading system used in  orthopaedics  to determine management of post-operative  periprosthetic   femoral   fractures  following a  hip arthroplasty .  It is named for the city  Vancouver , home to the  University of British Columbia  where the authors of the 1995 paper worked."}
{"_id": "WikiPedia_Orthopedics$$$corpus_573", "text": "The  Wassel classification  is used to categorise radial  polydactyly , based upon the most  proximal  level of skeletal duplication. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_574", "text": "The  Winquist and Hansen classification  is a system of categorizing  femoral shaft   fractures  based upon the degree of  comminution . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_575", "text": "Adnan Al-Bursh  ( Arabic :  \u0639\u062f\u0646\u0627\u0646 \u0627\u0644\u0628\u0631\u0634 ,  romanized :\u00a0 \u02bfAdn\u0101n al-Bursh ; 17 September 1974\u00a0\u2013  c.  19 April 2024) [ 1 ]  was a  Palestinian   orthopedic surgeon  and the head of orthopedics at the  Gaza Strip 's largest medical facility,  Al-Shifa Hospital . [ 2 ] [ 3 ]  He died after having been reportedly tortured in Israeli prison after four months of detention during the  Israel\u2013Hamas war . [ 4 ] [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_576", "text": "During the  Israeli invasion of Gaza , Al-Bursh was arrested by the Israeli military and held at Israel's  Ofer Prison  in the  Israeli-occupied   West Bank . Palestinian authorities and advocacy groups have attributed his death to  torture and mistreatment  in custody, with the  OHCHR  confirming his body showed signs of torture. [ 6 ]  His death has been highlighted as part of the \"systematic targeting process against physicians and the health care system in Gaza\" by Israel. [ 5 ] [ 2 ] [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_577", "text": "Adnan Al-Bursh was born in 1974 in  Jabalia , the  Israeli-occupied   Gaza Strip , and received his early education there before traveling to  Romania  to study medicine. [ 7 ] [ 8 ]  In his career, he was a prominent Palestinian  orthopedic surgeon  who served as the head of orthopedics at  Al-Shifa Hospital , Gaza's largest medical facility. [ 2 ] [ 7 ] [ 8 ] [ 9 ]  Al-Bursh was married and had five children. He served as an adviser to the  Palestine national football team . [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_578", "text": "In 2018, a viral photograph showed Al-Bursh in the Al-Shifa operating room covered in blood. [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_579", "text": "Shortly after the outbreak of the  Israel\u2013Hamas war  in October 2023, Al-Bursh started living full-time at Al-Shifa, sleeping in the hospital's staff room at night. [ 10 ]  In November 2023, during the  Israeli invasion of Gaza , Al-Bursh was stranded in the  besieged Al-Shifa Hospital  for 10 days with his nephew. Israeli forces later asked them to move south, but Al-Bursh refused to comply and instead moved north to assist at the  Indonesia Hospital . Al-Bursh's wife and six children [ clarification needed ]  also refused to move south and sought refuge at one UNRWA school in the northern area of the strip. [ 11 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_580", "text": "On 20 November, Al-Bursh was injured when he was at work in the operating room of the Indonesian Hospital when the hospital was surrounded by Israeli tanks. Projectiles fired on the building killed at least 12 people and destroyed the hospitals' front entrance. The IDF denied that it was responsible for the attack. Following a truce, he relocated again in early December to  Al-Awda Hospital , also in northern Gaza. [ 10 ] [ 11 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_581", "text": "On 5 December 2023, the IDF surrounded  Al-Awda Hospital  in North Gaza where Al-Bursh was temporarily working. The hospital director told him that staff would have to leave the building. According to a doctor who worked with him there, the IDF would destroy the hospital if all the male workers did not exit. [ 10 ]  Israeli forces arrested the 50-year-old doctor alongside 10 other workers. [ 3 ] [ 2 ] [ 9 ] [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_582", "text": "According to Israeli security sources, Al-Bursh was detained for national-security reasons;  IDF  sources reported that he was suspected of terrorism. [ 12 ] [ 13 ]  According to Naji Abbas, Physicians for Human Rights Israel's prisoners' department director, medical professionals have been mass arrested and interrogated to 'fish' for information even if they are not suspected of participating in the militant activity. [ 14 ]  An IDF statement to  Sky News  confirmed that Al-Bursh was taken to  Sde Teiman detention camp , which had been processing Palestinian prisoners since the start of the war and is the subject of multiple allegations of prisoner abuse. According to Dr. Khalid Hamoudeh, a former prisoner at Sde Teiman who was used as an assistant by the guards and had been ordered to receive Al-Bursh at the camp's gates, he was heavily beaten, unable to use the toilet without help, and believed that he had broken ribs. [ 10 ]  Hamoudeh also noted that he had breathing difficulties. [ 15 ] [ 16 ] [ 17 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_583", "text": "According to the IDF, Al-Bursh's processing at Sde Teiman was completed on 20 December, after which he was transferred to the  Israel Prison Service  (IPS). In April 2024, Al-Bursh was transferred to  Ofer Prison  near Jerusalem, where he died shortly after arrival. [ 10 ]  On 19 April 2024, the IPS confirmed Al-Bursh's death in custody at Ofer Prison, without disclosing the cause of his death. [ 5 ] [ 3 ] [ 9 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_584", "text": "Palestinian authorities and advocacy groups have attributed his death to torture or mistreatment in custody. [ 4 ] [ 15 ] [ 16 ] [ 17 ]  Released prisoners told Al-Bursh's family that he was being subjected to torture, [ 11 ]  and a UN statement on his death confirmed his body showed signs of torture. [ 6 ]  According to a  deposition  provided to  HaMoked , an Israeli human rights organization, by a prisoner who knew Al-Bursh, he was injured upon his arrival at Ofer in mid-April and was \"naked in the lower part of his body\". The deposition said that guards threw him down in the yard and left him there, unable to stand up, and that he died shortly after being helped to a room by prisoners. [ 10 ]  The IPS denied these events. [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_585", "text": "Al-Bursh's body was kept in Israeli custody, and the fate of the other detained medical workers remains uncertain. [ 4 ]  In May 2024, the family of Al-Bursh had a lawyer from  The Hague  look into his death and help facilitate the return of his body. [ 11 ]  On 15 May, Al-Bursh's wife and  Physicians for Human Rights\u2013Israel  submitted a request for an investigation and autopsy to the Jerusalem  Magistrate Court . [ 18 ]  Days later, Israel agreed to perform an autopsy, with a doctor representing the family present. [ 19 ]  As of June, [ needs update ]  Israel had not released Al-Bursh's body to his family. [ 16 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_586", "text": "The Prisoners' Affairs Authority and the  Palestinian Prisoners Club  labelled Al-Bursh's death an \"assassination\" and a part of the \"systematic targeting process against physicians and the health care system in Gaza\". [ 5 ] [ 2 ] [ 4 ] [ 11 ]  The  Palestinian Ministry of Health  wanted the investigation done immediately. [ 11 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_587", "text": "Francesca Albanese ,  UN Special Rapporteur  for human rights in the  occupied Palestinian territories , expressed her extreme alarm at the news of Al-Bursh's death and called for better protections for Palestinians. [ 11 ]  After additional details about his death were reported in November 2024, [ 10 ]  Albanese tweeted: \"A doctor. A stellar surgeon. The embodiment of Palestinian ethics. Likely raped to death.\" [ 20 ] [ 21 ] [ 22 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_588", "text": "Tlaleng Mofokeng , UN Special Rapporteur on the Right to Health, described herself as \"horrified\" by his death, lamenting that Al-Bursh \"died for trying to protect the rights to life and health of his patients\". She called for an international investigation on the matter. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_589", "text": "His death was highlighted as an example of the ongoing challenges and risks faced by healthcare workers in Gaza, with  hundreds killed , injured or arrested. [ 2 ] [ 4 ]  The Ministry of Health stated that 492 Palestinian doctors had been killed by Israel in the conflict. [ 11 ]  The international community and human rights organizations have repeatedly called for an end to attacks on medical personnel and the protection of Palestinians under Israeli occupation. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_590", "text": "Al-Bursh's nephew, Mohammad Al-Bursh, described him as a \"cheerful\" and \"loved\" figure who dedicated his life to his profession, often working nonstop during the height of the conflict in Gaza. [ 3 ]  Colleagues praised him as a \"rare individual\" and the \"safety valve\" for orthopedic departments across Gaza's hospitals, often working tirelessly even during the height of conflicts in the region. [ 2 ] [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_591", "text": "RCSI ,  Royal College of Surgeons in Ireland , 2011"}
{"_id": "WikiPedia_Orthopedics$$$corpus_592", "text": "Chichi Menakaya  (Chinyelu Uchechukwu Anne-Menakaya) is a  Nigerian  Trauma and  Orthopedic Surgeon  based in the  United Kingdom . She is the founder of Annomo Health concierge service, [ 1 ] [ 2 ]  which brings together doctors and hospitals to the awareness of patients. [ 1 ] [ 3 ] [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_593", "text": "Menakaya has held honorary lectures at Hull and York Medical Schools in  Yorkshire , United kingdom and works as a surgical medical student tutor for the  University College of London . [ 5 ] [ 3 ]  She is also the Founder of Okwu\u00eds_Frocentric, a fashion line with African ideas. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_594", "text": "She was born on June 4, 1980 to Dr.  Tim Menakaya  (Nigeria's former Minister of Health) and Chief Magistrate Ann Menakaya in Nigeria. She hails from  Umunya  in  Anambra State  of Nigeria. [ 3 ] [ 7 ]  \u00a0She attended the  University of Ibadan  from 1999 to 2006. While there, she served as Director of Finance, Federation of African Medical and Dental Students, and later earned a bachelor's degree in Medicine and Surgery. She then proceeded to the  Imperial College, London  in 2009 and earned a master's degree in Surgical Technology with supplementary module in Medico-legal Diploma from that college in 2011. She attended the Royal College of Surgeons in Ireland (RCSI) in 2011 and she is a member of the  Royal College of Surgeons of England  (MRCS RCSEng). [ 3 ] [ 8 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_595", "text": "Menakaya founded Annomo in 2013. [ 3 ] [ 4 ] [ 9 ]  In 2020, the group donated boxes of masks to rural areas and hospitals in Nigeria. [ 10 ]  Menakaya served as the development director (Europe) for RISE Global Health Initiative from July 2014 to September 2017. She served as clinical Research Fellow for Hull and East Yorkshire Hospitals from August 2011 to August 2013. She was orthopaedic trauma travelling and research fellow for  Harvard medical school  and  Massachusetts General Hospital  from 2013 to 2016. In 2023, she became a  National Health Service  (NHS) Clinical Entrepreneur Fellow. [ 3 ] [ 8 ]  Menakaya, through a non-profit organization, Okwu\u00ed Mask Scheme, based in the United Kingdom and Nigeria, empowers victims of domestic violence. [ 11 ] [ 12 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_596", "text": "Menakaya served as lce Hockey Doctor for the  Hull Stingrays  lce Hockey Club from September 2009 to August 2013. She is Foundation Board Member,  Chelsea and Westminster Hospital  NHS Foundation Trust from June 2007 to Present. Menakaya was Mail Room and Campaign Volunteer, Society for Protection of Unborn Children from July 2006 to August 2007 and Director, CareConnect Incorporated from September 2015 to Present. She was Academic Honorary Clinical Tutor for  Hull York Medical School  (HYMS) from August 2011 to August 2013. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_597", "text": "Menakaya was awarded the Marcela Uribe Zamudio Award for Women Researchers (Issued by SICOT.  Soci\u00e9t\u00e9 Internationale de Chirurgie Orthop\u00e9dique et de Traumatologie ) Nov 2014; [ 13 ]  Travelling Fellow and Research Collaborator (Issued by  Harvard  Orthopedics Combined Residency Program) Sep 2013.; [ 3 ]  and, Year of the African Child Essay Award for  Eastern Nigeria  (Issued by  UNICEF ) \u00a0Jun 1997. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_598", "text": "Menakaya is cousin to  Lorenzo Menakaya . The name of her company, Annomo, is taken from the names of her mother, \u201cAnn Okwuchukwu Menakaya Orakwue.\u201d  [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_599", "text": "Dr.  Raul Geller  (\u05e8\u05d0\u05d5\u05dc \u05d2\u05dc\u05e8; born 23 January 1936) [ 1 ]  is a Peruvian-Israeli former professional  footballer , who played as a  forward , and an orthopaedic surgeon. [ 2 ]  In Peru he played for  Deportivo Municipal ,  Porvenir Miraflores , and the  Peru national football team . In Israel, he is the third -leading scorer of all time of  Beitar Jerusalem . His 0.64 goals per game ranks first. He also competed in soccer in the  1969 Maccabiah Games . In 2013, Geller was ranked #161 in the world in 75+ tennis by the  International Tennis Federation ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_600", "text": "Geller was born in  Quillabamba , Peru. [ 1 ]  His father Marcus (Mordechai) played football in Poland, and fled it before  the Holocaust  to Peru. [ 3 ]  Geller as a child was a member of the youth movements  Beitar  and  HaNoar HaTzioni . [ 3 ]  When he was 13, he and his family moved to  Lima, Peru . [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_601", "text": "Geller was a  midfielder  in football. [ 1 ]   Geller played football in Peru for  Deportivo Municipal  (1956\u201359),  Porvenir Miraflores  (1960\u201364), and the  Peru national football team  (1964) at the 1964  Copa Am\u00e9rica . [ 4 ] [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_602", "text": "He emigrated to Israel in January 1965. [ 3 ] [ 7 ]  Geller played football in Israel for  Beitar Jerusalem  (1965\u201370; scoring 41 goals in 1966\u201367 and helping the club gain promotion to the Israeli top division). [ 8 ] [ 1 ] [ 4 ] [ 5 ] [ 6 ]  In 1971 he returned to the club for half a season. [ 3 ]  He is the third -leading scorer of all time of Beitar Jerusalem. [ 9 ] [ 5 ]  His 0.64 goals per game ranks first. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_603", "text": "Geller competed in the  1969 Maccabiah Games . [ 8 ]  He played  football at the 1969 Maccabiah Games  for Peru, which came in 8th. [ 8 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_604", "text": "Geller also worked as an  orthopaedic surgeon  at  Hadassah Ein Kerem , specialising in sports injuries. [ 3 ] [ 5 ] [ 10 ] [ 9 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_605", "text": "In 2013, Geller was ranked #161 in the world in 75+ tennis by the  International Tennis Federation . [ 11 ] [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_606", "text": "This biographical article related to Peruvian association football is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_607", "text": "Yip Wing-Yuk  is a  Hong Kong   orthopedic surgeon . She is  International Powerlifting Federation  level 1 referee and  International Weightlifting Federation  referee. [ 1 ]  Former president of The Hong Kong, China Weightlifting and Powerlifting Association. [ 2 ]  She is also a clinical associate professor in the Department of Orthopaedics and Traumatology at the School of Clinical Medicine,  The University of Hong Kong . She has studied the Bachelor of Medicine and Bachelor of Surgery (MBBS) and the Master of Surgery (MS) at the University of Hong Kong, and the Diploma in Hand Surgery from the Federation of European Societies for Surgery of the Hand (FESSH). She is a Fellow of the Royal College of Surgeons of Edinburgh, a Fellow of the Hong Kong College of Orthopaedic Surgeons, and a Fellow of the Hong Kong Academy of Medicine (Orthopaedic Surgery). [ 3 ] \u3002"}
{"_id": "WikiPedia_Orthopedics$$$corpus_608", "text": "In March 2024, during her speech at the \"Hong Kong Weightlifting Invitation 2024\", Ip Wing-yuk described Hong Kong as a \"relatively small country\", which caused dissatisfaction from the Hong Kong government and  Sports Federation & Olympic Committee of Hong Kong, China  (SF&OC). Later, the SF&OC acknowledged that it was a slip of the tongue and decided not to pursue the matter further. [ 4 ] [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_609", "text": "In May 2024, during the opening ceremony speech of the \"Asian Equipped Powerlifting Championships cum Asian University Cup\", Ip Wing-yuk mistakenly stated that \"13 countries are participating in the competition\". Since  Taiwan  and Hong Kong were participating in the competition, the  Hong Kong Special Administrative Region (HKSAR) Government  criticized her statement for potentially violating the  One-China principle . [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_610", "text": "Yaser Jabbar  is a consultant orthopaedic surgeon. After graduating from  St. George's medical school at the University of London  in 2004, his surgical training and surgical practice has been predominately based in the United Kingdom. As of January 2024, Jabbar no longer has a license to practice in the UK, and has been subject to allegations of surgical malpractice with multiple past and ongoing investigations into his surgical practice and professional conduct. As of September 2024, Jabbar is believed to be working in Dubai in the United Arab Emirates. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_611", "text": "Jabbar gained his primary medical qualification from  St. George's University of London  in 2004. He received provisional registration with the  General Medical Council  (GMC) in July 2004, extended to full registration in August 2005, allowing him to practice medicine in the United Kingdom. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_612", "text": "Jabber trained in orthopaedic surgery at hospitals in  Oxford  and London, with further training at the  University of Cardiff  where he completed an MSc in Orthopaedic Engineering, before working for a year at the  Royal Children's Hospital  in  Melbourne  and  The Children's Hospital  at  Westmead ,  Sydney . [ 3 ]  On returning to the UK, Jabbar worked at the  Chelsea and Westminster Hospital NHS Foundation Trust  and in December 2014, Jabbar received registration on the GMC's Specialist Registrar, as a consultant in trauma and orthopaedic surgery. [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_613", "text": "From 2017 until late 2023, Jabber worked as a consultant paediatric orthopaedic surgeon at the  Great Ormond Street Hospital , whilst also working privately at the  Portland Hospital  in London. [ 2 ] [ 3 ] [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_614", "text": "Whilst working with children at the Great Ormond Street Hospital, the hospital placed Jabbar on 11 months of paid sabbatical leave after staff and parents had raised concerns about his conduct and care. These concerns prompted the hospital to ask  Royal College of Surgeons  to conduct a review into Jabbar's surgical practice at the hospital. [ 3 ]  Jabbar resigned from his post at the hospital in September 2023, one month before the  Royal College of Surgeons  produced a confidential report at a result of their investigations. [ 3 ] [ 1 ]  As of January 2024, Jabbar no longer has a license to practice in the UK, with interim tribunal conditions in place and fitness to practice proceedings against him currently ongoing. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_615", "text": "In February 2024 it was reported that limb lengthening devices were used by Jabbar. The use of such devices between 2017 and 2022 would raise concerns about patient safety, medical ethics, and the standards of care provided by the surgeon. The revelation came about after parents raised concerns. [ 4 ] [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_616", "text": "In September 2024,  The Times  newspaper, having seen a copy of the Royal College of Surgeons' report published details of the investigation's findings. [ 3 ]  The investigation found Jabbar had exhibited \u201cunacceptable and unprofessional behaviour\u201d. His record-keeping was poor and assessments of children before surgery were unacceptable and he carried out operations for which he had not sought proper consent. It also concluded that children were also subjected to surgery that had no clear benefits or justification. Accusations were made that Jabbar would alter clinical records after surgery and dismissed concerns raised about the post-surgical recovery of children. According to the report, \u201cthe review team heard of serious complications \u2026 with staff reportedly seeing more amputations in recent times than they ever had within the service\u201d and that some staff working with Jabbar \u201cwould not wish for their friends and family to be operated on\u201d by him. The report also concluded that Jabbar \"hid his complications and he didn\u2019t learn from them. So they kept happening.\u201d In a review of one child's care, the report concluded surgery by Jabbar was \u201cincorrect and unsuitable\u201d. It said Jabbar \u201cdemonstrated a lack of understanding of the principles of deformity correction surgery, in addition to a lack of insight\u201d. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_617", "text": "It was announced [ by whom? ]  in September 2024 that Great Ormond Street Hospital was launching an urgent review into the 721 children who had been treated by him. Patients treated by Mr Jabbar \u2013 who has not worked at the Trust since October 2022 \u2013 are now to have their medical records independently reviewed to check that the treatment provided was appropriate. As of September 2024, only 39 out of 721 cases had been fully reviewed, but of these 39 cases, 22 children had been harmed, 13 were classified as having suffered \"severe harm\" as a result of Jabbar's surgical practice, with potentially lifelong injuries as a result. One child harmed was only four months of age during surgery. At least one child had to have a leg amputation following Jabbar's surgery, with another child at risk of amputation if the work of other surgeons cannot save the limb. In other cases, children have been left with a disparity in leg length by as much as 20 centimetres (7.9\u00a0in), with children living with chronic pain even years after surgery and other having to be repeatedly operated on due to muscle damage, nerve injuries and permanent deformities after surgery. [ 1 ] [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_618", "text": "Beyond Jabbar's behaviour and care, the Royal College of Surgeons report was highly critical of the working environment at the hospital, with staff and patients feeling their concerns weren't listened to, and the report accusing the hospital of being run like a \"political organisation\". [ 3 ] [ 1 ]  The father of one child said \"we tried to raise our concerns repeatedly through the official complaints procedure, and I copied the clinical director into many emails, but heard nothing back.\" He described the initial investigation as feeling like everything was being \"brushed under the carpet,\" which he found \"very upsetting.\" [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_619", "text": "Jamil bey Lambaranski ( Azerbaijani : C\u0259mil M\u0259\u015f\u0259di Nasir o\u011flu L\u0259nb\u0259ranski; b. 1884, Lambaran,  Shusha Uyezd ,  Elizavetpol Governorate ,  Russian Empire  - d. 1959,  Baku ,  Azerbaijani SSR ) was an Azerbaijani public figure and statesman, a member of the parliament of the Azerbaijan Democratic Republic (1918-1920). He was  Alish Lambaranski 's father. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_620", "text": "Jamil bey Meshedi Nasir oglu Lambaranski was born in 1884 in the village of Lambaran, Shusha district. In 1913, Jamil bey graduated from the medical faculty of Kyiv University. Until 1920, he worked in the Terter hospital, which he himself created. In 1918 he was a participant in the Batumi Conference. On November 20, 1918, the National Council of Azerbaijan adopted the Law on the Formation of the Azerbaijani Parliament. In accordance with the adopted law, Jamil bey Lambaranski was included in the Parliament of the  ADR , was a member of the  Ittihad  faction. [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_621", "text": "After the  Red Army invasion of Azerbaijan , Jamil bey served as head of the medical department of the People's Commissariat of Health of Azerbaijan, head physician of the 1st surgical hospital, head of traumatology departments in oil fields ( Sabunchi ,  Black City ), during the Great Patriotic War - chief surgeon of the garrison hospital and adviser to the evacuation hospitals of the commissariat healthcare. In 1949, Jamil beyLambaranski defended his Ph.D. thesis, headed the Department of Orthopedics and Traumatology of the Azerbaijan Institute for the Improvement of Doctors. In 1957, Jamil bey Lambaranski was awarded the honorary title of Honored Doctor of the Azerbaijan SSR. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_622", "text": "Jamil bey Lambaranski died in 1959 in Baku. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_623", "text": "Hatim Rida Jarrar  ( Arabic :  \u062d\u0627\u062a\u0645 \u0631\u0636\u0627 \u062c\u0631\u0627\u0631 ) is an orthopedic surgeon from  Jenin , in the  West Bank . He was elected as Mayor of the city, until he was arrested by the Israel Forces and spent 3 years in jail. After his release, he resigned from the position and went back to practice in his clinic in Jenin city. [ 2 ] [ 1 ]  He is diagnosed with  diabetes ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_624", "text": "This article about a mayor in  Palestine  is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_625", "text": "Muthana Mithqal Sartawi  is a Kuwaiti  orthopedic surgeon  specialized in  joint replacement  surgery. [ 1 ] [ 2 ] [ 3 ]  He is best known for inventing the  Modified Intervastus Approach  surgical approach used in  total knee replacement surgery. [ 4 ]  He has operated on notable individuals including  Saud bin Fahd Al Saud  and was part of the medical team that performed the knee replacement for  George W. Bush . [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_626", "text": "Sartawi completed his medical degree from  Arabian Gulf University  in 2006, [ 6 ]  and went on to conduct his training at the General Surgery Department at  Farwaniya Hospital  in Kuwait. In 2007, he relocated to Canada after receiving a scholarship to train as a neurosurgery resident for three years in the department of neurosurgery at the  University of Alberta, Canada . In 2013, he completed  residency  at the department of orthopedics at  Dalhousie University  in  Halifax, Canada . [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_627", "text": "In 2014, Sartawi completed a fellowship in joint replacement surgery at  Rush University Medical Center  in  Chicago, Illinois . [ 8 ]  He joined the faculty of surgery at the  University of Illinois  from 2014 to 2019 and has served as director of the Joint Care Center of Excellence at  Presence Hospital  in Illinois. [ 9 ]  He was appointed head of the orthopedic department at Christie Clinic in  Champaign, Illinois . [ 8 ] [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_628", "text": "In 2018, he patented the  Modified Intervastus Approach , a surgical technique in knee replacement surgery where the surrounding ligaments and muscles of the knee are preserved, helping to shorten the recovery period. [ 11 ] [ 12 ] [ 13 ]  This technique was patented by the  United States Patent and Trademark Office . He has received other patents in the field of orthopedics. [ 14 ] [ 15 ]  Sartawi is both American and Canadian  board-certified . [ 16 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_629", "text": "His achievements were recognized by  Emir of Kuwait   Sabah al-Ahmad al-Jaber al-Sabah  who named Sartawi as a source of pride to Kuwait, [ 17 ] [ 18 ] [ 19 ]  and by  Kuwait Youth Sports Authority . [ 20 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_630", "text": "Selected publications by Muthana M. Sartawi include the following:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_631", "text": "The  Abbreviated Injury Scale  ( AIS ) is an anatomical-based coding system created by the  Association for the Advancement of Automotive Medicine  to classify and describe the severity of  injuries . [ 1 ] [ 2 ] [ 3 ]  It represents the threat to life associated with the injury rather than the comprehensive assessment of the severity of the injury. [ 4 ]   AIS is one of the most common anatomic scales for  traumatic  injuries. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_632", "text": "The first version of the scale was published in 1969 [ 6 ]  with major updates in 1976, 1980, 1985, 1990, 1998, 2005, 2008 [ 7 ]  and 2015. [ 8 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_633", "text": "The score describes three aspects of the injury using seven numbers written as 12(34)(56).7 [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_634", "text": "Each number signifies"}
{"_id": "WikiPedia_Orthopedics$$$corpus_635", "text": "Fractures, rupture, laceration, etc."}
{"_id": "WikiPedia_Orthopedics$$$corpus_636", "text": "Abbreviated Injury Score-Code is on a scale of one to six, one being a minor injury and six being maximal (currently untreatable). [ 1 ]  An AIS-Code of 6 is not the arbitrary code for a deceased patient or fatal injury, but the code for injuries specifically assigned an AIS 6 severity. [ 1 ]  An AIS-Code of 9 is used to describe injuries for which not enough information is available for more detailed coding, e.g. crush injury to the  head ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_637", "text": "The AIS scale is a measurement tool for single injuries. A universally accepted injury aggregation function has not yet been proposed, though the  injury severity score  and its derivatives are better aggregators for use in clinical settings. [ 1 ] [ 5 ]  In other settings such as automotive design and occupant protection, MAIS is a useful tool for the comparison of specific injuries and their relative severity and the changes in those frequencies that may result from evolving motor vehicle design. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_638", "text": "The  European Union  defined the MAIS3+ as the maximum abbreviated injury scale (MAIS) with a score of 3 or more. The definition was used to harmonize count of serious injuries or serious  road injury  in different member States (see  Killed or Seriously Injured ). Since 2017 Valletta Council conclusions on road safety, States started collecting those numbers. This need use of hospital data rather than police data. [ 9 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_639", "text": "Patients often have more than one injury. The Maximum Abbreviated Injury Score (MAIS) is the highest AIS score of all injuries of a person. A road casualty with a MAIS score of 3 or more is referred to as MAIS3+"}
{"_id": "WikiPedia_Orthopedics$$$corpus_640", "text": "Those data can be computed in three different ways: [ 9 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_641", "text": "Previously each State had a different definition of a serious injury. [ 11 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_642", "text": "It has been estimated that 110,000 people were seriously injured in traffic collisions on the roads of European Union member States in 2019, based on MAIS3+ definition. [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_643", "text": "The  Harris Hip Score  (HHS) is a common evaluation instrument of the results of various hip disabilities and methods of treatment, especially for the assessment of  hip replacement . [ 1 ]  It was developed by  William H. Harris  in 1969 with 30 patients who had suffered a fracture of the acetabulum or a luxation of the hip. [ 2 ]  The HHS contains 10 questions/ items, which can be divided in 4 categories: pain, function, range of motion and deformity. It scales from 0 to 100 points. Today, in most cases the version of Haddad et al. is used, where the calculation of the result of the category range of motion has been simplified. [ 3 ] [ 4 ]  The HHS differs from other hip scores as it contains objective as well as subjective items. This has been sparked some controversies as results as the range of motion may be biased by the investigator. [ 5 ]  In recent years, (solely subjective) patient reported outcome measurement-tools have been developed such as the  WOMAC -Score or the Forgotten Joint Score (FJS). Another issue with HHS lies in so called ceiling effects, as it does not allow to differentiate between a very good and an excellent result. [ 6 ]  However, the HHS still offers a valid and reproducible tool for the results of hip surgery, [ 7 ]  although comorbidities should be assessed simultaneously, for example with the Charnley-Score. [ 8 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_644", "text": "The  Kapandji score  is a tool useful for assessing the  opposition of the thumb , based on where on their hand the patient is able to touch with the tip of their thumb. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_645", "text": "The  Kocher criteria  are a tool useful in the differentiation of  septic arthritis  from  transient synovitis  in the child with a painful hip. [ 1 ]   They are named for  Mininder S. Kocher , an  orthopaedic surgeon  at  Boston Children's Hospital  and Professor of Orthopaedic Surgery at  Harvard Medical School ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_646", "text": "The original study used retrospective pediatric cases to develop the criteria over multiple years. The score is primarily used in orthopedic cases in which the symptoms experienced in septic arthritis and transient synovitis are similar. [ 2 ]  The criteria can be used on multiple joints \u2014 the hip being the most tested given its frequency of diagnosis and importance to the patient's mobility. The knee and the ankle can also experience these symptoms and the criteria can be applied to symptomatic joints such as these. [ 3 ] [ 4 ]  Septic arthritis is an orthopedic emergency, which, if treatment is delayed, can lead to irreversible joint damage. Septic arthritis occurs more often in childhood than at any other time. [ 4 ] [ 5 ]  Kocher criteria are a useful guide to the diagnosis of septic arthritis in children, especially in the hip, one of the most frequently affected joints. However, the attending physician is requested to put these criteria into clinical context. For example, the attending physician has to use his own clinical judgement and experience to rule out the presence of concurrent acute hematogenous osteomyelitis in cases of proven  septic arthritis . Further, children with septic arthritis - of hip - are highly unlikely to  be able to weight bear freely. Contrastingly, children with  transient synovitis  of the hip can occasionally. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_647", "text": "A point is given for each of the four following criteria:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_648", "text": "Mirels' score  is a tool useful in the management of  bone tumors , by identifying those patients who would benefit from prophylactic  fixation  if they have a high enough risk of  pathological fracture ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_649", "text": "A score of 1 to 3 is given for four criteria and summed together. A score greater than 8 suggests prophylactic internal fixation prior to irradiation."}
{"_id": "WikiPedia_Orthopedics$$$corpus_650", "text": "In  medicine , the  Ottawa ankle rules  are a set of guidelines for clinicians to help decide if a patient with foot or  ankle  pain should be offered  X-rays  to diagnose a possible  bone fracture . Before the introduction of the rules most patients with ankle injuries would have been imaged. However the vast majority of patients with unclear ankle injuries do not have bone fractures. [ 1 ]  As a result, many unnecessary X-rays were taken, which was costly, time-consuming and a slight health risk due to radiation exposure."}
{"_id": "WikiPedia_Orthopedics$$$corpus_651", "text": "Ankle X-ray is only required if:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_652", "text": "Additionally, the Ottawa ankle rules indicate whether a foot X-ray series is required. It states that it is indicated if:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_653", "text": "Certain groups are excluded [ clarification needed ] , in particular  pregnant  women, and those with diminished ability to follow the test (for example due to  head injury  or  intoxication ). Several studies strongly support the use of the Ottawa Ankle Rules in children over 6 (98.5% sensitivity); [ 2 ]  however, their usefulness in younger children has not yet been thoroughly examined."}
{"_id": "WikiPedia_Orthopedics$$$corpus_654", "text": "The rules have been found to have a very high  sensitivity , moderate  specificity , and therefore a very low rate of  false negatives . Evidence supports the rules as an accurate instrument for excluding fractures of the ankle and mid-foot, reducing the number of unnecessary investigations and length of stay in emergency departments. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_655", "text": "The original study reported that the test was 100% sensitive and reduced the number of ankle X-rays by 36%. [ 4 ]  A second trial with a larger number of patients replicated these findings. [ 5 ]   Subsequently, a multi-centre study explored the feasibility of implementing the rules on a wider scale. [ 6 ]  Teaching the rules to patients does not appear to help reduce presentation to hospital. [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_656", "text": "This list of rules was published in 1992 by a team of doctors in the emergency department of the Ottawa Civic Hospital in  Ottawa ,  Canada . [ 4 ]   Since the rules were formulated in Ottawa they were dubbed the  Ottawa ankle rules  by their creators a few years after their development, a title that has stuck. [ 5 ]    In this respect, the naming of the rules is similar to that of the  Bristol stool scale  or the  Glasgow Coma Scale  (GCS), which also take their names from the cities in which they were formulated."}
{"_id": "WikiPedia_Orthopedics$$$corpus_657", "text": "The original rules were developed for ankle and foot injuries only, but similar guidelines have been developed for other injuries such as the  Ottawa knee rules . [ 8 ] [ 9 ] [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_658", "text": "The  Ottawa knee rules  are a set of rules used to help physicians determine whether an x-ray of the  knee  is needed. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_659", "text": "They state that an X-ray is required only in patients who have an acute knee injury with one or more of the following:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_660", "text": "The Ottawa knee rules were derived to aid in the efficient use of radiography in acute knee injuries and have since been prospectively validated on multiple occasions in different populations and in both children and adults. [ 2 ]  Some studies found the  sensitivity  of the Ottawa knee rules is 98-100% for clinically significant knee fractures, meaning that 98-100% of all patients with a fracture will meet the criteria for X-ray. However,  specificity  for the Ottawa knee rules is typically poor, meaning that a significant proportion of those who meet Ottawa knee criteria will have no knee fracture on X-ray. The  Pittsburgh knee rules  have been found to be more specific in diagnosis. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_661", "text": "Clinical decision guidelines such as these not only avoid  unnecessary health care  and its costs but also help minimize exposure to ionizing radiation. Such radiation is necessary for radiography but may raise risk for cancer, so physicians  try to avoid using it whenever practical ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_662", "text": "This  medical  diagnostic article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_663", "text": "The  Pittsburgh knee rules  are medical rules created to ascertain whether a  knee injury  requires the use of an  X-ray  to assess a  fracture ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_664", "text": "Blunt trauma  or a fall as mechanism of injury and either of the following:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_665", "text": "If the patient satisfies the above criteria, they should receive an X-ray to assess for a possible fracture."}
{"_id": "WikiPedia_Orthopedics$$$corpus_666", "text": "The sensitivity of using the Pittsburgh knee rules is 99% with a specificity of 60%. That means the use of the above rules has a  false negative  result of 1% and a  false positive  result of 40%. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_667", "text": "From a medical point of view, the false positive result is less important as if the patient is positive, they should receive an X-ray to assess for a possible fracture, which has a much higher specificity. However, from a practical point of view, false positives that lead to negative X-ray tests were the very thing that the knee rules are trying to address. Nonetheless, the Pittsburgh knee rules offer fewer false positives than do the  Ottawa knee rules , though the Ottawa knee rules are more commonly used. [ 2 ]  The Ottawa knee rules count even a  limping  step as a step. Pittsburgh counts only a complete heel/toe plant as a step. This key difference likely accounts for the difference in specificity."}
{"_id": "WikiPedia_Orthopedics$$$corpus_668", "text": "The use of the Pittsburgh knee rules reduces the use of knee  radiographs  by 52%. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_669", "text": "The  Revised Trauma Score  ( RTS ) is a physiologic scoring system based on the initial  vital signs  of a patient. [ 1 ]  A lower score indicates a higher severity of injury. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_670", "text": "The Revised Trauma Score is made up of three categories:  Glasgow Coma Scale ,  systolic  blood pressure, and respiratory rate. The score range is 0\u201312.  In  START   triage , a patient with an RTS score of 12 is labeled delayed, 11 is urgent, and 3\u201310 is immediate. Those who have an RTS below 3 are declared dead and should not receive certain care because they are highly unlikely to survive without a significant amount of resources. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_671", "text": "The score is as follows: [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_672", "text": "These three scores (Glasgow Coma Scale, Systolic Blood Pressure, Respiratory Rate) are then used to take the weighted sum by RTS = 0.9368 GCSP + 0.7326 SBPP + 0.2908 RRP Values for the RTS are in the range 0 to 7.8408. The RTS is heavily weighted towards the Glasgow Coma Scale to compensate for major head injury without multisystem injury or major physiological changes. A threshold of RTS < 4 has been proposed to identify those patients who should be treated in a trauma centre, although this value may be somewhat low."}
{"_id": "WikiPedia_Orthopedics$$$corpus_673", "text": "This template is used to identify a stub about  orthopedic surgery . It uses {{ asbox }}, which is a meta-template designed to ease the process of creating and maintaining stub templates."}
{"_id": "WikiPedia_Orthopedics$$$corpus_674", "text": "Typing  {{Orthopedics-stub}}  produces the message shown at the beginning, and adds the article to the following category:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_675", "text": "This is a  stub template . A brief explanation of these templates follows; for full details please consult  Wikipedia:Stub ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_676", "text": "A stub is an article containing only a few sentences of text which is too short to provide encyclopedic coverage of a subject."}
{"_id": "WikiPedia_Orthopedics$$$corpus_677", "text": "Further information can be found at:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_678", "text": "New stub templates and categories (collectively \"stub types\") should not be created without prior proposal at  Wikipedia:WikiProject Stub sorting/Proposals . This allows for the proper coordination of all stub types across Wikipedia, and for the checking of any new stub type for possible problems prior to its creation."}
{"_id": "WikiPedia_Orthopedics$$$corpus_679", "text": "Acromioplasty  is an  arthroscopic  surgical procedure involving the  acromion , a bony process of the  shoulder blade ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_680", "text": "Generally, it implies removal of a small piece of the surface of the acromion that is in contact with a tendon of the  rotator cuff  causing, by friction, damage to the tendon."}
{"_id": "WikiPedia_Orthopedics$$$corpus_681", "text": "The procedure has been used to treat  rotator cuff tears  and  impingement syndrome , [ 1 ] [ 2 ]  although its benefits have been debated. [ 3 ] [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_682", "text": "Arthroscopy: The Journal of Arthroscopic and Related Surgery  is a  peer-reviewed   medical journal  that was established in 1985 and covers research on the clinical practice of  arthroscopic  and  minimally invasive surgery , a subspecialty of  orthopedic surgery . It is the official journal of the  Arthroscopy Association of North America . The initiative in establishing the journal was taken by Imran sheikh and the first  editor-in-chief  was S. Ward Casscells, who was succeeded in 1992 by Gary G. Poehling. In 2014 James H. Lubowitz succeeded the retiring Dr. Poehling. [ 1 ] [ 2 ]   Arthroscopy Techniques  is an  open access  online companion journal publishing peer-reviewed techniques videos."}
{"_id": "WikiPedia_Orthopedics$$$corpus_683", "text": "The journal is abstracted and indexed by  MEDLINE ,  Web of Science , and  Scopus ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_684", "text": "Blumensaat's line  is a line which corresponds to the roof of the  intercondylar fossa of femur  as seen on a  lateral   radiograph  of the  knee joint . [ 1 ]  The angle at which this line appears on the radiograph can be used to determine the position of the patella or diagnose an ACL injury. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_685", "text": "On a normal radiograph, the line intersects the  inferior  pole of the  patella , and so can be useful in diagnosing a broken femur as well as a  patellar tendon rupture ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_686", "text": "It also helps to define \"Schottle point\" intra-operatively for reconstruction of MPFL(Medial patello-femoral ligament.) [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_687", "text": "It may also be used to describe the course of an ACL graft."}
{"_id": "WikiPedia_Orthopedics$$$corpus_688", "text": "A  bone cutter  is a  surgical instrument  used to cut or remove  bones . [ 1 ] [ 2 ]  In addition to surgery, they are also used in  forensics  and  dismemberment ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_689", "text": "Types of medical bone cutters include:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_690", "text": "In medicine,  Clarke's test  (also known as the  Osmond-Clarke test  or  patellar grind test ) is a component of  knee examination  which may be used to test for  patellofemoral pain syndrome ,  chondromalacia patellae , patellofemoral  arthritis , or anterior knee pain. It is not a standard part of the knee examination but is used to diagnose anterior knee pain where the history indicates this as the likely pathology. The patient is asked to actively contract the  quadriceps  muscle while the examiner's hand exerts pressure on the  superior  pole of the  patella , so trying to prevent the  proximal  movement of the patella. While it can produce some discomfort even in normal people, the reproduction of the symptoms suggest pain of patellofemoral origin. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_691", "text": "Evidence for the validity of Clarke's test is limited and some sources claim the test is not clinically useful, [ 2 ] [ 3 ]  though it remains prevalent in clinical practice."}
{"_id": "WikiPedia_Orthopedics$$$corpus_692", "text": "The  Codman triangle  (previously referred to as  Codman's triangle ) is the triangular area of new  subperiosteal  bone that is created when a lesion, often a  tumor , raises the  periosteum  away from the bone. [ 1 ]   A Codman triangle is not actually a full triangle.  Instead, it is often a pseudotriangle on  radiographic  findings, with  ossification  on the original bone and one additional side of the triangle, which forms a two sided triangle with one open side.  This two sided appearance is generated due to a tumor (or growth) that is growing at a rate which is faster than the periosteum can grow or expand, so instead of  dimpling , the periosteum tears away and provides ossification on the second edge of the triangle. [ 2 ]  The advancing tumour displaces the periosteum away from the bone medulla. The displaced and now lateral periosteum attempts to regenerate underlying bone. This describes a periosteal reaction. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_693", "text": "The main causes for this sign are  osteosarcoma ,  Ewing's sarcoma ,  eumycetoma , and a  subperiosteal abscess . [ 3 ] [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_694", "text": "Darrach's procedure  or  distal ulna resection  is a surgical technique for the surgical removal of the  head of ulna . It is performed in cases of  radial \u2013 ulnar  joint pain and instability. [ 1 ]  The styloid process and muscular attachments are left intact. [ 2 ]  Weakness and instability can develop after the procedure. It is most appropriate for elderly patients with low physical demands. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_695", "text": "The  Denis Browne bar , also known as the  Denis Browne splint  or  foot abduction orthosis , is a medical device used in the treatment of  club foot . The device is named after  Sir Denis Browne  (1892-1967), an Australian-born surgeon at  Great Ormond Street Hospital  in London who was considered the father of  pediatric surgery  in the United Kingdom. [ 1 ]  Browne first described the device in 1934. [ 2 ]  The bar may be used as part of the  Ponseti method , a series of nonsurgical techniques to address club foot. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_696", "text": "This  pediatrics  article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_697", "text": "This article related to  medical equipment  is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_698", "text": "The  Denis classification  is a system of categorizing  sacral  fractures. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_699", "text": "Dynamic hip screw (DHS)  or  Sliding Screw Fixation  is a type of  orthopaedic  implant designed for fixation of certain types of  hip fractures  which allows controlled dynamic sliding of the  femoral head  component along the construct. [ citation needed ]  It is the most commonly used implant for  extracapsular fractures  of the hip, [ 1 ]  which are common in older  osteoporotic  patients. There are 3 components of a dynamic hip screw, including a lag screw (inserted into the neck of the femur), a sideplate and several cortical screws (fixated into the proximal femoral shaft). The idea behind the dynamic compression is that the femoral head component is allowed to move along one plane; since bone responds to dynamic stresses, the native femur may undergo primary healing: cells join along boundaries, resulting in a robust joint requiring no remodeling."}
{"_id": "WikiPedia_Orthopedics$$$corpus_700", "text": "Elbow fractures  are any broken bone in or near the  elbow joint  and include  olecranon fractures ,  supracondylar humerus fractures  and  radial head fractures . [ 1 ]  The elbow joint is formed by three different bones: the  ulna ,  radius , and  humerus  that permit the joint to move like a hinge and allow a person to straighten and bend their arm and these bones are connected by tendons, ligaments, and muscle to form the joint. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_701", "text": "The  terrible triad of the elbow  (not to be confused with the  terrible triad  of the knee) is a combination of: [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_702", "text": "The  terrible triad of the elbow  is confers joint instability and a major risk of developing  osteoarthritis . [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_703", "text": "The  Evans\u2013Jensen classification  is a system of categorizing  intertrochanteric   hip fractures  based on the  fracture  pattern of the proximal  femur ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_704", "text": "Fairbank's changes  describe the radiological changes observed on an  AP   radiograph  of the  knee  after  meniscectomy . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_705", "text": "Fairbank identified significant changes including squaring of the  femoral condyles , peak eminences, ridging, and  joint space  narrowing. [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_706", "text": "Femoral head fractures  are very rare  fractures  of the upper end ( femoral head ) of the thigh bone ( femur ). They are a very rare kind of  hip fracture  that may be the result of a fall like most hip fractures but are more commonly caused by more violent incidents such as traffic accidents They are categorized according to the Pipkin classification based on the following  bone fracture  patterns: [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_707", "text": "Fixation  in  orthopedics  is the process by which an injury is rendered immobile. [ 1 ]  This may be accomplished by  internal fixation , using  intramedullary rod ,  Kirschner wire  or  dynamic compression plate ; or by  external fixation , using a  spanning external fixator ,  Taylor Spatial Frame  or  Ilizarov apparatus . [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_708", "text": "A  foot deformity  is a disorder of the foot that can be congenital or acquired."}
{"_id": "WikiPedia_Orthopedics$$$corpus_709", "text": "Such deformities can include  hammer toe ,  club foot ,  flat feet ,  pes cavus , etc."}
{"_id": "WikiPedia_Orthopedics$$$corpus_710", "text": "The  Galeazzi test , also known as the Allis sign, is used to assess for  hip dislocation , primarily in order to test for  developmental dysplasia of the hip . It is performed by flexing an  infant's  knees when they are  lying down  so that the feet touch the surface and the  ankles  touch the  buttocks . If the knees are not level then the test is positive, indicating a potential  congenital  hip malformation. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_711", "text": "Gilula's lines  are three arcs drawn on an  AP   radiograph  of the  wrist  used to assess the alignment of the  carpal bones . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_712", "text": "There should be no step-off in the contour of the lines when drawn on a normal wrist."}
{"_id": "WikiPedia_Orthopedics$$$corpus_713", "text": "The  Gosselin fracture  is a V-shaped  fracture  of the  distal   tibia  which extends into the  ankle  joint and fractures the tibial  plafond  into anterior and posterior fragments. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_714", "text": "The fracture was described by  Leon Athanese Gosselin , chief of surgery at the  H\u00f4pital de la Charit\u00e9  in Paris. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_715", "text": "A  hand deformity  is a  disorder  of the hand that can be  congenital  or acquired. An example is  Madelung's deformity ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_716", "text": "The  Hawkins\u2013Kennedy Test  is a test used in the evaluation of orthopedic shoulder injury.  It was first described in the 1980s by Canadians  R. Hawkins  and J. Kennedy, and a positive test is most likely indicative of damage to the  tendon  of the  supraspinatus muscle . [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_717", "text": "A positive Hawkins\u2013Kennedy test is indicative of an impingement of all structures that are located between the  greater tubercle  of the  humerus  and the  coracohumeral ligament . The impinged structures include the  supraspinatus  muscle,  teres minor muscle , and the  infraspinatus muscle . The Hawkins\u2013Kennedy test is considered to be a highly  sensitive  test (79%) [ 3 ]  and thus a positive Hawkins\u2013Kennedy test suggests that injury is likely."}
{"_id": "WikiPedia_Orthopedics$$$corpus_718", "text": "The patient is examined while sitting, with their  shoulder  flexed to 90\u00b0 and their  elbow  flexed to 90\u00b0.  The examiner grasps and supports proximal to both, the patient's  wrist  and elbow, to ensure maximal relaxation, then quickly rotates the patient's arm  internally . [ 4 ] [ 5 ]   Pain located below the  acromioclavicular joint  with  internal rotation  is considered a positive test result. [ 6 ] [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_719", "text": "The  Herbert screw  (invented by  Timothy Herbert ) is a variable pitch  cannulated  screw typically made from  titanium  for its biocompatible properties as the screw is normally intended to remain in the patient indefinitely. It became generally available in 1978. [ 1 ] [ 2 ]  It is one of the earliest designs of headless compression screws which are used to achieve interfragmentary compression through its differential pitch between the threads at each end of the screw (distance between adjacent threads of screw)."}
{"_id": "WikiPedia_Orthopedics$$$corpus_720", "text": "It is used in  scaphoid ,  capitellum ,  radial head  and in osteochondral fractures. Other uses include osteochondritis dissecans & small joint arthrodesis. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_721", "text": "Hilgenreiner's line  is a horizontal line drawn on an  AP   radiograph  of the  pelvis  running between the inferior aspects of both  triradiate cartilages  of the  acetabulums . [ 1 ]   It is named for  Heinrich Hilgenreiner . [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_722", "text": "Used in conjunction with  Perkin's line  or the  acetabular angle , Hilgenreiner's line is useful in the diagnosis of  developmental dysplasia of the hip ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_723", "text": "A  hip spica cast  is a sort of  orthopedic cast  used to immobilize the  hip  or  thigh . It is used to facilitate healing of injured  hip joints  or of  fractured   femora ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_724", "text": "A  hip spica  includes the trunk of the body and one or both legs. A hip spica which covers only one leg to the ankle or foot may be referred to as a single hip spica, while one which covers both legs is called a double hip spica. A one-and-a-half hip spica encases one leg to the ankle or foot and the other to just above the knee. The extent to which the hip spica covers the trunk depends greatly on the injury and the surgeon; the spica may extend only to the navel, allowing mobility of the spine and the possibility of walking with the aid of crutches, or may extend to the rib cage or even to the armpits in some rare cases. Hip spicas were formerly common in reducing femoral fractures. Spica casts are used for treating  hip dysplasia  (developmental dislocation of hip). [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_725", "text": "Spica casts are typically made using a soft padded lining, which tightly wrapped around the leg and hip joint. It is then wrapped in either a fiberglass or plaster cast. Fiberglass is generally preferred, as it is stronger than plaster and significantly lighter. It also dries faster than plaster casts. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_726", "text": "In some cases, a hip spica may only extend down one or more legs to above the knee. Such casts, called pantaloon casts, are occasionally seen to immobilize an injured lumbar spine or pelvis, in which case the trunk portion of the cast usually extends to the armpits. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_727", "text": "Some spica casts also include a cross bar attached the legs near the knee or calf to add additional stability. Spica casts have a large opening in the front and back to allow the wearer to use the toilet. For babies, the opening is large enough to tuck a diaper on the inside, and then an additional diaper is worn over the cast to keep the inside diaper in place. Many casts also include a Gore-Tex lining, which is similar to the texture of a thin raincoat. It provides waterproofing on the inside of the cast and allows the inside to be wiped down with wipes or water as needed. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_728", "text": "A  Hoffa fracture  is an  intra-articular  supracondylar distal  femoral  fracture, characterized by a  fracture  in the  coronal plane . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_729", "text": "It is named for  Albert Hoffa . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_730", "text": "The  Hubscher maneuver  (or  Jack's test ) is a method of evaluating the flexibility of a  pes planus  or  flat foot  type. The test is performed with the patient  weight bearing , with the foot flat on the ground, while the clinician dorsiflexes the  hallux  and watches for an increasing concavity of the Arches of the foot.  A positive result (arch formation) results from the flatfoot being flexible. A negative result (lack of arch formation) results from the flatfoot being rigid. In a Jack's test, the patient raises the rearfoot off the ground, thus passively dorsiflexing the hallux in Closed Kinetic Chain. This will result in an increase of the arch height in cases of Dynamic (Flexible) Flat Foot.  If the deformity is a Static (rigid) Flat foot, the height of the arch will be unaffected by raising up the heel on the forefoot."}
{"_id": "WikiPedia_Orthopedics$$$corpus_731", "text": "It is also one method of diagnosing functional hallux limitus. Recent investigations into its reliability have questioned its ability to predict range of motion at the 1st MTP during Gait."}
{"_id": "WikiPedia_Orthopedics$$$corpus_732", "text": "The  Lauge-Hansen classification  is a system of categorizing  ankle fractures  based on the foot position and the force applied. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_733", "text": "In  orthopedic surgery , the  lunotriquetral shear test  or  lunotriquetral shear maneuver  involves stabilizing the  lunate  between thumb and index finger of one hand and the  triquetrum  between the thumb and index finger of the other. The  pisiform  and triquetrum are pushed in a  palmar  to  dorsal  direction. Discomfort in this area suggests the possibility of injury to the lunotriquetral interosseous ligament. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_734", "text": "A  Malgaigne fracture  is vertical  pelvic fracture  with bilateral  sacroiliac  dislocation and fracture of the  pubic rami ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_735", "text": "It is named for  Joseph-Fran\u00e7ois Malgaigne ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_736", "text": "Mulder's sign  is a physical exam finding associated with  Morton's neuroma , which may be elicited while the patient is in the  supine  position on the examination table.  The pain of the neuroma, as well as a click, can be produced by squeezing the two metatarsal heads together with one hand, while concomitantly putting pressure on the interdigital space with the other hand.  With this technique, the pain of the Morton's neuroma will be localized strictly to the  plantar  surface of the involved interspace, with  paresthesias  radiating into the affected toes."}
{"_id": "WikiPedia_Orthopedics$$$corpus_737", "text": "It is named after the Dutch surgeon and  podiatrist , Jacob D. Mulder (1901\u20131965). [ 1 ] [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_738", "text": "The  Mumford procedure , also known as distal clavicle excision or distal clavicle resection, is an orthopedic procedure performed to ameliorate shoulder pain and discomfort by excising the distal (lateral) end  of the  clavicle . Those suffering from  osteoarthritis  in the  acromioclavicular joint  can opt for this procedure when non-surgical alternatives (e.g.,  cortisone  injection) are unsuccessful. [ 1 ]  The surgery can be performed through an open or  arthroscopic  procedure. A regimen of physical therapy following surgery is prescribed and most patients experience full recovery within 8 to 10 weeks post-surgery. [ 1 ]  The procedure was created by, and named for, orthopedic surgeon  Eugene Bishop Mumford  in 1941. [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_739", "text": "This  surgery  article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_740", "text": "Osteitis  is  inflammation  of  bone . More specifically, it can refer to one of the following conditions:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_741", "text": "Osteochondritis  is a painful type of  osteochondrosis  where the  cartilage  or  bone  in a  joint  is  inflamed . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_742", "text": "It often refers to  osteochondritis dissecans  (OCD). The term  dissecans  refers to the \"creation of a flap of cartilage that further dissects away from its underlying subchondral attachments (dissecans)\". [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_743", "text": "The other recognized types of osteochondritis are  osteochondritis deformans juvenilis  (osteochondritis of the  capitular head  of the  epiphysis  of the  femur ) [ 1 ]  and  osteochondritis deformans juvenilis dorsi  (osteochondrosis of the  spinal vertebrae , also known as Scheuermann's disease). [ 1 ] [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_744", "text": "Osteochondritis, and especially osteochondritis dissecans, can manifest in animals as a primary cause of  elbow dysplasia , a  chronic  condition in some dog breeds. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_745", "text": "In February 2021, the U.S.  Food and Drug Administration  (FDA) approved the  Patient Specific Talus Spacer   3D-printed   talus   implant  for humanitarian use. [ 1 ]  The Patient Specific Talus Spacer is the first in the world and first of its kind implant to replace the talus; the bone in the  ankle joint  that connects the  leg  and the  foot . The implant is used for the treatment of  avascular necrosis  (AVN) of the ankle joint, a serious and progressive condition that causes the death of  bone tissue  stemming from a lack of  blood supply  to the area. [ 1 ]  The implant provides a joint sparing alternative to other surgical interventions commonly used in late stage AVN that may disable motion of the ankle joint. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_746", "text": "The Patient Specific Talus Spacer is a 3D printed implant that can be used in talus replacement surgery. [ 1 ]  The talus spacer is made for each recipient individually modeled from  computed tomography  (CT) imaging and is fitted to a recipient's specific  anatomy . [ 1 ]  During the replacement surgery, the recipient's  talus bone  is removed and replaced with the implant, which is made from  cobalt chromium alloy . [ 1 ]  This procedure\u2019s intention is to improve motion and reduce pain for AVN patients who would otherwise require  ankle arthrodesis  or  amputation  procedures. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_747", "text": "The FDA reviewed data for the Patient Specific Talus Spacer through the  humanitarian device exemption  (HDE) process. [ 1 ]  A  Humanitarian Use Device  (HUD) is a device that is intended to benefit people by treating or diagnosing a disease or condition that affects not more than 8,000 individuals in the U.S. per year. [ 1 ] [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_748", "text": "Data supporting the safety and probable benefit of the Patient Specific Talus Spacer include results from 31 patients and 32 talus replacement surgeries (one patient had operations on both ankles) with the implant. [ 1 ]  At three years post-operation, the average reported pain decreased from \"moderate to severe\" prior to surgery to \"mild\" post-surgery, and average range of motion in the ankle joint also improved. [ 1 ]  These measures were assessed using standard subjective scoring systems for pain and functionality. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_749", "text": "By the three-year mark, out of 32 cases, there were three reported additional surgeries. [ 1 ]  The most common reported adverse events were pain and  scar tissue  at the  surgery site . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_750", "text": "The FDA granted the HDE approval of the Patient Specific Talus Spacer to Additive Orthopaedics, LLC. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_751", "text": "This article incorporates  public domain material  from the  United States Department of Health and Human Services"}
{"_id": "WikiPedia_Orthopedics$$$corpus_752", "text": "Pauwel's angle  is the angle between the line of a  fracture of the neck of the femur  and the horizontal as seen on an anterio-posterior  radiograph . [ 1 ]  Pauwel's angle is named after the  German   orthopedist   Friedrich Pauwels . [ 2 ]      Introduced in 1935, this system was the first biomechanical classification for femoral neck fractures, and is still in use. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_753", "text": "An increasing angle leads to a more unstable  fracture  and an increase in the  shear stress  at the fracture site. This shear leads to higher rates of nonunion."}
{"_id": "WikiPedia_Orthopedics$$$corpus_754", "text": "Perkin's line  is a line drawn on an  AP   radiograph  of the  pelvis  perpendicular to  Hilgenreiner's line  at the  lateral aspects of the  triradiate cartilage  of the  acetabulum . [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_755", "text": "Used in conjunction with  Hilgenreiner's line , Perkin's line is useful in the diagnosis of  developmental dysplasia of the hip ; the upper femoral  epiphysis  should be in the inferomedial quadrant on a normal radiograph. Lateral displacement relative to Perkin's line is indicative of DDH."}
{"_id": "WikiPedia_Orthopedics$$$corpus_756", "text": "The  Ruedi\u2013Allgower classification  is a system of categorizing  pilon fractures  of the  distal   tibia . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_757", "text": "The  Seinsheimer classification  is a system of categorizing  subtrochanteric   hip fractures  based on the  fracture  pattern of the proximal  femoral  shaft. The classification was developed by  Frank Seinsheimer III  in 1978. In the published work, fifty-six patients were treated for subtrochanteric fractures, and their fractures were \"classified according to the number of major fragments and the locations and shapes of the fracture lines.\" This system of classification was used to assess the correlation between type of fracture and success of treatment. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_758", "text": "A later study of 50 subtrochanteric fractures, which were assessed using the Seinsheimer classification, criticized the classification system for having poor  inter-rater reliability . They noted that \"Earlier studies of pertrochanteric [sic] and femoral neck fractures show that the use of classification systems is often difficult, with low agreement (Frandsen et al. 1988, Andersen et al. 1990, Gehrchen et al. 1993). The results of these studies accord with the low level of interobserver agreement in our study. A total agreement of 26% or at the best 60% is not acceptable.\" [ 2 ]   A further study published in 2014 assessed four subtrochanteric fracture classification systems, including the Seinsheimer system, and concluded that \"the four subtrochanteric classification systems which we assessed were not found to be sufficiently reproducible to be of any significant value in clinical practice.\" [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_759", "text": "A  spiral fracture  (a.k.a.  torsion fracture ) is a  bone fracture  occurring when  torque  (a rotating force) is applied along the axis of a  bone . [ 1 ]  Spiral fractures often occur when the body is in motion while one extremity is planted. For example, a spiral fracture of the  tibia  (the shinbone) can occur in young children when they fall short on an extended leg while jumping. This occurrence is known as \" toddler 's fracture\". Spiral fractures are also recognized as being suspicious in very young children since to obtain a fracture of this sort requires forceful twisting or jerking of the limbs.  Child abuse  (physical abuse) and certain conditions such as  osteogenesis imperfecta  (OI) are considered  differentials  when identifying spiral or torsion fractures. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_760", "text": "Sulcoplasty  is an  orthopedic   surgical  procedure performed on a groove ( sulcus ) or indentation present on particular bones. In veterinary surgery it is often employed to remedy a displaced kneecap ( luxating patella ) by deepening the trochlear sulcus, the groove at the end of the  femur  on which the  patella  normally sits. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_761", "text": "A  tension band wire  is a form of orthopaedic  internal fixation [ 1 ]  method used to convert distraction forces into compression forces, promoting  bone healing . [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_762", "text": "The  Thompson and Epstein classification  is a system of categorizing  posterior   fracture/dislocations of the hip . [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_763", "text": "The  Thurstan Holland sign [ 1 ]  or fragment, also known as the  shiny corner sign , [ 2 ]  is the small  metaphyseal  triangular portion of bone carried with the  physis  in type II and IV  Salter\u2013Harris fractures . The sign was named after the Liverpool pioneer in radiology,  Charles Thurstan Holland  (1863\u20131941). [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_764", "text": "Trethowan's sign  is when  Klein's line  does not intersect the lateral part of the superior femoral epiphysis on an AP radiograph of the  pelvis . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_765", "text": "Trethowan's sign is indicative of a diagnosis of  slipped capital femoral epiphysis ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_766", "text": "Waddell's triad  is a pattern of injury seen in pedestrian  children  who are struck by motor vehicles. [ 1 ]  The triad comprises:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_767", "text": "The mechanism of injury is an initial impact causing injury to the femur on one side ( bumper  injury) and the torso on the same side ( fender  or  hood ), following which the child is thrown, striking the head on the ground or another object and sustaining injury to the opposite side of the head. [ 2 ]  In countries where cars drive on the right, pedestrians tend to be struck on the left, causing left femur fractures, injuries to the left chest or  spleen , and right sided head injuries. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_768", "text": "Although this injury pattern may not be common, [ 4 ]  it is used to emphasize the point that children involved in high energy impacts should not be assumed to have isolated injuries. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_769", "text": "Le Fort's fracture of the ankle  is a vertical  fracture  of the  antero - medial  part of the  distal   fibula  with  avulsion  of the  anterior tibiofibular ligament , [ 1 ]  opposite to a  Tillaux-Chaput avulsion fracture"}
{"_id": "WikiPedia_Orthopedics$$$corpus_770", "text": "The injury was described by  L\u00e9on Cl\u00e9ment Le Fort  in 1886. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_771", "text": "Articular cartilage damage  in the knee may be found on its own but it will more often be found in conjunction with injuries to  ligaments  and  menisci . People with previous surgical interventions face more chances of articular cartilage damage due to altered mechanics of the  joint . Articular cartilage damage may also be found in the shoulder causing pain, discomfort and limited movement.\n Cartilage  structures and functions can be damaged. Such damage can result from a variety of causes, such as a bad fall or traumatic sport-accident, previous knee injuries or wear and tear over time. Immobilization for long periods can also result in cartilage damage. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_772", "text": "Articular cartilage does not usually regenerate (the process of repair by formation of the same type of tissue) after injury or disease leading to loss of tissue and formation of a defect. This fact was first described by William Hunter in 1743. [ 1 ]  Several surgical techniques have been developed in the effort to  repair  articular cartilage defects."}
{"_id": "WikiPedia_Orthopedics$$$corpus_773", "text": "Articular cartilage has a very limited capacity for self repair. Small damage does not repair itself and can often get worse over time. As cartilage is aneural and avascular (lack of nerve and blood supply, respectively), shallow damage often does not trigger pain. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_774", "text": "When the damage increases and the chondral defect reaches the  subchondral bone , the blood supply in the bone starts a healing process in the defect. Scar tissue made up of a type of cartilage called  fibrocartilage  is then formed. Although fibrocartilage is able to fill in articular cartilage defects, its structure is significantly different from that of hyaline cartilage; it is much denser and it doesn't withstand the demands of everyday activities as much as hyaline cartilage. It is therefore at a higher risk of breaking down. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_775", "text": "Wang  et al.  (2006) found that small articular cartilage defects can progress to  osteoarthritis  over time if left untreated. [ 3 ]  An articular cartilage defect that initially may be small still has the potential to have a physical and chemical \"domino effect\" on the surrounding \"normal\" articular cartilage. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_776", "text": "Pitkin  et al.  (2014) discovered a potential etiology for articular cartilage damage. When the interarticular transmission of pressures is interrupted so that cartilage cannot distribute its pressure load to adjacent joints, it bears exceptionally high loads, which in time lead to degradation. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_777", "text": "No non-invasive tests are currently able to diagnose articular cartilage damage. Additionally, symptoms vary considerably from person to person. Or as Dr. Karen Hambly stated:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_778", "text": "You may or may not have pain and you could have no, or limited, swelling. Yes you may experience locking if a piece of articular cartilage has broken off and is a loose body in the joint or you may experience catching or giving way. You are likely to have some muscle wasting and difficulty in activities such as going up and down stairs, walking or running but then people with any moderate knee injury are likely to as well. This is why articular cartilage damage is the 'Cinderella' of knee problems. It tends to be diagnosed only after other structures have been ruled out \u2013 well if it isn't your meniscus or ligaments, what else could it be, perhaps we should look at the articular cartilage?"}
{"_id": "WikiPedia_Orthopedics$$$corpus_779", "text": "MRI -scans are becoming more valuable in the analysis of articular cartilage but their use is still expensive and time-consuming.  X-rays  show only bone injuries and are therefore not very helpful in diagnosing cartilage damage, especially not in early stages. The best tool for diagnosing articular damage is the use of  arthroscopy . [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_780", "text": "The International Cartilage Repair Society has set up an arthroscopic grading system by which cartilage defects can be ranked:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_781", "text": "Doctors will often also measure the size of each defect. Defects smaller than 2\u00a0cm 2 , for example, are considered to be small. It is also important to remember that although the amount of damage is an important factor, the location of the defect(s) can also influence the symptoms you are getting in terms of pain and function and their repair options available. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_782", "text": "In contrast to popular perception, pain is not a good indicator for determining the extent of articular cartilage damage. One person can have severe pain with a single small defect while another person can have very little pain with several large full thickness defects. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_783", "text": "Since articular cartilage does not have a blood supply and chondrocytes (cells in articular cartilage) have limited mobility, the articular cartilage has very limited ability to heal itself. If left untreated, the cartilage lesions will gradually worsen and the grade of the lesion or defect will increase. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_784", "text": "Though articular cartilage damage is not life-threatening, it does strongly affect one's quality of life. Articular cartilage damage is often the cause of severe pain, knee swelling, substantial reduction in mobility and severe restrictions to one's activities. Over the last decades, however, research has focused on  regenerating damaged joints ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_785", "text": "These regenerative procedures are believed to delay  osteoarthritis  of injuries on the articular cartilage of the knee, by slowing down the degeneration of the joint compared to untreated damage. [ 2 ]  According to Mithoefer  et al.  (2006), these  articular cartilage repair  procedures offer the best results when the intervention takes place in the early stages of the cartilage damage. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_786", "text": "Back strain  is the injury occurring to muscles or  tendons . Due to back strain, the tendons and muscles supporting the spine are twisted or pulled. Chronic back strain occurs because of the sustained trauma and wearing out of the back muscles. [ 1 ]  Acute back strain can occur following a single instance of over stressing of back muscles, as in lifting a heavy object. Chronic back strain is more common than the acute type."}
{"_id": "WikiPedia_Orthopedics$$$corpus_787", "text": "To avoid back strain it is important to bend the knees whenever you lift a heavy object \u2013 see  partial squats . [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_788", "text": "The pain over the back is localized and does not radiate into the leg. It occurs suddenly and may be accompanied by muscle spasms. The pain is dull, aching type and decreases on rest. It may be aggravated with activity. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_789", "text": "Back strain is treated using analgesics such as ibuprofen, rest and use of  ice packs . The patient can resume activities 24\u201348 hours after pain and swelling is reduced. It is not recommended to have prolonged immobilization or bed rest. If the pain does not subside in two weeks, additional treatment may be required. \nPrevention of back strain is possible by adopting proper body mechanics while sitting, standing and lifting. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_790", "text": "A  Bankart lesion  is a type of shoulder  injury  that occurs following a  dislocated shoulder . [ 3 ]  It is an  injury  of the  anterior  ( inferior )  glenoid labrum  of the shoulder. [ 4 ]  When this happens, a pocket at the front of the glenoid forms that allows the humeral head to dislocate into it. It is an indication for  surgery  and often accompanied by a  Hill-Sachs lesion , damage to the posterior  humeral  head. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_791", "text": "A bony Bankart is a Bankart lesion that includes a  fracture  of the anterior-inferior  glenoid cavity  of the  scapula bone . [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_792", "text": "The Bankart lesion is named after English orthopedic surgeon  Arthur Sydney Blundell Bankart  (1879\u20131951). [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_793", "text": "Bankart lesions are characterized by recurrent shoulder instability and widespread shoulder discomfort. Some individuals may experience catching, locking, or popping feelings in their shoulders. The majority of Bankart lesion patients have primary or recurrent anterior shoulder dislocation. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_794", "text": "The diagnosis is usually initially made by a combination of physical exam and  medical imaging , where the latter may be  projectional radiography  (in cases of bony Bankart) and/or  MRI  of the shoulder. The presence of intra-articular contrast allows for better evaluation of the  glenoid labrum . [ 8 ]  Type V  SLAP tears  extends into the Bankart defect. [ 9 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_795", "text": "Arthroscopic repair of Bankart injuries have good success rates, though nearly one-third of patients require further surgery for continued instability after the initial procedure in a study of young adults, with higher re-operation rates in those less than 20 years of age. [ 10 ]  Options for repair include an  arthroscopic  technique or a more invasive open  Latarjet procedure , [ 11 ]  with the open technique tending to have a lower incidence of recurrent dislocation, but also a reduced range of motion following surgery. [ 12 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_796", "text": "Blount's disease  (or  Blount disease ) is a growth disorder of the  tibia  (shin bone) which causes the lower leg to angle inward, resembling a  bowleg . [ 2 ]  It is also known as \"tibia vara\". [ 3 ] [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_797", "text": "Blount disease is a growth disorder of the  shin bone  which causes the lower leg to angle inward, resembling a  bowleg . It can present in boys under 4-years in both legs, or in adolescents usually on one side. Causes are thought to be genetic and environmental, like obesity, African-American lineage, and early walkers. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_798", "text": "Lower extremity deformities in  rickets  can closely mimic those produced by Blount's disease. To differentiate between rickets and Blount's disease it is important to correlate the clinical picture with laboratory findings such as calcium, phosphorus and  alkaline phosphatase . Besides the X-ray appearance. Bone deformities in rickets have a reasonable likelihood to correct over time, while this is not the case with Blount's disease. [ citation needed ]   Nevertheless, both disorders may need surgical intervention in the form of bone osteotomy or more commonly guided growth surgery. [ 5 ]   Osteochondrodysplasias  or genetic bone diseases can cause lower extremity deformities similar to Blount's disease. The clinical appearance and the characteristic radiographic are important to confirm the diagnosis. [ 6 ] [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_799", "text": "Children who develop severe bowing before the age of 3 may be treated with  knee ankle foot orthoses . [ 9 ]  However, bracing may fail, or bowing may not be detected until the child is older. Bracing should be started by 3 years of age. In some cases, surgery may be performed. [ 10 ] [ 2 ] [ 11 ] [ 8 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_800", "text": "Blount disease is one of the 8 severe comorbidities of  severe obesity  (BMI >35), which are an indication for  bariatric surgery  in children per a 2019 policy statement of the  American Academy of Pediatrics .\nThe other severe comorbidities are: obstructive sleep apnea (Apnea-Hypopnea Index > .5), Type2 Diabetes mellitus, idiopathic intracranial hypertension (IIH), nonalcoholic steatohepatitis,  SCFE ,  GERD , and hypertension. [ 12 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_801", "text": "Blount disease is named after  Walter Putnam Blount  (1900\u20131992), an American pediatric orthopedic surgeon, who described it in 1937. [ 13 ] [ 14 ]  It has also been known as Mau-Nilsonne syndrome, after C. Mau and H. Nilsonne, who published early case reports of the condition. [ 15 ] [ 16 ]  it is today considered an acquired disease of the proximal tibial metaphysis rather than an epiphyseal dysplasia or osteochondrosis. [ 11 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_802", "text": "Calcific tendinitis  is a common condition where deposits of  calcium phosphate  form in a tendon, sometimes causing pain at the affected site. Deposits can occur in several places in the body, but are by far most common in the  rotator cuff  of the shoulder. Around 80% of those with deposits experience symptoms, typically chronic pain during certain shoulder movements, or sharp acute pain that worsens at night. Calcific tendinitis is typically diagnosed by  physical exam  and  X-ray imaging . The disease often resolves completely on its own, but is typically treated with  non-steroidal anti-inflammatory drugs  to relieve pain, rest and  physical therapy  to promote healing, and in some cases various procedures to breakdown and/or remove the calcium deposits."}
{"_id": "WikiPedia_Orthopedics$$$corpus_803", "text": "Adults aged 30\u201350 are most commonly affected by calcific tendinitis. It is twice as common in women as men, and is not associated with exercise. Calcifications in the rotator cuff were first described by  Ernest Codman  in 1934. The name, \"calcifying tendinitis\" was coined by  Henry Plenk  in 1952."}
{"_id": "WikiPedia_Orthopedics$$$corpus_804", "text": "Up to 20% of those with calcification in the tendons have no symptoms because it is an integral part of the tendinopathy. [ 1 ]  For those with symptoms, the symptoms vary based on the phase of the disease. In the initial \"formative phase\" when the calcium deposits are being formed, people rarely experience any symptoms. [ 1 ]  Those that do have symptoms tend to have intermittent shoulder pain, particularly during forward shoulder flexion (i.e. lifting the arm in front of the body). [ 1 ]  In the \"resorptive phase\" when the calcium deposit is breaking down, many experience severe acute pain that worsens at night. [ 1 ]  Those affected tend to hold the shoulder rotated inwards to alleviate pain, and have difficulty lying on the affected shoulder. [ 1 ]  Some people experience heat and redness at the affected shoulder, as well as a limited range of motion. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_805", "text": "The pathophysiology of tendinopathy is mucoid degeneration, part of which is chondroid metaplasia of the fibroblasts.  Chondroid metaplasia means the fibroblasts are acting like cartilage cells (chondrocytes). Fibroblasts that are acting like chondrocytes can deposit calcium into the soft tissues as they do in bone.  Calcification in the tendons is a common component of tendinopathy."}
{"_id": "WikiPedia_Orthopedics$$$corpus_806", "text": "The calcification consists of  tendinitis is caused by deposits of  calcium phosphate  crystals in the tendon. [ 1 ]  These deposits are common in rotator cuff tendinopathy and are most frequently found in the  supraspinatus tendon  (63% of the time), and less frequently in the  infraspinatus tendon  (7%),  subacromial bursa  (7%),  subscapularis tendon  (3%), or in both the supraspinatus and subscapularis tendons at the same time (20%). [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_807", "text": "The development of calcific tendinitis is often divided into three stages. First, in the \"precalcific stage\", something causes tendon cells to transform into other cells that can act as sites for calcium deposition. [ 2 ]  This is followed by the two-part \"calcific stage\"; first calcium is deposited (the formative phase), then the body begins to break down the calcium deposit (the resorptive phase). [ 2 ]  Finally, in the \"postcalcific stage\" the calcium deposits are replaced with  new tissue  and the tendon completely heals. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_808", "text": "Calcific tendinitis is typically diagnosed by  physical examination  and  X-ray  imaging. [ 1 ]  During the formative phase, X-ray images typically reveal calcium deposits with uniform density and a clear margin. [ 1 ]  In the more painful resorptive phase, deposits instead appear cloudy and with unclear margins. [ 1 ]  By  arthroscopy , formative stage deposits appear crystalline and chalk-like, while resorptive stage deposits appear smooth resembling toothpaste. [ 1 ]   Ultrasound  is also used to locate and assess calcium deposits. In the formative stage, deposits are  hyperechoic  and arc-shaped; in the resorptive stage deposits are less  echogenic  and appear fragmented. [ 1 ] [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_809", "text": "The first line of treatment for calcific tendinitis is typically  nonsteroidal anti-inflammatory drugs  to relieve pain, rest for the affected joint, and sometimes physical therapy to avoid joint stiffness. [ 3 ] [ 1 ]  For those with severe pain direct injections of steroids to the affected site are often effective for pain relief, [ 1 ]  but may interfere with reabsorption of the calcium deposit. [ 3 ]  For those whose pain doesn't improve with medication and rest, the deposit can be dissolved and removed with techniques called \"ultrasound-guided needling\", \"barbotage\", and \"US-PICT\" (for \"ultrasound percutaneous injection in calcific tenditis\"). In each, ultrasound is used to locate the deposit and guide a needle to the affected site. There  saline  and  lidocaine  are injected to dissolve the deposit, then removed to wash it away. [ 1 ] [ 3 ] [ 2 ]  Another common treatment is  extracorporeal shockwave therapy , where pulses of sound are used to break up the deposit and promote healing. [ 1 ]  There is little standardization of energy levels, duration, and time interval of treatment; though most studies report positive outcomes with low- to medium-energy waves (below 0.28  mJ /mm 2 ). [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_810", "text": "Surgery is only recommended once 6 months of conservative, non-operative treatment has failed to reduce symptoms. Surgery is arthroscopic and involves calcification removal with or without acromioplasty of the shoulder. [ 4 ]  Additionally, debate remains over whether a complete removal of the deposits is necessary, or if equal pain relief can be obtained from a partial removal of calcium deposits. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_811", "text": "Removing the deposits either with open shoulder surgery or arthroscopic surgery are both difficult operations, but with high success rates (around 90%). About 10% require re-operation.  If the deposit is large, then frequently the patient will require a rotator cuff repair to fix the defect left in the tendon when the deposit is removed or to reattach the tendon to the bone if the deposit was at the tendon insertion into the bone."}
{"_id": "WikiPedia_Orthopedics$$$corpus_812", "text": "Nearly all people with calcific tendinitis recover completely with time or treatment. [ 6 ]  Treatment helps alleviate pain, but long-term follow-up studies have shown that people recover with or without treatment. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_813", "text": "Calcific tendinitis typically occurs in adults aged 30 to 50, and is rare in those older than 70. It is twice as common in women as men. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_814", "text": "Risk factors that increase the chance of developing calcific tendinitis include; hormonal disorders, like diabetes and  hypothyroidism , autoimmune disorders, like  rheumatoid arthritis , and metabolic disorders that also cause kidney stones, gallstones, and  gout . Occupations that consist of repetitive overhead lifting, such as athletes or construction workers, do not seem to significantly increase the likelihood of developing calcific tendinitis. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_815", "text": "Calcifications in the  rotator cuff  tendon were first described by  Ernest Codman  in his 1934 book  The Shoulder . [ 3 ]  In 1952, in his study on x-ray therapy for people with such calcifications,  Henry Plenk  coined the term \"calcifying tendinitis\". [ 3 ] [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_816", "text": "Clay-shoveler's fracture  is a stable  fracture  through the  spinous process  of a  vertebra  occurring at any of the lower cervical or upper thoracic vertebrae, classically at  C6  or  C7 . [ 1 ]  In Australia in the 1930s, men digging deep ditches tossed clay 10 to 15 feet above their heads using long handled shovels. [ 2 ]   Instead of separating, the sticky clay would sometimes stick to the shovel. At the top of the arc of motion, with the arms extended, the worker may hear a pop and feel a sudden pain between the shoulder blades, unable to continue working. [ 3 ] [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_817", "text": "Dactylitis  or  sausage digit  is inflammation of an entire digit (a finger or toe), [ 1 ]  and can be painful."}
{"_id": "WikiPedia_Orthopedics$$$corpus_818", "text": "The word  dactyl  comes from the  Greek  word  daktylos  'finger'. As a medical term, it refers to both the fingers and the toes."}
{"_id": "WikiPedia_Orthopedics$$$corpus_819", "text": "Dactylitis can occur in  seronegative arthropathies , such as  psoriatic arthritis  and  ankylosing spondylitis , and in  sickle-cell disease  as result of a vasoocclusive crisis with bone infarcts, and in infectious conditions including  tuberculosis ,  syphilis , and  leprosy . In  reactive arthritis , sausage fingers occur due to synovitis. [ 2 ]  Dactylitis may also be seen with  sarcoidosis ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_820", "text": "In sickle-cell disease it typically occurs after 6 months of age (as in infants protective  fetal hemoglobin , HbF, is replaced with adult hemoglobin and the disease manifests) and is often the first clinical presentation of the disorder. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_821", "text": "In  neurology ,  diastematomyelia  (occasionally  diastomyelia ) is a  congenital disorder  in which a part of the  spinal cord  is split, usually at the level of the upper lumbar  vertebra  in the  longitudinal  ( sagittal ) direction. Females are affected much more commonly than males. This condition occurs in the presence of an  osseous ,  cartilaginous  or  fibrous   septum  in the central portion of the  spinal canal  which then produces a complete or incomplete sagittal division of the spinal cord into two hemicords. When the split does not reunite distally to the spur, the condition is referred to as  diplomyelia , which is true duplication of the spinal cord. [ 1 ] [ additional citation(s) needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_822", "text": "The signs and symptoms of diastematomyelia may appear at any time of life, although the  diagnosis  is usually made in childhood.  Cutaneous  lesions (or stigmata), such as a hairy patch,  dimple ,  Hemangioma ,  subcutaneous  mass,  Lipoma  or  Teratoma  over the affected area of the spine is found in more than half of cases. Neurological symptoms are nonspecific, indistinguishable from other causes of  cord tethering . The symptoms are caused by tissue attachments that limit the movement of the spinal cord within the spinal column.  These attachments cause an abnormal stretching of the spinal cord. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_823", "text": "The course of the disorder is progressive.  In children, symptoms may include the \" stigmata \" mentioned above and/or foot and spinal  deformities ; weakness in the legs;  low back pain ;  scoliosis ; and  incontinence .  In adulthood, the signs and symptoms often include progressive sensory and motor problems and loss of bowel and bladder control.  This delayed presentation of symptoms is related to the degree of strain placed on the spinal cord over time.\n Tethered spinal cord syndrome  appears to be the result of improper growth of the neural tube during fetal development, and is closely linked to  spina bifida ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_824", "text": "Tethering may also develop after spinal cord injury and scar tissue can block the flow of fluids around the spinal cord.  Fluid pressure may cause  cysts  to form in the spinal cord, a condition called  syringomyelia .  This can lead to additional loss of movement, feeling or the onset of pain or  autonomic  symptoms."}
{"_id": "WikiPedia_Orthopedics$$$corpus_825", "text": "Cervical diastematomyelia can become symptomatic as a result of  acute trauma , and can cause major neurological deficits, like hemiparesis, to result from otherwise mild trauma. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_826", "text": "The following definitions may help to understand some of the related entities: [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_827", "text": "Diastematomyelia is a \" dysraphic state \" of unknown embryonic origin, but is probably initiated by an  accessory neurenteric canal  (an additional embryonic spinal canal.) This condition may be an isolated phenomenon or may be associated with other segmental anomalies of the  vertebral bodies  such as  spina bifida ,  kyphoscoliosis ,  butterfly vertebra ,  hemivertebra  and  block vertebrae  which are observed in most of the cases.  Scoliosis  is identified in more than half of these patients. In most of the symptomatic patients, the spinal cord is split into halves by a bony spicule or  fibrous  band, each half being surrounded by a  dural  sac. Other conditions, such as  intramedullary tumors ,  tethered cord ,  dermoids ,  lipoma ,  syringomyelia ,  hydromyelia  and  Arnold\u2013Chiari malformations  have been described in medical literature, but they are exceptionally rare. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_828", "text": "Diastematomyelia usually occurs between 9th  thoracic  and 1st  sacral  levels of the  spinal column  with most being at the level of the upper  lumbar vertebra .  Cervical  diastematomyelia is a very rare entity. The extent (or length of spinal cord involved) varies from one affected individual to another. In approximately 60% of patients with diastematomyelia, the two hemicords, each covered by an intact layer of  pia   arachnoid , travel through a single  subarachnoid space  surrounded by a single dural sac. Each hemicord has its own  anterior spinal artery . This form of diastematomyelia is not accompanied by any bony spur or fibrous band and is rarely symptomatic unless hydromyelia or tethering is present. The other 40% of patients have a bony spur or a fibrous band that passes through the two hemicords. In these cases, the  dura  and arachnoid are split into two separate dural and arachnoidal sacs, each surrounding the corresponding hemicord which are not necessarily symmetric. Each hemicord contains a central canal, one  dorsal horn  (giving rise to a  dorsal nerve root ), and one  ventral horn  (giving rise to a  ventral nerve root .) One study showed the bony spur typically situated at the most inferior aspect of the dural cleft. They advised that if the imaging appears to show otherwise, a second spur (present in about 5% of patients with diastematomyelia) is likely to be present.The  conus medullaris  is situated below the L2 level in more than 75% of these diastematomyelia patients. Thickening of the  filum terminale  is seen in over half of the cases. While the level of the cleft is variable, it is most commonly found in the lumbar region. The two hemicords usually reunite caudally to the cleft. Occasionally, however, the cleft will extend unusually low and the cord will end with two separate coni medullarae and two fila terminale (\"Diplomyelia\")."}
{"_id": "WikiPedia_Orthopedics$$$corpus_829", "text": "Adult presentation in diastematomyelia is unusual. With modern imaging techniques, various types of spinal  dysraphism  are being diagnosed in adults with increasing frequency. The commonest location of the lesion is at first to third lumbar vertebrae. Lumbosacral adult diastematomyelia is even rarer. Bony malformations and dysplasias are generally recognized on plain  x-rays .  MRI  scanning is often the first choice of screening and diagnosis. MRI generally give adequate analysis of the spinal cord deformities although it has some limitations in giving detailed bone anatomy. Combined myelographic and post-myelographic  CT  scan is the most effective diagnostic tool in demonstrating the detailed bone, intradural and extradural pathological anatomy of the affected and adjacent spinal canal levels and of the bony spur."}
{"_id": "WikiPedia_Orthopedics$$$corpus_830", "text": "Prenatal ultrasound  diagnosis of this anomaly is usually possible in the early to mid third-trimester. An extra posterior echogenic focus between the fetal  spinal laminae  is seen with splaying of the posterior elements, thus allowing for early surgical intervention and have a favorable prognosis. Prenate ultrasound could also detect whether the diastematomyelia is isolated, with the skin intact or association with any serious neural tube defects. Progressive neurological lesions may result from the \"tethering cord syndrome\" (fixation of the spinal cord) by the diastematomyelia phenomenon or any of the associated disorders such as  myelodysplasia ,  dysraphia  of the spinal cord."}
{"_id": "WikiPedia_Orthopedics$$$corpus_831", "text": "Surgical intervention is warranted in patients who present with new onset neurological signs and symptoms or have a history of progressive neurological manifestations that can be related to this abnormality. The surgical procedure required for the effective treatment of diastematomyelia includes  decompression (surgery)  of neural elements and removal of bony spur. This may be accomplished with or without resection and repair of the duplicated dural sacs. Resection and repair of the duplicated dural sacs is preferred since the dural abnormality may partly contribute to the \"tethering\" process responsible for the symptoms of this condition."}
{"_id": "WikiPedia_Orthopedics$$$corpus_832", "text": "Post-myelographic CT scanning provides individualized detailed maps that enable surgical treatment of cervical diastematomyelia, first performed in 1983. [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_833", "text": "Asymptomatic patients do not require surgical treatment. These patients should have regular neurological examinations since it is known that the condition can deteriorate. If any progression is identified, then a resection should be performed."}
{"_id": "WikiPedia_Orthopedics$$$corpus_834", "text": "Failed Back Syndrome  ( abbreviated  as  FBS )  is a  condition  characterized by  chronic pain  following  back surgeries . [ 1 ] [ 2 ]  The term \"post-laminectomy syndrome\" is sometimes used by doctors to indicate the same condition as failed back syndrome. [ 3 ]  Many factors can contribute to the onset or development of FBS, including residual or recurrent  spinal disc herniation , persistent  post-operative  pressure on a  spinal nerve , altered joint mobility,  joint hypermobility  with instability, scar tissue ( fibrosis ),  depression ,  anxiety ,  sleeplessness ,  spinal  muscular  deconditioning  and  Cutibacterium acnes  infection. [ 4 ]   An individual may be predisposed to the development of FBS due to  systemic disorders  such as  diabetes ,  autoimmune disease  and  peripheral blood vessels (vascular) disease ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_835", "text": "Common symptoms of Failed Back Surgery Syndrome (FBS) include diffuse, dull, and aching pain in the back or legs, often accompanied by abnormal sensations such as sharp, pricking, or stabbing pain in the extremities. [ 5 ]  Patients may also experience pain at a different level from the location originally treated, along with an inability to fully recuperate and restricted mobility. Sharp, stabbing pain in the back, numbness, back spasms, or pain radiating from the lower back into the legs are frequently reported. In addition to physical discomfort, FBS can lead to psychological symptoms such as anxiety, depression, and  insomnia . Some individuals may develop a dependence on pain medication due to  chronic pain . [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_836", "text": "The number of  spinal surgeries  varies around the world. The  United States  and the  Netherlands  report the highest number of spinal surgeries, while the  United Kingdom  and  Sweden  report the fewest. Recently, there have been calls for more aggressive surgical treatment in  Europe . Success rates of spinal surgery vary for many reasons. [ 7 ] [ 8 ] [ 9 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_837", "text": "Patients who have undergone one or more operations on the  lumbar spine  and continue to experience pain afterwards can be divided into two groups."}
{"_id": "WikiPedia_Orthopedics$$$corpus_838", "text": "In 1992, Turner  et al.  published a survey of 74 journal articles which reported the results after decompression for  spinal stenosis .  Good to excellent results were on average reported by 64% of the patients.  There was, however, a wide variation in outcomes reported.  There was a better result in patients who had a degenerative  spondylolisthesis . [ 13 ]  A similarly designed study by Mardjekto et al. found that a concomitant spinal  arthrodesis  (fusion) had a greater success rate. [ 14 ]  Herron and Trippi evaluated 24 patients, all with degenerative  spondylolisthesis  treated with  laminectomy  alone.  At follow-up varying between 18 and 71 months after surgery, 20 out of the 24 patients reported a good result. [ 15 ]   Epstein  reported on 290 patients treated over a 25-year period.  Excellent results were obtained in 69% and good results in 13%. [ 16 ]   These optimistic reports do not correlate with \"return to competitive employment\" rates, which for the most part are dismal in most spinal surgery series. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_839", "text": "In the past two decades there has been a dramatic increase in  fusion surgery  in the U.S.: in 2001 over 122,000 lumbar fusions were performed, a 22% increase from 1990 in fusions per 100,000 population, increasing to an estimate of 250,000 in 2003, and 500,000 in 2006. [ 17 ] [ 18 ] [ 19 ]  In 2003, the national bill for the hardware for fusion alone was estimated to have soared to $2.5 billion a year. [ 18 ] [ 20 ] \nFor patients with continued  pain after surgery  which is not due to the above complications or conditions,  interventional pain physicians  speak of the need to identify the \"pain generator\" i.e. the anatomical structure responsible for the patient's pain. To be effective, the surgeon must operate on the correct  anatomic structure , but is often not possible to determine the source of the pain. [ 21 ] [ 22 ]  The reason for this is that many patients with  chronic pain  often have disc bulges at multiple spinal levels and the physical examination and imaging studies are unable to pinpoint the source of pain. [ 21 ]  In addition,  spinal fusion  itself, particularly if more than one spinal level is operated on, may result in \"adjacent segment degeneration\". [ 23 ]   This is thought to occur because the fused segments may result in increased  torsional  and  stress forces  being transmitted to the  intervertebral discs  located above and below the fused  vertebrae . [ 23 ]  This pathology is one reason behind the development of artificial discs as a possible alternative to fusion surgery.  But fusion surgeons argue that  spinal fusion  is more time-tested, and artificial discs contain metal hardware that is unlikely to last as long as biological material without shattering and leaving metal fragments in the spinal canal. These represent different  schools of thought . (See discussion on disc replacement infra.) [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_840", "text": "Another highly relevant consideration is the increasing recognition of the importance of \" chemical radiculitis \" in the generation of  back pain . [ 24 ]   A primary focus of surgery is to remove \"pressure\" or reduce mechanical compression on a  neural  element: either the  spinal cord , or a  nerve root . But it is increasingly recognized that  back pain , rather than being solely due to compression, may instead entirely be due to chemical  inflammation of the nerve root.   It has been known for several decades that disc herniations result in a massive inflammation of the associated nerve root. [ 24 ] [ 25 ] [ 26 ] [ 27 ]  In the past five years increasing evidence has pointed to a specific inflammatory mediator of this pain. [ 28 ] [ 29 ]   This inflammatory molecule, called  tumor necrosis factor-alpha  (TNF), is released not only by the herniated or protruding disc, but also in cases of disc tear (annular tear), by facet joints, and in  spinal stenosis . [ 24 ] [ 30 ] [ 31 ] [ 32 ]  In addition to causing pain and inflammation, TNF may also contribute to  disc degeneration . [ 33 ]  If the cause of the pain is not compression, but rather is inflammation mediated by TNF, then this may well explain why surgery might not relieve the pain, and might even exacerbate it, resulting in FBS."}
{"_id": "WikiPedia_Orthopedics$$$corpus_841", "text": "A 2005 review by Cohen concluded, 'The SI joint is a real yet underappreciated pain generator in an estimated 15% to 25% of patients with axial LBP'. [ 34 ]  Studies by Ha, et al., show that the incidence of SI joint degeneration in post-lumbar fusion surgery is 75% at 5 years post-surgery, based on imaging. [ 35 ]  Studies by DePalma and Liliang, et al., demonstrate that 40\u201361% of post-lumbar fusion patients were symptomatic for  SI joint dysfunction  based on diagnostic blocks. [ 36 ] [ 37 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_842", "text": "Recent studies have shown that  cigarette smokers  will routinely fail all spinal surgery, if the goal of that surgery is the decrease of pain and impairment.  Many surgeons consider smoking to be an absolute  contraindication  to spinal surgery.   Nicotine  appears to interfere with bone metabolism through induced  calcitonin  resistance and decreased  osteoblastic  function.  It may also restrict small blood vessel diameter leading to increased scar formation. [ 38 ] [ 39 ] [ 40 ] [ 41 ] [ 42 ] [ 43 ] [ 44 ] [ excessive citations ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_843", "text": "There is an association between  cigarette smoking ,  back pain  and  chronic pain syndromes  of all types. [ 45 ] [ 46 ] [ 39 ] [ 47 ] [ 48 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_844", "text": "In a report of 426 spinal surgery patients in  Denmark , smoking was shown to have a negative effect on fusion and overall patient satisfaction, but no measurable influence on the functional outcome. [ 49 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_845", "text": "There is a validation of the hypothetical assumption that postoperative  smoking cessation  helps to reverse the impact of cigarette smoking on outcome after spinal fusion.  If patients cease cigarette smoking in the immediate post operative period, there is a positive impact on success. [ 50 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_846", "text": "Regular  smoking in adolescence  was associated with low back pain in  young adults . Pack-years of smoking showed an exposure-response relationship among girls. [ 51 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_847", "text": "A recent study suggested that cigarette smoking adversely affects serum  hydrocodone  levels. Prescribing physicians should be aware that in some cigarette smokers, serum hydrocodone levels might not be detectable. [ 52 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_848", "text": "In a study from Denmark reviewing many reports in the literature, it was concluded that smoking should be considered a weak risk indicator and not a cause of low back pain. In a multitude of  epidemiologic  studies, an association between smoking and low back pain has been reported, but variations in approach and study results make this literature difficult to reconcile. [ 53 ]  In a massive study of 3482 patients undergoing lumbar spine surgery from the National Spine Network, co-morbidities of (1) smoking, (2) compensation, (3) self reported poor overall health and (4) pre-existing psychological factors were predictive in a high risk of failure. Followup was carried out at 3 months and one year after surgery. Pre-operative depressive disorders tended not to do well. [ 54 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_849", "text": "Smoking has been shown to increase the incidence of post operative infection as well as decrease fusion rates. One study showed 90% of post operative infections occurred in smokers, as well as  myonecrosis  (muscle destruction) around the  wound . [ 55 ] [ 56 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_850", "text": "Before the advent of CT scanning, the pathology in failed back syndrome was difficult to understand.  Computerized tomography  in conjunction with  metrizamide   myelography  in the late 1960s and 1970s allowed direct observation of the mechanisms involved in post operative failures. Six distinct pathological conditions were identified: [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_851", "text": "Removal of a disc at one level can lead to  disc herniation  at a different level at a later time.  Even the most complete  surgical excision  of the disc still leaves 30\u201340% of the disc, which cannot be safely removed. This retained disc can re-herniate sometime after surgery. Virtually every major structure in the abdomen and the posterior  retroperitoneal space  has been injured, at some point, by removing discs using posterior  laminectomy / discectomy  surgical procedures. The most prominent of these is a laceration of the  left internal iliac vein , which lies in close proximity to the anterior portion of the disc. [ 57 ] [ 58 ]  In some studies, recurrent pain in the same radicular pattern or a different pattern can be as high as 50% after disc surgery. [ 59 ] [ 60 ]    Many observers have noted that the most common cause of a failed back syndrome (FBS) is caused from recurrent disc herniation at the same level originally operated. A rapid removal in a second surgery can be curative. The clinical picture of a recurrent disc herniation usually involves a significant pain-free interval.  However, physical findings may be lacking, and a good history is necessary. [ 61 ] [ 62 ] [ 63 ] [ 64 ]  The time period for the emergence of new symptoms can be short or long.  Diagnostic signs  such as the  straight leg raise  test may be negative even if real  pathology  is present. [ 60 ] [ 65 ]  The presence of a  positive myelogram  may represent a new disc herniation, but can also be indicative of a post operative scarring situation simply mimicking a new disc. Newer  MRI  imaging techniques have clarified this dilemma somewhat. [ 61 ] [ 62 ] [ 66 ] [ 67 ] [ 68 ]  Conversely, a recurrent disc can be difficult to detect in the presence of post op scarring.  Myelography  is inadequate to completely evaluate the patient for recurrent disc disease, and  CT  or MRI scanning is necessary.  Measurement of  tissue density  can be helpful. [ 11 ] [ 66 ] [ 69 ] [ 70 ] [ 71 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_852", "text": "Even though the complications of  laminectomy  for disc herniation can be significant, a recent series of studies involving thousands of patients published under auspices of  Dartmouth Medical School  concluded at four-year follow-up that those who underwent surgery for a lumbar disc herniation achieved greater improvement than nonoperatively treated patients in all primary and secondary outcomes except work status. [ 72 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_853", "text": "Spinal stenosis  can be a late complication after  laminectomy  for disc herniation or when surgery was performed for the primary pathological condition of  spinal stenosis . [ 11 ] [ 73 ] [ 74 ]  In the Maine Study, among patients with  lumbar spinal stenosis  completing 8- to 10-year follow-up, low back pain relief, predominant symptom improvement, and satisfaction with the current state were similar in patients initially treated surgically or non-surgically. However, leg pain relief and greater back-related functional status continued to favor those initially receiving surgical treatment. [ 75 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_854", "text": "A large study of  spinal stenosis  from Finland found the  prognostic factors  for ability to work after surgery were ability to work before surgery, age under 50 years, and no prior back surgery. The very long-term outcome (mean follow-up time of 12.4 years) was excellent-to-good in 68% of patients (59% women and 73% men). Furthermore, in the longitudinal follow-up, the result improved between 1985  and 1991. No special complications were manifested during this very long-term follow-up time. The patients with total or subtotal block in preoperative  myelography  achieved the best result.  Furthermore, patients with block stenosis improved their result significantly in the longitudinal follow-up. The postoperative stenosis seen in  computed tomography  (CT)  scans  was observed in 65% of 90 patients, and it was severe in 23 patients (25%). However, this successful or unsuccessful  surgical decompression  did not correlate with patients' subjective  disability , walking capacity or  severity of pain . Previous back surgery had a strong worsening effect on surgical results. This effect was very clear in patients with total block in the preoperative  myelography . The surgical result of a patient with previous back surgery was similar to that of a patient without previous back surgery when the time interval between the last two operations was more than 18 months. [ 76 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_855", "text": "Post-operative MRI findings of  stenosis  are probably of limited value compared to symptoms experienced by patients. Patients' perception of improvement had a much stronger correlation with long-term surgical outcome than structural findings seen on post-operation  magnetic resonance imaging . Degenerative findings had a greater effect on patients' walking capacity than stenotic findings. [ 77 ] [ 78 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_856", "text": "Postoperative radiologic stenosis was very common in patients operated on for  lumbar spinal stenosis , but this did not correlate with  clinical outcome . The clinician must be cautious when reconciling clinical symptoms and signs with postoperative  computed tomography  findings in patients operated on for lumbar spinal stenosis. [ 79 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_857", "text": "A study from  Georgetown University  reported on one-hundred patients who had undergone  decompressive surgery  for lumbar stenosis between 1980 and 1985.  Four patients with post-fusion stenosis were included. A 5-year follow-up period was achieved in 88 patients. The mean age was 67 years, and 80% were over 60 years of age. There was a high incidence of coexisting medical diseases, but the principal disability was lumbar stenosis with neurological involvement.  Initially there was a high incidence of success, but recurrence of neurological involvement and persistence of low-back pain led to an increasing number of failures. By 5 years this number had reached 27% of the available population pool, suggesting that the failure rate could reach 50% within the projected  life expectancies  of most patients. Of the 26 failures, 16 were secondary to renewed neurological involvement, which occurred at new levels of stenosis in eight and recurrence of stenosis at operative levels in eight. Reoperation was successful in 12 of these 16 patients, but two required a third operation. The incidence of  spondylolisthesis  at 5 years was higher in the surgical failures (12 of 26 patients) than in the surgical successes (16 of 64). Spondylolisthetic  stenosis  tended to recur within a few years following decompression.  Because of  age and associated illnesses , fusion may be difficult to achieve in this group. [ 80 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_858", "text": "A small minority of lumbar surgical patients will develop a post operative infection. In most cases, this is a bad complication and does not bode well for eventual improvement or future employability.  Reports from the surgical literature indicate an infection rate anywhere from 0% to almost 12%. [ 81 ] [ 82 ] [ 83 ] [ 84 ] [ 85 ] [ 86 ] [ 87 ] [ 88 ] [ 89 ] [ 90 ] [ 91 ] [ 92 ] [ 93 ] [ 94 ] [ 95 ] [ 96 ] [ excessive citations ]  The  incidence of infection  tends to increase as the complexity of the procedure and operating time increase.  Usage of  metal implants  (instrumentation) tends to increase the risk of infection.  Factors associated with an increased infection include  diabetes mellitus ,  obesity ,  malnutrition ,  smoking , previous infection,  rheumatoid arthritis , and  immunodeficiency . [ 97 ] [ 98 ] [ 99 ] [ 100 ] [ 101 ] [ 102 ] [ excessive citations ]  Previous wound infection should be considered as a contraindication to any further spinal surgery, since the likelihood of improving such patients with more surgery is small. [ 103 ] [ 104 ] [ 105 ] [ 106 ] [ 107 ] [ 108 ]   Antimicrobial prophylaxis  reduces the rate of surgical site infection in lumbar spine surgery, but a great deal of variation exists regarding its use. In a Japanese study, utilizing the  Centers for Disease Control  recommendations for antibiotic prophylaxis, an overall rate of 0.7% infection was noted, with a single dose antibiotic group having 0.4% infection rate and multiple dosage antibiotic infection rate of 0.8%. The authors had previously used  prophylactic antibiotics  for 5 to 7 postoperative days. Based on the  Centers for Disease Control and Prevention  (CDC) guideline, their antibiotic prophylaxis was changed to the day of surgery only. It was concluded there was no statistical difference in the rate of infection between the two different antibiotic protocols. Based on the  CDC  guideline, a single dose of prophylactic antibiotic was proven to be efficacious for the prevention of infection in  lumbar spine  surgeries. [ 109 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_859", "text": "Epidural scarring following a  laminectomy  for disc excision is a common feature when re-operating for recurrent  sciatica  or  radiculopathy . [ 61 ]  When the scarring is associated with a  disc herniation  and/or recurrent  spinal stenosis , it is relatively common, occurring in more than 60% of cases. For a time, it was theorized that placing a  fat graft  over the dural could prevent post operative scarring.  However, initial enthusiasm has waned in recent years. [ 110 ] [ 111 ] [ 112 ] [ 113 ] [ 114 ]  In an extensive  laminectomy  involving 2 or more  vertebra , post operative scarring is the norm.  It is most often seen around the  L5  and  S1 nerve roots . [ 115 ] [ 116 ] [ 117 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_860", "text": "Fibrous scarring can also be a complication within the  subarachnoid  space.  It is notoriously difficult to detect and evaluate.  Prior to the development of  magnetic resonance imaging , the only way to ascertain the presence of  arachnoiditis  was by opening the  dura . In the days of  CT  scanning and  Pantopaque  and later,  Metrizamide   myelography , the presence of  arachnoiditis  could be speculated based on  radiographic  findings.  Often,  myelography  prior to the introduction of  Metrizamide  was the cause of  arachnoiditis .   It can also be caused by the long term pressure brought about with either a severe  disc herniation  or  spinal stenosis . [ 62 ] [ 61 ] [ 118 ] [ 119 ] [ 64 ]   The presence of both  epidural scarring  and  arachnoiditis  in the same patient are probably quite common.  Arachnoiditis  is a broad term denoting  inflammation of the meninges  and  subarachnoid  space. A variety of causes exist, including infectious,  inflammatory , and  neoplastic  processes. Infectious causes include  bacterial ,  viral ,  fungal , and  parasitic   agents .  Noninfectious inflammatory processes  include surgery, intrathecal hemorrhage, and the administration of  intrathecal  (inside the  dural canal ) agents such as myelographic contrast media,  anesthetics  (e.g.  chloroprocaine ), and  steroids  (e.g. Depo-Medrol, Kenalog). Lately iatrogenic arachnoiditis has been attributed to misplaced  Epidural Steroid Injection therapy  when accidentally administered intrathecally. The preservatives and suspension agents found in all steroid injectates, which aren't indicated for epidural administration by the  U.S. Food & Drug Administration  (FDA) due to reports of severe adverse events including  arachnoiditis ,  paralysis  and  death , have now been directly linked to the onset of the disease following the initial stage of  chemical meningitis . [ 120 ] [ 121 ] [ 122 ] [ 123 ] \n Neoplasia  includes the  hematogenous spread  of  systemic tumors , such as  breast  and  lung carcinoma ,  melanoma , and  non-Hodgkin lymphoma . Neoplasia also includes direct seeding of the  cerebrospinal fluid  (CSF) from primary central nervous system (CNS) tumors such as  glioblastoma multiforme ,  medulloblastoma ,  ependymoma , and  choroid plexus carcinoma . Strictly speaking, the most common cause of  arachnoiditis  in failed back syndrome is not infectious or from cancer.  It is due to non-specific scarring secondary to the surgery or the underlying pathology. [ 124 ] [ 125 ] [ 126 ] [ 127 ] [ 128 ] [ 129 ] [ 130 ] [ 131 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_861", "text": "Laceration  of a  nerve root , or damage from  cautery  or  traction  can lead to  chronic pain , however this can be difficult to determine. Chronic compression of the nerve root by a persistent agent such as  disc , bone ( osteophyte ) or  scarring  can also permanently damage the nerve root.  Epidural scarring  caused by the initial  pathology  or occurring after the surgery can also contribute to  nerve damage .  In one study of failed back patients, the presence of pathology was noted to be at the same site as the level of surgery performed in 57% of cases. The remaining cases developed pathology at a different level, or on the opposite side, but at the same level as the surgery was performed. In theory, all failed back patients have some sort of nerve injury or damage which leads to a  persistence of symptoms  after a reasonable  healing time . [ 59 ] [ 60 ] [ 132 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_862", "text": "Failed back syndrome (FBS) is a well-recognized complication of surgery of the lumbar spine. It can result in chronic pain and disability, often with disastrous emotional and financial consequences to the patient. Many patients have traditionally been classified as \"spinal cripples\" and are consigned to a life of long-term narcotic treatment with little chance of recovery.  Despite extensive work in recent years, FBS remains a challenging and costly disorder. [ 133 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_863", "text": "The treatments of post-laminectomy syndrome include  physical therapy ,  microcurrent electrical neuromuscular stimulator , [ 134 ]  minor nerve blocks,  transcutaneous electrical nerve stimulation  (TENS),  behavioral medicine ,  non-steroidal anti-inflammatory  (NSAID) medications,  membrane stabilizers ,  antidepressants ,  spinal cord stimulation , and  intrathecal   morphine   pump . Use of  epidural steroid injections  may be minimally helpful in some cases. The targeted  anatomic  use of a potent anti-inflammatory  anti-TNF   therapeutics  is being investigated."}
{"_id": "WikiPedia_Orthopedics$$$corpus_864", "text": "A study of chronic pain patients from the  University of Wisconsin  found that  methadone  is most widely known for its use in the treatment of  opioid  dependence, but  methadone  also provides effective  analgesia .  Patients who experience inadequate pain relief or intolerable side effects with other opioids or who suffer from neuropathic pain may benefit from a transition to methadone as their  analgesic  agent. Adverse effects, particularly respiratory depression and death, make a fundamental knowledge of  methadone 's pharmacological properties essential to the provider considering  methadone  as  analgesic  therapy for a patient with chronic pain. [ 135 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_865", "text": "Patients who have  sciatic  pain (pain in the back, radiating down the buttock to the leg) and clear clinical findings of an identifiable  radicular  nerve loss caused by a herniated disc will have a better post operative course than those who simply have low back pain. If a specific disc herniation causing pressure on a nerve root cannot be identified, the results of surgery are likely to be disappointing. Patients involved in worker's compensation, tort litigation or other compensation systems tend to fare more poorly after surgery. Surgery for spinal stenosis usually has a good outcome, if the surgery is done in an extensive manner, and done within the first year or so of the appearance of symptoms. [ 11 ] [ 60 ] [ 136 ] [ 137 ] [ 138 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_866", "text": "Oaklander and North define the Failed Back Syndrome as a chronic pain patient after one or more surgical procedure to the spine.  They delineated these characteristics of the relation between the patient and the surgeon:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_867", "text": "In the absence of a financial source for disability or worker's compensation, other psychological features may limit the ability of the patient to recover from surgery.  Some patients are simply unfortunate, and fall into the category of \"chronic pain\" despite their desire to recover and the best efforts of the physicians involved in their care. [ 140 ] [ 141 ] [ 142 ] [ 143 ] [ 144 ] [ 145 ] [ 146 ] [ 147 ] [ 148 ] [ 149 ] [ 150 ]  Even less invasive forms of surgery are not uniformly successful; approximately 30,000-40,000  laminectomy  patients obtain either no relief of symptomatology or a recurrence of symptoms. [ 151 ]  Another less invasive form of spinal surgery, percutaneous disc surgery, has reported revision rates as high as 65%. [ 152 ]  It is no surprise, therefore, that FBS is a significant medical concern which merits further research and attention by the medical and surgical communities. [ 21 ] [ 22 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_868", "text": "Lumbar  total disc replacement was originally designed to be an alternative to lumbar  arthrodesis  (fusion). The procedure was met with great excitement and heightened expectations both in the United States and Europe. In late 2004, the first lumbar total disc replacement received approval from the  U.S. Food and Drug Administration  (FDA). More experience existed in Europe.  Since then, the initial excitement has given way to skepticism and concern. [ 153 ] [ 154 ] [ 155 ] [ 156 ] [ 157 ] [ 158 ] [ 159 ]  Various failure rates and strategies for revision of total disc replacement have been reported. [ 160 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_869", "text": "The role of artificial or total disc replacement in the treatment of spinal disorders remains ill-defined and unclear. [ 161 ]  Evaluation of any new technique is difficult or impossible because physician experience may be minimal or lacking.  Patient expectations may be distorted. [ 162 ] [ 163 ]  It has been difficult to establish clear cut indications for artificial disc replacement.  It may not be a replacement procedure or alternative to fusion, since recent studies have shown that 100% of fusion patients had one or more contraindications to disc replacement. [ 164 ] [ 165 ] [ 166 ]    The role of disc replacement must come from new indications not defined in today's literature or a relaxation of current contraindications. [ 161 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_870", "text": "A study by Regan found the result of replacement was the same at L4-5 and L5-S1 with the CHARITE disc.  However, the ProDisc II had more favorable results at L4-5 compared with L5-S1. [ 167 ] [ 168 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_871", "text": "A younger age was predictive of a better outcome in several studies. [ 158 ] [ 169 ] [ 170 ]  In others it has been found to be a negative predictor or of no predictive value. [ 171 ] [ 172 ] [ 173 ] [ 174 ] [ 175 ]  Older patients may have more complications. [ 174 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_872", "text": "Prior spinal surgery has mixed effects on disc replacement.  It has been reported to be negative in several studies. [ 171 ] [ 176 ] [ 177 ] [ 178 ] [ 175 ] [ 179 ]  It has been reported to have  no effect in other studies. [ 180 ] [ 169 ] [ 173 ] [ 178 ] [ 181 ] [ 158 ]  Many studies are simply inconclusive. [ 171 ]  Existing evidence does not allow drawing definite conclusions about the status of disc replacement at present. [ 161 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_873", "text": "Many failed back patients are significantly impaired by chronic pain in the back and legs. Many of these will be treated with some form of electrical stimulation. This can be either a  transcutaneous electrical nerve stimulation  device placed on the skin over the back or a nerve stimulator implanted into the back  with electrical probes which directly touch the spinal cord. Also, some chronic pain patients utilize  fentanyl  or narcotic patches.  These patients are generally severely impaired and it is unrealistic to conclude that application of  neurostimulation  will reduce that impairment. For example, it is doubtful that  neurostimulation  will improve the patient enough to return to competitive employment.  Neurostimulation  is  palliative . TENS units work by blocking  neurotransmission  as described by the pain theory of Melzack and Wall. [ 182 ]  Success rates for implanted  neurostimulation  has been reported to be 25% to 55%. Success is defined as a relative decrease in pain. [ 183 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_874", "text": "Limited case series have shown improvement for patients with failed back surgery who were managed with  chiropractic care . [ 184 ] [ 185 ] [ 186 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_875", "text": "Smaller procedures that do not remove  bone  (such as Endoscopic Transforaminal Lumbar Discectomy and Reconfiguration) do not cause post  laminectomy / laminotomy  syndrome. [ 187 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_876", "text": "Under rules promulgated by Titles II and XVI of the United States  Social Security Act , chronic  radiculopathy ,  arachnoiditis  and spinal stenosis are recognized as disabling conditions under Listing 1.04 A ( radiculopathy ), 1.04 B ( arachnoiditis ) and 1.04 C ( spinal stenosis ). [ 188 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_877", "text": "In a groundbreaking  Canadian  study, Waddell  et al.  reported on the value of repeat surgery and the return to work in worker's compensation cases. They concluded that workers who undergo spinal surgery take longer to return to their jobs. Once two spinal surgeries are performed, few if any ever return to gainful employment of any kind. After two spinal surgeries, most people in the worker's comp system will not be made better by more surgery. Most will be worse after a third surgery. [ 189 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_878", "text": "Episodes of back pain associated with on the job injuries in the worker's compensation setting are usually of short duration. About 10% of such episodes will not be simple, and will degenerate into chronic and disabling back pain conditions, even if surgery is not performed. [ 190 ] [ 191 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_879", "text": "It has been hypothesized that  job dissatisfaction  and individual perception of physical demands are associated with an increased time of recovery or an increased risk of no recovery at all. [ 192 ]  Individual psychological and social work factors, as well as worker-employer relations are also likely to be associated with time and rates of recovery. [ 193 ] [ 194 ] [ 195 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_880", "text": "A Finnish study of return to work in patients with  spinal stenosis  treated by surgery found that:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_881", "text": "In fact, women's and men's working capacity do not differ after  lumbar spinal stenosis  operation. If the aim is to maximize working capacity, then, when a lumbar spinal stenosis operation is indicated, it should be performed without delay. In lumbar spinal stenosis patients who are older than 50 years old and on sick leave, it is unrealistic to expect that they will return to work. Therefore, after such an extensive surgical procedure, re-education of patients for lighter jobs could improve the chances of these patients returning to work. [ 196 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_882", "text": "In a related  Finnish  study, a total of 439 patients operated on for lumbar spinal stenosis during the period 1974\u20131987 was re-examined and evaluated for working and functional capacity approximately 4 years after the  decompressive surgery . The ability to work before or after the operation and a history of no prior back surgery were variables predictive of a good outcome. Before the operation 86 patients were working, 223 patients were on sick leave, and 130 patients were retired. After the operation 52 of the employed patients and 70 of the unemployed patients returned to work. None of the retired patients returned to work. Ability to work preoperatively, age under 50 years at the time of operation and the absence of prior back surgery predicted a postoperative ability to work. [ 197 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_883", "text": "A report from Belgium noted that patients reportedly return to work an average of 12 to 16 weeks after surgery for lumbar disc herniation. However, there are studies that lend credence to the value of an earlier stimulation for return to work and performance of normal activities after a limited  discectomy . At follow-up assessment, it was found that no patient had changed employment because of back or leg pain. The sooner the recommendation is made to return to work and perform normal activities, the more likely the patient is to comply. Patients with ongoing disabling back conditions have a low priority for return to work. The probability of return to work decreases as time off work increases.   This is especially true in Belgium, where 20% of individuals did not resume work activities after surgery for a disc herniation of the lumbar spine. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_884", "text": "In Belgium, the medical advisers of sickness funds have an important role legally in the assessment of working capacity and medical rehabilitation measures for employees whose fitness for work is jeopardized or diminished for health reasons. The measures are laid down in the sickness and invalidity legislation. They are in accordance with the principle of preventing long-term disability. It is apparent from the authors' experience that these measures are not adapted consistently in medical practice. Most of the medical advisers are focusing purely on evaluation of corporal damage, leaving little or no time for rehabilitation efforts. In many other countries, the evaluation of work capacity is done by social security doctors with a comparable task. [ 198 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_885", "text": "In a comprehensive set of studies carried out by the  University of Washington School of Medicine , it was determined that the outcome of lumbar fusion performed on injured workers was worse than reported in most published case series.  They found 68% of lumbar fusion patients still unable to return to work two years after surgery.  This was in stark contrast to reports of 68% post-op satisfaction in many series. [ 199 ] [ 142 ]  In a follow-up study it was found that the use of intervertebral fusion devices rose rapidly after their introduction in 1996.  This increase in metal usage was associated with a greater risk of complication  without improving disability or re-operation rates. [ 200 ] [ 201 ] [ 202 ] [ 203 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_886", "text": "The identification of  tumor necrosis factor-alpha  (TNF) as a central cause of inflammatory spinal pain now suggests the possibility of an entirely new approach to selected patients with FBS.  Specific and potent inhibitors of TNF became available in the U.S. in 1998, and were demonstrated to be potentially effective for treating  sciatica  in experimental models beginning in 2001. [ 204 ] [ 205 ] [ 206 ]  Targeted anatomic administration of one of these anti-TNF agents,  etanercept , a patented treatment method, [ 207 ]  has been suggested in published pilot studies to be effective for treating selected patients with chronic disc-related pain and FBS. [ 208 ] [ 209 ]  The scientific basis for pain relief in these patients is supported by the many current review articles. [ 210 ] [ 211 ]  In the future new imaging methods may allow non-invasive identification of sites of neuronal inflammation, thereby enabling more accurate localization of the \"pain generators\" responsible for symptom production. These treatments are still experimental. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_887", "text": "If chronic pain in FBS has a chemical component producing inflammatory pain, then prior to additional surgery it may make sense to use an anti-inflammatory approach. Often this is first attempted with non-steroidal anti-inflammatory medications, but the long-term use of  Non-steroidal anti-inflammatory drugs  (NSAIDS) for patients with persistent back pain is complicated by their possible cardiovascular and gastrointestinal toxicity; and NSAIDs have limited value to intervene in TNF-mediated processes. [ 22 ]  An alternative often employed is the injection of cortisone into the spine adjacent to the suspected pain generator, a technique known as \"epidural steroid injection\". [ 212 ]  Although this technique began more than a decade ago for FBS, the efficacy of epidural steroid injections is now generally thought to be limited to short term pain relief in selected patients only. [ 213 ]  In addition, epidural steroid injections, in certain settings, may result in serious complications. [ 214 ]  Fortunately there are now emerging new methods that directly target TNF. [ 208 ]  These TNF-targeted methods represent a highly promising new approach for patients with chronic severe spinal pain, such as those with FBS. [ 208 ]  Ancillary approaches, such as rehabilitation,  physical therapy ,  anti-depressants , and, in particular, graduated exercise programs, may all be useful adjuncts to anti-inflammatory approaches. [ 22 ]  In addition, more invasive modalities, such as spinal cord stimulation, may offer relief for certain patients with FBS, but these modalities, although often referred to as \"minimally invasive\", require additional surgery, and have complications of their own. [ 215 ] [ 216 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_888", "text": "A report from  Spain  noted that the investigation and development of new techniques for instrumented  surgery  of the  spine  is not free from  conflicts of interest . The influence of financial forces in the development of new technologies and its immediate application to spine surgery, shows the relationship between the published results and the industry support. Authors who have developed and defended fusion techniques have also published new articles praising new spinal technologies. The author calls spinal surgery the  \"American Stock and Exchange\" and \"the bubble of spine surgery\". The scientific literature doesn't show clear evidence in the cost-benefit  studies  of most instrumented surgical interventions of the spine compared with the conservative treatments. It has not been yet demonstrated that fusion surgery and disc replacement are better options than the conservative treatment. It's necessary to point out that at present \" there are relationships between the industry and back pain, and there is also an industry of the back pain \"."}
{"_id": "WikiPedia_Orthopedics$$$corpus_889", "text": "Nonetheless, the \"market of the spine surgery\" is growing because patients are demanding solutions for their back problems. The tide of scientific evidence seems to go against the spinal fusions in the degenerative disc disease,  discogenic pain  and in specific back pain. After decades of advances in this field, the results of spinal fusions are mediocre. New epidemiological studies show that \" spinal fusion must be accepted as a non proved or experimental method for the treatment of back pain \". The surgical literature on  spinal fusion  published in the last 20 years establishes that instrumentation seems to slightly increase the fusion rate and that instrumentation doesn't improve the clinical results in general. We still are in need of randomized studies to compare the surgical results with the natural history of the disease, the placebo effect, or conservative treatment. The European Guidelines for lumbar chronic pain management show  \"strong evidence\" indicating that complex and demanding spine surgery where different instrumentation is used, is not more effective than a simple, safer and cheaper  posterolateral  fusion without instrumentation. Recently, the literature published in this field is sending a message to use \"minimally invasive techniques\"; \u2013 the abandonment of transpedicular fusions. Surgery in general, and usage of metal fixation should be discarded in most cases. [ 217 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_890", "text": "In  Sweden , the national registry of lumbar spine surgery reported in the year 2000 that 15% of patients with spinal stenosis surgery underwent a concomitant fusion. [ 218 ]  Despite the traditionally conservative approach to spinal surgery in Sweden, there have been calls from that country for a more aggressive approach to lumbar procedures in recent years. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_891", "text": "Finally, Cherkin et al. evaluated worldwide surgical attitudes. [ 219 ]  There were twice the number of surgeons per capita in the  United States  compared to the  United Kingdom . Numbers were similar to  Sweden . Despite having very few spinal surgeons, the  Netherlands  proved to be quite aggressive in surgery. Sweden, despite having a large number of surgeons was conservative and produced relatively few surgeries. The most surgeries were done in the United States. In the UK, more than a third of non-urgent patients waited over a year to see a spinal surgeon. In  Wales , more than half waited over three months for consult. Lower rates of referrals in the United Kingdom was found to discourage surgery in general. Fee for service and easy access to care was thought to encourage spinal surgery in the United States, whereas salaried position and a conservative philosophy led to less surgery in the United Kingdom. There were more spinal surgeons in Sweden than in the United States.  However, it was speculated that the Swedish surgeons being limited to compensation of 40\u201348 hours a week might lead to a  conservative  philosophy. There have been calls for a more aggressive approach to lumbar surgery in both the United Kingdom and Sweden in recent years. [ 71 ] [ 220 ] [ 221 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_892", "text": "Flat feet , also called  pes planus  or  fallen arches , is a  postural  deformity in which the  arches of the foot  collapse, with the entire  sole  of the foot coming into complete or near-complete contact with the ground. Sometimes children are born with flat feet (congenital). There is a functional relationship between the structure of the arch of the foot and the  biomechanics  of the lower  leg . The arch provides an elastic, springy connection between the  forefoot  and the hind foot so that a majority of the forces incurred during weight bearing on the foot can be dissipated before the force reaches the long bones of the leg and  thigh . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_893", "text": "In pes planus, the head of the  talus bone  is displaced medially and distal from the  navicular bone . As a result, the  plantar calcaneonavicular ligament  (spring ligament) and the tendon of the tibialis posterior muscle are stretched to the extent that the individual with pes planus loses the medial longitudinal arch (MLA). If the MLA is absent or nonfunctional in both the seated and standing positions, the individual has \"sigma\" flatfoot. If the MLA is present and functional while the individual is sitting or standing up on their toes, but this arch disappears when assuming a foot-flat stance, the individual has \"supple\" flatfoot. This latter condition is often treated with arch supports. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_894", "text": "Studies have shown flat feet are a common occurrence in  children  and adolescents. The human arch develops in infancy and early childhood as part of normal  muscle ,  tendon ,  ligament  and  bone  growth. [ 2 ]   Flat arches in children usually become high arches as the child progresses through adolescence and into adulthood. Children with flat feet are at a higher risk of developing knee, hip, and back pain. A 2007  randomized controlled trial  found no evidence for the efficacy of treatment of flat feet in children either from expensive prescribed  orthotics  (i.e. shoe inserts) or less expensive over-the-counter orthotics. [ 3 ]  As a symptom itself, flat feet usually accompany genetic musculoskeletal conditions such as  dyspraxia , [ 4 ]   ligamentous laxity  or  hypermobility ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_895", "text": "Since children are unlikely to suspect or identify flat feet on their own, it is important for adult caregivers to check on this themselves. Besides visual inspection of feet and of the treadwear pattern on shoe soles, caregivers should notice when a child's gait is abnormal, or the child seems to be in pain from walking. Children who complain about calf muscle pains, arch pain, or any other pains around the foot area may be developing or have developed flat feet. A systematic review and meta-analysis study by Xu, et.al., found that urban sedentary boys, aged 6\u20139, were frequently diagnosed with flatfeet. The researchers also explored and listed additional risk factors that played a role in diagnosing flatfeet. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_896", "text": "Training of the feet, utilizing  foot gymnastics  and going  barefoot  on varying terrain, can facilitate the formation of arches during childhood, with a developed arch occurring for most by the age of four to six years. Ligament laxity is also among the factors known to be associated with flat feet. One medical study in India with a large sample size of children who had grown up wearing shoes and others going barefoot found that the longitudinal arches of the bare-footers were generally strongest and highest as a group, and that flat feet were less common in children who had grown up wearing  sandals  or  slippers  than among those who had worn closed-toe  shoes . Focusing on the influence of footwear on the prevalence of pes planus, the cross-sectional study performed on children noted that wearing shoes throughout early childhood can be detrimental to the development of a normal or a high medial longitudinal arch. The vulnerability for flat foot among shoe-wearing children increases if the child has an associated ligament laxity condition. The results of the study suggest that children be encouraged to play barefooted on various surfaces of terrain and that slippers and sandals are less harmful compared to closed-toe shoes. It appeared that closed-toe shoes greatly inhibited the development of the arch of the foot more so than slippers or sandals. This conclusion may be a result of the notion that intrinsic muscle activity of the arch is required to prevent slippers and sandals from falling off the child's foot. [ 7 ]  In children with few symptoms orthotics is not recommended. [ 8 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_897", "text": "Flat feet can also develop as an adult (\"adult acquired flatfoot\") due to injury, illness, unusual or prolonged stress to the foot, faulty  biomechanics , [ 9 ]  or as part of the normal aging process.  This is most common in women over 40 years of age. Known risk factors include obesity,  hypertension  and  diabetes . [ 10 ]  Flat feet can also occur in pregnant women as a result of temporary changes due to increased  elastin  (elasticity) during pregnancy; if developed by adulthood, flat feet generally remain flat permanently."}
{"_id": "WikiPedia_Orthopedics$$$corpus_898", "text": "If a youth or adult appears flatfooted while standing in a full  weight bearing  position, but an arch appears when the person  plantarflexes , or pulls the toes back with the rest of the foot flat on the floor, this condition is called flexible flatfoot.  This is not a true collapsed arch, as the  medial longitudinal arch  is still present and the windlass mechanism still operates; this presentation is actually due to  excessive pronation of the foot  (rolling inwards), although the term 'flat foot' is still applicable as it is a somewhat generic term.  Muscular training of the feet is helpful and will often result in increased arch height regardless of age. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_899", "text": "Research has shown that tendon specimens from people who have adult-acquired flat feet show evidence of increased activity of  proteolytic   enzymes . These enzymes can break down the constituents of the involved tendons and cause the foot arch to fall. In the future, these enzymes may become targets for new drug therapies. [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_900", "text": "Many medical professionals can diagnose a flat foot by examining the patient standing or just looking at them. On going up onto tip toe the deformity will correct when this is a flexible flat foot in a child with lax joints. Such correction is not seen in adults with a rigid flat foot. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_901", "text": "An easy and traditional home diagnosis is the \"wet footprint\" test, performed by wetting the feet in water and then standing on a smooth, level surface such as smooth concrete or thin cardboard or heavy paper. Usually, the more the sole of the foot that makes contact (leaves a footprint), the flatter the foot.  In more extreme cases, known as a kinked flatfoot, the entire inner edge of the footprint may actually bulge outward, where in a normal to high arch this part of the sole of the foot does not make contact with the ground at all. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_902", "text": "On  plain radiography , flat feet can be diagnosed and graded by several measures, the most important in adults being the talonavicular coverage angle, the calcaneal pitch, and the talar-1st metatarsal angle (Meary's angle). [ 11 ]  The talonavicular coverage angle is abnormally laterally rotated in flat feet. [ 11 ]  It is normally up to 7 degrees laterally rotated, so a greater rotation indicates flat feet. [ 11 ]  Radiographies generally need to be taken on weightbearing feet in order to detect misalignment. [ 12 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_903", "text": "Most flexible flat feet are asymptomatic and do not cause pain. In these cases there is usually no cause for concern. Flat feet were formerly a physical-health reason for service rejection in many militaries. However three military studies on asymptomatic adults (see section below) suggest that persons with asymptomatic flat feet are at least as tolerant of foot stress as the population with various grades of arch. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_904", "text": "In a study performed to analyze the activation of the tibialis posterior muscle in adults with pes planus, it was noted that the tendon of this muscle may be dysfunctional and lead to disabling weightbearing symptoms associated with acquired flat foot deformity. The results of the study indicated that, while barefoot, subjects activated additional lower-leg muscles to complete an exercise that resisted foot adduction. However, when the same subjects performed the exercise while wearing arch supporting orthotics and shoes, the tibialis posterior was selectively activated. Such discoveries suggest that the use of shoes with properly fitting arch-supporting orthotics will enhance selective activation of the tibialis posterior muscle, thus acting as an adequate treatment for the undesirable symptoms of pes planus. [ 14 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_905", "text": "Rigid flatfoot, a condition where the sole of the foot is rigidly flat even when a person is not standing, often indicates a significant problem in the bones of the affected feet and can cause pain in about a quarter of those affected. [ 15 ] [ 16 ]   Other flatfoot-related conditions, such as various forms of  tarsal  coalition (two or more bones in the midfoot or hindfoot abnormally joined) or an accessory  navicular  (extra bone on the inner side of the foot), should be treated promptly, usually by the very early teen years, before a child's bone structure firms up permanently as a young adult.  Both  tarsal coalition  and an  accessory navicular  can be confirmed by  X-ray .  Rheumatoid arthritis can destroy tendons in the foot (or both feet), which can cause this condition, and untreated can result in deformity and early onset of osteoarthritis of the joint. Such a condition can cause severe pain and considerably reduced ability to walk, even with orthoses.  Ankle fusion is usually recommended. [ 17 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_906", "text": "Treatment of flat feet may also be appropriate if there is associated foot or lower-leg pain, or if the condition affects the knees or the lower back. Treatment may include  foot gymnastics  or other exercises as recommended by a  podiatrist  or physical therapist. In cases of severe flat feet, orthoses should be used through a gradual process to lessen discomfort.  Over several weeks, slightly more material is added to the orthosis to raise the arch.  These small changes allow the foot structure to adjust gradually, as well as giving the patient time to acclimatize to the sensation of wearing orthoses.  In some cases, surgery can provide lasting relief and even create an arch where none existed before; it should be considered a last resort, as it is usually very time-consuming and costly. [ 18 ]  A minimally invasive surgical intervention involving a small implant is also available. The implant is inserted into the sinus tarsi and prevents the calcaneus and talus from sliding relative to each other. This prevents the sinus tarsi from collapsing and thus prevents the external symptom of the fallen arch from occurring. [ 19 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_907", "text": "The effects of flat feet fall under two categories, which are asymptomatic and symptomatic. Individuals with rigid flat feet tend to exhibit symptoms such as foot and knee tendonitis and are recommended to consider surgical options when managing symptoms. Individuals with flexible flat generally exhibit asymptomatic effects in response to their flat feet. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_908", "text": "According to AAP news and journal gateway, being flexibly flat-footed does not impede athletic performance in children 11-15. [ 20 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_909", "text": "It is generally assumed by running professionals (primarily including some physical trainers, podiatrists, and shoe manufacturers) that a person with flat feet tends to  overpronate  in the running form. [ 21 ]  However, some also assert that persons with flat feet may have an  underpronating  if they are not in a neutral gait. With standard running shoes, these professionals claim, a person who overpronates in his or her running form may be more susceptible to  shin splints , back problems, and  tendonitis  in the knee. [ 22 ]  Running in shoes with extra medial support or using special shoe inserts, orthoses, may help correct one's running form by reducing pronation and may reduce risk of injury. [ 23 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_910", "text": "Studies analyzing the correlation between flat feet and physical injuries in soldiers have been inconclusive, but none suggests that flat feet are an impediment, at least in soldiers who reached the age of military recruitment without prior foot problems."}
{"_id": "WikiPedia_Orthopedics$$$corpus_911", "text": "A 2005 study of  Royal Australian Air Force  recruits that tracked the recruits over the course of their basic training found that neither flat feet nor high-arched feet had any impact on physical capability, injury rates or bipedal aptitude, although there have been results of military trials that have shown those with flat feet to have fewer injuries. [ 24 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_912", "text": "No current studies have been successful in fully ascertaining the long-term detriments to health caused by the overexertion (necessary for athletes/soldiers performing with flat feet) and other compensating measures commonly enacted by the body during bipedal movement."}
{"_id": "WikiPedia_Orthopedics$$$corpus_913", "text": "Another divergent study of 295  Israel Defense Forces  recruits found that those with high arches had almost four times as many stress fractures as those with the lowest arches. [ 25 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_914", "text": "A later study of 449  U.S. Navy special warfare  trainees found no significant difference in the incidence of stress fractures among sailors and Marines with different arch heights. [ 26 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_915", "text": "A  flexion teardrop fracture  is a  fracture  of the anteroinferior aspect of a  cervical vertebral  body due to flexion of the spine along with vertical axial compression. [ 1 ]  The fracture continues sagittally through the vertebral body, and is associated with deformity of the body and subluxation or dislocation of the  facet joints  at the injured level. [ 2 ]  A flexion teardrop fracture is usually associated with a  spinal cord injury , often a result of displacement of the posterior portion of the vertebral body into the  spinal canal . [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_916", "text": "The flexion teardrop fracture should not be confused with a similar-looking vertebral fracture called \"extension teardrop fracture\". Both usually occur in the cervical spine, but as their names suggest, they result from different mechanisms (flexion-compression vs. hyperextension). Both are associated with a small fragment being broken apart from the anteroinferior corner of the affected vertebra. Flexion teardrop fractures usually involve instability in all elements of the spine at the injured level, commonly occur at the C4-C7 vertebra, and have a high association with spinal cord injury (in particular  anterior cord syndrome ). In comparison, the extension-type fracture occurs more commonly at C2 or C3, causes less if any disruption to the middle and posterior elements, and does not usually result in spinal cord injury (however, it may co-occur with more serious spine injuries). [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_917", "text": "This article about an injury is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_918", "text": "Genu recurvatum  is a deformity in the  knee joint , so that the knee bends backwards. In this deformity, excessive extension occurs in the  tibiofemoral joint . Genu recurvatum is also called  knee hyperextension  and  back knee . This deformity is more common in women [ citation needed ]  and people with familial  ligamentous laxity . [ 2 ]  Hyperextension of the knee may be mild, moderate or severe."}
{"_id": "WikiPedia_Orthopedics$$$corpus_919", "text": "The normal range of motion (ROM) of the knee joint is from 0 to 135 degrees in an adult. Full knee extension should be no more than 10 degrees. In genu recurvatum, normal extension is increased. The development of genu recurvatum may lead to  knee pain  and  knee osteoarthritis ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_920", "text": "The following factors may be involved in causing this deformity: [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_921", "text": "The most important factors of knee stability include: [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_922", "text": "Treatment generally includes the following: [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_923", "text": "This condition is considered to be rare, with about 1 in 100,000 births being affected by the congenital form of genu recurvatum, [ 3 ]  although it's a common feature in some disorders, such as in joint hypermobility, which affects 1 in 30 people. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_924", "text": "A  Hill\u2013Sachs lesion , or  Hill\u2013Sachs fracture , is a cortical depression in the posterolateral  head  of the  humerus . It results from forceful impaction of the humeral head against the anteroinferior  glenoid  rim when the  shoulder is dislocated  anteriorly."}
{"_id": "WikiPedia_Orthopedics$$$corpus_925", "text": "Pain while rotating joint bones sounds of rotating bone joints"}
{"_id": "WikiPedia_Orthopedics$$$corpus_926", "text": "Recurrent dislocation of shoulder\nApprehension sign"}
{"_id": "WikiPedia_Orthopedics$$$corpus_927", "text": "The lesion is associated with anterior  shoulder dislocation . [ 1 ]  When the humerus is driven from the  glenoid cavity , its relatively soft head impacts against the anterior edge of the  glenoid . The result is a divot or flattening in the  posterolateral  aspect of the  humeral head , usually opposite the  coracoid process . The mechanism which leads to shoulder dislocation is usually traumatic but can vary, especially if there is history of previous dislocations.  Sports , falls,  seizures , assaults, throwing, reaching, pulling on the arm, or turning over in bed can all be causes of anterior dislocation. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_928", "text": "Diagnosis can be suspected by  history  and  physical examination  which is usually followed by imaging. Because of the mechanism of injury, apprehension of anterior dislocation is common with provocative maneuvers. Hill\u2013Sachs lesions have been classified as \"engaging\" or \"non-engaging\", with engaging lesions defined by the ability of the glenoid to  sublux  into the humeral head defect during  abduction  and external rotation. Engaging dislocations have a higher risk of recurrent anterior dislocation, and their presence can help guide surgical management. [ 2 ]  Imaging diagnosis conventionally begins with  plain film   radiography . Generally, anteroposterior (AP) radiographs of the shoulder with the arm in internal rotation offer the best yield while axillary views and AP radiographs with external rotation tend to obscure the defect. However, pain and tenderness in the injured joint make appropriate positioning difficult and in a recent study of plain film x-ray for Hill\u2013Sachs lesions, the sensitivity was only about 20%. i.e. the finding was not visible on plain film x-ray about 80% of the time. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_929", "text": "By contrast, studies have shown the value of  ultrasonography  in diagnosing Hill\u2013Sachs lesions. In a population with recurrent dislocation using findings at surgery as the gold standard, a sensitivity of 96% was demonstrated. [ 4 ]  In a second study of patients with continuing shoulder instability after trauma, and using double contrast  CT  as a gold standard, a sensitivity of over 95% was demonstrated for ultrasound. [ 5 ]  It should be borne in mind that in both those studies, patients were having continuing problems after initial injury, and therefore the presence of a Hill\u2013Sachs lesion was more likely. Nevertheless, ultrasonography, which is noninvasive and free from  radiation , offers important advantages. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_930", "text": "MRI  has also been shown to be highly reliable for the diagnosis of Hill-Sachs (and  Bankart ) lesions. One study used challenging methodology. First of all, it applied to those patients with a single, or first time, dislocation. Such lesions were likely to be smaller and therefore more difficult to detect. Second, two radiologists, who were blinded to the surgical outcome, reviewed the MRI findings, while two orthopedic surgeons, who were blinded to the MRI findings, reviewed videotapes of the arthroscopic procedures. Coefficiency of agreement was then calculated for the MRI and arthroscopic findings and there was total agreement (  kappa  = 1.0) for Hill-Sachs and Bankart lesions. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_931", "text": "The decision to repair of the Hill\u2013Sachs lesion is based on its association with continuing symptoms and instability. This is particularly important in patients below 25 year of age and in throwing athletes. The role of the Hill-Sachs in continuing symptoms, in turn, may be related to its width and depth, particularly if involving greater than 20% of the articular surface. Associated bony lesions or fractures may coexist in the glenoid such as the bony Bankart lesion. In such scenarios, surgical repair may include bony augmentation, a common example of which is the  Latarjet procedure . Additional lesions such as a Bankart,  SLAP tear , or biceps injury may also be present. [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_932", "text": "The  incidence  of Hill\u2013Sachs lesion is not known with certainty. It has been reported to be present in 40% to 90% of patients presenting with anterior shoulder instability, that is subluxation or dislocation. [ 8 ] [ 9 ]  In those who have recurrent events, it may be as high as 100%. [ 10 ]  Its presence is a specific sign of dislocation and can thus be used as an indicator that dislocation has occurred even if the joint has regained its normal alignment. Large, engaging Hill-Sachs fractures can contribute to shoulder instability and will often cause painful clicking, catching, or popping. [ citation needed ]  The average depth of Hill\u2013Sachs lesion has been reported as 4.1\u00a0mm. [ 11 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_933", "text": "The lesion is named after Harold Arthur Hill (1901\u20131973) and Maurice David Sachs (1909\u20131987), two radiologists from San Francisco, USA. In 1940, they published a report of 119 cases of shoulder dislocation and showed that the defect resulted from direct compression of the humeral head. Before their paper, although the fracture was already known to be a sign of shoulder dislocation, the precise mechanism was uncertain. [ 12 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_934", "text": "Knee pain  is  pain  in or around the  knee ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_935", "text": "The  knee  joint consists of an articulation between four bones: the  femur ,  tibia ,  fibula  and  patella . There are four compartments to the knee. These are the medial and lateral tibiofemoral compartments, the patellofemoral compartment and the superior tibiofibular joint. The components of each of these compartments can experience repetitive strain, injury or disease. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_936", "text": "Running long distance can cause pain to the knee joint, as it is a high-impact exercise. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_937", "text": "The location and severity of knee pain may vary, depending on the cause of the problem. Signs and symptoms that sometimes accompany knee pain include: [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_938", "text": "Some common injuries based on the location include: [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_939", "text": "Some of the diseases of cause of knee pain include the following:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_940", "text": "Common deformities of the knee include:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_941", "text": "Knee pain is more common among people working in the cold than in those in normal temperature. [ 21 ]  Cold-induced knee pain may also be due to  tenosynovitis  of the  tendons  around the knee, in which cold exposure has a specific role, either as a causative or a contributing factor. [ 21 ]  Frank  arthritis  has been reported in children due to  frostbite  from extreme cold causing direct  chondrocyte  injury. [ 22 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_942", "text": "There is also a  hereditary disease ,  familial cold autoinflammatory syndrome  (FCAS), which often features knee pain, in addition to hives, fever and pain in other joints, following general exposure to cold. [ 23 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_943", "text": "A lower level of physical activity and a work environment where one is required to sit in a chair during the work day is one reason for developing knee joint pain, as the lower degree of physical movement tends to weaken the knee muscles. Blood vessels also can be affected, leading to development of painful conditions. Working on building strength through a full range of motion is crucial for rebuilding strength and getting rid of knee pain.  [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_944", "text": "As age progresses the movement of the knee joint involves higher friction with adjacent tissue and cartilages. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_945", "text": "Referred pain  is that pain perceived at a site different from its point of origin but innervated by the same spinal segment. [ 24 ]  Sometimes knee pain may be related to another area from body. For example, knee pain can come from ankle, foot, hip joints or  lumbar spine ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_946", "text": "Knee MRIs should be avoided for knee pain without symptoms or  effusion , unless there are non-successful results from a functional rehabilitation program. [ 25 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_947", "text": "In some diagnosis, such as in knee osteoarthritis, magnetic resonance imaging does not prove to be clear for its determination. [ 26 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_948", "text": "Although surgery has a role in repairing traumatic injuries and broken bones,  arthroscopic surgeries  do not provide significant or lasting improvements to either pain or function to people with  knee pain, and therefore should almost never be performed. [ 27 ]  Knee pain is pain caused by wear and tear, such as  osteoarthritis  or a  meniscal tear .  Effective treatments for knee pain include  physical therapy  exercises, [ 28 ]  pain-reducing drugs such as  ibuprofen , joint stretching, [ 29 ] [ 30 ]   knee replacement  surgery, and weight loss in people who are overweight. [ 27 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_949", "text": "Overall, a combination of interventions seems to be the best choice when treating knee pain. Interventions such as exercises that target both the knee and the hip, foot bracing, and patellar taping are all recommended for use with patients who have knee pain. [ 31 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_950", "text": "Current evidence suggests that psychological factors are elevated in individuals with patellofemoral pain. [ 32 ]  Non-physical factors such as anxiety, depression, fear of movement, and catastrophizing are thought to have a linear correlation with increased pain experience and decreased physical function. [ 32 ]  Catastrophizing is defined as imagining the worst possible outcome of an action or event. [ 33 ]  The psychosocial factors may have either a positive or negative impact on adherence to rehabilitation programs for managing knee pain. [ 32 ]  Furthermore, studies have found knee pain to be negatively associated with health-related quality of life, and an increase in knee pain to be associated with a reduction in patient-reported quality of life, as compared to those with no or stable knee pain, even in the relatively younger middle-aged population. [ 34 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_951", "text": "About 25% of people over the age of 50 experience knee pain from degenerative knee diseases. [ 27 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_952", "text": "In the United States, more than US$3 billion is spent each year on arthroscopic knee surgeries that are known to be ineffective in people with degenerative knee pain. [ 27 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_953", "text": "Larsen syndrome  ( LS ) is a  congenital disorder  discovered in 1950 by Larsen and associates when they observed  dislocation  of the large joints and face anomalies in six of their patients. [ 1 ]  Patients with Larsen syndrome normally present with a variety of symptoms, including  congenital  anterior  dislocation  of the knees,  dislocation  of the hips and elbows, flattened facial appearance, prominent foreheads, and depressed nasal bridges. [ 2 ]  Larsen syndrome can also cause a variety of  cardiovascular [ 3 ]  and  orthopedic  abnormalities. [ 4 ]  This rare disorder is caused by a genetic defect in the gene encoding  filamin  B, a cytoplasmic protein that is important in regulating the structure and activity of the  cytoskeleton . [ 5 ]  The gene that influences the emergence of Larsen syndrome is found in chromosome region, 3p21.1-14.1, a region containing human type VII  collagen  gene. [ 6 ]  Larsen syndrome has recently been described as a  mesenchyme  disorder that affects the  connective tissue  of an individual. [ 2 ]   Autosomal dominant  and  recessive  forms of the disorder have been reported, although most cases are autosomal dominant. [ 1 ]  Reports have found that in Western societies, Larsen syndrome can be found in one in every 100,000 births, but this is most likely an underestimate because the disorder is frequently unrecognized or misdiagnosed. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_954", "text": "Symptoms are related to defects in connective tissue."}
{"_id": "WikiPedia_Orthopedics$$$corpus_955", "text": "Cardiac defects are similar to those associated with  Marfan's syndrome , a disorder of the connective tissue."}
{"_id": "WikiPedia_Orthopedics$$$corpus_956", "text": "These symptoms were found in rare cases of Larsen syndrome. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_957", "text": "Filamins are cytoplasmic proteins that regulate the structure and activity of the  cytoskeleton . These proteins serve as scaffolds on which intracellular signaling and protein trafficking are organized.  Filamin B  has been found to be expressed in human growth plate  chondrocytes , which are especially important in vertebrae segmentation and skeleton  morphogenesis . Genetic analysis of patients with Larsen syndrome has found the syndrome is caused by  missense mutations  in the gene that codes for filamin B. These mutations cause an accelerated rate of  apoptosis  in the  epiphyseal growth plates  of individuals with the mutation. The defects can cause short stature and other symptoms associated with Larsen syndrome. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_958", "text": "Genetic analysis has found that a gene linked to Larsen syndrome,  LAR1 , is strongly linked to chromosome 3p markers. The locus of this gene is found in a region defined distally by D3S1581 and proximally by D3S1600. This location can be mapped to chromosome region 3p21.1-14.1. Human type VII collagen gene is found within this region in chromosome region 3p21.1. It is reasonable to believe that the joint abnormalities and cardiac anomalies associated with Larsen syndrome are related to the fact that the human type VII collagen gene is found within the same chromosome region as the  LAR1  gene. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_959", "text": "Both  autosomal dominant  and  recessive  forms of Larsen syndrome have been reported. The former is significantly more common than the latter. Symptoms such as  syndactyly ,  cleft palate , short stature, and cardiac defects are seen more commonly in individuals with the autosomal recessive form of the disorder. A lethal form of the disorder has been reported. It is described as being a combination of the Larsen  phenotype  and  pulmonary hypoplasia . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_960", "text": "Ultrasound  remains as one of the only effective ways of prenatally diagnosing Larsen syndrome.  Prenatal  diagnosis is extremely important, as it can help families prepare for the arrival of an infant with specifics necessities. Ultrasound can capture prenatal images of multiple joint dislocations, abnormal positioning of legs and knees, depressed nasal bridge, prominent forehead, and  club feet . These symptoms are all associated with Larsen syndrome, so they can be used to confirm that a  fetus  has the disorder. [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_961", "text": "Treatment for Larsen syndrome varies according to the symptoms of the individual. [ 1 ]  Orthopedic surgery can be performed to correct the serious joint defects associated with Larsen syndrome. Reconstructive surgery can be used to treat the facial abnormalities. Cervical kyphosis can be very dangerous to an individual because it can cause the vertebrae to disturb the  spinal cord . Posterior cervical  arthrodesis  has been performed on patients with cervical kyphosis, and the results have been successful [ 4 ]   Propranolol  has been used to treat some of the cardiac defects associated with Marfan's syndrome, so the drug also has been suggested to treat cardiac defects associated with Larsen syndrome. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_962", "text": "While Larsen syndrome can be lethal if untreated, the prognosis is relatively good if individuals are treated with orthopedic surgery, physical therapy, and other procedures used to treat the symptoms linked with Larsen syndrome. [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_963", "text": "Ankyrin :  Long QT syndrome 4"}
{"_id": "WikiPedia_Orthopedics$$$corpus_964", "text": "Myelopathy  describes any neurologic deficit related to the  spinal cord . [ 1 ]  The most common form of myelopathy in humans,  cervical spondylotic myelopathy (CSM) , [ 2 ] [ 3 ]  also called  degenerative cervical myelopathy , [ 4 ]  results from narrowing of the spinal canal ( spinal stenosis ) ultimately causing compression of the spinal cord. [ 5 ]  \nWhen due to  trauma , myelopathy is known as (acute)  spinal cord injury . When inflammatory, it is known as  myelitis . Disease that is vascular in nature is known as  vascular myelopathy ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_965", "text": "In Asian populations, spinal cord compression often occurs due to a different, inflammatory process affecting the  posterior longitudinal ligament . [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_966", "text": "Clinical signs and symptoms depend on which spinal cord level (cervical, [ 6 ]  thoracic, or lumbar) is affected and the extent (anterior, posterior, or lateral) of the pathology, and may include: [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_967", "text": "Myelopathy is primarily diagnosed by clinical exam findings. Because the term  myelopathy  describes a clinical syndrome that can be caused by many pathologies the differential diagnosis of myelopathy is extensive. [ 7 ]  In some cases the onset of myelopathy is rapid, in others, such as CSM, the course may be insidious with symptoms developing slowly over a period of months. As a consequence, the diagnosis of CSM is often delayed. [ 8 ]  As the disease is thought to be progressive, this may impact negatively on outcome. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_968", "text": "Once the clinical diagnosis  myelopathy  is established, the underlying cause must be investigated. Most commonly this involves medical imaging. The best way to visualize the spinal cord is  magnetic resonance imaging  (MRI). Apart from T1 and T2 MRI images, which are commonly used for routine diagnosis, more recently researchers are exploring quantitative MRI signals. [ 9 ]  Further imaging modalities used for evaluating myelopathy include plain  X-rays  for detecting arthritic changes of the bones, and  Computer Tomography , which is often used for pre-operative planning of surgical interventions for cervical spondylotic myelopathy.  Angiography  is used to examine blood vessels in suspected cases of vascular myelopathy. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_969", "text": "The presence and severity of myelopathy can also be evaluated by means of  transcranial magnetic stimulation  (TMS), a neurophysiological method that allows the measurement of the time required for a neural impulse to cross the pyramidal tracts, starting from the cerebral cortex and ending at the anterior horn cells of the cervical, thoracic or lumbar spinal cord. This measurement is called  Central Conduction Time  ( CCT ). TMS can aid physicians to: [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_970", "text": "TMS can also help in the differential diagnosis of different causes of pyramidal tract damage. [ 12 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_971", "text": "The treatment and prognosis of myelopathy depends on the underlying cause: myelopathy caused by infection requires medical treatment with pathogen specific antibiotics. Similarly, specific treatments exist for  multiple sclerosis , which may also present with myelopathy. As outlined above, the most common form of myelopathy is secondary to degeneration of the cervical spine. Newer findings have challenged the existing controversy with respect to surgery [ 13 ]  for cervical spondylotic myelopathy by demonstrating that patients benefit from surgery. [ 14 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_972", "text": "Creutzfeldt\u2013Jakob disease"}
{"_id": "WikiPedia_Orthopedics$$$corpus_973", "text": "Olecranon fracture  is a  fracture  of the  bony portion  of the  elbow . The injury is fairly common and often occurs following a fall or direct trauma to the elbow. The olecranon is the proximal extremity of the  ulna  which is articulated with the  humerus  bone and constitutes a part of the elbow articulation. Its location makes it vulnerable to direct trauma."}
{"_id": "WikiPedia_Orthopedics$$$corpus_974", "text": "People with olecranon fractures present with intense elbow pain after a direct blow or fall. [ 1 ]  Swelling over the bone site is seen and an inability to straighten the elbow is common. Due to the proximity of the olecranon to the ulnar nerve, the injury and swelling may cause numbness and tingling at the fourth and fifth fingers. [ 1 ]  Examination can bring out a palpable defect at the site of the fracture. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_975", "text": "Olecranon fractures are common. Typically they are caused by direct blows to the elbow (e.g. motor vehicle accidents), and due to falls when the triceps are contracted. [ 1 ] [ 3 ]   \"Side-swipe\" injury when driving a motor vehicle with an elbow projecting outside the vehicle resting on an open window's edge is an example. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_976", "text": "Direct trauma:  This can happen in a fall with landing on the elbow or by being hit by a solid object. Trauma to the elbow often results in  comminuted fractures  of the olecranon."}
{"_id": "WikiPedia_Orthopedics$$$corpus_977", "text": "Indirect trauma : by falling and landing with an outstretched arm."}
{"_id": "WikiPedia_Orthopedics$$$corpus_978", "text": "Powerful pull of the  triceps muscle  can also cause  avulsion fractures ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_979", "text": "To assess an olecranon fracture, a careful skin exam is performed to ensure there is no open fracture. Then a complete neurological exam of the upper limb should be documented. [ 5 ] [ 2 ]  Frontal and lateral  X-ray  views of the elbow are typically done to investigate the possibility of an olecranon fracture. [ 1 ]  A true lateral x-ray is essential to determine the fracture pattern, degree of displacement, comminution, and the degree of articular involvement. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_980", "text": "There are several classifications that describe different forms of olecranon fractures, yet none of them have gained widespread acceptance: [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_981", "text": "Based on the stability, the displacement and the  comminution of the fracture . It is composed of three types, and each type is divided in two subtypes: subtype A (non-comminuted) and subtype B (comminuted)."}
{"_id": "WikiPedia_Orthopedics$$$corpus_982", "text": "This classification incorporates all fractures of the proximal ulna and radius into one group, subdivided into three patterns:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_983", "text": "In fractures with little or no displacement, immobilization with a posterior splint may be sufficient. [ 1 ]  Elbows may be immobilized at 45\u00b0\u201390\u00b0 of flexion for 3 weeks, followed by limited (90\u00b0) flexion exercises. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_984", "text": "Most olecranon fractures are displaced and are best treated surgically: [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_985", "text": "Tension band fixation is the most common form of internal fixation used for non-comminuted olecranon fractures. [ 5 ]  It is typically reserved for noncomminuted fractures that are proximal to the coronoid. [ 2 ]  This procedure is performed using  Kirschner wire  (K-wires) which converts tensile forces into compressive force. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_986", "text": "Single intramedullary screws can be used to treat simple transverse or oblique fractures. [ 5 ]  Plates can be used for all proximal ulna fracture types including Monteggia fractures, and comminuted fractures. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_987", "text": "This method is indicated for cases when open reduction and internal fixation is unlikely to be successful. For example: extensive comminutions, elderly patients with osteoporotic bone, and small or non-union fractures. [ 5 ] [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_988", "text": "Olecranon fractures are rare in children, constituting only 5 to 7% of all elbow fractures. This is because in early life, olecranon is thick, short and much stronger than the lower extremity of the humerus. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_989", "text": "However, olecranon fractures are a common injury in adults. This is partly due to its exposed position on the point of the elbow. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_990", "text": "Patellar subluxation syndrome  is an injury involving the  kneecap . Patellar subluxation is more common than patellar dislocation and is just as disabling. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_991", "text": "In this condition, the  patella  repetitively subluxates and places  strain  on the  medial restraints  and excessive  stress / tension  on the  patellofemoral joint . Patellar subluxation can be caused by osseous abnormalities, such as incorrect articulation of the femoral groove with the patella, trochlear dysplasia, or patella alta, which is a distance of greater than 20\u00a0mm between the tibial tubercle and the trochlear groove. It can also result from soft-tissue abnormalities, such as a torn medial patellofemoral ligament, or a weakened vastus medialis obliquus. [ 2 ]  Symptoms are regulated by the amount of activity. Such  pain  is commonly caused by running and jumping  sports  and activities that place large forces on the patellofemoral joint. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_992", "text": "Symptoms usually include: [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_993", "text": "Patellar subluxation was once thought to occur mainly in women, [ 1 ]  due to the frequency of  genu valgum  and lax  ligaments . However, now the frequency of this condition in any athletic person, man or woman, is apparent. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_994", "text": "Conservative treatment in primary acute LPD (lateral patellar dislocation) is the therapy of choice. It includes a multimodal approach with behavioural education of the patient, physical therapy, braces, weight reduction and pain medication. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_995", "text": "Physical therapy especially focuses on muscle strengthening and proprioceptive exercises. The vastus medialis oblique muscle is described to have an important role in functional stabilization of the patella against lateral vector force. [ 5 ]  Proprioceptive exercises and strengthening of the hip abductors and positioning of the foot are crucial, especially indicated in patient with miserable malalignment syndrome or medial collapse. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_996", "text": "Several patellar braces or taping methods exist to improve return to sport. They may however not alter medial or lateral displacement, but can be helpful as a diagnostic tool for occult patellofemoral instability. [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_997", "text": "Increasing age is associated with decreased physical activity after surgical stabilization, and therefore in growing and very active athletes early surgical treatment intervention needs to be considered. Reconstruction of the MPFL (medial patellofemoral ligament) in patients with minor trochlear dysplasia is technically possible without interfering with distal growth plate of the femur, [ 8 ]  however, large studies are missing. Osseous articular correction before epiphyseal closure is contraindicated. [ 9 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_998", "text": "In adult patients with recurrent LPD and without trochlear dysplasia or type A or C according to Dejour classification, MPFL reconstruction alone might be beneficial, in which unchanged osseous or dynamic instability will be compensated. [ 10 ]  Patients with an important supra-trochlear spur as in type B and D trochlear dysplasia and chronic instability are more reluctant to conservative and soft-tissue surgical treatment options. [ 11 ]  In such cases sulcus-deepening trochleoplasty should be performed. [ 10 ]  Typically, post-surgical results are more favourable when instability was the main symptom. Hence, in such patients low-pivoting physical activity may be re-achieved. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_999", "text": "Perthes lesion  is a variant of  Bankart lesion , presenting as an  anterior   glenohumeral  injury that occurs when the  scapular   periosteum  remains intact but is stripped medially and the anterior  labrum  is  avulsed  from the  glenoid  but remains partially attached to the scapula by intact periosteum."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1000", "text": "The lesion is associated with any damage to the antero-inferior labrum. Most commonly due to anterior  shoulder dislocation . The lesion often occurs after the initial dislocation. In chronic cases, there may be  fibrosis  and resynovialization of the labrum and periosteum. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1001", "text": "The lesion is best identified on MR  arthrography . Additional views in  ABER  ( AB duction and  E xternal  R otation) of the shoulder aid in this diagnosis."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1002", "text": "Differential diagnoses include:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1003", "text": "Treatment is surgical re-attachment of the labrum preferably via  arthroscopy . [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1004", "text": "It is named after  Georg C. Perthes  (1869-1927), a German Surgeon and X-Ray diagnostic pioneer who first described the lesion in 1905. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1005", "text": "1. Perthes Lesion (A Variant of the Bankart Lesion): MR Imaging and MR Arthrographic Findings with Surgical Correlation\nThorsten K. Wischer, Miriam A. Bredella, Harry K. Genant, David W. Stoller, Frederic W. Bost, and Phillip F. J. Tirman\nAJR January 2002 178:233-237"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1006", "text": "2. MRI of the shoulder By Michael B. Zlatkin, Lippincott, Williams and Wilkins 2003"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1007", "text": "Pigeon toe , also known as  in-toeing , is a condition which causes the toes to point inward when walking. It is most common in infants and children under two years of age [ 1 ]  and, when not the result of simple muscle weakness, [ 2 ]  normally arises from underlying conditions, such as a twisted  shin bone  or an excessive anteversion (femoral head is more than 15\u00b0 from the angle of torsion) resulting in the twisting of the  thigh bone  when the front part of a person's foot is turned in."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1008", "text": "The cause of in-toeing can be differentiated based on the location of the misalignment. The variants are: [ 3 ] [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1009", "text": "This is the most common form of being pigeon toed, when the feet bend inward from the middle part of the foot to the toes. This is the most common congenital foot abnormality, occurring every 1 in 5,000 births. [ 5 ] [ 6 ]  The rate of metatarsus adductus is higher in twin pregnancies and preterm deliveries. [ 5 ]   Most often self-resolves by one year of age and 90% of cases will resolve spontaneously (without treatment) by age 4. [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1010", "text": "Signs and Symptoms [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1011", "text": "The tibia or lower leg slightly or severely twists inward when walking or standing.  Usually seen in 1-3 year olds, internal tibial torsion is the most common cause of intoeing in toddlers. [ 5 ] \u00a0 It is usually bilateral (both legs) condition that typically self-resolves by 4 to 5 years of age. [ 6 ] [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1012", "text": "The neck of the femur is angled forward compared to the rest of the bone, causing a compensatory internal rotation of the leg. [ 8 ]  As a result, all structures downstream of the hip including the thigh, knee, and foot will turn in toward mid-line. [ 8 ]  Femoral anteversion is the most common cause of in toeing in children older than 3 years of age. [ 5 ] [ 6 ]  It is most commonly bilateral, affects females twice as much as males, and in some families can show a hereditary pattern. [ 5 ]  This condition may progressively worsen from years 4 to 7, yet the majority of cases still spontaneously resolve by 8 years of age. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1013", "text": "Signs and Symptoms [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1014", "text": "Pigeon toe can be diagnosed by  physical examination  alone. [ 10 ]  This can classify the deformity into \"flexible\", when the foot can be straightened by hand, or otherwise \"nonflexible\". [ 10 ]  Still,  X-rays  are often done in the case of nonflexible pigeon toe. [ 10 ]  On X-ray, the severity of the condition can be measured with a \"metatarsus adductus angle\", which is the angle between the directions of the  metatarsal bones , as compared to the lesser  tarsus  (the  cuneiforms , the  cuboid  and the  navicular bone ). [ 11 ]  Many variants of this measurement exist, but  Sgarlato's angle  has been found to at least have favorable correlation with other measurements. [ 12 ]   Sgarlato's angle  is defined as the angle between: [ 9 ] [ 13 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1015", "text": "This angle is normally up to 15\u00b0, and an increased angle indicates pigeon toe. [ 9 ]  Yet, it becomes more difficult to infer the locations of the joints in younger children due to incomplete ossification of the bones, especially when younger than 3\u20134 years. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1016", "text": "Internal Tibial Torsion"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1017", "text": "Internal tibial torsion is diagnosed by physical exam. [ 6 ]  The principle clinical exam is an assessment of the thigh-foot angle. [ 6 ] \u00a0 The affected individual is placed in prone position with the knees flexed to 90 degrees. [ 6 ] \u00a0 An imaginary line is drawn along the longitudinal axis of the thigh, and of the sole of the foot from a birds-eye view\u00a0and the angle at the intersection of these two lines is measured. [ 6 ] \u00a0 A value greater than 10 degrees of internal rotation is considered internal tibial torsion. [ 6 ] \u00a0 A thigh-foot angle less than 10 degrees internal, and up to 30 degrees of external rotation is considered normal. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1018", "text": "Femoral Anteversion"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1019", "text": "Femoral anteversion is diagnosed by physical exam. [ 6 ] \u00a0 The principle physical exam maneuver is an assessment of hip mobility. [ 6 ]  The child is evaluated in the prone position with knees flexed to 90 degrees. [ 6 ]  Using the tibia as a lever arm the femur is rotated both internally and externally. [ 6 ] \u00a0 A positive exam demonstrates internal rotation of greater than 70 degrees and external rotation reduced to less than 20 degrees. [ 6 ]  Normal values for internal rotation are between 20 and 60 degrees and normal values for external rotation are between 30 and 60 degrees. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1020", "text": "In those less than eight years old with simple in-toeing and minor symptoms, no specific treatment is needed. [ 14 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1021", "text": "Metatarsus Adductus"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1022", "text": "Nonoperative management:   Non operative treatment of metatarsus adductus is dictated by the flexibility of the forefoot. [ 6 ] \u00a0 If the child can actively correct the forefoot to midline no treatment is indicated. [ 6 ] \u00a0 If the adduction cannot be corrected actively but is flexible in passive correction by an examiner, at-home stretching that mimics this maneuver can be performed by parents. [ 6 ]  In the case of a rigid deformity serial casting can straighten the foot. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1023", "text": "Surgical Management:   Most cases of metatarsus adductus that does not resolve is asymptomatic in adulthood and does not require surgery. [ 6 ]   Occasionally, persistent rigid metatarsus adductus can produce difficulty and significant pain associated with inability to find accommodating footwear. [ 5 ]   Surgical options include tasometatarsal capsulotomy with tendontransfers or tarsal osteotomies. [ 5 ]   Due to the high failure rate of capsulotomy and tendon transfer it is generally avoided. [ 6 ] [ 5 ]   Osteotomy (cutting of bone) and realignment of the medial cuneiform, cuboid, or second through fourth metatarsal the safer and most effective surgery in patients over the age of 3 years old with residual rigid metatarsus adductus. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1024", "text": "Nonoperative management:   There are no bracing, casting, or orthotic techniques that have been shown to impact resolution of tibial torsion. [ 5 ] [ 6 ] \u00a0 This rotational limb variant does not increase risk for functional disability or higher rates of arthritis if unresolved. [ 6 ]  Management involves parental education and observational visits to monitor for failure to resolve. [ 15 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1025", "text": "Surgical management:   Indications for surgical correction are a thigh foot angle greater than 15 degrees in a child greater than 8 years of age that is experiencing functional limitations because of their condition. [ 6 ]   Surgical correction is achieved most commonly through a tibial derotational osteotomy.  This procedure involves the cutting (osteotomy) and straightening (derotation) of the tibia, followed by internal fixation to allow the bone to heal in place. [ 15 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1026", "text": "Nonoperative management:   Nonoperative treatment includes observation and parental education.\u00a0Treatment modalities such as bracing, physical therapy, and sitting restrictions have not demonstrated any significant impact on the natural history of femoral anteversion. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1027", "text": "Surgical management:   Operative treatment is reserved for children with significant functional or cosmetic difficulties due to residual femoral anteversion greater than 50 degrees or internal hip rotation greater than 80 degrees after age 8. [ 5 ] [ 6 ]   Surgical correction is achieved  though a femoral derotation osteotomy. [ 8 ]  This procedure involves the cutting (osteotomy) and straightening (derotation) of the femur, followed by internal fixation and to allow the bone to heal in place. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1028", "text": "Planovalgus deformity  is a postural deformity,  flat foot  typology,  very frequent in people with  cerebral palsy  and often due to muscle imbalance resulting in a predominance of the pronotory versus the supinatory forces."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1029", "text": "Surgical treatment in the presence of planovalgus deformity can be of two types:\n [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1030", "text": "Both techniques provide for a thirty-day subsequent protection with a plastered knee-high without load. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1031", "text": "This article about a disease of musculoskeletal and connective tissue is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1032", "text": "Radioulnar synostosis  is a rare condition where there is an abnormal connection ( synostosis ) between the  radius  and  ulna  bones of the  forearm . [ 1 ]  This can be present at birth ( congenital ), when it is a result of a failure of the bones to form separately, or following an injury (post-traumatic). [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1033", "text": "It typically causes  restricted movement  of the forearm, in particular rotation ( pronation  and  supination ), though is usually not painful unless it causes  subluxation  of the  radial head . [ 1 ]  It can be associated with  dislocation  of the radial head which leads to limited elbow extension. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1034", "text": "Congenital radioulnar synostosis is rare, with approximately 350 cases reported in journals. It typically affects both sides (bilateral) and can be associated with other skeletal problems such as hip and knee abnormalities, finger abnormalities ( syndactyly  or  clinodactyly ), or  Madelung's deformity . [ 1 ]  It is sometimes part of known genetic syndromes such as  Klinefelter syndrome  (48,XXXY variant),  Apert ,  Williams ,  Cornelia de Lange , or  Holt\u2013Oram . [ 1 ] [ 3 ]  It has been reported to run in families typically following an  autosomal dominant  inheritance pattern, which means that children of an affected parent have a 50% chance of having the condition. [ 3 ]  When associated with  amegakaryocytic thrombocytopenia , this inheritance has been found to be caused by mutations to the  HOXA11  gene. [ 4 ]  It is also one of the known manifestations of the  fetal alcohol spectrum disorder , which results from prenatal exposure to alcohol. [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1035", "text": "Post-traumatic cases are most likely to develop following surgery for a forearm  fracture ; this is more common with high-energy injuries where the bones are broken into many pieces ( comminuted ). [ 1 ]  It can also develop following soft tissue injury to the forearm where there is  haematoma  formation. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1036", "text": "Diagnosis at birthday [ clarification needed ]  is best done using ultrasound technology. In younger children and adults, diagnosis is done with x-ray machine at the radioulnar bones. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1037", "text": "It is sometimes possible to correct the problem with surgery, though this has high failure rates for treatment of post-traumatic radioulnar synostosis. [ 1 ]  Indication for the surgical treatment of congenital radioulnar synostosis include severe disability due to bilateral disorder or hyperpronation \u2265 90\u00b0. [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1038", "text": "Rounded shoulder posture (RSP) , also known as \u201cmom posture\u201d, [ 1 ]  is a common postural problem in which the resting position of the shoulders leans forward from the body\u2019s ideal alignment. [ 1 ]  Patients usually feel slouched and hunched, [ 2 ]  with the situation deteriorating if left untreated. A 1992 study concluded that 73% of workers aged 20 to 50 years have a right rounded shoulder, [ 3 ]  and 66% of them have a left rounded shoulder. [ 3 ]  It is commonly believed that digitalisation [ 4 ]  combined with the improper use of digital devices have resulted in the prevalence of sedentary lifestyles, which contribute to bad posture. Symptoms of RSP will lead to upper back stiffness, neck stiffness and shoulder stiffness. [ 1 ]  It can be diagnosed by several tests, including physical tests [ 5 ]  and imaging tests. [ 5 ]  To prevent RSP from worsening, maintaining a proper posture, [ citation needed ]  doing regular exercise, [ 6 ]  and undergoing therapeutic treatments [ 7 ]  could be effective. If the situation worsens, patients should seek help from medical practitioners [ 8 ]  for treatments. If RSP is left untreated, chronic pain, [ 9 ]  reduction in lung capacity [ 10 ]  and worsened psychosocial health [ 11 ]  are likely to result."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1039", "text": "Poor posture can cause rounded shoulders because of the  muscle imbalance [ 12 ]  and uneven weight distribution in our upper body. [ 13 ]  Long periods of time spent in positions that put undue strain on the shoulders and neck may wear out some of the muscles while weakening others. For instance, if an individual spends a long period of time in sitting positions without stretching, the chest and front arm muscles shorten and tighten, whereas the upper back and neck muscles weaken and lengthen. [ 14 ]  Due to this asymmetry, the shoulders may roll forward and the upper back may be rounded."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1040", "text": "The development of RSP is often influenced by genetics, as certain inherited traits could possibly have an impact on bone structure, muscular strength, and connective tissue elasticity. [ 15 ]  For instance, some people naturally have a rounded upper back because of the way their spinal vertebrae are arranged. [ 16 ]  Others may naturally have muscles in their upper back and neck that are weaker and more prone to stretching, as well as with chest and front shoulder muscles that are more resistant to stretching.  Connective tissue disorders , such as  Ehlers-Danlos syndrome , [ 17 ]  could also alter the strength and elasticity of ligaments and tendons. [ 18 ]  The risk of  joint hypermobility  and instability will be increased."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1041", "text": "When the brain detects a threat, whether it is physical or psychological, the body will prepare itself to react against the threat (also known as the \u201c fight or flight response \u201d [ 19 ] ). Common responses include tensing one\u2019s jaw, contracting the  abdominal muscles , holding one\u2019s breath and hunching one\u2019s shoulders. [ 20 ]  Persistent psychological stressors such as career dissatisfaction, financial difficulties, or family problems [ 21 ]  may cause physical changes in the body like rounded shoulders, tension headaches and muscle tension. [ 22 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1042", "text": "RSP could be a symptom of some medical conditions, such as  kyphosis ,  scoliosis  or  ankylosing spondylitis . [ 23 ]   Kyphosis  is a spinal disorder that contributes to excessive curvature of the upper back, [ 24 ]  leading to a hunched posture and RSP.  Scoliosis  refers to a condition where there is a sideways curve in a person's  spine , [ 25 ]  causing our shoulders to become uneven and rounded."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1043", "text": "Symptoms of RSP include forward head posture, [ 3 ]  chronic shoulder and neck pain, [ 11 ]  as well as reduced mobility and flexibility in the shoulder; [ 26 ]  hindering the ability to perform daily activities."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1044", "text": "The diagnosis of rounded shoulders involves a physical examination. Healthcare professionals will assess the patient\u2019s posture, range of motion and strength during the examination. The following tests may be carried out:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1045", "text": "Patients are instructed to stand normally with their hands by their sides. Their  coracoid process  (CP),  sternal notch  (SN),  posterolateral angle of acromion  (PLA), and adjacent  thoracic vertebral spine  (TS) are found and marked. [ 27 ]  The distance between the CP and SN, and the distance between the PLA and TS are measured with tape to calculate  scapular index  using the formula (CP to SN)/(PLA to TS) *100. [ 28 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1046", "text": "The ability of the patient to move their shoulders and upper back through their complete range of motion [ 29 ]  will be assessed by the medical professionals to check if there are any restrictions or limitations."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1047", "text": "Muscle strength  testing are also utilised to evaluate RSP. The following tests can assess the strength of muscles:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1048", "text": "With this test, the strength of external rotators of the shoulders are examined, including the  infraspinatus  and  teres minor muscles . [ 30 ]  Patients are instructed to keep their forearms bent at right angles while holding their arms at their sides. Resistance will be applied on patients while the patient rotates their shoulders."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1049", "text": "The middle and lower  trapezius , which are responsible for retracting the  scapula , are evaluated in this test. Patients are instructed to pose with their arms at the sides. [ 31 ]  Resistance is applied as the patients try to pinch their shoulder blades together."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1050", "text": "Deltoid muscle  strength is measured by this test. [ 32 ]  Patients are instructed to lift the arm away from the body. Resistance is applied when the patients attempt to raise the arm during the test."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1051", "text": "The examiner will feel the patient\u2019s upper back and neck muscles with their hands to check the tightness, tension or abnormalities of muscles. [ 33 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1052", "text": "Imaging tests such as  X-rays ,  CT scans  and  MRI [ 7 ]  scans are used to determine the cause and extent of RSP."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1053", "text": "The examiner will be able to identify areas of weakness, and provide patients with a targeted exercise regime for treatment to improve RSP."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1054", "text": "Although the cause of RSP is multifactorial, two major contributors to RSP are the tightness of the  pectoralis minor muscle  and the weakening of lower  trapezius  muscle. [ 34 ]  As the only  scapulothoracic muscle  anteriorly originating and inserting to the  scapula , the  pectoralis minor \u2019s function in favoring the internal and downward rotation of the scapula has been clinically established. [ 35 ]  Muscle strength deficits in the lower  trapezius  muscles are also a common clinical finding in patients with rounded shoulders as it has been speculated to restrict  zygapophyseal  extension in the middle to lower  thoracic spine . [ 36 ]  Therefore, RSP treatment often targets the symptoms or root causes associated with these problem areas."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1055", "text": "A randomized, blinded and controlled experimental study concluded that physical therapy treatment targeting the pectoralis minor soft tissue combined with self-stretching significantly improved rounded shoulder posture. [ 37 ]  Commonly applied regimens include the  McKenzie exercise \u2013 [ 38 ]  a self therapy exercise consisting of repetitive motions such as mobilization and manipulation to aid posture correction; and the  Kendall exercise  for strengthening the deep  cervical flexor  and  pectoral muscle  to correct neck alignment."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1056", "text": "Chiropractic adjustments, decompression therapy as well as therapeutic massages have also been known to unlock tight shoulders by strengthening the chest muscles. [ 39 ] [ 40 ]  By applying controlled forces to spinal joints, creating space between vertebrae [ 41 ]  and kneading soft tissues of the body [ 42 ]  respectively; these therapeutic treatments address core sources of rounded shoulders and restore musculoskeletal imbalances by realigning the spine and shoulders."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1057", "text": "The prevalence of rounded shoulders is often linked to modern lifestyles, [ 43 ]  such as spending long hours sitting in front of a computer or hunching over a mobile device. [ 44 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1058", "text": "One of the most direct preventive measure for rounded shoulders is consistently maintaining a good posture. [ 45 ]  Sitting up straight and engaging the core muscles to keep the shoulders back and down can help maintain proper alignment and prevent the shoulders from rounding forward. [ 46 ]  Additionally, stretching the chest muscles and strengthening the back muscles can also help improve posture. [ 47 ]  Exercises that strengthen the back muscles include rows, pull-ups, and shoulder blade squeezes. Exercises like doorway stretches for the chest can help stretch out tension that contributes to rounded shoulders. Synergistically implementing muscle strengthening and stretching can effectively prevent the development of rounded shoulders. [ 47 ] [ 48 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1059", "text": "Rounded shoulders can also be prevented by taking frequent breaks from prolonged sitting to engage in regular physical activity. [ 6 ]  Activities that require arm and shoulder motion, such as swimming, walking, and other sports, can help to strengthen and stretch the associated muscles, improving posture and reducing the likelihood of developing rounded shoulders. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1060", "text": "However, if left undiagnosed, rounded shoulders can lead to several prolonged complications. The extent of postural abnormality may result in a significantly increased incidence of pain and discomfort in the neck, shoulders, and upper back, which then possibly affects overall health and well-being. [ 49 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1061", "text": "Chronic pain  and discomfort brought on by the persistent tension in the muscles of the upper body may have a negative influence on everyday life. [ 9 ]  This discomfort leads to reduced  agility  and range of motion, making it harder to accomplish regular chores. A patient's quality of life may also be significantly impacted by unilateral cervicogenic headaches that originate in musculoskeletal tissue innervated by  cervical nerves  and progress to the  fronto-temporal  and  orbital areas . [ 50 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1062", "text": "Lung capacity  reduction is another issue associated with rounded shoulders. The chest cavity might become constrained when the shoulders are positioned forward, making it more difficult to take deep breaths due to a lowered total lung capacity. Furthermore, secondary muscles of inspiration, such as the  serratus anterior ,  sternocleidomastoid , and  pectoralis minor , become weak as a result of the kyphotic posture and  posterior pelvic tilt  that flatten the  lumbar lordosis . [ 10 ]  Atypical breathing patterns then arise from the overactivation of secondary muscles of inspiration due to their weakness. [ 10 ] [ 51 ] [ 52 ]  This might lead to shortness of breath and exhaustion, making it increasingly difficult to participate in physical exercise. [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1063", "text": "Rounded shoulders can also affect psychosocial and mental health [ 11 ]   Depression  and anxiety are two prevalent psychological side effects of chronic pain. Individuals with chronic pain may have anxiety about the future and their capacity to manage the pain, as well as depressive symptoms owing to the negative effects the pain has on their quality of life. If the pain is not being properly managed or if it is interfering with everyday tasks, these emotions can be particularly difficult to navigate. [ 53 ]  Social interactions could also be impacted by chronic pain. [ 54 ]  Patients with chronic pain could find that their discomfort makes it difficult for them to work, exercise, and socialize, which can lead to feelings of loneliness and frustration that might exacerbate the psychological issues outlined above."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1064", "text": "Additional reported complications of rounded shoulders include poor balance, jaw pain,  migraines  and other issues."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1065", "text": "RSP is an issue that should be addressed, as many serious complications, such as chronic pain, headaches, or breathing difficulties will result if left untreated. RSP may also lower one\u2019s self-esteem and confidence because of its atypical appearance."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1066", "text": "To prevent or correct RSP, individuals should maintain good posture when performing daily tasks, and take frequent breaks when necessary. Regular exercise is also useful in strengthening the upper back and neck muscles. Postural alignment, pain and discomfort will be reduced to improve our overall health and wellbeing."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1067", "text": "Prolonged pain or discomfort as a result of rounded shoulders should be reported to medical practitioners. [ 33 ]  Seeking the counsel of a physician or physical therapist could help create a specific strategy for avoiding and treating the issue. Any underlying problems correlated to the patient\u2019s lifestyle habits can be addressed by a healthcare expert, who can then suggest particular stretches and exercises to correct them. [ 8 ] [ 55 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1068", "text": "Sciatica  is  pain  going down the leg from the  lower back . [ 1 ]  This pain may go down the back, outside, or front of the leg. [ 3 ]  Onset is often sudden following activities such as heavy lifting, though gradual onset may also occur. [ 5 ]  The pain is often described as shooting. [ 1 ]  Typically, symptoms are only on one side of the body. [ 3 ]  Certain causes, however, may result in pain on both sides. [ 3 ]   Lower back pain  is sometimes present. [ 3 ]  Weakness or numbness may occur in various parts of the affected leg and foot. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1069", "text": "About 90% of sciatica is due to a  spinal disc herniation  pressing on one of the  lumbar  or  sacral nerve  roots. [ 4 ]   Spondylolisthesis ,  spinal stenosis ,  piriformis syndrome ,  pelvic tumors , and  pregnancy  are other possible causes of sciatica. [ 3 ]  The  straight-leg-raising test  is often helpful in diagnosis. [ 3 ]  The test is positive if, when the leg is raised while a person is lying on their back, pain shoots below the knee. [ 3 ]  In most cases  medical imaging  is not needed. [ 2 ]  However, imaging may be obtained if bowel or bladder function is affected, there is significant loss of feeling or weakness, symptoms are long standing, or there is a concern for  tumor  or infection. [ 2 ]  Conditions that may present similarly are diseases of the hip and infections such as early  shingles  (prior to rash formation). [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1070", "text": "Initial treatment typically involves  pain medications . [ 2 ]  However, evidence for effectiveness of the pain medication and  muscle relaxants  is lacking. [ 6 ]  It is generally recommended that people continue with normal activity to the best of their abilities. [ 3 ]  Often all that is required for sciatica resolution is time; in about 90% of people symptoms resolve in less than six weeks. [ 2 ]  If the pain is severe and lasts for more than six weeks, surgery may be an option. [ 2 ]  While surgery often speeds pain improvement, its long term benefits are unclear. [ 3 ]  Surgery may be required if complications occur, such as loss of normal bowel or bladder function. [ 2 ]  Many treatments, including  corticosteroids ,  gabapentin ,  pregabalin ,  acupuncture , heat or ice, and  spinal manipulation , have  limited or poor evidence  for their use. [ 3 ] [ 7 ] [ 8 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1071", "text": "Depending on how it is defined, less than 1% to 40% of people have sciatica at some point in time. [ 4 ] [ 9 ]  Sciatica is most common between the ages of 40 and 59, and men are more frequently affected than women. [ 2 ] [ 3 ]  The condition has been known since ancient times. [ 3 ]  The first known modern use of the word  sciatica  dates from 1451, [ 10 ]  although  Dioscorides  (1st-century CE) mentions it in his  Materia Medica . [ 11 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1072", "text": "The term \"sciatica\" usually describes a  symptom \u2014pain along the  sciatic nerve  pathway\u2014rather than a specific condition, illness, or disease. [ 4 ]  Some use it to mean any pain starting in the lower back and going down the leg. [ 4 ]  The pain is characteristically described as shooting or shock-like, quickly traveling along the course of the affected nerves. [ 12 ]  Others use the term as a  diagnosis  (i.e. an indication of cause and effect) for nerve dysfunction caused by compression of one or more lumbar or sacral nerve roots from a spinal disc herniation. [ 4 ]  Pain typically occurs in the distribution of a  dermatome  and goes below the knee to the foot. [ 4 ] [ 6 ]  It may be associated with neurological dysfunction, such as weakness and numbness. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1073", "text": "Modifiable risk factors for sciatica include  smoking ,  obesity , occupation, [ 9 ]  and physical sports where back muscles and heavy weights are involved. Non-modifiable risk factors include increasing age, being male, and having a personal history of  low back pain . [ 9 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1074", "text": "Spinal disc herniation  pressing on one of the  lumbar  or  sacral nerve  roots is the most frequent cause of sciatica, being present in about 90% of cases. [ 4 ]  This is particularly true in those under age 50. [ 13 ]  Disc herniation most often occurs during heavy lifting. [ 14 ]  Pain typically increases when bending forward or sitting, and reduces when lying down or walking. [ 13 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1075", "text": "Other compressive spinal causes include  lumbar spinal stenosis , a condition in which the  spinal canal , the space the spinal cord runs through, narrows and compresses the spinal cord,  cauda equina , or sciatic nerve roots. [ 15 ]  This narrowing can be caused by  bone spurs ,  spondylolisthesis ,  inflammation , or a  herniated disc , which decreases available space for the spinal cord, thus pinching and irritating nerves from the spinal cord that become the sciatic nerve. [ 15 ]  This is the most frequent cause after age 50. [ 13 ]  Sciatic pain due to spinal stenosis is most commonly brought on by standing, walking, or sitting for extended periods of time, and reduces when bending forward. [ 13 ] [ 15 ]  However, pain can arise with any position or activity in severe cases. [ 15 ]  The pain is most commonly relieved by rest. [ 15 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1076", "text": "Piriformis syndrome is a condition that, depending on the analysis, varies from a \"very rare\" cause to contributing up to 8% of low back or buttock pain. [ 16 ]  In 17% of people, the sciatic nerve runs through the  piriformis muscle  rather than beneath it. [ 15 ]  When the piriformis shortens or spasms due to trauma or overuse, it is posited that this causes compression of the sciatic nerve. [ 16 ]  Piriformis syndrome has colloquially been referred to as \"wallet sciatica\" since a  wallet  carried in a rear hip pocket compresses the buttock muscles and sciatic nerve when the bearer sits down. Piriformis syndrome may be suspected as a cause of sciatica when the spinal nerve roots contributing to the sciatic nerve are normal and no herniation of a spinal disc is apparent. [ 17 ] [ 18 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1077", "text": "Deep gluteal syndrome is non-discogenic, extrapelvic sciatic  nerve entrapment  in the deep gluteal space. [ 19 ]  Piriformis syndrome was once the traditional model of sciatic nerve entrapment in this anatomic region. The understanding of non-discogenic sciatic nerve entrapment has changed significantly with improved knowledge of posterior hip anatomy, nerve kinematics, and advances in  endoscopic  techniques to explore the sciatic nerve. [ 20 ] [ 21 ]  There are now many known causes of sciatic nerve entrapment, such as fibrous bands restricting nerve mobility, that are unrelated to the piriformis in the deep gluteal space. Deep gluteal syndrome was created as an improved classification for the many distinct causes of sciatic nerve entrapment in this anatomic region. [ 21 ]  Piriformis syndrome is now considered one of many causes of deep gluteal syndrome. [ 20 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1078", "text": "Sciatic  endometriosis , also called catamenial or cyclical sciatica, is a sciatica whose cause is endometriosis. Its incidence is unknown. Diagnosis is usually made by an  MRI  or CT- myelography . [ 22 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1079", "text": "Sciatica may also occur during pregnancy, especially during later stages, as a result of the weight of the  fetus  pressing on the sciatic nerve during sitting or during leg spasms. [ 15 ]  While most cases do not directly harm the woman or the fetus, indirect harm may come from the numbing effect on the legs, which can cause loss of balance and falls. There is no standard treatment for pregnancy-induced sciatica. [ 23 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1080", "text": "Pain that does not improve when lying down suggests a nonmechanical cause, such as  cancer ,  inflammation , or  infection . [ 13 ]  Sciatica can be caused by tumors impinging on the spinal cord or the nerve roots. [ 4 ]  Severe back pain extending to the hips and feet, loss of bladder or bowel control, or muscle weakness may result from  spinal tumors  or  cauda equina syndrome . [ 15 ]  Trauma to the spine, such as from a car accident or hard fall onto the heel or buttocks, may also lead to sciatica. [ 15 ]  A relationship has been proposed with a latent  Cutibacterium acnes  infection in the intervertebral discs, but the role it plays is not yet clear. [ 24 ] [ 25 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1081", "text": "The sciatic nerve comprises nerve roots L4, L5, S1, S2, and S3 in the spine. [ 26 ]  These nerve roots merge in the pelvic cavity to form the  sacral plexus  and the sciatic nerve branches from that. Sciatica symptoms can occur when there is pathology anywhere along the course of these nerves. [ 27 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1082", "text": "Intraspinal, or discogenic sciatica refers to sciatica whose pathology involves the spine. In 90% of sciatica cases, this can occur as a result of a spinal disc bulge or  herniation . [ 14 ] [ 28 ]  Sciatica is generally caused by the compression of  lumbar nerves  L4 or L5 or  sacral nerve  S1. [ 29 ]  Less commonly,  sacral nerves  S2 or S3 may cause sciatica. [ 29 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1083", "text": "Intervertebral spinal discs consist of an outer  anulus fibrosus  and an inner  nucleus pulposus . [ 14 ]  The  anulus fibrosus  forms a rigid ring around the  nucleus pulposus  early in human development, and the gelatinous contents of the nucleus pulposus are thus contained within the disc. [ 14 ]  Discs separate the spinal vertebrae, thereby increasing spinal stability and allowing nerve roots to properly exit through the spaces between the vertebrae from the spinal cord. [ 30 ]  As an individual ages, the  anulus fibrosus  weakens and becomes less rigid, making it at greater risk for tear. [ 14 ]  When there is a tear in the  anulus fibrosus , the  nucleus pulposus  may extrude through the tear and press against spinal nerves within the spinal cord,  cauda equina , or exiting  nerve roots , causing inflammation, numbness, or excruciating pain. [ 31 ]  Inflammation of spinal tissue can then spread to adjacent facet joints and cause  facet syndrome , which is characterized by lower back pain and referred pain in the  posterior thigh . [ 14 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1084", "text": "Other causes of sciatica secondary to spinal nerve entrapment include the roughening, enlarging, or misalignment ( spondylolisthesis ) of  vertebrae , or  disc degeneration  that reduces the diameter of the lateral foramen through which nerve roots exit the spine. [ 14 ]   When sciatica is caused by compression of a  dorsal nerve root , it is considered a lumbar  radiculopathy  or  radiculitis  when accompanied by an inflammatory response. [ 15 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1085", "text": "The sciatic nerve is highly mobile during hip and leg movements. [ 32 ] [ 33 ]  Any pathology which restricts normal movement of the sciatic nerve can put abnormal pressure, strain, or tension on the nerve in certain positions or during normal movements. For example, the presence of  scar tissue  around a nerve can cause traction neuropathy. [ 34 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1086", "text": "A well known muscular cause of extraspinal sciatica is  piriformis syndrome . The  piriformis muscle  is directly adjacent to the course of the sciatic nerve as it traverses through the intrapelvic space. Pathologies of the piriformis muscle such as injury (e.g. swelling and scarring), inflammation (release of  cytokines  affecting the local cellular environment), or space occupying lesions (e.g. tumor, cyst, hypertrophy) can affect the sciatic nerve. [ 35 ]  Anatomic variations in nerve branching can also predispose the sciatic nerve to further compression by the piriformis muscle, such as if the sciatic nerve pierces the piriformis muscle. [ 36 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1087", "text": "The sciatic nerve can also be entrapped outside of the pelvic space and this is called  deep gluteal syndrome . [ 19 ]  Surgical research has identified new causes of entrapment such as fibrovascular scar bands, vascular abnormalities,  heterotropic ossification ,  gluteal muscles ,  hamstring muscles , and the  gemelli - obturator internus  complex. [ 20 ]  In almost half of the endoscopic surgery cases, fibrovascular scar bands were found to be the cause of entrapment, impeding the movement of the sciatic nerve. [ 37 ] [ 38 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1088", "text": "Sciatica is typically diagnosed by physical examination, and the history of the symptoms. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1089", "text": "Generally, if a person reports the typical radiating pain in one leg, as well as one or more neurological indications of nerve root tension or neurological deficit, sciatica can be diagnosed. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1090", "text": "The most frequently used diagnostic test is the  straight leg raise  to produce  Las\u00e8gue's sign , which is considered positive if pain in the distribution of the sciatic nerve is reproduced with passive flexion of the straight leg between 30 and 70 degrees. [ 39 ]  While this test is positive in about 90% of people with sciatica, approximately 75% of people with a positive test do not have sciatica. [ 4 ]  Straight leg raising of the leg unaffected by sciatica may produce sciatica in the leg on the affected side; this is known as the Fajersztajn sign. [ 15 ]  The presence of the Fajersztajn sign is a more specific finding for a herniated disc than Las\u00e8gue's sign. [ 15 ]  Maneuvers that increase intraspinal pressure, such as coughing, flexion of the neck, and bilateral compression of the  jugular veins , may transiently worsen sciatica pain. [ 15 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1091", "text": "Imaging modalities such as  computerised tomography  or magnetic resonance imaging can help with the diagnosis of lumbar disc herniation. [ 40 ]  Both are equally effective at diagnosing lumbar disk herniation, but computerized tomography has a higher radiation dose. [ 6 ]   Radiography  is not recommended because disks cannot be visualized by  X-rays . [ 6 ]  The utility of  MR neurography  in the diagnosis of piriformis syndrome is controversial. [ 16 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1092", "text": "Discography  could be considered to determine a specific disc's role in an individual's pain. [ 14 ]   Discography  involves the insertion of a needle into a disc to determine the pressure of disc space. [ 14 ]   Radiocontrast  is then injected into the disc space to assess for visual changes that may indicate an anatomic abnormality of the disc. [ 14 ]  The reproduction of an individual's pain during  discography  is also diagnostic. [ 14 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1093", "text": "Cancer  should be suspected if there is previous history of it, unexplained weight loss, or unremitting pain. [ 13 ]  Spinal  epidural abscess  is more common among those who have  diabetes mellitus  or  immunodeficiency , or who have had  spinal   surgery ,  injection  or  catheter ; it typically causes  fever ,  leukocytosis  and increased  erythrocyte sedimentation rate . [ 13 ]  If cancer or spinal epidural abscess is suspected, urgent  magnetic resonance imaging  is recommended for confirmation. [ 13 ]   Proximal diabetic neuropathy  typically affects middle aged and older people with well-controlled type-2  diabetes mellitus ; onset is sudden, causing pain, usually in multiple  dermatomes , quickly followed by weakness. Diagnosis typically involves  electromyography  and  lumbar puncture . [ 13 ]   Shingles  is more common among the elderly and immunocompromised; typically, pain is followed by the appearance of a  rash  with small blisters along a single  dermatome . [ 13 ] [ 41 ]  Acute  Lyme radiculopathy  may follow a history of outdoor activities during warmer months in likely tick habitats in the previous 1\u201312 weeks. [ 42 ]  In the U.S., Lyme is most common in  New England  and  Mid-Atlantic  states and parts of  Wisconsin  and  Minnesota , but it is expanding to other areas. [ 43 ] [ 44 ]  The first manifestation is usually an  expanding rash  possibly accompanied by flu-like symptoms. [ 45 ]  Lyme can also cause a milder, chronic radiculopathy an average of 8 months after the acute illness. [ 13 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1094", "text": "Sciatica can be managed with a number of different treatments [ 46 ]  with the goal of restoring a person's normal functional status and  quality of life . [ 14 ]  When the cause of sciatica is  lumbar disc herniation  (90% of cases), [ 4 ]  most cases resolve spontaneously over weeks to months. [ 47 ]  Initially treatment in the first 6\u20138\u00a0weeks should be conservative. [ 4 ]  More than 75% of sciatica cases are managed without surgery. [ 14 ]  Smokers with sciatica are strongly urged to  quit  in order to promote healing. [ 14 ]  Treatment of the underlying cause of nerve compression is needed in cases of  epidural abscess ,  epidural tumors , and  cauda equina syndrome . [ 14 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1095", "text": "Physical activity is often recommended for the  conservative management  of sciatica for persons who are physically able. [ 3 ]  Bed rest is not recommended. [ 48 ]   Although structured exercises provide small, short-term benefit for leg pain, in the long term no difference is seen between exercise or simply staying active. [ 49 ]  The evidence for  physical therapy  in sciatica is unclear though such programs appear safe. [ 3 ]  Physical therapy is commonly used. [ 3 ]  Nerve mobilization techniques for sciatic nerve are supported by tentative evidence. [ 50 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1096", "text": "There is no one medication regimen used to treat sciatica. [ 46 ]  Evidence supporting the use of  opioids  and  muscle relaxants  is poor. [ 51 ]  Low-quality evidence indicates that  NSAIDs  do not appear to improve immediate pain, and all NSAIDs appear to be nearly equivalent in their ability to relieve sciatica. [ 51 ] [ 52 ] [ 53 ]  Nevertheless, NSAIDs are commonly recommended as a first-line treatment for sciatica. [ 46 ]  In those with sciatica due to  piriformis syndrome ,  botulinum toxin  injections may improve pain and function. [ 54 ]  While there is little evidence supporting the use of epidural or systemic  steroids , [ 55 ] [ 56 ]  systemic steroids may be offered to individuals with confirmed disc herniation if there is a contraindication to NSAID use. [ 46 ]  Low-quality evidence supports the use of  gabapentin  for acute pain relief in those with chronic sciatica. [ 51 ]   Anticonvulsants  and  biologics  have not been shown to improve acute or chronic sciatica. [ 46 ]   Antidepressants  have demonstrated some efficacy in treating chronic sciatica, and may be offered to individuals who are not amenable to NSAIDs or who have failed NSAID therapy. [ 46 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1097", "text": "If sciatica is caused by a herniated disc, the disc's partial or complete removal, known as a  discectomy , has tentative evidence of benefit in the short term. [ 57 ]  A modest reduction in pain is seen after 26\u00a0weeks, but not after one year (about 52\u00a0weeks). [ 48 ]   If the cause is spondylolisthesis or spinal stenosis, surgery appears to provide pain relief for up to two years. [ 57 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1098", "text": "For non-discogenic sciatica, the surgical treatment is typically a  nerve decompression . A decompression seeks to remove tissue around the nerve that may be compressing it or restricting movement of the nerve. [ 58 ] [ 59 ] [ 60 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1099", "text": "Low to moderate-quality evidence suggests that  spinal manipulation  is an effective treatment for acute sciatica. [ 3 ] [ 61 ]  For chronic sciatica, the evidence supporting spinal manipulation as treatment is poor. [ 61 ]  Spinal manipulation has been found generally safe for the treatment of disc-related pain; however, case reports have found an association with  cauda equina syndrome , [ 62 ]  and it is  contraindicated  when there are progressive neurological deficits. [ 63 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1100", "text": "About 39% to 50% of people with sciatica still have symptoms after one to four years. [ 64 ]  In one study, around 20% were unable to work at their one-year followup, and 10% had surgery for the condition. [ 64 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1101", "text": "Depending on how it is defined, less than 1% to 40% of people have sciatica at some point in time. [ 9 ] [ 4 ]  Sciatica is most common between the ages of 40 and 59, and men are more frequently affected than women. [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1102", "text": "Shoulder problems  including  pain , are  one of the more common reasons for physician visits for musculoskeletal symptoms. The shoulder is the most movable joint in the body.  However, it is an unstable joint because of the range of motion allowed. This instability increases the likelihood of joint injury, often leading to a degenerative process in which tissues break down and no longer function well."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1103", "text": "Shoulder pain may be localized or may be referred to areas around the shoulder or down the arm. Other regions within the body (such as  gallbladder ,  liver , or  heart disease , or disease of the cervical spine of the neck) also may generate pain that the brain may interpret as arising from the shoulder. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1104", "text": "The  shoulder  joint is composed of three bones: the  clavicle  (collarbone), the  scapula  (shoulder blade), and the  humerus  (upper arm bone) (see diagram). Two joints facilitate shoulder movement. The  acromioclavicular (AC) joint  is located between the  acromion  (part of the scapula that forms the highest point of the shoulder) and the clavicle. The  glenohumeral joint , to which the term \" shoulder joint \" commonly refers, is a ball-and-socket joint that allows the arm to rotate in a circular fashion or to hinge out and up away from the body. The \"ball\" is the top, rounded portion of the upper arm bone or humerus; the \"socket,\" or  glenoid , is a dish-shaped part of the outer edge of the scapula into which the ball fits.  Arm movement is further facilitated by the ability of the scapula itself to slide along the rib cage.  The capsule is a soft tissue envelope that encircles the glenohumeral joint. It is lined by a thin, smooth synovial membrane. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1105", "text": "The bones of the shoulder are held in place by  muscles ,  tendons , and  ligaments . Tendons are tough cords of tissue that attach the shoulder muscles to bone and assist the muscles in moving the shoulder. Ligaments attach shoulder bones to each other, providing stability. For example, the front of the joint capsule is anchored by three glenohumeral ligaments. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1106", "text": "The  rotator cuff  is a structure composed of tendons that, with associated muscles, holds the ball at the top of the humerus in the glenoid socket and provides mobility and strength to the shoulder joint. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1107", "text": "Four filmy sac-like structures called  bursa  permit smooth gliding between bone, muscle, and tendon. They cushion and protect the  rotator cuff  from the bony arch of the acromion. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1108", "text": "Following are some of the ways doctors diagnose shoulder problems:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1109", "text": "The shoulder joint is the most frequently dislocated major joint of the body. In a typical case of a dislocated shoulder, a strong force that pulls the shoulder outward (abduction) or extreme rotation of the joint pops the ball of the humerus out of the shoulder socket. Dislocation commonly occurs when there is a backward pull on the arm that either catches the muscles unprepared to resist or overwhelms the muscles. When a shoulder dislocates frequently, the condition is referred to as shoulder instability. A partial dislocation where the upper arm bone is partially in and partially out of the socket is called a subluxation. In the medical community, dislocation is commonly referred to as luxation. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1110", "text": "Almost all shoulder dislocations are downwards (inferior) and of these, 95 percent are in a forward direction. Clinically this is referred to as an anterior dislocation of the glenohumeral joint. Not only does the arm appear out of position when the shoulder dislocates, but the dislocation also produces pain. Muscle spasms may increase the intensity of pain. Swelling and bruising normally develop, and in some cases there may be numbness and muscle weakness. Problems seen with a dislocated shoulder are tearing of the ligaments or tendons reinforcing the joint capsule and, less commonly, nerve damage. Doctors usually diagnose a dislocation by a physical examination, but X-rays are taken to confirm the diagnosis and to rule out a related fracture and other complications. X-rays are also taken after relocation to ensure it is in the correct place. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1111", "text": "Doctors treat a dislocation by putting the head of the humerus back into the joint socket (glenoid fossa) of the scapula\u2014a procedure called  manipulation and reduction . This is usually followed up with an X-ray to make sure the reduction did not fracture the surrounding bones. The arm is then immobilized in a sling or a device called a shoulder immobilizer for several days. Usually the doctor recommends resting the shoulder and applying ice three or four times a day. After pain and swelling have been controlled, the patient enters a rehabilitation program that includes exercises to restore the range of motion of the shoulder and strengthen the muscles to prevent future dislocations. These exercises may progress from simple motion to the use of weights. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1112", "text": "After treatment and recovery, a previously dislocated shoulder may remain more susceptible to reinjury, especially in young, active individuals. Ligaments are stretched and may tear due to dislocation. Torn ligaments and other problems resulting from dislocation can increase the chance of repeated dislocation.  A shoulder that dislocates severely or often, injuring surrounding tissues or nerves, usually requires surgery to repair the damaged parts of the shoulder. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1113", "text": "Sometimes the doctor performs surgery through a tiny incision into which a small scope (arthroscope) is inserted to observe the inside of the joint. After this procedure, called arthroscopic surgery, the shoulder is generally restrained by a sling for three to six weeks, while full recovery, including physical therapy, takes several months. Arthroscopic techniques involving the shoulder are relatively new and many surgeons prefer to repair a recurrent dislocating shoulder by the time-tested open surgery under direct vision. There are usually fewer repeat dislocations and improved movement following open surgery, but it may take a little longer to regain motion. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1114", "text": "A shoulder separation occurs where the collarbone (clavicle) meets the shoulder blade (scapula). When ligaments that hold the AC (acromioclavicular) joint together are partially or completely torn, the outer end of the clavicle may slip out of place, preventing it from properly meeting the scapula. Most often the injury is caused by a blow to the shoulder or by falling on an outstretched hand. After injury it is hard to do a 180 degrees rotation. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1115", "text": "Shoulder pain or tenderness and, occasionally, a bump in the middle of the top of the shoulder (over the AC joint) are signs that a separation may have occurred. Sometimes the severity of a separation can be detected by taking X-rays while the patient holds a light weight that pulls on the muscles, making a separation more pronounced. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1116", "text": "A shoulder separation is usually treated conservatively by rest and wearing a sling. Soon after injury, an ice bag may be applied to relieve pain and swelling. After a period of rest, a therapist helps the patient perform exercises that put the shoulder through its range of motion. Most shoulder separations heal within two or three months without further intervention. However, if ligaments are severely torn, surgical repair may be required to hold the clavicle in place. A doctor may wait to see if conservative treatment works before deciding whether surgery is required. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1117", "text": "While not directly a shoulder problem, this may affect shoulder functionality due to problems with sternoclavicular rotation.  A sternoclavicular separation occurs when the  sternum  separates from the clavicle at the  sternoclavicular joint .  Sternoclavicular separations (dislocation and subluxation) are rare [ 6 ]  and generally caused by accident.  If the clavicle is separated posteriorly (i.e. the clavicle separates and goes behind the sternum) the situation can be dangerous and the clavicle can cause damage to interior arteries, veins or organs. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1118", "text": "An X-ray or CT Scan may be necessary to accurately diagnose a sternoclavicular separation. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1119", "text": "Treatment consists of the standard use of plenty of rest, icing, NSAIDs and a sling.  The joint may need to be reduced (i.e. put back in place), especially after posterior separations.  In severe cases, surgery may be advised. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1120", "text": "The \"rotator cuff\" is a group of four tendons that blend together as they attach to the upper end of the arm bone (humerus). These tendons transmit the force of muscles originating on the shoulder blade (scapula) to the arm providing rotational motion and centering or stability of the joint. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1121", "text": "The rotator cuff tendons degenerate with age. [ 7 ] [ 8 ] [ 9 ] [ 10 ]  A group of respected scientists wrote in a review of existing evidence that, the theory that this degeneration is related to pinching (or impingement) between the head of the  humerus  and the  acromion  is now considered inaccurate. [ 11 ]  Rotator cuff pathology is similar in non-dominant compared to dominant and symptomatic compared to asymptomatic shoulder. [ 8 ] [ 9 ] [ 12 ] [ 13 ] [ 14 ] [ 15 ]  About two-thirds of all humans develop rotator cuff tendinopathy if they live to 70 years of age. [ 7 ]  The pathology is mucoid degeneration, not inflammation. [ 11 ]  The process can involve the intra-articular part of the long head of biceps in addition to the supraspinatus, infraspinatus, and subscapularis tendons. [ 16 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1122", "text": "Tendinitis  is inflammation (redness, soreness, and swelling) of a tendon. In tendinitis of the shoulder, the rotator cuff and/or biceps tendon become inflamed, usually as a result of being pinched by surrounding structures. The injury may vary from mild inflammation to involvement of most of the rotator cuff. When the rotator cuff tendon becomes inflamed and thickened, it may get trapped under the acromion. Squeezing of the rotator cuff is called impingement syndrome. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1123", "text": "An inflamed bursa is called  bursitis . Tendinitis and impingement syndrome are often accompanied by inflammation of the bursa sacs that protect the shoulder. Inflammation caused by a disease such as rheumatoid arthritis may cause rotator cuff tendinitis and bursitis. Sports involving overuse of the shoulder and occupations requiring frequent overhead reaching are other potential causes of irritation to the rotator cuff or bursa and may lead to inflammation and impingement. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1124", "text": "The most commonly affected tendon is that of the supraspinatus muscle. Defects in the rotator cuff can come from an injury (cuff tear) or from degeneration (cuff wear). The degree to which a tendon is reparable depends on its quantity and quality. Degenerated tendons are often frail and retracted and may not be amenable to repair. Individuals that are elderly, smokers, or those having had cortisone injections often have weaker tendon tissue that fails without a significant injury. By contrast those whose tendon was torn by a substantial fall often have good quality tendon that can be repaired if surgery is performed promptly after the injury. The symptoms of rotator cuff disease include difficulty lifting the arm. Repair of a rotator cuff requires that the tendon be securely anchored to the bone at surgery and that the repair be protected for several months during healing. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1125", "text": "Signs of these conditions include the slow onset of discomfort and pain in the upper shoulder or upper third of the arm and/or difficulty sleeping on the shoulder, similar condition can have sharp pain or discomfort when the upper shoulder is positioned at certain angles. Tendinitis and bursitis also cause pain when the arm is lifted away from the body or overhead. If tendinitis involves the biceps tendon (the tendon located in front of the shoulder that helps bend the elbow and turn the forearm), pain will occur in the front or side of the shoulder and may travel down to the elbow and forearm. Pain may also occur when the arm is forcefully pushed upward overhead. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1126", "text": "Diagnosis of tendinitis and bursitis begins with a medical history and physical examination. X-rays do not show tendons or the bursae but may be helpful in ruling out bony abnormalities or arthritis. The doctor may remove and test fluid from the inflamed area to rule out infection.\n Ultrasound scans  are frequently used to confirm a suspected tendinitis or bursitis as well as rule out a tear in the rotator cuff muscles.\nImpingement syndrome may be confirmed when injection of a small amount of anesthetic (lidocaine hydrochloride) into the space under the acromion relieves pain. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1127", "text": "Anti-inflammatory medicines such as  aspirin ,  naproxen  or  ibuprofen  among others can be taken to help with pain. In some cases the physical therapist will use  ultrasound  and electrical stimulation, as well as manipulation. Gentle stretching and strengthening  exercises  are added gradually. If there is no improvement, the doctor may inject a  corticosteroid  medicine into the space under the acromion. However, recent  level one evidence  showed limited efficacy of corticosteroid injections for pain relief. [ 17 ]  While steroid injections are a common treatment, they must be used with caution because they may lead to tendon rupture. If there is still no improvement after six to 12 months, the doctor may perform either arthroscopic or open surgery to repair damage and relieve pressure on the tendons and bursae. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1128", "text": "In those with  calcific tendinitis  of the shoulder high energy  extracorporeal shock-wave therapy  can be useful. [ 18 ]  It is not useful in other types of tendonitis. [ 18 ]  For a rotator cuff tear, tentative evidence suggests exercise may reduce pain in the short-term. [ 19 ]  Combination of exercise and joint mobilization can result in long term benefits. [ 19 ]  Other evidence demonstrates the use of corticosteroids injections to be more effective. [ 19 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1129", "text": "A SLAP (superior labrum anterior to posterior) tear occurs when the cartilage of the shoulder (labrum) delaminates from glenoid. This causes an instability of the shoulder, typically in overhead movements. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1130", "text": "Symptoms include a dull ache deep in the shoulder joint, trouble sleeping due to the instability and discomfort, and extreme weakness in overhead activities. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1131", "text": "The best diagnosis for a SLAP tear is a clinical exam\nfollowed by an MRI combined with a contrast agent. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1132", "text": "Very few cases recover to complete mobility without surgical intervention. Some patients are able to strengthen their shoulders to limit the day to day dull ache, but with limited mobility and function. Surgery reattaches the labrum to the glenoid through the use of surgical anchors. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1133", "text": "Recovery is often a lengthy process. The first four or so weeks the patient is required to wear a sling. Following this, there is a month of physical therapy to regain range of motion. At two months limited strength training occurs. At six months the patient is typically released to full active use, although many patients find that full recovery takes longer than this. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1134", "text": "As the name implies, movement of the shoulder is severely restricted in people with a \" frozen shoulder \". This condition, which doctors call  adhesive capsulitis , is frequently caused by injury that leads to lack of use due to  pain . Rheumatic disease progression and recent shoulder surgery can also cause frozen shoulder. Intermittent periods of use may cause inflammation. Adhesions (abnormal bands of tissue) grow between the joint surfaces, restricting motion. There is also a lack of  synovial fluid , which normally lubricates the gap between the arm bone and socket to help the shoulder joint move. It is this restricted space between the capsule and ball of the humerus that distinguishes adhesive capsulitis from a less complicated painful, stiff shoulder. People with diabetes, stroke, lung disease, rheumatoid arthritis, and heart disease, or who have been in an accident, are at a higher risk for frozen shoulder. The condition rarely appears in people under the age of 40. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1135", "text": "A  bone fracture  of the shoulder involves a partial or total crack through one of the three bones in the shoulder, the  clavicle , the  scapula , and the  humerus . The break in a bone usually occurs as a result of an impact injury, such as a fall or blow to the shoulder. Fractures usually involve the  clavicle  or the neck (area below the ball) of the humerus. Fractures of the scapula sometimes occur through the  coracoid process . [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1136", "text": "A shoulder fracture that occurs after a major injury is usually accompanied by severe pain. Within a short time, there may be redness and bruising around the area. Sometimes a fracture is obvious because the bones appear out of position.\n(However this occur in non-involved dislocations and separations.) Both diagnosis and severity can be confirmed by X-rays. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1137", "text": "When a fracture occurs, the doctor tries to bring the bones into a position that will promote healing and restore arm movement. If the clavicle is fractured, the patient must at first wear a strap and sling around the chest to keep the clavicle in place. After removing the strap and sling, the doctor will prescribe exercises to strengthen the shoulder and restore movement. Surgery is occasionally needed for certain clavicle fractures, especially for disunions. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1138", "text": "Fracture of the neck of the humerus is usually treated with a sling or shoulder immobilizer. If the bones are out of position, surgery may be necessary to reset them. Exercises are also part of restoring shoulder strength and motion. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1139", "text": "In arthritis of the shoulder, the cartilage of the ball and socket (glenohumeral joint) is lost so that bone rubs on bone.\nIt may be caused by wear and tear (degenerative joint disease), injury (traumatic arthritis), surgery (secondary degenerative joint disease), inflammation (rheumatoid arthritis) or infection (septic arthritis). [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1140", "text": "Arthritis of the shoulder causes pain and loss of motion and use of the shoulder. X-rays of the shoulder show loss of the normal space between the ball and socket. X-ray can provide  radiographic staging of shoulder osteoarthritis . [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1141", "text": "Early on arthritis of the shoulder can be managed with mild analgesics and gentle exercises. [ 20 ]  Known gentle exercises include warm water therapy pool exercises that are provided by a trained and licensed physical therapist; approved land exercises to assure free movement of the arthritic area; cortisone injections (administered at the minimum of every six months according to orthopedic physicians) to reduce inflammation; ice and hot moist pact application are very effective. Moist heat is preferred over ice whereas ice is preferred if inflammation occurs during the daytime hours.  Local analgesics along with ice or moist heat are adequate treatments for acute pain. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1142", "text": "In the case of rheumatoid arthritis, specific medications selected by a rheumatologist may offer substantial relief. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1143", "text": "When exercise and medication are no longer effective, shoulder replacement surgery for arthritis may be considered.  In this operation, a surgeon replaces the shoulder joint with an artificial ball for the top of the humerus and a cap (glenoid) for the scapula. Passive shoulder exercises (where someone else moves the arm to rotate the shoulder joint) are started soon after surgery. Patients begin exercising on their own about three to six weeks after surgery. Eventually, stretching and strengthening exercises become a major part of the rehabilitation programme. The success of the operation often depends on the condition of rotator cuff muscles prior to surgery and the degree to which the patient follows the exercise programme. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1144", "text": "In young and active patients a partial shoulder replacement with a non-prosthetic glenoid arthroplasty may also be a consideration"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1145", "text": "The  acromioclavicular articulation  consists of the  acromioclavicular ligament  and a small disk of cartilage located in between the acromion and the clavicle.  This disk can wear down through  injury , extreme joint stress (via  bodybuilding ) or normal wear. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1146", "text": "Pain is perceived on shoulder motion, especially on certain movements.  Often a crossover arm test is utilized in diagnosis because this compresses the AC joint, exacerbating the symptoms.  X-rays of the shoulder joint may show either  arthritic changes  of the ac joint or  osteolysis ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1147", "text": "Conservative treatment for this joint is similar to treatments for other types of arthritis, including restricting activity, anti-inflammatory medications (or supplements), physical therapy, and occasionally cortisone shots.  If the pain is severe, surgery may be an option.  The most common surgical treatment, known as resection arthroplasty, involves cutting a very small portion off the clavicle end and letting scar tissue fill in its place. Some portions of the acromioclavicular ligament may still remain attached. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1148", "text": "A  mnemonic  for the basic treatment principles of any musculoskeletal problems is  PRICE :  P rotection,  R est,  I ce,  C ompression, and  E levation: [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1149", "text": "If pain and stiffness persist, see a  doctor ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1150", "text": "According to the American Academy of Orthopaedic Surgeons (AAOS) visits to orthopedic specialists  for shoulder pain has been rising since 1998 and in 2005 over 13 million patients sought medical care for shoulder pain, of which only 34 percent were related to injury. [ 21 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1151", "text": "This article contains and extends text from the public domain document \"Questions and Answers about Shoulder Problems\", NIH Publication No. 01-4865, available from URL  http://www.niams.nih.gov/hi/topics/shoulderprobs/shoulderqa.htm"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1152", "text": "Spondylitis  is an inflammation of the  vertebrae . It is a form of  spondylopathy . In many cases, spondylitis involves one or more  vertebral joints , as well, which itself is called  spondylarthritis ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1153", "text": "Pott disease  is a tuberculous disease of the vertebrae marked by stiffness of the  vertebral column , pain on motion, tenderness on pressure, prominence of certain vertebral spines, and occasionally abdominal pain, abscess formation, and paralysis."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1154", "text": "Ankylosing spondylitis  (AS) is a form of arthritis that primarily affects the spine, although other joints can become involved. It causes inflammation of the spinal joints (vertebrae) that can lead to severe, chronic pain and discomfort. In more advanced cases this inflammation can lead to ankylosis\u2014new bone formation in the spine causing sections of the spine to fuse in a fixed, immobile position."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1155", "text": "A combination of spondylitis and inflammation of the  intervertebral disc space  is termed a  spondylodiscitis ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1156", "text": "Subtalar arthroereisis  is a common treatment for symptomatic  pes planus , also known as flatfoot. There are two forms of pes planus: rigid flatfoot (RFF) and flexible flatfoot (FFF). The symptoms of the former typically necessitate surgical intervention. [ 1 ]  The latter may manifest  fatigue  or pain, but is typically asymptomatic. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1157", "text": "Subtalar arthroereisis is considered as the last resort for treating FFF in cases when conservative measures fail. [ 2 ]  This is accomplished by putting an implant into the  sinus tarsi  to prevent excessive eversion of the  subtalar joint  and improve talus alignment relative to the  calcaneus  and  navicular . This treatment is considered minimally invasive and joint sparing. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1158", "text": "Complications associated with subtalar arthroereisis include undercorrection (due to the use of undersized implants),  sinus tarsi  pain, and implant extrusion. Less common complications include overcorrection caused by oversized implants,  synovitis , infection, and peroneal  spasm .  Nerve injury  can also occur as a complication but can be avoided with careful procedural execution."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1159", "text": "Subtalar arthroereisis allows for the removal of the implant in case of postoperative complications while still maintaining the correction achieved for flat feet. The surgery also allows patients to bear weight right after the treatment."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1160", "text": "Subtalar arthroereisis is primarily used for the treatment of flexible  pes planus , a condition characterized by the loss of the  medial longitudinal arch , abduction of the forefoot, and excessive subtalar eversion. [ 4 ]  This surgical procedure is specifically designed to address the biomechanical abnormalities associated with flexible flatfoot. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1161", "text": "When conservative measures such as  physiotherapy ,  orthotics , and anti-inflammatory medications fail to provide sufficient relief, subtalar arthroereisis becomes a valuable option. [ 5 ]  It is particularly indicated for patients who experience persistent pain and functional limitations despite non-surgical interventions. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1162", "text": "The main purpose of subtalar arthroereisis is to correct the excessive subtalar eversion and restore the subtalar joint to a more neutral position. [ 5 ] [ 6 ]  This is achieved by inserting an implant, typically made of materials such as silicone or polyethylene, into the  sinus tarsi  or adjacent to it. The implant serves to provide stability and support to the subtalar joint, helping to improve foot alignment and function. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1163", "text": "Subtalar arthroereisis can alleviate pain, enhance foot functionality, and improve overall quality of life for individuals with flexible pes planus. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1164", "text": "The clinical significance of subtalar arthroereisis can be shown by different measurements and physical conditions. Such as radiological measurements, kinematic measurements, and soreness, function, and alignment."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1165", "text": "The radiological assessments have exhibited notable enhancements, converging towards the anticipated normal range. Following the surgical procedure, there have been significant improvements observed in several key measurements, including the post-operative  anteroposterior (AP)  Talar calcaneal angle, which is also known as the kite angle, refers to the angle between lines drawn down the axis of the  talus  and  calcaneus ;  AP Talar first metatarsal angle  which is the angle between the axis of the  1st metatarsal  and the axis of the  proximal phalanx  of the 1st toe;  lateral Talar first metatarsal angle , and calcaneal inclination (or  calcaneal pitch ). [ 5 ] [ 7 ] [ 8 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1166", "text": "The kinematic measurements have demonstrated notable improvements, characterized by an average reduction of 8.1\u00b0 in hindfoot valgus. [ 5 ]  Furthermore, enhancements have been observed in  supination ,  dorsiflexion , and Viladot grade, approaching values indicative of a normal function. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1167", "text": "Clinical outcomes were evaluated using standardized surveys, including the Manchester-Oxford Foot Questionnaire and the  American Orthopedic Foot and Ankle Score , which provide quantitative assessments of various parameters such as pain, function, and alignment. [ 5 ]  These outcome scores exhibited significant improvements, indicating favorable treatment effects. For instance, pain levels, as measured by the  Visual Analogue Scale , decreased from an average of 5.5 before the operation to 1.4 after the operation, reflecting a substantial reduction in pain intensity. [ 4 ] [ 9 ] [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1168", "text": "Subtalar arthroereisis is primarily used for the correction of flexible flatfoot, while its utilisation as the primary surgical procedure may not be recommended for cases of rigid pes planus. Contraindications to subtalar arthroereisis encompass various factors, including active infection, previous sinus tarsi surgery or trauma, and advanced  arthritis  of the  subtalar joint . [ 4 ] [ 11 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1169", "text": "Arthroereisis surgery can be performed using a variety of methods and strategies and is usually finished in 20 minutes. [ 12 ]   Anesthesia  might be applied locally, regionally, or generally for the surgery. In the case of children, general  anesthesia  is commonly employed to ensure their stillness during the surgery. A  tourniquet  is not required because the procedure is carried out  percutaneously . During the surgery, the patient lies in a  supine position , and the foot undergoing the operation is internally rotated. An incision of approximately 1 cm is made along the relaxed skin's  tension lines  over the  sinus tarsi . Using a  hemostat , the tissues are spread until reaching the  sinus tarsi . Then,  a guide is inserted percutaneously from the lateral to the medial side across the floor of the  sinus tarsi . The direction of insertion follows from lateral anterior distal to medial posterior proximal, aligning with the  sinus tarsi . To prevent the guidewire from sliding back during trials, the guide pin is pushed towards the medial side and clamped with a  hemostat ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1170", "text": "The guiding pin passes beneath the medial  malleolus  and above the posterior  tibial   tendon . Sizing guides are then installed, followed by trial implants. The objective is to restrict excessive outward turning of the foot, allowing for approximately 5 degrees of  eversion  from the neutral position. It is important not to insert a large implant that may overcrowd the  sinus tarsi . The implant is positioned about 1 to 1.5 cm inside the lateral edge of the  calcaneus , towards the medial side, and its position can be confirmed using  anteroposterior  images. On the lateral side, the implant should be observed resting on the floor of the  sinus tarsi . [ 13 ]  In cases where deformities are present in both feet, bilateral arthroereisis can be performed.  Dorsiflexion  of the foot is accomplished with the knee extended post surgical repair. Subcutaneous  Achilles tendon  lengthening is necessary if  dorsiflexion  is restricted until the foot can be dorsiflexed to 10 degrees. [ 14 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1171", "text": "Subtalar arthroereisis has advantages over other foot pain treatments for primary and secondary flatfoot, as well as for stabilizing the  subtalar joint  into its correct alignment. While this procedure offers certain benefits, it is not without its drawbacks. A systematic review of 76 studies has revealed that complication rates range from 4.8% to 18.6%. Of particular concern is the occurrence of unplanned implant removal, which was reported in 7.1% to 19.3% of cases. [ 15 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1172", "text": "Various complications can arise with different types of devices used in subtalar arthroereisis. Common issues include undercorrection resulting from the use of undersized implants, pain in the  sinus tarsi , and implant extrusion. Less frequently encountered complications include overcorrection caused by oversized implants,  synovitis , infection, and peroneal spasm. [ 16 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1173", "text": "Synovitis , a condition characterized by joint inflammation, is often associated with a reaction to  silicone   microparticles  released from  silastic  implants. [ 17 ]  Over time,  silicone  implants can fragment due to the forces exerted on them within the joint. The use of metal implants instead of  silastic  may potentially reduce implant degradation rates and the corresponding  inflammatory response . [ 18 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1174", "text": "Nerve injury  is another complication that can be prevented through careful procedural execution.  Sinus tarsi  pain, a common complication, can usually be resolved by removing the implant. [ 19 ]  However, a rare but serious complication is the occurrence of a talar neck  fracture , which can significantly impact mobility and recovery potential. [ 20 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1175", "text": "Treatment options for these complications vary depending on their severity. Possible remedies include replacing an incorrectly-sized implant with a larger or smaller one, complete removal of the implant in cases of persistent pain, or the appropriate use of  anti-inflammatory  or  antibiotic  treatments. It is important to note that all surgical interventions carry inherent risks. It is crucial to consider all available treatment options, starting with the least invasive approaches, in order to achieve the best possible outcomes."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1176", "text": "Post-operative care is essential for patients who have undergone  Achilles tendon  lengthening and medial  soft tissue  tightening, while those without  soft tissue  surgery or  gastrocnemius  release may not require plaster fixation. For patients requiring plaster fixation, it is typically maintained for a duration of 4 weeks. During this time, they wear walking braces during the night and engage in passive  plantar  and  dorsal flexion  exercises starting from the first day after surgery. On the second day after surgery, active flexion exercises of the  ankle  are initiated. Suture removal takes place approximately 12-14 days after the operation."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1177", "text": "Around 3 weeks after surgery, patients are usually advised to engage in non-weight-bearing exercises such as swimming and bicycling. After 6 weeks, partial weight-bearing functional exercises can be commenced. To monitor the progress of the correction of deformities and the positioning of the implant, AP, lateral, and oblique  radiographs  are performed immediately after surgery, at 6 weeks, and at 12 weeks. Subsequently,  X-rays  are taken every 3 months. During the last follow-up, measurements of the Meary angle and the talus-first metatarsal angle are recorded and compared with pre-operative data. The evaluation of functionality is conducted using the AOFAS ankle-hind foot score and the VAS score. [ 21 ]  Remarkably, all patients are able to resume sports activities within a period of 12 months."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1178", "text": "The concept of surgically modifying the tarsi and subtalar joint to address flatfoot conditions emerged in 1946 through the proposal made by Chambers. [ 6 ]  He suggested using a wedge placed on the superior surface of the calcaneus to restrict the anterior displacement of the talus from the calcaneus. [ 4 ]  The first surgeon to introduce a cortical bone wedge graft into the sinus tarsi was Stef\u00e1n Haraldsson in 1962. [ 4 ]  This technique aimed to limit subtalar eversion and treat patients with pes planus. [ 4 ]  In 1970, LeLi\u00e8vre from France coined the term \"arthroereisis\" while describing the insertion of a bone graft into the sinus tarsi, secured with a staple. [ 4 ]  Subotnick, in 1974, proposed the use of a synthetic silicone implant placed in the sinus tarsi to enhance the proper positioning of the talus with the calcaneus. [ 4 ]  These developments laid the foundation for the modern-day arthroereisis procedure."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1179", "text": "A  compression fracture  is a collapse of a  vertebra . It may be due to trauma or due to a weakening of the vertebra (compare with  burst fracture ). This weakening is seen in patients with  osteoporosis  or  osteogenesis imperfecta ,  lytic  lesions from  metastatic  or  primary tumors , [ 1 ]  or infection. [ 2 ]  In healthy patients, it is most often seen in individuals suffering extreme vertical shocks, such as ejecting from an  ejection seat . Seen in lateral views in plain  x-ray  films, compression fractures of the spine characteristically appear as  wedge deformities , with greater loss of height anteriorly than posteriorly and intact  pedicles  in the anteroposterior view. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1180", "text": "Acute fractures will cause severe  back pain . Compression fractures which develop gradually, such as in osteoporosis, may initially not cause any symptoms, but will later often lead to back pain and loss of height. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1181", "text": "Compression fractures are usually diagnosed on  spinal radiographs , where a wedge-shaped vertebra may be visible or there may be loss of height of the vertebra. In addition,  bone density measurement  may be performed to evaluate for osteoporosis. When a tumor is suspected as the underlying cause, or the fracture was caused by severe trauma,  CT  or  MRI  scans may be performed. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1182", "text": "Volkmann's contracture  is a permanent  flexion   contracture  of the  hand  at the  wrist , resulting in a claw-like deformity of the hand and fingers. Passive extension of fingers is restricted and painful. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1183", "text": "The most important signs and symptoms of  compartment syndrome  are observable before actual contracture. What is known as the five Ps of compartment syndrome include:  pain , generally the initial symptom, accompanied by pulselessness,  pallor ,  paralysis , and  paraesthesias . Pain will likely also increase upon extension of the affected limbs hands and fingers, which is one of the earliest signs of compartment syndrome and should urgently be followed up by an exam to look for potential development of Volkmann contracture itself. Palpating for tissue firmness in the forearm, and the pulse volume and character of the  radial artery , also reflects the degree of compartment syndrome. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1184", "text": "Any fracture in the elbow region or upper arm may lead to Volkmann's ischemic contracture, but it is especially associated with  supracondylar fracture  of the  humerus . It is also caused by fractures of the forearm bones if they cause bleeding from the major blood vessels of the forearm. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1185", "text": "The condition may be caused by obstruction on the  brachial artery  near the elbow, possibly from improper use of a  tourniquet , improper use of a  plaster cast , or  compartment syndrome . [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1186", "text": "Volkmann's contracture results from acute  ischaemia  and  necrosis  of the muscle fibres of the flexor group of  muscles of the forearm , especially the  flexor digitorum profundus  and  flexor pollicis longus . The muscles become fibrotic and shortened. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1187", "text": "Prevention of the condition requires restoration of blood flow after injury and reduction of compartmental pressure on the muscles. Any splints, bandages, or other devices that might be obstructing circulation must be removed. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1188", "text": "A  fasciotomy  may be required to reduce pressure in the muscle compartment. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1189", "text": "If contracture occurs, surgery to release the fixed tissues may help with the deformity and function of the hand. In established stage reconstructive surgery may be needed.  [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1190", "text": "It is named after  Richard von Volkmann  (1830\u20131889), the 19th century German doctor who first described it, [ 4 ]  in a paper on  \"non-Infective Ischemic conditions of various fascial compartments in the extremities\" . [ 5 ]  Because the contracture occurred at the same time as the paralysis, he considered a nerve cause to be unlikely. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1191", "text": "A  Gigli saw  is a flexible  wire saw  used by  surgeons  for  bone cutting . [ 1 ]  A Gigli saw is used mainly for  amputation , where the bones have to be smoothly cut at the level of amputation. [ 2 ]  It is also used in  veterinary medicine  for cutting  antler ,  horn , and  tusks , as well as bone."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1192", "text": "The saw was invented by  Leonardo Gigli , an Italian  obstetrician , to simplify the performance of a lateral  pubiotomy  in  obstructed labour . [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1193", "text": "It is featured in the 2023 American  horror film   Saw X . [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1194", "text": "In medicine, the  Ilizarov apparatus  is a type of  external fixation  apparatus used in  orthopedic surgery  to lengthen or to reshape the damaged bones of an arm or a leg; used as a  limb-sparing technique  for treating complex fractures and open  bone fractures ; and used to treat an infected non-union of bones, which cannot be surgically resolved. The Ilizarov apparatus corrects angular deformity in a leg, corrects differences in the lengths of the legs of the patient, and resolves osteopathic non-unions; [ 1 ]  further developments of the Ilizarov apparatus progressed to the development of the  Taylor Spatial Frame ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1195", "text": "Gavriil Abramovich Ilizarov  developed the Ilizarov apparatus as a limb-sparing surgical remedy for the treatment of the  osteopathic non-unions  of patients with unhealed broken limbs. [ 1 ]  Consequent to a patient lengthening, rather than shortening, the adjustable-rod frame of his external-fixation apparatus, Ilizarov observed the formation of a  fibrocartilage callus  at and around the site of the bone fracture, and so discovered the phenomenon of  distraction osteogenesis , the regeneration of bone and soft tissues that culminates in the creation of new bone. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1196", "text": "In 1987, the Ilizarov apparatus and Ilizarov's surgical techniques for repairing the broken bones of damaged limbs were introduced to U.S. medicine. [ 2 ]  The mechanical functions of the Ilizarov apparatus derive from the mechanics of the  shaft bow  harness for a horse. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1197", "text": "The Ilizarov apparatus is a specialized  external fixator  of modular construction, composed of rings ( stainless steel ,  titanium ) that are transfixed to healthy bone with  Kirschner wires  and pins of heavy-gauge stainless steel, and immobilised in place with additional rings and threaded rods that are attached with and through adjustable nuts. The circular construction of the apparatus, the rods, and the controlled tautness of the Kirschner wires immobilises the damaged limb to allow healing. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1198", "text": "The mechanical functions of the Ilizarov apparatus are based upon the principles of  tension  (pulling force), wherein the controlled application of mechanical tension to the damaged limb immobilises the broken bones, and so facilitates the biological process of  distraction osteogenesis  (the regeneration of bone and soft tissue) in a reliable and reproducible manner. Moreover, external fixation with the apparatus allows the damaged limb to bear weight early in the medical treatment. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1199", "text": "Once emplaced onto the limb, the top rings of the apparatus transfer mechanical force to the bottom ring through the rods, and so by-pass the site of the fractured bone, thus the Ilizarov apparatus immobilizes the damaged limb and relieves mechanical stresses from the wound, which then allows the patient to move the entire limb. The middle rings stiffen the support rods and hold the bone fragments in place, whilst supporting the immobilised limb. In by-passing the site of the bone fracture, the top and bottom rings bear the critical load by transferring mechanical force from the area of healthy bone above the fracture to the area of healthy bone below the fracture. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1200", "text": "The Ilizarov surgical method of  distraction osteogenesis  (regeneration of bone and soft tissues) for repairing complex fractures of the bones of the limbs is the preferred treatment for cases featuring a high risk of bacterial  infection ; and for cases wherein the extent and severity of the fracture precludes using  internal fixators  to immobilise the damaged bone for proper repair. [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1201", "text": "In 1968, Ilizarov successfully treated the  non-union osteopathy  of  Valeriy Brumel , a Soviet athlete, who suffered a broken ankle and a broken shinbone (tibia) of the right leg, [ 1 ]  had undergone more than twenty failed bone-repair surgeries in three years, and yet his broken leg-bones had not healed and the leg was shorter than before the motorcycle accident in 1965. [ 3 ]  By way of distraction osteogenesis and an external-fixation apparatus, Ilizarov resolved Brumel's osteopathic non-union, by growing new leg bone, which extended the athlete's leg 3.5\u00a0cm (1.4\u00a0in) to its normal length. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1202", "text": "In 1980, Ilizarov successfully treated the osteopathic non-union of  Carlo Mauri , a journalist and an explorer, who, ten years earlier, had broken the distal end of a tibia in an Alpine accident, yet his broken leg-bone had yet to heal. [ 1 ] [ 2 ]  During an expedition in the Atlantic Ocean, Mauri's leg wound reopened; a concerned teammate, a Russian doctor, recommended that Mauri consult with Ilizarov for proper diagnosis, surgical repair, and treatment in the city of  Kurgan , Russia. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1203", "text": "In 2013, consequent to a PTSD-induced fall that broke his left leg, the British war correspondent  Ed Vulliamy  underwent limb-sparing medical treatment that featured surgeries and an Ilizarov apparatus to repair and heal the severely fractured bones in his left leg. [ 8 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1204", "text": "The photographs and  radiographs  illustrate the application and emplacement of an external fixator, an Ilizarov apparatus, to repair the  open fracture  of the lower left leg of a man. The photographs were taken four weeks after the patient fractured the shinbone ( tibia ) and the calfbone ( fibula ) of his left leg, and two weeks after the surgical emplacement of the Ilizarov apparatus to immobilise the leg and isolate the wound and fracture site to facilitate healing."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1205", "text": "The Ilizarov apparatus corrects deformed bones by way of the process of  distraction osteogenesis , which reproduces bone tissues. After an initial surgery during which the bone to repair is fractured, and the apparatus is attached to the limb of the patient; once the fracture has been immobilised, the bone tissues begin to grow and eventually bridge the fracture with new bone. [ 9 ]  In the course of the osteogenesis process, the bone grows and the physician extends the rods of the Ilizarov apparatus to increase the space between the rings at each end of the apparatus. As the rings are installed at and connected to the opposite ends of the fracture site, the adjustment, done four times a day, separates the healing fracture by approximately one millimetre per day; in due course, the millimetric adjustments lengthen the bone of the damaged limb. Upon completing the bone-lengthening phase of treatment, the Ilizarov apparatus remains emplace for a period of osteopathic consolidation, the ossification of the regenerated bone tissues. Using crutches, the patient is able to bear weight on the damaged limb; once healed, the patient undergoes a second surgery to remove the Ilizarov apparatus from the repaired limb. The result of the Ilizarov surgical treatment is a limb that is much longer than before the medical treatment."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1206", "text": "In the case of lengthening a leg bone, an additional surgery will lengthen the  Achilles tendon  to accommodate the longer length of the treated bone. The therapeutic advantage of the Ilizarov treatment is that the patient can be physically active whilst awaiting the bone to repair. The Ilizarov apparatus also is used to treat and resolve a structural defect in a long bone, by transporting a segment of bone whilst simultaneously lengthening and regenerating the bone to reduce the defect, and so produce a single bone. Installing the Ilizarov apparatus requires minimally invasive surgery, and is not free of medical complications, such as inflammation, muscle transfixion, and  contracture  of the affected joint."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1207", "text": "An  osteotome  is an instrument used for cutting or preparing bone. [ 1 ]  Osteotomes are similar to a  chisel  but bevelled on both sides. [ 2 ]  They are used today in  plastic surgery ,  orthopedic surgery  and  dental implantation . [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1208", "text": "The  chain osteotome , originally referred to simply as the osteotome, was invented by the German physician  Bernhard Heine  in 1830. [ 4 ] [ 5 ]   This device is essentially a small  chainsaw . [ 6 ] [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1209", "text": "The  Taylor Spatial Frame  (TSF) is an  external fixator  used by  podiatric  and  orthopaedic surgeons  to treat  complex fractures [ 1 ]  and  bone deformities . The medical device shares a number of components and features of the  Ilizarov apparatus . The Taylor Spatial Frame is a  hexapod  device based on a  Stewart platform , and was invented by orthopaedic surgeon Charles Taylor. The device consists of two or more  aluminum  or  carbon fibre  rings connected by six  struts . Each strut can be independently lengthened or shortened to achieve the desired result, e.g. compression at the fracture site, lengthening, etc. Connected to a bone by tensioned wires or half pins, the attached bone can be manipulated in three dimensions and 9 degrees of freedom. Angular, translational, rotational, and length deformities can all be corrected simultaneously with the TSF."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1210", "text": "The TSF is used in both adults and children. It is used for the treatment of acute  fractures , mal-unions, non-unions and  congenital  deformities. It can be used on both the upper and lower limbs. Specialised foot rings (which are not seen in the picture) are also available for the treatment of complex foot deformities. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1211", "text": "Once the fixator is attached to the bone, the deformity is characterised by studying the postoperative  x-rays , or  CT scans . The angular,  translational ,  rotational , and length deformity values are then entered into specialised software, along with mounting parameters and hardware parameters such as the ring size and initial strut lengths. The software then produces a \"prescription\" of strut changes that the patient follows. The struts are adjusted daily by the patient until the correct alignment is achieved. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1212", "text": "Correction of the bone deformity can typically take 3\u20134 weeks. For simpler fractures where no deformity is present the struts may still be adjusted post-surgery to achieve better bone alignment, but the correction takes less time. For individuals performing strut adjustment. a hand mirror may be useful to aid in reading the strut settings."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1213", "text": "Once the deformity has been corrected, the frame is then left on the limb until the bone fully heals. This often takes 3\u20136 months, depending on the nature and degree of deformity."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1214", "text": "When the bone has sufficiently healed, the frame can be dynamised. This is a process of gradually reducing the supportive role of the frame by reducing the length stability. This causes force that was previously transmitted around the fracture site and through the struts to be transmitted through the bone. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1215", "text": "After a period of dynamisation, the frame can be removed. This is a relatively simple procedure often performed under  gas and air  analgesic."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1216", "text": "The rings are removed by cutting the olive wires using wire cutters."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1217", "text": "The wires are then removed by first sterilising them and then pulling them through the leg using pliers. The threaded half pins are simply unscrewed."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1218", "text": "External fixation via TSFs tends to be less invasive than  internal fixation  and therefore has lower risks of infection associated with it. This is particularly relevant for  open fractures ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1219", "text": "For open  comminuted  fractures of the  tibial plateau  the use of circular frames (like TSF) has markedly reduced infection rates. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1220", "text": "The time taken for bones to heal (time to union) varies depending on a number of factors.  Open fractures  take longer to heal, and infection will delay union. For tibial fractures union is generally achieved after between 3 and 6 months, [ 3 ]  though time to union can be rather subjective, [ 4 ]  and the dynamistion process combined with irregular appointments may interfere with these measures."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1221", "text": "Infection of the pin sites (points where wires enter the skin) of the TSF is a common complication (estimates are that it affects 20% percent of patients). In extreme cases this can result in  osteomylitis  which is difficult to treat. However, pin site infections are normally successfully treated with a combination of oral antibiotics,  intravenous  antibiotics, or removal of the affected pin. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1222", "text": "Pin sites are classified as  percutaneous  wounds"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1223", "text": "Best practice for maintenance of pin sites is unclear and requires more study. [ 5 ]  Common practice involves the regular cleaning of the pin sites with  chlorhexidine gluconate  solution (advice varies from every day to every week), regular showering, and dressing of sites that exude liquid with non-woven gauze soaked in chlorhexidine gluconate. This dressing can be held in place with bungs or makeshift clips or by twisting around the wire."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1224", "text": "Advice varies as to whether scab tissue or any \"crust\" surrounding a pin site should be maintained. With some literature arguing that this acts as a barrier to entry, while other literature argues this may increase the risk of infection."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1225", "text": "Arthroscopic lavage  is the washing out or cleaning out the contents (blood, fluid or loose debris) inside a joint space.  Lavage  is a general term referring to the therapeutic washing, cleaning or rinsing. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1226", "text": "Excessive growth of irritated  synovial membrane  causes it to increase its surface area by buckling into fronds, and the fronds may become inflamed and pour destructive enzymes into the joint space, causing joint swelling and joint surface destruction. Removing this excess material via lavage frequently resolves arthritic knee inflammation or pain. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1227", "text": "Arthroscopic lavage is one of many procedures available to help reverse the damage of early  arthritis .  There is, however, controversy about the value of simple lavage and debridement for the older patient with established  osteoarthritis . [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1228", "text": "Needle lavage should not be used in an attempt to treat persons seeking long-term relief for symptomatic osteoarthritis of the knee. [ 4 ]  The use of this treatment in this case has not been shown to decrease pain, stiffness, tenderness, or swelling, or to increase 50-foot walking time or body function. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1229", "text": "A   cast saw  is an  oscillating   saw  used to remove  orthopedic casts . Instead of a rotating blade, cast saws use a sharp, small-toothed blade rapidly oscillating or vibrating back and forth over a minimal angle to cut material and are therefore not  circular saws . [ 1 ]  This device is often used with a cast spreader. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1230", "text": "The patient's skin frequently comes into contact with the cast saw blade without cutting although it can cause lacerations when used over bony prominences. [ 3 ]  The design enables the saw to cut rigid materials such as plaster or fiberglass. In contrast, soft tissues such as skin move back and forth with the blade, dissipating the shear forces, and preventing injury. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1231", "text": "Modern cast saws date back to the plaster cast cutting saw which was submitted for a patent on April 2, 1945, by  Homer H. Stryker , an orthopedic surgeon from  Kalamazoo ,  Michigan . [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1232", "text": "Cast removal procedures result in complications in less than 1% of patients. These complications include skin abrasions or thermal injuries from friction between the saw and cast. Temperatures exceeding 101\u00a0\u00b0C (214\u00a0\u00b0F) have been recorded during the removal of fiberglass casts. The proper use of the saw is to perforate (instead of cutting) the cast, which can then be separated using a cast spreader. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1233", "text": "Alternatives include cast cutting shears which were patented in 1950 by Neil McKay. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1234", "text": "Cunningham shoulder reduction  was originally published in 2003  [ 1 ]  and is an anatomically based method of  shoulder reduction  that utilizes positioning (analgesic position), voluntary scapular retraction, and  bicipital   massage . It is designed for true  anterior /subcoracoid  glenohumeral dislocations  in patients who can fully adduct their  humerus . [ 2 ]  This is distinct from anteroinferior/subglenoid glenohumeral dislocations for which alternative techniques should be used. [ 3 ] \nThe method is one of several techniques used for  shoulder reduction . [ 4 ] [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1235", "text": "Shoulder dislocation is a common complication of  upper limb trauma  (arm pulled while in  abduction  or direct impact to shoulder) resulting with the humeral head sitting anteriorly out of the  glenoid  fossa."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1236", "text": "Technique is as follows: [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1237", "text": "Step 1  Sit patient up (without slouching, towel or pillow down spine) and place into analgesic position. \u2018Hold\u2019- take control of the affected limb with a 'hold.' This is a firm steady downward hold (not a pull) designed to move the humeral head towards where it needs to be, taking off some of the stretch from the  capsule  (reducing pain), and providing confidence to the patient that you have taken control of the limb. Once you are in this position, it can be useful to ask the patient their  pain level , and explain again what you are going to do. It\u2019s important to note that the elbow is not being supported from below, but is being placed in a downwards \u2018hold\u2019. The affected arm is  adducted  (next to the body) and the elbow fully  flexed  (optimally shortens the biceps muscle, allowing full relaxation) The humerus points directly down and should be in a neutral position (no forward flexion or external rotation). Ask the patient to \u201cshoulders back, chest out.\u201d (reducing scapular  anteversion  and so reducing the static obstruction of the glenoid rim). Kneel next to your patient and place your wrist onto their forearm, with their hand resting on your shoulder."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1238", "text": "Step 2  Massage the  biceps . Ask your patient to again put \u201cshoulders back, chest out\u201d and relax. Massage the biceps (gently) at mid humeral level. Wait for your patient to fully relax and the  humeral head  slips back into place. Tell your patient that they will feel \u201cstrange\u201d as the joint slips back in and not to fight this movement. Continue to gently move the humerus forwards and back in order to find the perfect angle, and provide a small amount of momentum to allow the head to slide across the glenoid."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1239", "text": "Step 3  anterior/posterior humeral movements. The humerus can then be gently moved forwards and back in order to find the perfect angle, and provide a small amount of momentum to allow the head to slide across the glenoid. This combines the principle of overcoming the movement inertia with the apposition of the slippery  articular surfaces  of the  glenoid rim  and the  humeral head ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1240", "text": "If performed correctly most patients do not require  analgesia  for the performance of this technique. [ 7 ]  Inappropriate use of  traction  will result in pain for the patient with subsequent  spasm  and failure to reduce. If the patient is unable to adduct the humerus, or unable to cooperate with positioning, the technique should not be attempted. The patient may require analgesia or  sedation  if they are in pain or unable to relax spasming muscles. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1241", "text": "Friedrich Hessing , after 1913  von Hessing  (19 June 1838,  Buch am Wald  - 16 March 1918,  G\u00f6ggingen ) was an  organ builder  and a pioneer in the field of  orthopedic  technology."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1242", "text": "He was the thirteenth and youngest child born to Johann Georg Hessing (1793-1858), a farmer, and his wife Maria Barbara, n\u00e9e Klee (1796-1861), a  midwife . An impoverished upbringing may have led to his small stature of only 4' 8\". [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1243", "text": "After completing his primary education in 1852, he began training as a gardener for the  Hohenlohe  family. After two years, he quit to take an apprenticeship in carpentry; obtaining his  journeyman 's license in 1857. He then found employment at the organ building firm of  G. F. Steinmeyer & Co. \u00a0[ de ]  in  Oettingen , where he learned how to build organs and  harmoniums . After some further training in  Stuttgart , he moved to  Augsburg  to work with the piano manufacturer, Max Joseph Schramm (1838-1916)."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1244", "text": "In 1866, he received a business license to make organs. That same year, he made an artificial foot for an amputee. The following year, he asked the city of Augsburg for financial support, so he could make artificial limbs a regular part of his business. His request was denied. In 1868, his application to open an orthopedic sanatorium was also denied. He was not discouraged and, later that year, received permission from the  Regierung von Schwaben \u00a0[ de ] . His clinic opened within a few weeks and he took out a newspaper advertisement, assuring everyone that his therapies would not include surgery."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1245", "text": "The response was positive and he treated thousands of people there; including the writer  Max Brod , who was fitted with what came to be known as a  Hessingkorsett \u00a0[ de ] , for a  spinal curvature . Later, Brod would describe his stay there in his memoirs. In addition to the corset, he was also known for a \" schienenh\u00fclsenapparat \u00a0[ de ] \", for treating the effects of  polio , the basic design of which is still in use today. Despite this, for many years, the sale of organs and pianos remained his primary source of income and provided most of the funds needed for establishing the sanatorium."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1246", "text": "In 1886, he added an entertainment facility, the  Kurhaus G\u00f6ggingen \u00a0[ de ] , designed by the architect,  Jean Keller \u00a0[ de ] . In the 1890s, he opened a spa complex at  Rothenburg ob der Tauber . His true breakthrough came in 1899, when he successfully treated  Augusta Victoria of Schleswig-Holstein , German Empress and Queen of Prussia, for an ankle fracture. [ 2 ]  As a result, he became acceptable to the aristocracy and the international public. In 1904, he was appointed a \"Royal Bavarian Councilor\" and, in 1913, was named a Knight in the  Order of Merit of the Bavarian Crown , which gave him the right to use the noble prefix \"von\"."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1247", "text": "His legacy was passed to the Hessing Foundation which still exists today and operates, among things, the  Hessing-Klinik \u00a0[ de ] , a geriatric rehabilitation center. The private Hessingpark Clinic operates a  rheumatism  center as well as an orthopedic shoe company. [ 3 ]  A street in  Bad Reichenhall  is named after him."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1248", "text": "A  hip protector  is a specialized form of pants or underwear containing pads (either hard or soft) along the outside of each hip/leg, designed to prevent  hip fractures  following a fall. Recent developments include the use of double-sided adhesive films that are breathable and more comfortable to wear than specialised pants. The adhesive films are safer because they can be worn in the bath or shower, or when toileting. Hip protectors are most commonly used in elderly individuals who have a high risk of falls and hip fractures (for example, due to history of a previous fall and underlying  osteoporosis ). [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1249", "text": "Most hip fractures follow an impact due to a  lateral  fall. [ 2 ]  The pads are located over the  trochanters , the bony extrusions of the hip region."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1250", "text": "A 2014  Cochrane review  found that hip protectors decrease the number of  hip fractures  among the elderly. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1251", "text": "A number of reviews have found that hip protectors are cost-effective, particularly among residents of care homes and for long-stay patients in hospital [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1252", "text": "A previous review found that the effect for preventing hip fracture among nursing home residents was small and not effective among community dwelling elderly individuals. [ 5 ]   A 2007 review found a decreased risk of hip fractures in elderly nursing home residents. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1253", "text": "However,  acceptance  and long-term compliance towards them has historically been quite low, [ 5 ]  mainly because of discomfort, dislike of their appearance by the person wearing it, and disagreement about fracture risk. [ 7 ]  More modern hip protectors do not suffer from these disadvantages because they are slimmer with a low profile, so less noticeable, have ventilation holes and ducting to keep the skin cool under the pad and are soft and pliable conforming to the contours of the hip. Better independent testing procedures developed by Professor Julian Minns have established a reliable baseline for impact absorption performance. [ 8 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1254", "text": "Research which has found hip protectors to be beneficial found that hard, energy-shunting hip protectors to be superior to soft, energy-absorbing ones. [ 9 ]  However this research predates the introduction of hip protector pads in 2011/2012 using modern non-Newtonian materials, such as  D3o  that absorb around 75% of the impact, typically twice that of previous devices that used soft materials such as textiles or foam pads in an airtight bag, but comparable to the best of the energy-shunting devices, which have now largely disappeared from the market because of a slight tendency to cause pelvic fractures when the energy is transferred [ 10 ]  Another study showed that hip protectors' design and mechanical properties vary drastically among commercially available hip protectors. [ 11 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1255", "text": "Hip protectors are either of the \"crash helmet type\" or \"energy-absorbing type\". The \"crash helmet type\" distributes impacts into the surrounding soft tissue, while the \"energy-absorbing type\" is made of a compressible material and diminishes the force of impact. Both of these systems aim to reduce the focused force beneath an estimated fracture threshold. [ 1 ] [ 12 ]  Several different commercially available hip protectors exist. [ 1 ] [ 9 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1256", "text": "Orthopaedic nursing  (or  orthopedic nursing ) is a  nursing  specialty focused on the prevention and treatment of  musculoskeletal disorders .   Orthopaedic  issues range from acute problems such as  fractures  or hospitalization for  joint replacement  to chronic systemic disorders such as loss of  bone density  or  lupus erythematosus ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1257", "text": "Orthopaedic nurses have specialized skills such as neurovascular status monitoring, traction,  continuous passive motion  therapy,  casting , and care of patients with  external fixation ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1258", "text": "Certification in general orthopaedic nursing results in the designation \" Orthopaedic Nurse Certified \" (ONC)."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1259", "text": "Orthopedic templating  is a process wherein  surgeons  use either  acetate  templates or digital templates to estimate the correct size of the  prosthesis  to be used in surgery.  The biggest educator on the subject has been AO/ASIF.  In a study published in the Injury journal published in 1998, 94% of consultants and 100% of trainees felt that planning was important but half, respectively, routinely planned fracture treatment. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1260", "text": "Since 1999, companies have developed software to computerize the process. In 1999, mediCAD\u00ae was the first commercially available software [ 2 ]  focused mainly on the German market. The orthopedic templating software market began in the United States in 2000 [ 3 ]  when Medstrat, bootstrapped by Mike Cowden and company, introduced their Workflow Engine (WFE), the industry\u2019s first orthopedic-specific PACS. The market grew in 2003 when UK-based OrthoView was founded by Albany Ventures and the Israeli-based Orthocrat-TraumaCad was bootstrapped by an Orthopedic Surgeon Doron Norman MD and a software entrepreneur Zeev Glozman. Other later work includes that of the orthopedic pediatric surgeon Peter Stevens MD from the University Of Utah."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1261", "text": "The main driver of software-based orthopedic templating was the introduction of computed radiography (CR) and  digital radiography  (DR) systems on a mass scale, which in essence eliminated film from the hospital environment, creating the need for digital templating. Unfortunately, eliminating film creates a major flaw when viewing digital images in a variety of viewing formats. Therefore, a value of known size must be present within the image much like a legend on a map. The first calibration device has been introduced into the market by Zimmer corporation which consisted of an acrylic bar with two embedded steel balls. OrthoMark and J2 Medicals Akucal were the first devices to use a spherical marker on an articulating and adjustable arm attached to a base that could be placed next to or under a patient. Subsequently, several different OrthoMark models became available with a variety of bases. Some companies copied these devices, among them was Orthocrat-TraumaCad (subsequently Voyant Health, then Brainlab) with what they called VoyantMark. Another adaptation was the development by Mr Richard King of the University of Coventry & Warwickshire of a dual marker calibration device dubbed KingMark."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1262", "text": "Several PACS ( picture archiving and communication system ) providers such as Medstrat, Sectra, and Cedara developed templating in-house as part of their PACS solution, making them orthopedic-specific PACS. Many non-orthopedic PACS providers have partnered with Voyant Health (previously Orthocrat-TraumaCad, now Brainlab, purchased in 2012) or OrthoView. \nWhile none of the software packages necessarily address the entire aspect of the surgical tactic, instead focusing on pre-operative implant size selection, the tools prove to be quite usable, convenient, and efficient."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1263", "text": "The next step of this technology was making it available on mobile devices such as iPad as well as Android platforms. Medstrat introduced its echoes iPad application in January of 2011. BrainLab demonstrated its iPad application for Orthopaedic templating at AAOS 2014."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1264", "text": "Medstrat envisioned digital templating helping pre-plan cases as a result of the relationship between a Stryker joint rep and his brother-in-law. Orthocrats TraumaCad was founded as a result of  patient-doctor relationship  between a young rock climber and an orthopedic surgeon. OrthoView was founded in 2003 by Adrian Dwyer, Peter Quinn, and John Chambers as well as an orthopaedic surgeon Grant Shaw of Southampton. It was acquired by Materialise NV in 2014. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1265", "text": "As technology moves forward,  Artificial Intelligence (AI) made its way to orthopedic templating .  PeekMed  launched in 2015 an AI-based system, that speeds and automatizes several time-consuming and cumbersome steps by performing automatic bone segmentation, automatic landmark detection, and the automatic planning of the procedure, using the best surgical practices and quick selection of the correction and implants needed. Furthermore, PeekMed allows the surgeon to edit the planning and to simulate different outcomes of the procedure. One of the features of this ultimate technology, automatic  orthopedic templating  helps the surgeon by automatically placing the most suitable template in the correct position with extreme accuracy."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1266", "text": "A variety of  orthopedic boots  are used for the treatment of injuries of the foot or ankle. Along with  orthopedic casts ,  leg braces ,  splints  and  orthotics , they can immobilize and shift weight bearing to help treat injuries to the foot area. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1267", "text": "A  controlled ankle motion walking boot , also referred to as a  controlled ankle movement walking boot ,  below knee walking boot ,  CAM boot ,  CAM walker , or  moon boot , is an  orthopedic  device prescribed for the treatment and stabilization of severe  sprains , [ 3 ]   fractures , and  tendon  or  ligament  tears in the ankle or foot. In situations where ankle motion but not weight is to be limited, it may be used in place of a  cast . [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1268", "text": "A walking boot consists of:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1269", "text": "CAM walkers may range in height from mid-calf to nearly knee-length, depending on the condition they are meant to treat. Some contain inflatable compartments that can be adjusted by the patient for maximum support and comfort. For further protection of the injured ankle and leg, CAM walkers may also utilize a more extensive plastic shell that also encloses the back and sides of the walker, with detachable plastic plates for the front. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1270", "text": "While CAM walkers do not provide the same degree of immobility that an orthopedic cast offers, they have some advantages. [ 6 ]  Unlike casts, they are adjustable and reusable, and fully removable, permitting the patient to bathe the foot and ankle and remove the walker at night, if they so desire; [ 7 ]  and a CAM walker requires no special modifications for the patient to bear weight and walk. With some fractures, however, removal may result in worse outcomes and thus this may be a negative; also, with some fractures, the person should be non-weight bearing. Additionally, there is greater cost."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1271", "text": "For more severe fractures, a traditional cast may still be preferable."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1272", "text": "Orthopedic casts  or just  casts  are a form of medical treatment used to immobilize and support bones and soft tissues during the healing process after fractures, surgeries, or severe injuries. By restricting movement, casts provide stability to the affected area, enabling proper alignment and healing of bones, ligaments, and tendons. They are commonly applied to the limbs but can also be used for the trunk, neck, or other parts of the body in specific cases. Orthopedic casts come in various types and designs, tailored to the nature and severity of the injury, as well as the patient's needs. Advances in medical techniques have made casts more comfortable, effective, and versatile, allowing for both weight-bearing and non-weight-bearing options."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1273", "text": "Upper extremity casts are frequently utilized to immobilize the arm, wrist, or hand for the treatment of fractures, soft tissue injuries, or during post-surgical recovery. They offer stabilization and support, aiding in proper healing while minimizing the risk of further injury. Common types include  long arm casts ,  short arm casts , and specialized versions such as  thumb spica casts . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1274", "text": "A long arm cast extends from the upper arm to the wrist or hand, immobilizing the elbow joint in addition to the forearm. It is typically used for injuries requiring stabilization across multiple joints, such as forearm fractures, certain elbow injuries, and complex soft-tissue damage. It is usually insured that the elbow remains immobilized in a slightly flexed position, usually around 90 degrees, to promote healing while maintaining comfort. Patients with long arm casts often require close monitoring for swelling and circulation issues, given the cast\u2019s extensive coverage."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1275", "text": "A short arm cast is designed to immobilize the wrist and part of the forearm, extending from below the elbow to the hand, often leaving the fingers free for limited mobility. It is used to treat less severe injuries, such as wrist fractures, sprains, or carpal bone issues. The cast restricts wrist movement while allowing elbow mobility, providing a balance between immobilization and functionality. In some cases, a  thumb spica  variant is added to include the thumb in immobilization, such as for scaphoid fractures or severe thumb sprains. Proper fit and careful alignment are critical to ensure effective healing and prevent complications."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1276", "text": "Leg casts are designed to immobilize the lower limb, facilitating the healing process for fractures, ligament injuries, or post-surgical repairs. They provide stability to the affected area, helping to alleviate pain and prevent additional damage. The design of leg casts can vary to cater to specific injuries, from simple foot fractures to more complicated multi-joint issues. The most common types of lower extremity casts include,  long leg casts ,  Short leg casts . Different varieties exist between the two main types."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1277", "text": "A long leg cast extends from the upper thigh to the toes, immobilizing the knee joint as well as the lower leg and ankle. It is typically used for injuries requiring stabilization across multiple joints, such as tibial or fibular fractures, severe knee injuries, or post-surgical recovery. It is ensured that the knee remains immobilized in a slightly flexed position, typically around 20-35 degrees, [ 2 ]  to promote healing while maintaining comfort. Patients with long leg casts often require close monitoring for swelling, circulation issues, and mobility challenges due to the cast\u2019s extensive coverage."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1278", "text": "The short leg cast is designed to immobilize the lower leg and ankle, extending from just below the knee to the toes. It is used to treat less severe injuries, such as ankle fractures, foot fractures, or severe sprains. The cast restricts ankle movement while allowing knee mobility. In some cases, a toe plate is added to a short leg cast to provide additional protection for toe injuries or fractures. The toe plate is an extension of the cast that covers the toes, shielding them from external forces and reducing the risk of further injury during recovery. It also helps maintain proper alignment of the toes, preventing displacement of fractured bones or soft tissue damage. Toe plates are particularly useful for injuries where direct impact or accidental movement could hinder healing, such as complex fractures or severe soft tissue injuries in the toes."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1279", "text": "When a patient is advised not to put weight on an injured limb, mobility aids like  crutches ,  walkers , or  wheelchairs  can be used to help with movement during the recovery process. These aids protect the injured area while allowing the patient to move around safely. For those who cannot use crutches due to balance or strength challenges, a wheelchair or knee scooter might be suggested as a more stable mobility option. In certain situations, partial weight-bearing may be permitted, and specialized footwear can be fitted over the cast for added support. For leg casts that allow weight-bearing, the under-sole is usually reinforced to evenly distribute pressure and minimize strain on the injury. Walking casts, as they are called, come with a hard, flat sole to aid in walking while ensuring proper alignment and stability. Other  alternative for ambulation with an injured leg include using an"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1280", "text": "Cylinder casts are orthopedic devices used to immobilize the arm or leg while leaving the surrounding joints free, providing focused stabilization to specific regions. In the arm, a cylinder cast typically extends from the upper arm to just above the wrist, stabilizing injuries like isolated humeral fractures or post-surgical repairs that do not require elbow immobilization. For the leg, the cast extends from the thigh to just above the ankle, often used to manage patellar fractures, some types of tibial plateau injuries, or post-operative care following knee surgeries. The application involves precise alignment to maintain proper positioning of the affected area while ensuring adjacent joints remain mobile, allowing for some functional movement and reducing stiffness during recovery."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1281", "text": "Body casts, also known as full-body casts are devices designed to immobilize the trunk of the body, sometimes extending to the neck, head, or extremities. They are less commonly used today due to advances in less restrictive bracing systems and surgical techniques but remain crucial in specific cases where maximum immobilization is essential. Body casts are often used in pediatric patients, particularly young children, who may struggle to comply with wearing a back brace consistently. They are also employed after radical surgeries to repair spinal injuries, congenital deformities, or significant trauma to the spine, pelvis, or upper thigh."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1282", "text": "A common variant, the body jacket, encases the trunk and includes shoulder straps to provide added stabilization, particularly for injuries involving the thoracic or lumbar spine. These casts are meticulously shaped to maintain spinal alignment and prevent movement that could disrupt healing. Despite their efficacy, body casts can be extremely uncomfortable due to their restrictive nature and the challenges they pose for hygiene and mobility. In some cases, openings or windows are incorporated into the cast to allow access for wound care or medical monitoring."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1283", "text": "An EDF (elongation, derotation, flexion) cast is a specialized orthopedic device used in the treatment of Infantile Idiopathic Scoliosis. This method of correction was pioneered by UK scoliosis specialist Min Mehta and is a non-surgical approach designed to guide spinal growth and alignment during a critical developmental period. [ 3 ]  Scoliosis is a three-dimensional spinal deformity requiring correction in all planes\u2014coronal, sagittal, and axial\u2014and EDF casting addresses these complex needs. By employing traction, the EDF method elongates the spine, derotates the vertebrae and pelvis, and improves lordosis and overall body alignment, significantly enhancing the patient\u2019s posture and physical function."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1284", "text": "The EDF casting technique is distinct from  Risser casting  in its design and application. EDF casts are tailored to each child\u2019s anatomy, with configurations either over or under the shoulder, depending on the curve pattern and severity. A key feature is the large mushroom-shaped opening on the front, which facilitates proper chest expansion and breathing. On the back, a small cutout is strategically placed on the concave side of the curve, stopping at the midline. This cutout has been shown to improve rotational correction and enhance spinal alignment compared to casts without it. The combination of elongation, derotation, and flexion in this casting method offers an effective early intervention to correct scoliosis and guide proper spinal development."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1285", "text": "A spica cast encases the trunk of the body and one or more limbs, providing immobilization for injuries or conditions requiring stabilization across multiple joints. Spica casts can be used for both upper and lower extremities. For instance, a shoulder spica covers the trunk of the body and one arm, typically extending to the wrist or hand. These casts were once common for severe shoulder injuries but are rarely used today, as specialized splints and slings have largely replaced them, promoting early mobility to prevent joint stiffness during recovery."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1286", "text": "A hip spica cast, by contrast, is used to immobilize the trunk and one or more legs. Variants include the single hip spica, which covers the trunk and one leg down to the ankle or foot; the double hip spica, which covers the trunk and both legs; and the one-and-a-half hip spica, which encases one leg fully and the other only to above the knee. The extent of trunk coverage depends on the specific injury or condition and the surgeon\u2019s preference, ranging from the navel for spinal mobility to as high as the rib cage or armpits in rare cases. Hip spicas are commonly used to maintain reduction of femoral fractures, treat congenital hip dislocations in infants, and stabilize the hips and pelvis after surgery."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1287", "text": "In some cases, a spica cast may not fully encase the legs, extending only to above the knee. These casts, known as pantaloon casts, are occasionally used to immobilize the lumbar spine or pelvis. When applied for such injuries, the trunk portion of the cast typically extends to the armpits to ensure adequate stabilization."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1288", "text": "Maintaining proper hygiene while wearing a cast is crucial to ensure patient comfort, prevent skin irritation, and reduce the risk of infection. Since casts are often made of non-breathable materials and remain in place for weeks, they can create an environment prone to moisture buildup, which can lead to odors, skin irritation, or fungal growth. Patients are advised to keep the cast completely dry, as moisture can weaken the cast material and compromise its integrity. Waterproof covers or plastic bags secured with elastic can be used during bathing to protect the cast, but immersing the cast in water should always be avoided unless it is specifically designed to be waterproof."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1289", "text": "To maintain hygiene around the cast, patients should clean and moisturize the exposed skin near the cast edges, being cautious not to let any liquids seep inside. A damp cloth with mild soap can be used for cleaning, followed by gentle drying. Avoid inserting objects, such as sticks or sharp items, into the cast to alleviate itching, as this can cause skin abrasions or damage the cast lining. If itching becomes unbearable or if there is persistent discomfort, a healthcare provider should be consulted rather than attempting to adjust the cast."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1290", "text": "For long-term casts, regular inspections by a medical professional are recommended to ensure the skin underneath remains healthy and the cast fits properly. Unpleasant odors, excessive itching, or discharge from the cast are potential signs of an infection or skin breakdown, requiring immediate medical attention. Maintaining proper cast hygiene not only contributes to physical comfort but also supports a safe and successful healing process."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1291", "text": "Casts typically come in two main types of material, fiberglass, and plaster, though it is less common. Plaster casts have several limitations, including weight, which restricts movement, and skin complications such as dryness, itching, rashes, and infections, particularly in hot weather. Plaster can also break down if exposed to moisture. The cast removal process, which involves a noisy oscillating saw, can cause distress, especially in children, though it is generally painless. Due to these drawbacks, fiberglass casts were developed in the 1970s, offering a lighter, more durable, and water-resistant alternative, though they still have limitations in terms of skin irritation and moisture management."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1292", "text": "Plaster casts consist of a cotton bandage that has been combined with  plaster of paris , which hardens after it has been made wet. Plaster of Paris is  calcined   gypsum  (roasted gypsum), ground to a fine powder by milling. When water is added, the more soluble form of  calcium sulfate  returns to the relatively insoluble form, and heat is produced."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1293", "text": "The setting of unmodified plaster starts about 10 minutes after mixing and is complete in about 45 minutes; however, the cast is not fully dry for 72 hours. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1294", "text": "Bandages of synthetic materials are also used\u2014often knitted  fiberglass  bandages impregnated with  polyurethane , sometimes bandages of  thermoplastic . These are lighter and dry much faster than plaster bandages. However, plaster can be more easily moulded to make a snug and therefore more comfortable fit. In addition, plaster is much smoother and does not snag clothing or abrade the skin. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1295", "text": "Traditional cast liners are made from cotton or synthetic materials, which help absorb sweat and keep the skin dry. However, in modern casting, fiberglass or polyester liners are often used, offering greater durability and comfort. Some liners are specifically designed to be waterproof, allowing patients to bathe or swim while wearing their casts. These waterproof liners are typically made from materials like polyurethane or special synthetic fibers that prevent water from seeping into the cast. While waterproof liners offer significant convenience, they may increase the application time and cost of the cast"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1296", "text": "There are some washable casts like FlexiOH which provide good ventilation and maintain good skin hygiene. With this cast, patients are able to bathe and go out in the rain. These types of casts have advantages that deliver patients a better treatment than conventional casts made of plaster of Paris or Fiberglass. They are the next generation of orthopedic immobilization photo-curing specialty-resin technology that enables a waterproof, washable, lightweight, strong and comfortable way of recovering from fractures . [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1297", "text": "Alternative immobilization techniques offer non-cast methods for stabilizing injuries, providing options that may be more comfortable, adjustable, or suitable for specific conditions. While traditional casts are commonly used for fractures and soft tissue injuries, alternatives are increasingly being utilized to address various patient needs and preferences."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1298", "text": "One prominent alternative is the  splint , which is often used for fractures that are not as severe or when a temporary immobilization method is required. Splints are typically made from materials like fiberglass, aluminum, or plastic and are easier to apply and adjust than casts. They can be used for injuries like sprains, minor fractures, or post-surgical stabilization. Unlike casts, splints are generally open on one or both sides, allowing for adjustments as swelling fluctuates during the healing process. They also provide more flexibility and can be removed for hygiene or rehabilitation purposes."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1299", "text": "Orthopedic brace  are another alternative, commonly used for joint injuries or soft tissue sprains and strains. Braces provide support and stabilize joints like the knee, ankle, or wrist. They are often used for conditions such as ligament sprains, tendinitis, or as post-operative support. Braces are usually made of fabric, neoprene, or metal components, allowing for greater mobility and easier removal compared to casts. They can be particularly useful for injuries that require gradual rehabilitation and controlled movement."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1300", "text": "For certain types of fractures or injuries,  Traction (orthopedics)  is an effective immobilization method. Traction involves using a pulling force to align bones and reduce fractures, particularly in cases involving the spine, pelvis, or long bones. It can be achieved through a variety of mechanisms, including skin traction (using adhesive materials attached to the skin) or skeletal traction (which involves pins or wires placed directly into the bone). Traction helps maintain the correct alignment and promotes healing without the need for a cast, especially in more complex fractures."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1301", "text": "In cases where the injury requires complete immobilization but not the rigidity of a cast, an  orthopedic boot , also known as a CAM boot (controlled ankle motion) may be used, especially for foot or ankle injuries. These options are designed to protect the injured area while still allowing limited mobility. Orthopedic boots are often preferred in weight-bearing fractures, as they provide stability while allowing the patient to walk with  crutches  or other mobility aids. [ citation needed ] [ example needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1302", "text": "Casts are typically removed by perforation using a cast saw, an  oscillating saw  designed to cut rigid material such as plaster or fiberglass while not harming soft tissue. [ 7 ]  Manually operated shears, patented in 1950 by  Neil McKay , [ 8 ]  may be used on pediatric  or other patients who may be affected by the noise of the saw. [ 9 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1303", "text": "The earliest methods of holding a   reduced  fracture involved using  splints .  These are rigid strips laid parallel to each other alongside the bone. The  Ancient Egyptians  used wooden splints made of bark wrapped in linen. They also used stiff bandages for support that were probably derived from  embalming  techniques. The use of plaster of Paris to cover walls is evident, but it seems it was never used for bandages.   Ancient Hindus treated fractures with  bamboo  splints, and the writings of  Hippocrates  discuss management of fractures in some detail, recommending wooden splints plus exercise to prevent muscle  atrophy  during the immobilization.   The  ancient Greeks  also used waxes and resins to create stiffened bandages and the Roman  Celsus , writing in AD 30, describes how to use splints and bandages stiffened with starch.  Arabian  doctors used lime derived from sea shells and albumen from egg whites to stiffen bandages. The Italian School of  Salerno  in the twelfth century recommended bandages hardened with a flour and egg mixture as did  medieval  European bonesetters, who used casts made of egg white, flour, and animal fat. By the sixteenth century the famous French surgeon  Ambroise Par\u00e9  (1517\u20131590), who championed more humane treatments in medicine and promoted the use of artificial limbs, made casts of wax, cardboard, cloth, and parchment that hardened as they dried."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1304", "text": "These methods all had merit, but the standard method for the healing of fractures was  bed rest  and restriction of activity. The search for a simpler, less-time-consuming, method led to the development of the first modern occlusive dressings, stiffened at first with starch and later with plaster-of-paris. The ambulatory treatment of fractures was the direct result of these innovations. The innovation of the modern cast can be traced to, among others, four military surgeons,  Dominique Jean Larrey ,  Louis Seutin ,  Antonius Mathijsen , and  Nikolai Ivanovich Pirogov . [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1305", "text": "Dominique Jean Larrey  (1768\u20131842) was born in a small town in southern France. He first studied medicine with his uncle, a surgeon in Toulouse. After a short tour of duty as a naval surgeon, he returned to Paris, where he became caught up in the turmoil of the  French Revolution , being present at the  Storming of the Bastille . From then on, he made his career as a surgeon in France's revolutionary and  Napoleonic armies , which he accompanied throughout Europe and the Middle East. As a result, Larrey accumulated a vast experience of military medicine and surgery.\nOne of his patients after the  Battle of Borodino  in 1812 was an infantry officer whose arm was amputated at the shoulder. The patient was evacuated immediately following the operation and passed from Russia, through Poland and Germany. When the dressing was removed on his arrival home in France, the wound had healed. Larrey concluded that the fact that the wound had been undisturbed had facilitated healing. After the war, Larrey began stiffening bandages using  camphorated  alcohol,  lead acetate  and egg whites beaten in water."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1306", "text": "An improved method was introduced by  Louis Seutin , (1793\u20131865) of Brussels. In 1815 Seutin had served in the allied armies in the war against Napoleon and was on the field of  Waterloo . At the time of the development of his bandage he was chief surgeon in the Belgium army. Seutin's \"bandage amidonnee\" consisted of cardboard splints and bandages soaked in a solution of starch and applied wet. These dressings required 2 to 3 days to dry, depending on the temperature and humidity of the surroundings. The substitution of  Dextrin  for starch, advocated by Velpeau, the man widely regarded as the leading French surgeon at the beginning of the 19th century, reduced the drying time to 6 hours. Although this was a vast improvement, it was still a long time, especially in the harsh environment of the battlefield."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1307", "text": "A good description of Seutin's technique was provided by  Sampson Gamgee  who learned it from Seutin in France during the winter of 1851\u201352 and went on to promote its use in Britain. The limb was initially wrapped in wool, especially over any bony prominences. Pasteboard was then cut into shape to provide a splint, and dampened so it could be molded to the limb. The limb was then wrapped in bandages before a starch coating was applied to the outer surface. Seutin's technique for the application of the starch apparatus formed the basis of the technique used with plaster of Paris dressings today. The use of this method led to the early mobilization of patients with fractures and a marked reduction in hospital time required."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1308", "text": "Although these bandages were an improvement over Larrey's method, they were far from ideal. They required a long time to apply and dry and there was often shrinkage and distortion. A great deal of interest had been aroused in Europe around 1800 by a British diplomat, consul  William Eton , who described a method of treating fractures that he had observed in Turkey. He noted that  gypsum plaster  (plaster of Paris) was moulded around the patient's leg to cause immobilization. If the cast became loose due to atrophy or a reduction in swelling, then additional gypsum plaster was added to fill the space. Adapting the use of plaster of Paris for use in hospitals, however, took some time. In 1828, doctors in Berlin were treating leg fractures by aligning the bones in a long narrow box, which they filled with moist sand. Substitution of plaster of Paris for the sand was the next logical step. Such plaster casts did not succeed however as the patient was confined to bed due to the casts being heavy and cumbersome."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1309", "text": "Plaster of Paris bandages were introduced in different forms by two army surgeons, one at a peacetime home station and another on active service at the front.   Antonius Mathijsen  (1805\u20131878) was born in  Budel , the Netherlands, where his father was the village doctor. He was educated in Brussels, Maastricht and Utrecht obtaining the degree of doctor of medicine at Gissen in 1837. He spent his entire career as a medical officer in the Dutch Army. While he was stationed at Haarlem in 1851, he developed a method of applying plaster of Paris bandages. A brief note describing his method was published on January 30, 1852; it was followed shortly by more complete accounts. In these accounts Mathijsen emphasised that only simple materials were required and the bandage could be quickly applied without assistance. The bandages hardened rapidly, provided an exact fit and could be windowed or bivalved (cut to provide strain relief) easily. Mathijsen used coarsely woven materials, usually linen, into which dry plaster of Paris had been rubbed thoroughly. The bandages were then moistened with a wet sponge or brush as they were applied and rubbed by hand until they hardened."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1310", "text": "Plaster of Paris dressings were first employed in the treatment of mass casualties in the 1850s during the  Crimean War  by  Nikolai Ivanovich Pirogov  (1810\u20131881). Pirogov was born in Moscow and received his early education there. After obtaining a medical degree at  Dorpat  (now Tartu,  Estonia ) he studied at  Berlin  and  G\u00f6ttingen  before returning to Dorpat as a professor of Surgery. In 1840, he became the professor of surgery at the academy of military medicine in St. Petersburg. Pirogov introduced the use of  ether  anaesthesia to Russia and made important contributions to the study of cross-sectional human anatomy. With the help of his patron, the grand duchess  Helene Pavlovna , he introduced female nurses into the military hospitals at the same time that  Florence Nightingale  was beginning a similar program in British military hospitals."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1311", "text": "Seutin had travelled through Russia demonstrating his 'starched bandage', and his technique had been adopted by both the Russian army and navy by 1837. Pirogov had observed the use of plaster of Paris bandages in the studio of a sculptor who used strips of linen soaked in liquid plaster of Paris for making models (this technique, called \" modroc ,\" is still popular). Pirogov went on to develop his own methods, although he was aware of Mathijsen's work. Pirogov's method involved soaking coarse cloth in a plaster of Paris mixture immediately before application to the limbs, which were protected either by stockings or cotton pads. Large dressings were reinforced with pieces of wood."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1312", "text": "As time passed and the method moved more into the mainstream some disagreement arose as to the problems associated with cutting off air to skin contact, and also some improvements were made. Eventually Pirogov's method gave way to Mathijsen's. Among the improvements suggested as early as 1860 was that of making the dressing resistant to water by painting the dried plaster of Paris with a mixture of  shellac  dissolved in alcohol. The first commercial bandages were not produced until 1931 in Germany, and were called Cellona. Before that the bandages were made by hand at the hospitals."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1313", "text": "As a plaster cast is applied, it expands by approximately 0.5%. The less water used, the more linear expansion occurs.   Potassium sulfate  can be used as an accelerator and  sodium borate  as a retarder to control setting time. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1314", "text": "An orthopedic  implant  is a medical device manufactured to replace a missing joint or bone, or to support a damaged bone. [ 1 ]  The medical implant is mainly fabricated using  stainless steel  and  titanium alloys  for strength and the plastic coating that is done on it acts as an  artificial cartilage . [ 2 ]  The biodegradable metals in this category are magnesium-based  [ 3 ]  and iron-based alloys, though recently zinc has also been investigated. [ 4 ]  Currently, the uses of  bioresorbable metals  are as fracture fixation implants [ 5 ] [ 6 ] [ 7 ] [ 8 ]   Internal fixation  is an operation in  orthopedics  that involves the surgical implementation of implants to repair a bone. [ 9 ] [ 10 ]  During the surgery of broken bones through internal fixation the bone fragments are first reduced into their normal alignment then they are held together with the help of internal fixators such as plates,  screws , nails, pins, and wires. [ 11 ] [ 12 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1315", "text": "Bipolar"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1316", "text": "Thompson"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1317", "text": "Accolade"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1318", "text": "Endo-Model"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1319", "text": "Attune"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1320", "text": "Scorpio"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1321", "text": "Legion"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1322", "text": "Genesis II"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1323", "text": "VanguardXP"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1324", "text": "Persona"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1325", "text": "PFNA"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1326", "text": "TFN"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1327", "text": "PFNA II"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1328", "text": "Clamp"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1329", "text": "Trocar"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1330", "text": "Ilizarov\nJET-X"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1331", "text": "Galaxy"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1332", "text": "2.7mm Locking"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1333", "text": "3.5mm Locking"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1334", "text": "4.5/5.0mm Locking"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1335", "text": "Condylat Plate"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1336", "text": "DHC, DCS"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1337", "text": "Jewett Nail Plate"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1338", "text": "Monoaxial Screws"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1339", "text": "Polyaxial Screws"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1340", "text": "Cages"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1341", "text": "Mesh"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1342", "text": "The discipline of orthopedic implants is constantly evolving as new biomaterials become available. An important consideration in this respect is that the health status of the patient influences the optimal choice of the material to be implanten. For instance it was shown that patients with steatotic liver disease benefit from nanohydroxyapatite-coated (nHA) titanium surfaces, whereas this is not necessary for patients without fatty liver disease. [ 39 ]  A  surface engineering  method was developed for biodegradable magnesium alloys to enhance orthopedic implants. [ 40 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1343", "text": "An  orthopedic plate  is a form of  internal fixation  used in  orthopaedic surgery  to hold  fractures  in place to allow  bone healing [ 1 ]  and to reduce the possibility of  nonunion . Most modern plates include bone screws to help the orthopedic plate stay in place."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1344", "text": "Prior to the invention of the orthopedic plate, metal wiring was used to solve the issue of bone fractures until about 1850. It was debated when the first use of this technique was actually made. Supposedly, the first use of this metal wiring was by the ancient Greeks. [ 2 ]  The first recorded use of metal wiring was in 1755 in a French journal. [ 2 ]   It was not until 1870, a Frenchman by the name of Laurent Berenger-Feraud began writing a book on internal fixation and bone fractures called \" Trait\u00e9 de l'immobilisation directe des fragments osseux dans les fractures \"  (a book on direct immobilization of bone fragments of fractures). [ 2 ]  All the information proved to be beneficial in medical procedures, however one thing lacked, the antiseptic treatments needed to properly administer these techniques. Joseph Lister, a British assistant surgeon who in 1877 tried his techniques on a patient and showed huge success. Carl Hausmann is credited with making the first successful plate using both nickel sheets and screws and creating a method of removal without reopening the wound site in 1886. [ 2 ]  The years following focused on better surgical techniques and experimentation with other materials. Metals were the most common material for orthopedic plates, until cytotoxic tests were used to determine biocompatibility of metals put into the patients body post operation. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1345", "text": "Modern orthopedic plating did not start until the 1950s where Maurice Muller formed AO/ASIF (Association for the study of internal fixation) along with other surgeons to better improve plating techniques. [ 3 ]  The  purpose of the AO were to better understand bone repair, fracture formation and surgical techniques to gain better results in medical applications. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1346", "text": "Orthopedic plates are designed based on the bone fracture. While the general design is similar, each plate must be manufactured to not only to reduce the fracture but also fit the contour of the patient's bone. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1347", "text": "Protection"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1348", "text": "Locking plates can be used either to support a locking head screw, or to force bone together at the fracture. Locking head screws can be applied at the fracture, with the orthopedic plate in place to reduce applied force on the bone fracture."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1349", "text": "Tension and Compression"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1350", "text": "Compression plates can be implanted in such a way that it is in tension, forcing the bone together at the fracture. The use of an articulated tension device can also be used to compress the bone together by pulling the compression plate."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1351", "text": "Bridging"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1352", "text": "For fragmentary bone fractures, bridging plates can be used to hold the bone in place when there are no anchor points at the fracture point. Bridging can allow for relative stability along the bone, while not disturbing the bone fragments. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1353", "text": "Buttress"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1354", "text": "Buttress plates, or concave plates, are useful for fractures along concave surfaces. Due to the angle of the bone,  the contour of the concave plate aligns with the bone, providing even compressive force along the fracture. [ 6 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1355", "text": "A  splint  is defined as \"a rigid or flexible device that maintains in position a displaced or movable part; also used to keep in place and protect an injured part\" or as \"a rigid or flexible material used to protect, immobilize, or restrict motion in a part\". [ 1 ]  Splints can be used for injuries that are not severe enough to immobilize the entire injured structure of the body. For instance, a splint can be used for certain fractures, soft tissue sprains, tendon injuries, or injuries awaiting  orthopedic  treatment. A splint may be static, not allowing motion, or dynamic, allowing controlled motion. Splints can also be used to relieve pain in damaged  joints . Splints are quick and easy to apply and do not require a plastering technique. Splints are often made out of some kind of flexible material and a firm pole-like structure for stability. They often buckle or  Velcro  together."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1356", "text": "Splinting has been used since ancient times. Evidence suggests that splint usage dates back to 1500 B.C. that could treat not only fractures but burns as well. [ citation needed ]  These splints were made from materials like, \"leaves, reeds, bamboo, and bark padded with linen\u00a0\u2026 [and] copper.\"  Mummies  from  Egypt  have been uncovered wearing splints from previous injuries that were obtained in their lifetime. Hippocrates, alive from 460 to 377 B.C., was very well known for his discoveries and techniques for splinting. He created a \"distraction splint\" that was advanced for his time. The splint, made up of leather cuffs that were separated by slim wooden slats, worked to repair the fracture and realign the bones. Around 1000 A.D. the use of  Hippocrates ' splinting technique using plants, like palm branches and cane halves, continued to be practiced. Flour dust, egg whites, and vegetable mixtures were created to form plaster for creating splints. Most splints in ancient times were cast-like and made to immobilize an area of the body. This is illustrated by the  Aztecs  around 1400 A.D. They made splints with leaves, leather, and paste. [ 9 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1357", "text": "In the early 1500s  gunpowder  was introduced to Europe which caused a serious decline in the market of armor making. Armor makers had to figure out how to make a living with the skills they had already acquired. This led to the creation of braces due to the common use of metal in braces.  Armor makers  were knowledgeable in areas of the exterior  anatomy  and joint alignment, making braces the obvious replacement for their armor making. In 1517, after the evolution of the armor trade, injuries were being treated by metal  braces  secured by screws. Jumping to 1592, the first written piece on splints by surgeon  Hieronymus Fabricius , shows various drawings of armor-like splints for the entire body. [ 9 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1358", "text": "In the mid-1700s, doctors and mechanics worked with each other to create splints for certain injuries. Surgeons need these mechanics to design and build the splints for them. Most splints were made of metal.  Plaster of Paris , a white powdery substance used mostly for casts and molds in the form of a quick-setting paste with water, began to be used for immobilizing splints. [ 10 ]  This method was not a popular way of splinting as it took too long to dry and suitable fabric was sparse."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1359", "text": "In the 1800s it was beginning to be recognized that rehabilitation after an injury was important. Orthopedics started to become a separate field from general surgery. A famous British Surgeon,  Hugh Owen Thomas , created specialty splints that were cheap and best for injuries that were being rehabilitated. By 1883, mechanics and surgeons separated due to class issues. This created two different areas that shaped the way braces were being created and distributed. Around 1888, F. Gustav Ernst, a dedicated mechanic, released a book illustrating upper body splints. In 1899, orthopedic surgeon  Alessandro Codivilla  followed suit and published a book explaining the importance of using surgical procedures to set up better results using splints. [ 9 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1360", "text": "The  American Joint Replacement Registry  (AJRR) is a non-profit organization established to foster the creation of a national center for data collection, and is dedicated to the improvement in arthroplasty patient care."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1361", "text": "In partnership with the  American Academy of Orthopaedic Surgeons  (AAOS), the AJRR was founded in 2009 with the goal to optimize patient outcomes through collection of data on all primary and revision total joint replacement procedures in the U.S., while enhancing patient safety, improving quality of care, and reducing the cost for patients. Since then, the AJRR has grown to over 620 participating hospitals with over 400,000 procedures in their database. [ 1 ]  Both figures are expected to increase by year's end, and will continue to do so as more participants join the registry."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1362", "text": "In February 2010, The AAOS ratified the AJRR Board of Directors. In November 2010, AJRR received 501(c)(3) status, and in December 2010, their Business Plan was finalized and approved by the AJRR Board of Directors."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1363", "text": "In March 2011, the Pilot Program was initiated, with successful Level I data transmission and collection from pilot sites completed in July of the same year."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1364", "text": "In 2012, the national registry software was launched. In August 2012, Jeffrey P. Knezovich, CAE, was hired as AJRR's first Executive Director."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1365", "text": "In November 2013, AJRR launched a pilot program of Level II, Level III, and Level IV data collection systems. That pilot study is expected to be concluded by the end of the third quarter 2014."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1366", "text": "In February 2014, the AJRR was named to the National Quality Registry Network (NQRN) [1]  Council, an initiative of the  American Medical Association ; and, in May, 2014, the AJRR was named a Qualified Clinical Data Registry (QCDR) by the  Centers for Medicare and Medicaid Services  (CMS)."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1367", "text": "On January 1, 2015, the AJRR officially became a freestanding association. 2015 also marked the formation of the AJRR User Group Network, the merger of the California Joint Replacement Registry (CJRR) into AJRR, and the enrolling of the 600th hospital. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1368", "text": "(CMS)  [5]   Archived  2018-10-03 at the  Wayback Machine"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1369", "text": "A  joint replacement registry  is a system of collecting information of  arthroplasty  outcomes at a population (often national) level, in order to provide an evidence-base for safe and effective treatment options."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1370", "text": "The UK registry, the NJR, was set up as recommendation of a  Royal College of Surgeons of England  review into the high-profile failure of the  3M  Capital Hip. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1371", "text": "Registers collect information on a combination of  hip replacements ,  knee replacements  (both total and  unicompartmental ),  shoulder replacements ,  ankle replacements  and  elbow  replacements.  Some countries exclude  hemiarthroplasties  done for traumatic  hip fractures ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1372", "text": "Initially designed only to record  surgeon  and  implant  performance, the main outcome collected was  implant failure , however recently  patient-reported outcome  measures are being added."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1373", "text": "Given the amount of information stored, the data from many of the registries is used as the basis of scientific papers, for example on the  metal-on-metal hip controversy . [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1374", "text": "There are currently 31 national members of the International Society of Arthroplasty Registers (ISAR). [ 3 ]   In addition, in the United States, there are 10 regional or private registries collecting data."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1375", "text": "The  National Hip Fracture Database  (NHFD) is a nationwide audit within the  NHS  concerning the management and outcomes of patients with  hip fractures ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1376", "text": "It was initially set up by the  British Orthopaedic Association  and the  British Geriatrics Society , however it is now commissioned by the  Healthcare Quality Improvement Partnership  (HQIP), a consortium of the  Academy of Medical Royal Colleges  and the  Royal College of Nursing  which holds the contract to manage and develop the  National Clinical Audit and Patient Outcomes Programme  (NCAPOP), as part of the  Falls and Fragility Fracture Audit Programme  (FFFAP) of the  Royal College of Physicians , in association with the  BOA , BGS,  Royal College of Surgeons of England  and the  Falls and Fractures Alliance  (composed of  Age UK  and the  National Osteoporosis Society )."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1377", "text": "The NHFD aims to improve the quality and effectiveness of  hip fracture  care by enabling clinical teams to monitor their performance against agreed clinical standards from the  BOA  and BGS 'Blue Book' publication, [ 1 ]  in addition to compliance with  NICE  Guidance 124 - \u2018The Management of Hip Fracture in Adults\u2019. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1378", "text": "Data collected includes:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1379", "text": "The NHFD has reported nationally annually since 2010"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1380", "text": "In addition, quarterly reports are generated to allow for  best practice tariff  payments against the following criteria:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1381", "text": "The  American Academy of Orthopaedic Surgeons  ( AAOS ) is an  orthopedic  organization.   Founded at  Northwestern University  in 1933, as of 2015 AAOS had grown to include about 39,000 members. [ 1 ]  The group provides education and practice management services for orthopedic surgeons and allied  health professionals . It also lobbies and works on public education. It describes itself as \"the world's largest medical association of  musculoskeletal  specialists.\" [ 2 ]  It is a provider of musculoskeletal education to orthopaedic surgeons and others. Its continuing medical education activities include an annual meeting, multiple  CME  courses held around the country and at the Orthopaedic Learning Center, and various medical and scientific publications and electronic media materials."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1382", "text": "Monthly nonpeer-reviewed news magazine published by the AAOS."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1383", "text": "The  American Orthopaedic Foot and Ankle Society  (AOFAS) is a professional medical society based in  Rosemont ,  Illinois . It was founded in 1969 and currently has a membership of around 2,400 foot and ankle orthopaedic surgeons. The society provides education, research, grants, and other services to the general public and orthopaedic doctors, allied health practitioners, and researchers specializing in orthopaedic foot and ankle medicine and surgery. The organization also operates its own peer-reviewed journal,  Foot & Ankle International ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1384", "text": "The AOFAS was founded in 1969 as the American Orthopaedic Foot Society (AOFS) with around 150 members. Its founding members included doctors Nathaniel Gould, Robert Joplin, Nicholas Giannestras, Melvin Jahss, Hampar Kelikian, Paul Lapidus, and Joseph Milgram. Several of its founding members served as early presidents of the organization including Robert Joplin (1969\u201370), Nicholas Giannestras (1970\u201371), Nathaniel Gould (1971\u201372), and Melvin Jahss (1973\u201374). [ 1 ]  New presidents are elected by members of the society at an annual meeting each year. [ 2 ] [ 3 ]  The society held its first scientific meeting in  San Francisco  in 1971. In 1973, president Robert Samilson helped make the AOFS the first affiliate of the American Academy of Orthopaedic Surgeons (AAOS). [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1385", "text": "Throughout its first decade, the society provided research grants, [ 4 ]  advised shoe manufacturers, [ 5 ]  analyzed and disseminated research, [ 6 ]  and provided education and resources to orthopaedic surgeons and the general public. [ 1 ] [ 7 ]  In 1981, Melvin Jahss helped establish and became the first editor of the society's official peer-reviewed journal, [ 3 ]   Foot & Ankle , which would eventually be renamed  Foot & Ankle International . In 1983, the members of the AOFS voted unanimously to change the name of the organization to the \"American Orthopaedic Foot and Ankle Society\". In the mid-1980s, the AAOS dissolved the affiliation agreements with the AOFAS and other organizations allowing them to congregate independently. This occurred under AOFAS president, John Gould (the son of founder, Nathaniel Gould). [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1386", "text": "In the 1990s, the society researched and disseminated the results of several studies about footwear and its effects on feet and ankles. In particular, the studies often identified issues with women's footwear [ 8 ]  and, specifically, high heels. [ 9 ]  In a 1992 partnership with the National Shoe Retailers Association (NSRA), the AOFAS started a public awareness campaign with a pamphlet titled \"10 Points of Proper Shoe Fit\". [ 10 ]  In 1994, the AOFAS held a news conference to call on shoe manufacturers to create \"women's shoes that do not deform the foot\". [ 11 ]  Under president G. James Sammarco, in 1996, the society instituted a voluntary \"seal of approval\" program that allowed shoe manufacturers to send in their models to be inspected for comfort and design quality by AOFAS physicians and researchers. The organization also maintained offices in  Seattle  at that time. [ 12 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1387", "text": "In 2001, AOFAS president Pierce Scranton established the Orthopaedic Foot and Ankle Outreach and Education Fund (OEF), a  501(c)(3) organization  that provides education and medical services to under-served communities throughout the world. [ 1 ]  In 2005, the organization established the website FootCareMD.com to provide education and resources to the general public. [ 13 ]  By 2010, the organization's headquarters were located in Rosemont, Illinois. [ 14 ]  In 2011, Judith Baumhauer became the organization's first female president. In 2014, OEF changed its name to the Orthopaedic Foot & Ankle Foundation. [ 15 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1388", "text": "In July 2017, the AOFAS established a consumer awareness campaign called \"Look for the 'O'\", which urged individuals to seek the care of orthopaedic surgeons when experiencing foot or ankle pain. [ 16 ]  The current AOFAS president, Bruce E. Cohen, was elected in September 2020. The society maintained a membership of around 2,400 at that time. [ 17 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1389", "text": "The AOFAS is composed of around 2,400 foot and ankle orthopaedic surgeons. [ 17 ]  Each member is a medical doctor specializing in the diagnosis and treatment of numerous foot and ankle injuries, diseases, and other ailments. The training required includes four years of medical school and five years of  medical residency  followed by a one- or two-year fellowship with a specialty focus in foot and ankle care. [ 18 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1390", "text": "The American Orthopaedic Society for Sports Medicine (AOSSM)  promotes sports medicine education, research, communication, and fellowship and includes national and international  orthopaedic sports medicine  leaders. The Society works closely with many other sports medicine specialists, including  athletic trainers ,  physical therapists ,  family physicians , and others to improve the identification,  prevention ,  treatment , and rehabilitation of  sports injuries . Formed in 1972 as a forum for education and research with 100 members, the AOSSM today has to more than 2,000 members. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1391", "text": "The AOSSM developed out of the  American Academy of Orthopaedic Surgeons \u2019 (AAOS)  Committee  on  Sports Medicine . The committee was organized in 1964 with Jack Hughston as Chairman. Throughout the next seven years, interest in sports medicine among  orthopaedists  increased greatly. Don O\u2019Donoghue, MD, approached the AAOS concerning the committee branching off and forming an affiliated, yet separate, society. [ 2 ]  On  January 30, 1972 , at the invitation of Dr. Donoghue, 58 orthopaedic surgeons involved in sports medicine gathered to discuss the creation of the new society. A total of 75 orthopaedists were invited, and these physicians make up the list of founding members of the society. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1392", "text": "The founding members developed the mission of AOSSM: to hold a scientific meeting that would serve as a forum for  presentation  and  publication  of new ideas; to provide opportunities for physicians to meet and exchange ideas concerning research and the future of sports medicine; as well as to develop a high-quality publication controlled by the Society. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1393", "text": "In 2013, Jo A. Hannafin, M.D., Ph.D., an orthopedic surgeon at Hospital for Special Surgery (HSS) in New York City, was named the first female president of AOSSM. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1394", "text": "AOSSM members are physicians and allied  health professionals  who demonstrate scientific leadership, involvement, and dedication in the daily practice of sports medicine. Members must demonstrate continuing active research and educational activities in the field of sports medicine. Such activities may include service as a  team physician  at any level of competition, involvement in the health of  athletes , service to local, regional, national, and international competitions, and the presentation of  scientific research papers  at sports medicine meetings. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1395", "text": "Members focus on the effects of exercise and the monitoring of its impact on active individuals of all ages, abilities, and levels of  fitness . While many members treat high-profile athletes who play on  professional teams , many also devote their practices to helping their  community  by treating players on the local high school or  junior college  team. Through research and advances in  surgical  and rehabilitation techniques, orthopaedic sports medicine specialists have been able to treat and rehabilitate athletes whose injuries were once  career-ending  and put them back in the game sooner."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1396", "text": "Members are broken down into seven different groups: active members, associate members, candidate members, affiliate members, honorary members, emeritus members, and inactive members."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1397", "text": "Active members are: U.S. or Canadian citizens who are orthopaedic surgeons specializing in sports medicine. They must:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1398", "text": "Active members are eligible to vote, and unless specified otherwise, hold office in the Society."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1399", "text": "Associate members are: international orthopaedic surgeons practicing outside of the United States or Canada who are certified in orthopaedic surgery and members of their country's national orthopaedic organization, or osteopathic physicians not qualified to be Active Members but certified by the  American Osteopathic Board of Orthopedic Surgery . They must:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1400", "text": "Associate members are not eligible to vote, hold office, or serve on the Board of Directors. They may act in an  advisory  capacity and unless specified otherwise, may serve on committees with vote."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1401", "text": "Candidate members are physicians who are enrolled in or have completed an  Accreditation Council for Graduate Medical Education  (ACGME) approved orthopaedic sports medicine  fellowship  in the United States or Canada. They must:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1402", "text": "Candidate members are not eligible to vote, hold office, or serve on the Board of Directors. They may act in an advisory capacity and, unless specified otherwise, serve on committees with vote."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1403", "text": "Affiliate members are physicians, surgeons, or allied health professionals not qualifying for other membership categories who are interested in or contributing to the knowledge of sports medicine. They must:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1404", "text": "Affiliate members are not eligible to vote, hold office in the Society, or serve on the Board of Directors. They may act in an advisory capacity and unless specified otherwise may serve on committees with vote."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1405", "text": "Honorary members are those who do not meet the qualifications of Active, Associate, or Affiliate membership, but who have made special contributions to sports medicine. They are not eligible to vote, hold office in the Society, or serve as a member of the Board of Directors, but may act in an advisory capacity and, unless specified otherwise, may serve on committees with vote."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1406", "text": "Nominees for honorary membership are submitted to the Board of Directors for consideration. A limited number of honorary members is determined by the Board of Directors."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1407", "text": "Emeritus members are an active member or affiliate member who has reached the age of 65 and is no longer engaged in active medical practice due to age or health. Emeritus Members are not eligible to vote, hold office, or serve as a member of the Board of Directors but may act in an advisory capacity and unless specified otherwise serve on committees with vote."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1408", "text": "Inactive members are members or an allied health professional who have met the qualifications for any category of membership but are currently unable to practice medicine due to physical disability or such other reason acceptable to the Board of Directors. Inactive members are not eligible to vote, hold office, or serve as a member of the Board of Directors but may act in an advisory capacity and, unless specified otherwise, serve on committee with vote."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1409", "text": "The  AOSSM Annual Meeting  and  AOSSM Specialty Day  are two of the AOSSM\u2019s main meetings. The AOSSM Annual Meeting is held once a year (usually at the end of June or beginning of July) and is a place for the Society\u2019s members and Board of Directors to meet, as well as for educational courses and research to be presented. [ 5 ]  AOSSM Specialty Day is held during the  American Academy of Orthopaedic Surgeons\u2019 annual meeting . It is a one-day meeting that provides educational courses and presentations focused on sports medicine. The Society also hosts other meetings throughout the year focusing on particular injuries or sports specifics areas, such as  football  or  hockey ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1410", "text": "The AOSSM Web site houses a full  Online Library  of scientific and patient education materials. The AOSSM also has five print publications."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1411", "text": "American Journal of Sports Medicine  is a monthly, peer-reviewed scientific journal, first published in 1974. It is the official publication of AOSSM, and is ranked 1st out of 63 journals in Orthopaedics  [ 6 ]  and 5th out of 84 journals in Sport Sciences  [ 7 ]  in Thomson Reuters\u2019s 2012 Journal Citation Reports, with an Impact Factor of 4.439. [ 8 ]  The journal is published by SAGE Publishers."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1412", "text": "Sports Health  (January 2009) is published  bimonthly  and is a collaborative publication from AOSSM, the  American Medical Society for Sports Medicine  (AMSSM), the  National Athletic Trainers' Association  (NATA), and the  Sports Physical Therapy Section  (SPTS). Sports Health is a resource for all medical professionals involved in the training and care of the competitive or  recreational  athlete. The journal is published by SAGE Publishers. [ 9 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1413", "text": "Sports Medicine Update  is AOSSM's bimonthly publication and includes educational articles, Society news and research updates, resources, and new developments within the orthopaedic sports medicine community. [ 10 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1414", "text": "Both  Sports Tips  and  In Motion  are patient education publications.  Sports Tips  are one-page fact sheets on athletic related conditions and injuries.  In Motion  is a quarterly newsletter and features short articles focusing on sports medicine, fitness, and musculoskeletal issues for people of all ages. [ 11 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1415", "text": "AOSSM awards grants to researchers working on  break-through  treatments and investigations in sports medicine. [ 12 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1416", "text": "The Young Investigator Grant provides awards aimed at providing \"seed money,\" or start-up funds, for pilot projects. The principal investigator must be an early career orthopaedic surgeon, fellow, or resident with interests in sports medicine research. Any investigative team seeking such a grant must include at least one member of AOSSM in good standing."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1417", "text": "Dr. Sandy Kirkley was an advocate for well-conducted,  randomized controlled trials  to evaluate the efficacy of interventions in orthopaedic sports medicine. She said that the field must \"rise to the challenge of designing and implementing clinical trials that provide the same level of evidence in support of treatments as our nonsurgical colleagues demand.\" In honor and memory of Dr. Kirkley, AOSSM established a small grant that would provide start-up, \"seed,\" or supplemental funding for an outcome research project or pilot study."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1418", "text": "AOSSM offers a per year supplement grant to sports medicine orthopaedic surgeons who have an active Career Development Award (K Award) from the  National Institutes of Health  (NIH). The purpose of this grant is to facilitate the research careers of orthopaedic surgeons who have completed training in sports medicine and who have a faculty position at an academic institution. The award is open to individuals regardless of time since training."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1419", "text": "AOSSM has initiated the AOSSM Multi-Center ACL Revision Study (MARS), utilizing a grant from the  Musculoskeletal Transplant Foundation  (MTF). The study will evaluate outcome for patients undergoing revision  ACL surgery  and examine the predictors of outcome. The MARS project has been approved by the  Institution Review Board (IRB) of the central coordinating site,  Vanderbilt University ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1420", "text": "The Multi-Center Evaluation of the Responsiveness of the IKDC (MERI) Study is designed to evaluate and compare the responsiveness to change of several measures commonly used in patients undergoing knee surgery: the  International Knee Documentation Committee (IKDC) Subjective Knee Form , the  WOMAC , the Cincinnati Knee Rating System, and the  SF-36 . The specific patient population targeted for this study are those individuals who receive any form of surgical articular cartilage repair procedure for at least one symptomatic full thickness (Outerbridge Grade III or IV)  lesion  of the  femoral condyle  or  trochlea . These procedures can include  debridement ,  marrow  stimulation techniques such as  microfracture , drilling or abrasion  arthroplasty , osteochondral  autograft  or  allograft  transplantation, mosaicplasty or autologous  cartilage  implantation. Any surgeon who performs at least three of these procedures a year can be involved in the project."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1421", "text": "Each year during the AOSSM Annual Meeting a variety of awards are presented for research and outstanding achievement in sports medicine. [ 13 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1422", "text": "In 2001, AOSSM established the Hall of Fame to honor members of the orthopaedic sports medicine community who have contributed significantly to the specialty and set themselves apart. Being inducted into the Hall of Fame is one of the highest honors given to a Society member."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1423", "text": "This award is given to an individual who has provided outstanding service in the orthopaedic community, and made numerous contributions to the specialty of sports medicine."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1424", "text": "This lectureship is named in honor of John C. Kennedy, MD, FRCS(C) a past president of AOSSM. This lecture is supported by a Kennedy Family Endowment and AJSM and is named by the current AOSSM President."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1425", "text": "This award is given to an orthopaedic surgeon who has been dedicated to excellence in sports medicine on a local level, with local athletes."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1426", "text": "This award is given to the paper that best exemplifies clinically relevant  hypothesis -driven  basic science  research (hard or soft  tissue   biology ,  in vitro  research,  laboratory  or \"bench-type\" research, or  in vivo  animal)."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1427", "text": "This award is given to the best paper submitted in any category to the Awards Committee with a primary author under the age of 40 at the time of the Annual Meeting."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1428", "text": "The award is given to the best paper submitted that pertains to the health, safety, and well-being of collegiate student-athletes."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1429", "text": "This award is given to the best overall paper that deals with clinical based research or human  in vivo  research."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1430", "text": "This award is given annually to an individual AOSSM member to recognize their contribution to sports medicine education throughout the years."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1431", "text": "This award is given for the most outstanding paper that appeared in AJSM, the year prior to the award. It was named after the founder of AJSM, Jack C. Hughston, MD."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1432", "text": "The Christian Koi Awards are given to the best paper in  clinical science  and the best paper in basic science submitted by a sports medicine fellow for the AOSSM Annual Meeting."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1433", "text": "Given during the AOSSM Annual Meeting for an outstanding poster presented during the meeting."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1434", "text": "AOSSM member physicians are listed in the  AOSSM Member Doctor Directory  for the public's use. Searches can be done by physician\u2019s last name or by city/state or country."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1435", "text": "The  American Osteopathic Board of Orthopedic Surgery  ( AOBOS ) is an organization that provides  board certification  to qualified  Doctors of Osteopathic Medicine  (DO) and non-osteopathic (MD and equivalent) physicians who specialize in the medical and surgical treatment of disorders of the  musculoskeletal system  ( orthopedic surgeons ). The board is one of 16  medical specialty  certifying boards of the  American Osteopathic Association Bureau of Osteopathic Specialists  approved by the  American Osteopathic Association  (AOA), [ 2 ]  and was originally a subdivision of the  American Osteopathic Board of Surgery [ 3 ]  until it became an independent board in 1978. Additionally, diplomates of the American Osteopathic Board of Orthopedic Surgery are eligible for membership in the  American Osteopathic Academy of Orthopedics [ 4 ]  and the  American Academy of Orthopaedic Surgeons . [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1436", "text": "To become board certified in orthopedic surgery, candidates must have completed an ACGME-accredited  residency  in orthopedic surgery and one year of practice following the completion of residency. Additionally, candidates must have performed at least 100 major orthopedic surgeries in the six months preceding application for board certification, and successfully complete the required Written and Clinical exams. [ 6 ]  Since 2023, board certified osteopathic orthopedic surgeons complete the Osteopathic Continuous Certification (OCC) components, including annual Longitudinal Assessment, to maintain active board certification status. [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1437", "text": "Board certified osteopathic orthopedic surgeons may also receive Certification of Added Qualifications (CAQ) in  Orthopedic Sports Medicine  and  Hand Surgery . [ 8 ] [ 9 ]  Orthopedic surgeons holding subspecialty certification in Hand Surgery complete the Osteopathic Continuous Certification (OCC) components, including a recertification examination completed every ten years. Orthopedic surgeons holding subspecialty certification in Orthopedic Sports Medicine must complete the Osteopathic Continuous Certification (OCC) components, including annual Longitudinal Assessment."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1438", "text": "The  American Society for Surgery of the Hand  ( ASSH ) was founded in 1946 to facilitate the exchange of information related to problems of the  hand . [ 1 ] [ 2 ]   It is the oldest and largest medical specialty society in the United States devoted to the care of the hand."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1439", "text": "Hand surgery  as a specialty grew out of the treatment of the hand injuries that occurred during World War II. Sterling Bunnell, MD, founder and first president of the ASSH, set up nine regional hand centers at U.S. Army bases throughout the United States during the 1940s. As  World War II  drew to a close, Bunnell suggested forming an organization to continue to foster interest in hand care. In January 1946, he and 34 hand surgeons, many of whom had worked in the Army hospitals, met immediately preceding the annual meeting of the  American Academy of Orthopaedic Surgeons  (AAOS). The group continued to meet in conjunction with the AAOS annual meeting until 1987, when it held its first stand-alone annual meeting."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1440", "text": "ASSH offers four types of membership: Active, Candidate, International, and Affiliate."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1441", "text": "Active members  are physicians who reside in the  United States  or  Canada , and are certified by the  American Board of Orthopaedic Surgery  (ABOS), the  American Osteopathic Board of Orthopedic Surgery  (AOBOS), the  American Board of Plastic Surgery  (ABPS), the  American Board of Surgery  (ABGS) or by the  Royal College of Physicians and Surgeons of Canada . [ 3 ]  All American-based hand surgeons seeking admission to Active Membership within ASSH are required to hold a  Certificate of Added Qualifications in Hand Surgery , which is jointly administered by the three American boards. To maintain membership within ASSH, Active Members must attend an ASSH annual meeting at least once every three years."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1442", "text": "Candidate members  are qualified surgeons working in the United States who are interested in hand surgery and may eventually apply for full membership."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1443", "text": "International members  are qualified hand surgeons practicing medicine outside of the United States."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1444", "text": "Affiliate members  are allied healthcare professionals (e.g., hand therapists; occupational therapists; physical therapists; physician assistants; nurse practitioners; registered nurses) specializing in care of the hand and upper extremity."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1445", "text": "The  British Orthopaedic Association  is a  professional association  in  Britain  for doctors who specialize in  orthopaedic surgery ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1446", "text": "The British Orthopaedic Association was founded in 1918. [ 1 ]  One of the founders was  Harry Platt , who went on to serve as its president in 1934-1935. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1447", "text": "As of 2013 the organisation reports having 4,000 members with most based in the United Kingdom and  Ireland . [ 1 ]  The BOA represents 40% of the total surgical workforce in Britain. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1448", "text": "In 1919 the  Journal of Bone and Joint Surgery  became the official journal of the British Orthopaedic Association in addition to the American Orthopedic Association. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1449", "text": "In 2012  Royal College of Surgeons of England  and the British Orthopaedic Association called for increased regulation of implants to prevent implant failure. [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1450", "text": "In association with the BGS, the BOA set up the  National hip fracture database  for England and Wales."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1451", "text": "The  Brittle Bone Society [ 1 ]  is the only  UK  wide  charity  dedicated to providing support to people affected by  osteogenesis Imperfecta  (OI)."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1452", "text": "The Brittle Bone Society was established in 1968 in  Dundee  by Margaret Grant, who has OI. When she was young, Grant was aware that there was virtually no support for people with OI and that many medical professionals knew little or nothing about the condition. When her daughter Yvonne was born some years later, very little had changed. For many years Grant was the driving force of the society, which was recognised when she was awarded an  MBE  in 1989 [ 2 ]  and in 2018 when she was awarded an honorary degree from the  University of Dundee . [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1453", "text": "The society now has more than 1,000 members and works closely with specialist medical units and other professionals throughout the UK."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1454", "text": "The CEO is Patricia Osborne who has been working with the charity since 2009 [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1455", "text": "The society's archives, which include about thirty boxes of material, are held by the  University of Dundee . [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1456", "text": "This article about a charitable organisation in the United Kingdom is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1457", "text": "The  Indian Orthopaedic Association  was founded in 1955 and as on 2013 had over 9,000 members. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1458", "text": "The first surgeons who focused on  orthopedic surgeries  in India were  Dr. R J Katrak , Dr. N S Narasimha Aiyar and Dr. S R Chandra. After World War II, Dr. Mukhopadhaya and Dr.  K S Grewal  suggested forming an association during the annual conference of ASI in Vellore in 1952. Many practicing surgeons met in  Agra  in 1953, most prominently Katrak, Dr. B N Sinha, Grewal, Mukopadhaya and Dr. A K Gupta. They agreed to form an orthopedic section of ASI. However, in 1954, the general body of the ASI at Hyderabad rejected the proposal."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1459", "text": "The society was officially formed in Amritsar at an ASI meeting in December 1955. Dr. B N Sinha and Dr. Mukopadhaya were unanimously elected president and secretary.  Dr. A K Talwalkar started the Johnson & Johnson and the Smith & Nephew traveling fellowships on behalf of IOA. The annual Kini Memorial Oration started in 1958.  Sir Harry Platt  served as the first Orator in 1958. The members of the Association published the first issue of a journal in 1967 with Prakash Chandra as the Editor. A constitution prepared by a select committee was unanimously approved at the General Body meeting in 1967. This was later registered under the  Indian Societies Act ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1460", "text": "At the 1986 Agra ASI conference, the IOA became independent of ASI. Sixteen regional chapters were formed."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1461", "text": "{{columns-list|colwidth=22em|"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1462", "text": "The  International Fibrodysplasia Ossificans Progressiva Association  ( IFOPA ) is a US-based  501(c)(3)   non-profit organization  supporting medical research, education and communication for those afflicted by the rare genetic condition  Fibrodysplasia Ossificans Progressiva  (FOP). IFOPA's mission is to fund research to find a cure for FOP while supporting, connecting, and advocating for individuals with FOP and their families, and raising awareness worldwide. IFOPA is governed by a volunteer  board of directors  which may range in number from 9 to 15, at least one of whom must have FOP. The association's location is 1520 Clay St., Suite H2,  North Kansas City , MO, 64116,  part of the  Kansas City, Missouri  metropolitan area."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1463", "text": "IFOPA was founded in 1988 by Jeannie L. Peeper. Diagnosed with FOP in 1962 at age four, Peeper graduated from college in 1985 with a bachelor of arts degree in social work.  Michael Zasloff , then at the  National Institutes of Health  (NIH), was studying FOP and put Peeper in contact with all FOP patients known to the NIH, eighteen in total, to whom Peeper mailed a questionnaire. Eleven responded. In early 1988, Peeper started a newsletter called  FOP Connection  in collaboration with Nancy Sando, one of the respondents. In June of that year, Peeper founded the IFOPA to facilitate fund raising for FOP research and generally create awareness of the disease. With an initial association membership of eleven, Peeper became the inaugural president and Sando was appointed vice president. In 1989, Peeper collaborated with the  University of Pennsylvania  to support establishment of the FOP Collaborative Research Project, and in 1992, the Center for Research in FOP and Related Disorders, efforts spearheaded by Drs.  Frederick Kaplan , Michael Zasloff, and  Eileen Shore ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1464", "text": "Throughout the 1990s, IFOPA organized two international symposiums on FOP and several FOP family meetings. In the first decade of the 2000s, two more international symposiums were hosted by IFOPA, and other FOP scientific and family meetings were held in Argentina, Brazil, Canada, France, Germany, Italy, The Netherlands, Sweden, and the UK.  In April 2006, the Center for Research in FOP discovered the FOP gene. By 2020, the organization had over 500 members from 57 countries and had partnered with FOP organizations and communities on all continents except Antarctica."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1465", "text": "In 2010, IFOPA implemented the first annual Jeannie L Peeper Awards to recognize philanthropy, community involvement, international leadership and youth leadership in support of the FOP cause. Also in 2010, the Central Florida Chapter of the Association of Fund Raising Professionals named Peeper as winner of the 2010 Lifetime Achievement Award for her work in founding and establishing the IFOPA. A gathering of FOP families, supporters, researchers, and pharmaceutical industry representatives was held in Orlando in late 2013 on the 25th anniversary of the Association."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1466", "text": "IFOPA hosted FOP drug development forums in 2014 and 2016 in Boston, 2017 in Sardinia Italy, and 2019 in Orlando. The forums brought together FOP experts to discuss the latest research, solve drug development challenges and strengthen the global network of research collaborations. The 2019 Drug Development Forum attracted 154 attendees from 19 countries including researchers, clinicians, biotech and pharmaceutical company representatives, regulators, advocates and people living with FOP. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1467", "text": "Quoting the 27th Annual Report of the FOP Collaborative Research Project \"As of January 1, 2018, there were 37 research universities and/or clinical centers actively engaged in FOP research; 18 in the United States & Canada, 12 in Europe, five in Asia, one in Africa and one in Australia. As of January 1, 2018, there were 12 pharmaceutical and biotechnology companies actively developing drugs for FOP based on a multitude of hard targets, and over 30 companies that have expressed interest.\" [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1468", "text": "In early 2017, IFOPA closed its Orlando office and moved administrative operations to North Kansas City, Missouri.  A reorganization plan entailed creation of several new positions as follows: Director of Research Development and Partnerships, Family Services Manager, Donor Relations and Administrative Coordinator, Community Fundraising Manager, and FOP Registry Project Director."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1469", "text": "Historically, IFOPA has allocated over 80% of its annual budget to medical research and programs, donating in the range of $350,000 to $650,000 annually to the FOP Laboratory.  IFOPA is a  GuideStar  Gold Participant by virtue of the public information IFOPA provides beyond that available from the IRS. [ 3 ]  General overhead, defined as a combination of fund raising and management expenses, has for the past decade averaged below the Association of Fundraising Professionals statement that the average American believes 23 cents on the dollar being spent on such costs is a reasonable figure. IFOPA's financial statements and 990s are posted on the IFOPA website."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1470", "text": "IFOPA fund raising results principally from family-organized activities rather than large nationwide events. In addition to the association's own annual appeal, several grants, and traditional family/friends letter drives, the range of family fund raisers includes golf tournaments, barbecues, bingos, auctions, comedy shows, rock concerts, holiday card sales, raffles, suppers, athletic events, and a variety of other social events and receptions. Some of the more unusual fund raisers include an annual Burns Supper in Aberdeen Scotland, an ice fishing contest, and the auctioning of a quilt decorated with a double helical border symbolizing both the DNA double helix and the quest to find a cure. In 2010, the association established the Jeannie Peeper Heritage Society, a fund raising program that targets major donors and estate giving."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1471", "text": "IFOPA's medical and scientific advisors are  Frederick S. Kaplan , Eileen M. Shore, and  Michael Zasloff .  The foregoing advise the association on issues such as family support and counseling, dissemination of medical documents and treatment guidelines, medical document translation, physician awareness strategies, research funding requests and initiatives, and other matters for which their expertise is required."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1472", "text": "Kaplan is the Isaac and Rose Nassau Professor of Orthopaedic Molecular Medicine and Chief of the Division of Orthopaedic Molecular Medicine at the  Perelman School of Medicine at the University of Pennsylvania . Kaplan co-directs the Center for Research in FOP and Related Disorders and is recognized as the world's leading expert on genetic disorders of  heterotopic ossification  and skeletal metamorphosis. [ 4 ]  In 1997, Kaplan was awarded the first endowed chair in the USA for orthopaedic molecular medicine. In 2006,  Newsweek  named Kaplan as one of \"15 people who make America great\". [ 5 ]  In 2009, Kaplan was elected to the  Institute of Medicine , an organization established by the  United States National Academy of Sciences  to honor professional achievement in the health sciences."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1473", "text": "Shore is the Cali and Weldon Research Professor in FOP, and Professor of Orthopaedic Surgery and Genetics in the Perelman School of Medicine at the University of Pennsylvania, Co-Director of the Center for Research in FOP and Related Disorders, and director of the FOP Molecular Biology Laboratory. She is a past-president of the Advances in Mineral Metabolism (AIMM) Board of Directors and served on the American Society of Bone and Mineral Research (ASBMR) Council. Shore was awarded a PhD from the University of Pennsylvania (Cell and Molecular Biology) followed by post-doctoral training in  cell biology  at the  Fox Chase Cancer Center  in Philadelphia. Shore's collaboration with Kaplan led to the discovery of the mutated genes in both FOP and POH  Progressive osseous heteroplasia . [ 6 ] [ 7 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1474", "text": "Zasloff is Scientific Director, MedStar Georgetown Transplant Institute,  Georgetown University School of Medicine .  In the early 1980s, during his tenure at the National Institutes of Health as Chief of the Human Genetics Branch, he began clinical and basic studies of FOP and helped found the IFOPA with Jeannie Peeper.  In 1989, as the Upham Professor of Pediatrics and Genetics at the University of Pennsylvania and Chief of the Division of Human Genetics of the  Children's Hospital of Philadelphia , he began his collaboration with Fred Kaplan to find both the cause and cure of FOP."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1475", "text": "As a result of the rareness of FOP, the condition is little known even among medical clinicians. Close to 90% of FOP patients worldwide are misdiagnosed. [ 8 ]  In such circumstances, the association directly supports research, makes information about FOP including symptoms and treatment guidelines available to both physicians and families, and supports afflicted families with mentoring, family meetings and an information network. Below are IFOPA's programs of research, education, family support, and advocacy. Additional information about these programs, including downloadable reports, articles and other materials, may be obtained from the IFOPA website."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1476", "text": "The  International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine  ( ISAKOS ) is an international medical society with around 4,000 members. The membership comprises mostly orthopaedic surgeons along with sports scientists, sports physicians and sports physical therapists. The members are from some 92 different countries and are members of their local orthopaedic sports medicine societies or similar associations. Members may also be associated with their global regional orthopaedic sports medicine society such as the  Arthroscopy Association of North America , the  American Orthopaedic Society for Sports Medicine  (AOSSM), the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society, the European Society for Sports Traumatology, Knee Surgery and Arthroscopy and the Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte in particular."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1477", "text": "The purpose of ISAKOS is to act as an umbrella association for these regional societies to provide a means for exchange of knowledge between them and, most importantly, to promote education in the fields of knee surgery and orthopaedic sports medicine to those areas of the world where such educational opportunities are lacking. ISAKOS achieves these goals by the involvement of members in educational meetings, sponsoring of visitations by surgeons from poorer countries to centres of excellence along with other awards, scholarships and endorsements of regional meetings."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1478", "text": "Arthroscopy  (also called arthroscopic surgery) is a  minimally invasive   surgical procedure  on a  joint  in which a treatment or just an examination is performed using an arthroscope, an  endoscope  that is inserted into the joint through a small incision."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1479", "text": "Sports medicine , also known as sport and exercise medicine (SEM), is a part of  medicine  that deals with the prevention and treatment of  injuries  related to  sports  and  exercise ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1480", "text": "ISAKOS was formed in 1995, in Hong Kong, at the combined congress of the International Arthroscopy Association (IAA) and the International Society of the Knee (ISK). These two societies previously held meetings 'back to back' and as most delegates attended both it became a logical step to combine them. ISAKOS is the union of these International societies (IAA and ISK). ISAKOS holds an international Congress every two years. Since the founding in 1995, these Congress meetings have been held throughout the world. The first president of ISAKOS was Dr. Peter J. Fowler of Canada, in the years 1995 to 1997."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1481", "text": "For the 2015\u201317 term, the society was chaired by Dr. Philippe Neyret of France, followed by Dr. Marc Safran of the USA from 2017\u201319. [ 1 ]  The society is currently chaired by  Dr. Willem van der Merwe  of South Africa, who will hold the post until 2021. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1482", "text": "ISAKOS is an international society of individuals interested in Sports Orthopaedics and the fields of medicine and science related to that. These include knee surgery, arthroscopic surgery of all joints and orthopaedic sports medicine. It is very common for those applying for membership to also be a member of one of the major regional Associations. These are the Arthroscopy Association of North America (AANA), the American Orthopaedic Society for Sports Medicine (AOSSM), the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS), the European Society for Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) and the Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte (SLARD). Members are also members of their regional or National orthopaedic sports medicine society (or equivalent). Indeed, members of these Associations may gain Associate Membership of ISAKOS immediately on application."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1483", "text": "There are two primary membership categories:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1484", "text": "Associate members"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1485", "text": "Those with an interest or ability in the fields of medicine or science with an interest in arthroscopy, knee surgery, and orthopaedic sports medicine shall be eligible. These members are not entitled to vote and are not eligible to hold office."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1486", "text": "Active members"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1487", "text": "Individuals qualified as orthopaedic surgeons, musculoskeletal surgeons, rheumatologists or the equivalent in their home countries and who are in good medical standing in their national or regional association as determined by the membership committee of the ISAKOS. Active members are entitled to vote at all meetings of the membership and are eligible to hold office in the society. Active Membership is awarded pending an application review at a meeting of the Membership Committee. The Membership Committee meets at all annual AAOS meetings and at ISAKOS congresses."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1488", "text": "ISAKOS offers a number of awards. These awards are for original papers in the various categories which are submitted for the biennial Congress. The awards are presented at the Congress and notified in the Society Newsletter and on the ISAKOS website."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1489", "text": "Many of the Awards honour prominent present and past ISAKOS members and past notable doyens of sports surgery while others offer financial support for research, Fellowships and attendance at various ISAKOS sponsored meetings."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1490", "text": "In keeping with the fundamental mission of ISAKOS some preference is given to supporting research and scholarships to individuals from countries where such opportunities may not have otherwise been available."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1491", "text": "These awards include;"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1492", "text": "Awards"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1493", "text": "Fellowships and Scholarships"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1494", "text": "Applications for these Awards and Scholarships are usually invited a year before the Biennial Congress."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1495", "text": "The primary focus of ISAKOS is education in the fields of Orthopaedic Sports Medicine, Arthroscopy and Knee Surgery. It achieves this goal by 4 means; the Biennial ISAKOS Congress, focussed expert consensus meetings resulting in a publication, instructional courses and surgical techniques available on the ISAKOS website and involvement with approval of many other courses with similar educational intent throughout the world. ISAKOS also allows branding of Fellowship programs and financially supports specific educational Travelling Fellowships."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1496", "text": "The Biennial Congress"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1497", "text": "This is the most important event in the ISAKOS calendar and much activity centres on the planning and organisation of this International Congress. Many of the ISAKOS Committees have input into the structure, format and content of the Congress with the oversight of the Program Committee and the Program Chair. The Congress is a forum for free papers and abstracts are required usually 12 months in advance."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1498", "text": "In addition, the Congress also includes Instructional Courses on specific topics led by International experts along with Symposia on topics of current interest. In recent years the Congress has expanded to include live surgical demonstrations and 'Hands on Workshops'."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1499", "text": "Poster presentations are now presented electronically and delegates receive an electronic copy of these with their registration. More recently the Congress has also made available a dedicated app which allows delegates to preview abstracts and plan their involvement at the Congress."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1500", "text": "The Congress also includes sessions for debates on current issues, technical exhibits and time for networking which is so important in developing International professional contacts and acquaintances."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1501", "text": "The biennial ISAKOS Congress is usually held for a total of five days, during the months of May or June. Several ISAKOS Awards for outstanding clinical or laboratory research are presented during this meeting. The most recent ISAKOS meeting was held in 2017 in Shanghai, China, and involved over 4000 attendees from 84 countries presenting 256 papers and 753 E-posters."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1502", "text": "ISAKOS also supports and collaborates on several other meetings throughout the year focusing on knee injuries or other sports related areas of interest. In addition, the Society provides accreditation for numerous other educational courses all over the world."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1503", "text": "Focussed Expert Consensus Meetings"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1504", "text": "The Clinical Committees of ISAKOS are made up of multinational members with common interests. This provides a forum for discussion and often resolution of many issues relevant to that speciality. Often the Committee will convene a meeting to resolve a specific issue or discuss a specific topic. Experts from around the world, whether ISAKOS members or not, are invited to these meetings and a consensus is usually developed."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1505", "text": "These consensus meetings usually result in a publication on the topic. Such international consensus on a controversial topic is a much more considered resolution of an issue than the opinions of a single expert."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1506", "text": "A number of ISAKOS derived publications of the outcomes of consensus meetings are available to members, many of which have been published in respected orthopaedic literature."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1507", "text": "Instructional Course Lectures and Surgical Technique Videos"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1508", "text": "Through the ISAKOS website and the Global link members are able to view many Instructional videos on current topics. Surgical technique videos are also available. Many of these have been recorded during previous Congress sessions and others have been supplied by individual surgeons for the benefit of ISAKOS members."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1509", "text": "ISAKOS Approved Meetings"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1510", "text": "Regional societies have their local meetings attracting their members and other delegates from locally or from other countries. These local societies can apply to ISAKOS for approval of their program. This is determined by the Scientific Committee and if approval is granted then this can be advertised by the regional society. The expectation is that such approval offers a degree of enhanced credibility to the scientific nature of the approved meeting."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1511", "text": "The  Major Extremity Trauma Research Consortium  (METRC) is a network of clinical centers centered at the  Johns Hopkins Bloomberg School of Public Health  conducting multicenter  clinical research studies  on the treatment and outcomes of traumatic  orthopedic injuries ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1512", "text": "In 2024, the PREVENT CLOT study was awarded the Distinguished Clinical Research Achievement Award by the Clinical Research Forum. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1513", "text": "In 2023, the American Academy of Orthopaedic Surgeons (AAOS) awarded METRC the Kappa Delta Elizabeth Winston Lanier Award. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1514", "text": "In 2023, Dr. Michael J. Bosse and Dr. Ellen J. MacKenzie of METRC were awarded Lifetime Achievement Awards by the Orthopaedic Trauma Association. [ 3 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1515", "text": "The  National Association of Orthopaedic Nurses   (NAON) is an American non-profit volunteer-run  professional association  that aims to advance  orthopaedic nursing . Formed in 1980, NAON was designed to promote the highest standards of  nursing practice  by educating its practitioners, promoting research, and encouraging effective communication between orthopaedic nurses and other groups with similar interests."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1516", "text": "NAON membership consists of more than 6,000  registered nurses ,  licensed practical nurses , student nurses, and associate members from across the United States and around the world who share an interest in  musculoskeletal  health care. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1517", "text": "NAON is accredited as a provider of continuing nursing education by the  American Nurses Credentialing Center 's Commission on Accreditation. Starting in 1981, NAON has organized an annual congress at different locations in the United States."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1518", "text": "One of the main goals of the founders of NAON was to form a stronger and firmer foundation for the development of an orthopaedic nursing organization. Recovering from the unexpected dissolution of the previous organization, Orthopaedic Nurses Association (ONA), members from across the United States met on March 8, 1980, in  Atlanta, Georgia , under the leadership of Nancy Hesselbach and Barbara Fiehler. This meeting was convened during the annual meeting of the  American Academy of Orthopaedic Surgeons . Subsequently, NAON was established and incorporated in  Missouri  on April 14, 1980."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1519", "text": "NAON publishes:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1520", "text": "The NAON Foundation supports the goals and mission of NAON by providing grants, scholarships, and awards to nurses pursuing careers in orthopaedic nursing practice, education,  administration , and research. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1521", "text": "The  National Institute of Traumatology & Orthopaedic Rehabilitation (NITOR)  is an orthopedic hospital and undergraduate & post-graduate institute in  Sher-e-Bangla Nagar ,  Dhaka ,  Bangladesh . It was established in 1972 by the  Government of Bangladesh  as the Shaheed Suhrawardy Hospital. In October 2002 the name of the institute was changed to National Institute of Traumatology & Orthopaedic Rehabilitation (NITOR). [ 1 ]  NITOR is affiliated previously  to       Dhaka University  and now to  Bangabandhu Sheikh Mujib Medical University ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1522", "text": "Master of Surgery (MS) (Orthopedics) and D. Ortho. awarded by NITOR, a post-graduate institute, are recognized by the  Bangladesh Medical and Dental Council ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1523", "text": "23\u00b043\u203232\u2033N   90\u00b023\u203253\u2033E \ufeff / \ufeff 23.72556\u00b0N 90.39806\u00b0E \ufeff /  23.72556; 90.39806"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1524", "text": "This article about a hospital in Bangladesh is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1525", "text": "New England Baptist Hospital (NEBH)  is a 141-bed adult  medical - surgical   hospital  in  Boston, Massachusetts  specializing in  orthopedic  care and complex orthopedic procedures. NEBH is an international leader in the treatment of all forms of  musculoskeletal  disorders and diseases. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1526", "text": "NEBH is located atop Parker Hill in the  Mission Hill  neighborhood within walking distance of the  Longwood Medical and Academic Area ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1527", "text": "The hospital is a teaching affiliate of both the  University of Massachusetts Medical School  and  Tufts University School of Medicine . It also conducts teaching programs in collaboration with the  Harvard T.H. Chan School of Public Health  and  Harvard Medical School ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1528", "text": "Beth Israel Lahey Health  is the parent  non-profit  holding company for New England Baptist,  Beth Israel Deaconess Medical Center , the  Lahey Hospital & Medical Center ,  Mount Auburn Hospital  and others. [ 2 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1529", "text": "New England Baptist Hospital was established in 1893 by  American Baptist Churches USA , a  Baptist   Christian denomination  with a long history in  New England ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1530", "text": "When the hospital was created in 1893, Parker Hill was a  streetcar suburb  considered far enough away from  downtown Boston  to provide fresh air and an escape from the noise and congestion of the city for patients who might benefit from long term rest and relaxation. Parker Hill offers panoramic views of the city,  Boston Harbor , and the  Blue Hills . Even today, it is a remarkably peaceful site considering its location near the center of one of the largest metropolitan areas in  North America . In April 2017, New England Baptist Hospital agreed to join with Lahey Health and Beth Israel Deaconess Medical Center. [ 3 ] [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1531", "text": "Through the associated New England Baptist Bone & Joint Institute, the hospital offers a full range of services in orthopedics and  rheumatology ,  occupational medicine  and  sports medicine , foot and ankle care,  joint replacement ,  spine  care, and  hand surgery . The institute offers such services as preventive, educational, diagnostic, treatment, and rehabilitation services."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1532", "text": "NEBH has a long association with sports medicine and has provided services to U.S.  Olympic teams  and multiple  professional athletes ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1533", "text": "Boston Red Sox  legend  Ted Williams  came to the Baptist for treatment of a cervical disk disorder in the 1950s. In 1999, esteemed  PGA Tour  player  Jack Nicklaus  came to the Baptist for a new hip."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1534", "text": "NEBH is the official hospital of the eighteen-time world champion  Boston Celtics  and has a long association with the  Boston Athletic Association  which hosts the  Boston Marathon ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1535", "text": "Novosibirsk Research Institute of Traumatology and Orthopedics named after Y. L. Tsivyan  ( Russian :  \u041d\u043e\u0432\u043e\u0441\u0438\u0431\u0438\u0440\u0441\u043a\u0438\u0439 \u043d\u0430\u0443\u0447\u043d\u043e-\u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u0442\u0435\u043b\u044c\u0441\u043a\u0438\u0439 \u0438\u043d\u0441\u0442\u0438\u0442\u0443\u0442 \u0442\u0440\u0430\u0432\u043c\u0430\u0442\u043e\u043b\u043e\u0433\u0438\u0438 \u0438 \u043e\u0440\u0442\u043e\u043f\u0435\u0434\u0438\u0438 \u0438\u043c\u0435\u043d\u0438 \u042f. \u041b. \u0426\u0438\u0432\u044c\u044f\u043d\u0430 ) is a medical organization in  Novosibirsk , Russia, that specializes in  orthopedic surgery , the treatment of  rheumatologic  conditions and scientific research of diseases of the  musculoskeletal system . It was founded in 1946."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1536", "text": "The medical organization was created in 1946 on the basis of evacuation hospital No. 1239, which was located in the building of the Bookselling Technical School on  Frunze Street . Initially, the institute specialized in the surgical treatment of people who received injuries during the Second World War."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1537", "text": "In 2015, for the first time in Russia, the institute's doctors implanted nanoceramic hip joint implant made in Russia. A hip joint prosthesis was implanted free of charge to a resident of  Birobidzhan . [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1538", "text": "The  International Osteoporosis Foundation  ( IOF ), headquartered in  Nyon ,  Switzerland , is a  non-governmental organization  (NGO) founded in 1998. It was formed from the merger of the European Foundation for Osteoporosis, founded in 1987, and the International Federation of Societies on Skeletal Diseases. [ 1 ]  The foundation functions as a global alliance of individuals and organizations concerned with the prevention, diagnosis and treatment of  osteoporosis  and musculoskeletal  bone disease . The goal of the Foundation is to increase the early detection of osteoporosis and related musculoskeletal diseases, as well as to improve the treatment of these conditions through international collaboration among national healthcare systems and governments. [ 2 ]  The Foundation is the largest global NGO dedicated to osteoporosis and musculoskeletal diseases."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1539", "text": "Members of IOF are divided into a committee of 323 National Societies, a committee of 163 Scientific Advisors, and a committee of Corporate Advisors. The current president of IOF is Professor Cyrus Cooper. [ 3 ] [ 4 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1540", "text": "IOF is a member of the Non Communicable Disease (NCD) Alliance as of 2015. [ 5 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1541", "text": "IOF publishes the following journals:"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1542", "text": "The International Osteoporosis Foundation organises the annual  World Osteoporosis Day , observed internationally on October 20. [ 10 ]  The day is dedicated to raising global awareness of the prevention, diagnosis and treatment of osteoporosis and related diseases of bones, muscles and joints. [ 11 ] [ 12 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1543", "text": "The Capture the Fracture (CTF) [ 13 ]  program was created by IOF in 2012 to promote secondary fracture prevention through best practice framework guidance and recognition of Fracture Liaison Services [ 14 ]  around the World. 856 Fracture Liaisons Services (FLS) have been established in 54 countries as part of the CTF program. The Map of Best Practice, [ 15 ]  established as part of the CTF program, gives recognition to FLS by grading their level of service. The excellence obtained by the FLS is designated as gold, silver or bronze. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1544", "text": "Members of the IOF Committee of Scientific Advisors address key subjects in 13 Scientific Working Groups, [ 16 ]  and publish consensus statements, position papers, [ 17 ]  reviews and guidelines. Topics currently being studied include adherence, bone and cancer, bone and diabetes, epidemiology/quality of life, fracture care and secondary fracture prevention, therapeutic targets, HR-pQCT High Resolution Peripheral Quantitative Computer Tomography, bone marker standards, chronic inflammation and bone structure, Menopausal Hormone Therapy (MHT),  sarcopenia  and impaired mobility, and skeletal rare diseases. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1545", "text": "Calcium  is essential for building and maintaining healthy bones at all ages. The IOF Calcium Calculator [ 18 ]  is a simple calculator to enable individuals to assess whether they are consuming enough calcium as part of a regular diet."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1546", "text": "The IOF Osteoporosis Risk Check [ 19 ]  enables people to understand the status of bone health through a series of simple questions on family history and personal clinical risk factors."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1547", "text": "Launched in March 2017 with a call for \u2018 No more broken bones \u2019, the IOF Global Patient Charter [ 20 ]  was developed in cooperation with osteoporosis patient societies worldwide. It seeks to drive global action for improved osteoporosis prevention and fracture patient care. The Charter calls on healthcare authorities to address the needs of millions of osteoporosis patients worldwide, who should have the right to diagnosis, care, involvement, and support. [ citation needed ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1548", "text": "The International Osteoporosis Foundation was established in 1998 with the merger of the European Foundation for Osteoporosis (EFFO) and the International Federation of Societies on Skeletal Diseases (IFSSD). [ 21 ]  In 2008 IOF was granted Roster  Consultative Status  with the  United Nations Economic and Social Council . [ 22 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1549", "text": "Since 2010, IOF and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) [ 23 ]  jointly organize the annual World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO). [ 24 ]  The first WCO was held in 2000 in Chicago, Illinois and was formerly run by the IOF secretariat. Since 2010, there have been 13 WCO congresses organized in collaboration with ESCEO."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1550", "text": "In addition to the annual WCO congress, IOF also hosts regional meetings and has organized 9 regional meetings since 2010 across Latin America, Middle East & Africa, and Asia Pacific. [ 25 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1551", "text": "The  Soci\u00e9t\u00e9 Internationale de Chirurgie Orthop\u00e9dique et de Traumatologie (SICOT)  is an international non-profit organization in the field of orthopaedics and traumatology."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1552", "text": "The foundations of the Society were laid during its first Congress in  Paris  at the  Hotel Crillon  on October 10, 1929. [ 1 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1553", "text": "The group of founders who attended included: from Austria,  Erlacher  and  Spitzy ; from Belgium, Lorthioir, Delchef [ 2 ]  and Maffei; from Spain, San Ricart; from the United States, Albee, Baer and Meyerding; [ 3 ]  from France,  Ombr\u00e9danne ,  Rocher ,  Sorrel  and  Nov\u00e9-Josserand ; from Great Britain, Fairbank; [ 4 ]  from Germany, Bielsalski; from Italy,  Galeazzi  and Putti; from Holland, Murk Jansen; from Romania, Frans Jiano; from Sweden,  Haglund  and  Waldenstr\u00f6m ; from Switzerland, Machard; and from Czechoslovakia,  Zahradn\u00ed\u010dek ."}
{"_id": "WikiPedia_Orthopedics$$$corpus_1554", "text": "International Orthopaedics is an official journal of SICOT. The Journal is published monthly by  Springer Verlag , and is distributed to 50,000 surgeons in electronic format and in 3,200 printed issues for libraries and special subscribers. It has an impact factor of 2.7 (2022). [ 22 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1555", "text": "SICOT-J is an official journal of SICOT founded in 2014. It is a peer-reviewed open access journal. Its focus is on clinical, basic and transnational research in the field of orthopaedics surgery and traumatology. [ 23 ] [ 24 ] [ 25 ]"}
{"_id": "WikiPedia_Orthopedics$$$corpus_1556", "text": "The  Valdoltra Orthopedic Hospital  ( Slovene :  Ortopedska bolni\u0161nica Valdoltra ) is one of  Slovenia 's most important treatment facilities. It is located in  Ankaran  on the coast of the  Adriatic Sea  in southwestern Slovenia. Its beginnings go back to 1909, when it began receiving patients with skeletal  tuberculosis . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1", "text": "The  muscular system  is an  organ system  consisting of  skeletal ,  smooth , and  cardiac  muscle. It permits movement of the body, maintains posture, and circulates blood throughout the body. [ 1 ]  The muscular systems in  vertebrates  are controlled through the  nervous system  although some muscles (such as the  cardiac muscle ) can be completely autonomous. Together with the  skeletal system  in the human, it forms the  musculoskeletal system , which is responsible for the movement of the  body . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2", "text": "There are three distinct types of muscle:  skeletal muscle ,  cardiac or heart muscle , and  smooth (non-striated) muscle .  Muscles  provide strength, balance, posture, movement, and heat for the body to keep warm. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3", "text": "There are more than 600 muscles in an adult male human body. [ 4 ]  A kind of elastic tissue makes up each muscle, which consists of thousands, or tens of thousands, of small muscle fibers. Each fiber comprises many tiny strands called fibrils, impulses from nerve cells control the contraction of each muscle fiber."}
{"_id": "WikiPedia_Muscular_system$$$corpus_4", "text": "Skeletal muscle, is a type of  striated muscle , composed of  muscle cells , called  muscle fibers , which are in turn composed of  myofibrils . Myofibrils are composed of  sarcomeres , the basic building blocks of striated muscle tissue. Upon stimulation by an  action potential , skeletal muscles perform a coordinated contraction by shortening each sarcomere. The best proposed model for understanding contraction is the  sliding filament model  of muscle contraction. Within the sarcomere,  actin  and  myosin  fibers overlap in a contractile motion towards each other. Myosin filaments have club-shaped  myosin heads  that project toward the actin filaments, [ 1 ] [ 3 ] [ 5 ]  and provide attachment points on binding sites for the actin filaments. The myosin heads move in a coordinated style; they swivel toward the center of the sarcomere, detach and then reattach to the nearest active site of the actin filament. This is called a ratchet type drive system. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_5", "text": "This process consumes large amounts of  adenosine triphosphate  (ATP), the energy source of the cell. ATP binds to the cross-bridges between myosin heads and actin filaments. The release of energy powers the swiveling of the myosin head. When ATP is used, it becomes  adenosine diphosphate  (ADP), and since muscles store little ATP, they must continuously replace the discharged ADP with ATP. Muscle tissue also contains a stored supply of a fast-acting recharge chemical,  creatine phosphate , which when necessary can assist with the rapid regeneration of ADP into ATP. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_6", "text": "Calcium ions  are required for each cycle of the sarcomere. Calcium is released from the  sarcoplasmic reticulum  into the  sarcomere  when a muscle is stimulated to contract. This calcium uncovers the actin-binding sites. When the muscle no longer needs to contract, the calcium ions are pumped from the sarcomere and back into storage in the  sarcoplasmic reticulum . [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_7", "text": "There are approximately 639 skeletal muscles in the human body."}
{"_id": "WikiPedia_Muscular_system$$$corpus_8", "text": "Heart muscle is striated muscle but is distinct from skeletal muscle because the  muscle fibers  are laterally connected. Furthermore, just as with smooth muscles, their movement is involuntary. Heart muscle is controlled by the  sinus node  influenced by the  autonomic nervous system . [ 1 ] [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_9", "text": "Smooth muscle contraction is regulated by the autonomic  nervous system ,  hormones , and local chemical signals, allowing for gradual and sustained contractions. This type of  muscle tissue  is also capable of adapting to different levels of stretch and tension, which is important for maintaining proper blood flow and the movement of materials through the  digestive system ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_10", "text": "Neuromuscular junctions  are the focal point where a  motor neuron  attaches to a muscle.  Acetylcholine , (a  neurotransmitter  used in skeletal muscle contraction) is released from the axon terminal of the nerve cell when an action potential reaches the microscopic junction called a  synapse . A group of chemical messengers across the synapse and stimulate the formation of electrical changes, which are produced in the muscle cell when the acetylcholine binds to receptors on its surface. Calcium is released from its storage area in the cell's sarcoplasmic reticulum. An impulse from a nerve cell causes calcium release and brings about a single, short  muscle contraction  called a  muscle twitch . If there is a problem at the neuromuscular junction, a very prolonged contraction may occur, such as the muscle contractions that result from  tetanus . Also, a loss of function at the junction can produce  paralysis . [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_11", "text": "Skeletal muscles are organized into hundreds of  motor units , each of which involves a motor neuron, attached by a series of thin finger-like structures called  axon terminals . These attach to and control discrete bundles of muscle fibers. A coordinated and fine-tuned response to a specific circumstance will involve controlling the precise number of motor units used. While individual muscle units' contract as a unit, the entire muscle can contract on a predetermined basis due to the structure of the motor unit. Motor unit coordination, balance, and control frequently come under the direction of the  cerebellum  of the brain. This allows for complex muscular coordination with little conscious effort, such as when one drives a car without thinking about the process. [ 5 ] [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_12", "text": "A tendon is a piece of connective tissue that connects a muscle to a bone. [ 8 ]  When a muscle intercepts, it pulls against the skeleton to create movement. A tendon connects this muscle to a bone, making this function possible."}
{"_id": "WikiPedia_Muscular_system$$$corpus_13", "text": "At rest, the body produces the majority of its  ATP  aerobically in the  mitochondria [ 9 ]  without producing  lactic acid  or other fatiguing byproducts. During exercise, the method of ATP production varies depending on the fitness of the individual as well as the duration and intensity of exercise. At lower activity levels, when exercise continues for a long duration (several minutes or longer), energy is produced aerobically by combining oxygen with  carbohydrates  and  fats  stored in the body. [ 6 ] [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_14", "text": "During activity that is higher in intensity, with possible duration decreasing as intensity increases, ATP production can switch to anaerobic pathways, such as the use of the  creatine phosphate  and the phosphagen system or anaerobic  glycolysis . Aerobic ATP production is biochemically much slower and can only be used for long-duration, low-intensity exercise, but produces no fatiguing waste products that cannot be removed immediately from the  sarcomere  and the body, and it results in a much greater number of ATP molecules per fat or carbohydrate molecule. Aerobic training allows the oxygen delivery system to be more efficient, allowing aerobic metabolism to begin quicker. Anaerobic ATP production produces ATP much faster and allows near-maximal intensity exercise, but also produces significant amounts of  lactic acid  which render high-intensity exercise unsustainable for more than several minutes. The phosphagen system is also anaerobic. It allows for the highest levels of exercise intensity, but intramuscular stores of  phosphocreatine  are very limited and can only provide energy for exercises lasting up to ten seconds. Recovery is very quick, with full creatine stores regenerated within five minutes. [ 6 ] [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_15", "text": "Multiple diseases can affect the muscular system."}
{"_id": "WikiPedia_Muscular_system$$$corpus_16", "text": "Muscular dystrophy  is a group of disorders associated with progressive muscle weakness and loss of muscle mass. These disorders are caused by mutations in a person's genes. [ 12 ]  The disease affects between 19.8 and 25.1 per 100,000 person-years globally. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_17", "text": "There are more than 30 types of muscular dystrophy. Depending on the type, muscular dystrophy can affect the patient's heart and lungs, and/or their ability to move, walk, and perform daily activities. The most common types include:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_18", "text": "An  acceleromyograph  is a  piezoelectric   myograph , used to measure the force produced by a  muscle  after it has undergone nerve stimulation. Acceleromyographs may be used, during anaesthesia when muscle relaxants are administered, to measure the depth of neuromuscular blockade and to assess adequacy of  recovery from these agents at the end of surgery. Acceleromyography is classified as quantitative  neuromuscular monitoring . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_19", "text": "Patients who undergo anesthesia may receive a drug that  paralyzes  muscles, facilitating endotracheal intubation and improving operating conditions for the surgeon. Longer-acting drugs have higher prevalence of residual blockade in the  PACU  or  ICU  than shorter acting drugs. Different clinical tests to measure or exclude evidence of residual  muscle weakness  have been described but cannot exclude  postoperative residual curarization . [ 1 ]  Small degrees of muscle blockade can only accurately be measured by the use of quantitative neuromuscular monitoring. Specifically, the observer cannot reliably measure muscular fade when  train-of-four  ratios are between 0.4 and 0.9. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_20", "text": "Acceleromyographs measure muscle activity using a miniature  piezoelectric transducer  that is attached to the stimulated muscle. A voltage is created when the muscle accelerates and that acceleration is proportion to force of contraction. The mass of the piezoelectric transducer is known and the acceleration is measured therefore the force can be calculated, ( Force  =  mass  \u00d7  acceleration ). Acceleromyographs are more costly than the more common twitch monitors, but have been shown to better alleviate residual blockade and associated symptoms of muscle weakness, and to improve overall quality of recovery. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_21", "text": "An  accessory muscle  is a relatively rare  anatomical variation  where duplication of a  muscle  may appear anywhere in the  muscular system . Treatment is not indicated unless the accessory muscle interferes with normal function. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_22", "text": "Examples are the  accessory soleus muscle  in the calf or ankle, the  extensor digitorum brevis manus  in the hand and  epitrochleoanconeus muscle  of the upper arm."}
{"_id": "WikiPedia_Muscular_system$$$corpus_23", "text": "Additional examples in the hand include Flexor carpi radialis brevis which can compress the anterior interosseous nerve. [ 2 ]  Also see  palmaris profundus muscle ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_24", "text": "On the extensor side:\n extensor digitorum brevis manus , \n extensor carpi radialis intermedius , \n extensor medii proprius muscle"}
{"_id": "WikiPedia_Muscular_system$$$corpus_25", "text": "Accessory muscles of the anterior thoracic wall include the  sternalis muscle , the  axillary arch  (Langer's), variations of  pectoralis major  such as the  pectoralis minimus ,  pectoralis quartus , and  pectoralis intermedius , the  chondrocoracoideus  and  chondrofascialis . [ 3 ]  The whole pectoral region is subject to a high degree of variability. The pectoralis major or pectoralis minor may be absent, or in some cases the pectoralis major may be doubled. Other variants noted in this region are the  chondroepitrochleas  originating in one or more ribs, or directly from the pectoralis major; the  costocoracoideus  from the 6th to 8th ribs, and a  chondrocoracoideus  and another variant of this waiting to be named. Most of these accessory muscles are implicated in neurovascular compression. Of clinical use the newly described  chondrocoracoideus  has potential for use in reconstructive surgery. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_26", "text": "Axillary accessory muscles may be encountered in axillary lymph node removal, the awareness of which could avoid complications. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_27", "text": "An accessory muscle can also refer to a muscle that is not primarily responsible for movement but does provide assistance. [ 1 ]  Examples of such muscles are the  accessory muscles of respiration  where the  sternocleidomastoid  and the  scalene muscles  ( anterior ,  middle  and  posterior scalene ) are typically considered accessory muscles of respiration. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_28", "text": "Airway tone , short for  airway smooth muscle tone , is the degree of sustained  contractile  activation of  airway   smooth muscle . [ 1 ]  The airways have a tone baseline, and consequently a baseline level of contraction of their smooth musculature. Airway tone is a key determinant of  lung function  and the presence of  respiratory symptoms  in  obstructive lung diseases  such as  asthma , where baseline airway tone is elevated. [ 2 ]  The upper extreme of the spectrum of airway tone represents  bronchoconstriction , wherein the airway smooth muscles are significantly contracted, while the lower extreme represents  bronchodilatation , wherein the muscles are relatively relaxed."}
{"_id": "WikiPedia_Muscular_system$$$corpus_29", "text": "While airway tone is related to respiratory  airflow  and airway caliber insofar as an increase in airway tone decreases airflow due to the airway smooth muscle contraction, the two are not synonymous as airflow is determined by the structural and functional properties of the airways as well as the  lung parenchyma  in addition to airway tone. [ 1 ] [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_30", "text": "Airway tone and  airway resistance  are mostly correlated, [ 4 ]  but adequate  upper airway  tone is necessary for airflow and  airway patency ; [ 5 ]  insufficient upper airway tone during  sleep  can, for instance, result in  obstructive sleep apnea . [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_31", "text": "Autonomic nervous system  signalling plays a pivotal role in determining airway tone. The  innervation  of airway smooth musculature varies between the upper and  lower airways . [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_32", "text": "The  pharynx  is innervated by  cranial nerves   VII ,  IX ,  XII , while both the pharynx and the  larynx  are innervated by the vagus nerve. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_33", "text": "Lower airway, bronchial, or bronchus tone is mediated both by the innervation of airway smooth musculature and, possibly, also by the innervation of airway  mucosal   vasculature . Lower airway smooth muscles are mostly only innervated by the vagus nerve. [ 8 ] [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_34", "text": "Airway smooth muscle is primarily innervated by  cholinergic   parasympathetic  nerves, while its  adrenergic   sympathetic  innervation is sparse to non-existent. Specifically, cholinergic parasympathetic signalling increases the airway tone, meaning the airway tone is proportional to the  vagal tone . [ 8 ] [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_35", "text": "Despite this overall airway tone-increasing effect, the individual effects of  muscarinic acetylcholine receptors  expressed by airway muscle cells, of which there are 5 subtypes, M 1  through M 5 , are ambivalent.  M 3  receptors  directly lead to airway smooth muscle contraction, i.e., an increase in airway tone, while  M 2  receptors  (also) expressed by airway  neurons  suppress the further release of  acetylcholine  in a  negative feedback loop , wherein cholinergic parasympathetic signalling reduces further cholinergic parasympathetic signalling, which may explain the unexpectedly low effectivity of certain non-selective  muscarinic receptor antagonists  such as  ipratropium bromide . [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_36", "text": "M 2  receptors are less functional in asthma, disrupting the negative feedback which normally reduces airway tone, which may play a role in asthmatic airway hyperresponsiveness. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_37", "text": "As mentioned, adrenergic sympathetic innervation of airway smooth muscle is likely insignificant; however, the sympathetic innervation of the airway mucosal vasculature is significant. Airway muscular vasculature controls the flow of  nutrients  to the airways, the temperature of the airways, as well as the clearance of insoluble particles in the airways, which may play an important role in the  activity  of  inhaled bronchodilators , thus affecting  airway reactivity  and airway tone changes in obstructive lung diseases. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_38", "text": "There is conflicting evidence regarding  dopamine's  effect on airway tone  in vivo , with some studies reporting bronchoconstriction and others bronchodilatation following dopamine inhalation. In one study, dopamine attenuated the increase in airway tone caused by cholinergic signalling, but exacerbated  histaminergic  bronchoconstriction, while both signals were attenuated in the present study following the administration of intravenous dopamine. [ 11 ]  Thus, no conclusion can be drawn at this time."}
{"_id": "WikiPedia_Muscular_system$$$corpus_39", "text": "Acute activation of  D 2  receptors  expressed by airway smooth muscle cells inhibits the  adenylyl cyclase , lowering  cAMP  levels, leading to an increase in airway tone. However, their prolonged activation by  quinpirole , a D 2  and D 3  receptor  agonist , paradoxically enhances adenylyl cyclase activity, raising cAMP levels, leading to bronchodilatation via  phospholipase C  and  protein kinase C . [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_40", "text": "Histamine  is a direct bronchoconstrictor that increases airway tone by activating  H 1  receptors  expressed by airway smooth muscle cells. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_41", "text": "Six  type 2 (bitter) taste receptors  (TAS2Rs) are expressed by airway smooth muscle cells. In the tongue, bitter taste receptors have probably evolved for avoiding the ingestion of plant toxins. In the lungs, bitter taste receptors serve a paradoxically reversed function, causing the relaxation of airway smooth muscle, i.e., a lowering of airway tone. Thus, bitter taste receptor agonists represent promising potential novel bronchodilators. [ 12 ] [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_42", "text": "Theophylline 's non-selective  phosphodiesterase inhibition  has been proposed as the mechanism behind its bronchodilatating action. Phosphodiesterases degrade intracellular  cAMP , which leads to muscle contraction. Inhibiting phosphodiesterases increases cAMP concentrations in airway smooth muscle cells, lowering airway tone. Adenosine receptor agonism probably does not play a major role in theophylline-induced lowering of airway tone, as inhalation of adenosine actually increases airway tone, though it is probably the cause of theophylline's  arrhythmogenicity . [ 12 ] [ 14 ] [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_43", "text": "Like histamine, some  cysteinyl leukotrienes , such as  leukotriene D 4 , are direct bronchoconstrictors and increase airway tone by binding to receptors on airway smooth muscle cells. Bronchoconstrictive leukotrienes act via a common  cys-LT 1  receptor . [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_44", "text": "Thromboxane  is a direct bronchoconstrictor that acts via the  thromboxane receptor  on airway smooth muscle cells. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_45", "text": "Anatomical terminology  is used to uniquely describe aspects of  skeletal muscle ,  cardiac muscle , and  smooth muscle  such as their actions, structure, size, and location."}
{"_id": "WikiPedia_Muscular_system$$$corpus_46", "text": "There are three types of  muscle tissue  in the body: skeletal, smooth, and cardiac."}
{"_id": "WikiPedia_Muscular_system$$$corpus_47", "text": "Skeletal muscle , or \"voluntary muscle\", is a  striated muscle tissue  that primarily joins to  bone  with  tendons . Skeletal muscle enables movement of bones, and  maintains posture . [ 1 ]  The widest part of a muscle that pulls on the tendons is known as the  belly ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_48", "text": "A  muscle slip  is a slip of muscle that can either be an  anatomical variant , [ 2 ]  or a branching of a muscle as in  rib  connections of the  serratus anterior muscle ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_49", "text": "Smooth muscle  is involuntary and found in parts of the body where it conveys action without conscious intent. The majority of this type of muscle tissue is found in the  digestive  and  urinary systems  where it acts by propelling forward food,  chyme , and  feces  in the former and  urine  in the latter. Other places smooth muscle can be found are within the  uterus , where it helps facilitate  birth , and the  eye , where the  pupillary sphincter  controls  pupil  size. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_50", "text": "Cardiac muscle  is specific to the  heart . It is also involuntary in its movement, and is additionally self-excitatory, contracting without outside stimuli. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_51", "text": "As well as  anatomical terms of motion , which describe the motion made by a muscle, unique terminology is used to describe the action of a set of muscles."}
{"_id": "WikiPedia_Muscular_system$$$corpus_52", "text": "Agonist muscles and antagonist muscles are muscles that cause or inhibit a movement. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_53", "text": "Agonist muscles  are also called  prime movers  since they produce most of the force, and control of an action. [ 6 ]  Agonists cause a movement to occur through their own activation. [ 7 ]  For example, the  triceps brachii  contracts, producing a  shortening (concentric) contraction , during the up phase of a push-up ( elbow extension ). During the down phase of a push-up, the same triceps brachii actively controls elbow flexion while producing a  lengthening (eccentric) contraction . It is still the agonist, because while resisting gravity during relaxing, the triceps brachii continues to be the prime mover, or controller, of the joint action."}
{"_id": "WikiPedia_Muscular_system$$$corpus_54", "text": "Another example is the dumb-bell curl at the elbow. The  elbow flexor group  is the agonist, shortening during the lifting phase ( elbow flexion ). During the lowering phase the elbow flexor muscles lengthen, remaining the agonists because they are controlling the load and the movement (elbow extension). For both the lifting and lowering phase, the \"elbow extensor\" muscles are the antagonists (see below). They lengthen during the dumbbell lifting phase and shorten during the dumbbell lowering phase. Here it is important to understand that it is common practice to give a name to a muscle group (e.g. elbow flexors) based on the joint action they produce during a shortening contraction. However, this naming convention does not mean they are only agonists during shortening. This term typically describes the function of  skeletal muscles . [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_55", "text": "Antagonist muscles  are simply the muscles that produce an opposing joint torque to the agonist muscles. [ 9 ]  This torque can aid in controlling a motion. The opposing torque can slow movement down - especially in the case of a  ballistic movement . For example, during a very rapid (ballistic) discrete movement of the elbow, such as throwing a dart, the triceps muscles will be activated very briefly and strongly (in a \"burst\") to rapidly accelerate the extension movement at the elbow, followed almost immediately by a \"burst\" of activation to the elbow flexor muscles that decelerates the elbow movement to arrive at a quick stop. To use an automotive analogy, this would be similar to pressing the accelerator pedal rapidly and then immediately pressing the brake. Antagonism is not an intrinsic property of a particular muscle or muscle group; it is a role that a muscle plays depending on which muscle is currently the agonist. During slower joint actions that involve gravity, just as with the agonist muscle, the antagonist muscle can shorten and lengthen. Using the example of the triceps brachii during a push-up, the elbow flexor muscles are the antagonists at the elbow during both the up phase and down phase of the movement. During the dumbbell curl, the elbow extensors are the antagonists for both the lifting and lowering phases. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_56", "text": "Antagonist and agonist muscles often occur in pairs, called  antagonistic pairs . As one muscle contracts, the other  relaxes . An example of an antagonistic pair is the  biceps  and  triceps ; to contract, the triceps relaxes while the biceps contracts to lift the arm. \"Reverse motions\" need antagonistic pairs located in opposite sides of a joint or bone, including  abductor-adductor  pairs and flexor-extensor pairs. These consist of an  extensor muscle , which \"opens\" the joint (by increasing the angle between the two bones) and a  flexor muscle , which does the opposite by decreasing the angle between two bones."}
{"_id": "WikiPedia_Muscular_system$$$corpus_57", "text": "However, muscles do not always work this way; sometimes agonists and antagonists contract at the same time to produce force, as per  Lombard's paradox . Also, sometimes during a joint action controlled by an agonist muscle, the antagonist will be slightly activated, naturally. This occurs normally and is not considered to be a problem unless it is excessive or uncontrolled and disturbs the control of the joint action. This is called agonist/antagonist co-activation and serves to mechanically stiffen the joint."}
{"_id": "WikiPedia_Muscular_system$$$corpus_58", "text": "Not all muscles are paired in this way. An example of an exception is the  deltoid . [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_59", "text": "Synergist muscles  also called  fixators , act around a joint to help the action of an  agonist muscle . Synergist muscles can also act to counter or neutralize the force of an agonist and are also known as  neutralizers  when they do this. [ 12 ]  As neutralizers they help to cancel out or neutralize extra motion produced from the agonists to ensure that the force generated works within the desired plane of motion."}
{"_id": "WikiPedia_Muscular_system$$$corpus_60", "text": "Muscle fibers can only contract up to 40% of their fully stretched length.  [ citation needed ]  Thus the short fibers of  pennate muscles  are more suitable where power rather than range of contraction is required. This limitation in the range of contraction affects all muscles, and those that act over several joints may be unable to shorten sufficiently to produce the full range of movement at all of them simultaneously (active insufficiency, e.g., the fingers cannot be fully flexed when the wrist is also flexed). Likewise, the opposing muscles may be unable to stretch sufficiently to allow such movement to take place (passive insufficiency). For both these reasons, it is often essential to use other synergists, in this type of action to fix certain of the joints so that others can be moved effectively, e.g., fixation of the wrist during full flexion of the fingers in clenching the fist. Synergists are muscles that facilitate the fixation action."}
{"_id": "WikiPedia_Muscular_system$$$corpus_61", "text": "There is an important difference between a  helping synergist  muscle and a  true synergist  muscle. A true synergist muscle is one that only neutralizes an undesired joint action, whereas a helping synergist is one that neutralizes an undesired action but also assists with the desired action.  [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_62", "text": "A muscle that fixes or holds a bone so that the agonist can carry out the intended movement is said to have a neutralizing action. A good famous example of this are the  hamstrings ; the  semitendinosus  and  semimembranosus muscles  perform knee flexion and knee  internal rotation  whereas the  biceps femoris  carries out knee flexion and knee  external rotation . For the knee to flex while not rotating in either direction, all three muscles contract to stabilize the knee while it moves in the desired way."}
{"_id": "WikiPedia_Muscular_system$$$corpus_63", "text": "Composite  or  hybrid  muscles have more than one set of fibers that perform the same function, and are usually supplied by different nerves for different set of fibers. For example, the tongue itself is a composite muscle made up of various components like longitudinal, transverse, horizontal muscles with different parts innervated from a different nerve supply."}
{"_id": "WikiPedia_Muscular_system$$$corpus_64", "text": "There are a number of terms used in the naming of muscles including those relating to size, shape, action, location, their orientation, and their number of heads."}
{"_id": "WikiPedia_Muscular_system$$$corpus_65", "text": "The insertion and origin of a muscle are the two places where it is anchored, one at each end. The connective tissue of the attachment is called an  enthesis ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_66", "text": "The  origin  of a muscle is the  bone , typically proximal, which has greater mass and is more stable during a  contraction  than a muscle's insertion.  [ 14 ]  For example, with the  latissimus dorsi muscle , the origin site is the torso, and the insertion is the arm. When this muscle contracts, normally the arm moves due to having less mass than the torso. This is the case when grabbing objects lighter than the body, as in the typical use of a  lat pull down  machine. This can be reversed however, such as in a  chin up  where the torso moves up to meet the arm."}
{"_id": "WikiPedia_Muscular_system$$$corpus_67", "text": "The  head  of a muscle, also called  caput musculi  is the part at the end of a muscle at its origin, where it attaches to a fixed bone. Some muscles such as the  biceps  have more than one head."}
{"_id": "WikiPedia_Muscular_system$$$corpus_68", "text": "The  insertion  of a muscle is the structure that it attaches to and tends to be moved by the  contraction  of the muscle.  [ 15 ]  This may be a  bone , a  tendon  or the subcutaneous dermal  connective tissue . Insertions are usually connections of muscle via  tendon  to bone. [ 16 ]  The insertion is a bone that tends to be distal, have less mass, and greater motion than the origin during a contraction."}
{"_id": "WikiPedia_Muscular_system$$$corpus_69", "text": "Intrinsic muscles  have their origin in the part of the body that they act on, and are contained within that part. [ 17 ]   Extrinsic muscles \nhave their origin outside of the part of the body that they act on. [ 18 ]  Examples are the  intrinsic and extrinsic muscles of the tongue , and  those of the hand ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_70", "text": "Muscles may also be described by the direction that the  muscle fibres  run, in their  muscle architecture ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_71", "text": "Hypertrophy  is increase in muscle size from an increase in size of individual muscle cells. This usually occurs as a result of exercise."}
{"_id": "WikiPedia_Muscular_system$$$corpus_72", "text": "This article incorporates text in the  public domain  from the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_73", "text": "The  anterior chain , which comprises the  antagonists  of the  posterior chain , refers to the group of  skeletal muscles  that lies on the front of the human body. This includes the  biceps , the  pectoralis major  and  pectoralis minor  (chest) muscles, the  abdominals , the  obliques , the  serratus anterior , and the  quadriceps . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_74", "text": "Beach muscles  are muscles developed for the purpose of looking good and largely consist of the muscles of the anterior chain.  This is because it is these muscles that are seen from the front (or in a mirror) and are thus the most noticeable to an observer. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_75", "text": "Often, these muscles are not emphasized by  power lifters  who aim exclusively to increase their maximal strength in the  squat ,  deadlift , and  bench press , or by athletes who seek to increase physical performance. [ dubious  \u2013  discuss ]   They are overall not as important for pure physical performance as the posterior chain. [ citation needed ]   It is however, necessary to train both the anterior chain and the posterior chain."}
{"_id": "WikiPedia_Muscular_system$$$corpus_76", "text": "Architectural gear ratio , also called  anatomical gear ratio  (AGR) is a feature of  pennate muscle  defined by the ratio between the longitudinal strain of the muscle and  muscle fiber  strain.\nIt is sometimes also defined as the ratio between muscle- shortening  velocity and fiber-shortening velocity. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_77", "text": "AGR = \u03b5 x /\u03b5 f"}
{"_id": "WikiPedia_Muscular_system$$$corpus_78", "text": "where \u03b5 x  = longitudinal strain (or muscle-shortening velocity) and \u03b5 f  is fiber strain (or fiber-shortening velocity)\nIn  fusiform  muscle, the fibers are longitudinal, so longitudinal strain is equal to fiber strain, and AGR is always 1."}
{"_id": "WikiPedia_Muscular_system$$$corpus_79", "text": "As the pennate muscle is activated, the fibers rotate as they shorten and pull at an angle. In pennate muscles, fibers are oriented at an angle to the muscle's  line of action  and rotate as they shorten, becoming more  oblique  such that the fraction of force directed along the muscle's line of action decreases throughout a contraction. Force output is dependent upon the angle of fiber rotation, so changes in muscle thickness and the vector of change in thickness vary; based upon the force being produced. Due to the rotational motion; pennate muscles operate at low velocities (low shortening distance). The shortening velocity of the pennate muscle as a whole is greater than that of the individual fibers. This gives rise to the property of AGR. Fiber rotation decreases a muscle's output force but increases output velocity by allowing the muscle to function at a higher gear ratio (muscle velocity/fiber velocity). Azizi and Brainerd demonstrated that the gear ratio of pennate muscle can vary; dependent on external load. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_80", "text": "Segmented musculature, like pennate muscle, has fibers aligned at an angle and due to this feature of design, when muscle fibers increase in angle with respect to the  medial axis , along with the direction and amount of muscle bulging, the Architectural gear ratio increases. [ 1 ] [ 3 ]  A variable gear ratio, based upon different  anatomical position , loading and movement conditions, has since been dubbed spatially varying gear ratio. The occurrence of spatially varying gear ratio gives rise to a new insight of muscle biology; \u201cinhomogenous muscle mechanics. [ 4 ] \u201d"}
{"_id": "WikiPedia_Muscular_system$$$corpus_81", "text": "One feature of the ratio is that there is an optimal gear ratio for each muscle; as the  length-tension  and force-velocity relationships describe. Length-tension refers to the max tension that can be created over the muscle fiber strain range and force-velocity refers to the power that is possible of the fiber compared to the shortening velocity. These two features of musculature help to define an optimal AGR for a muscle. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_82", "text": "The Architectural gear ratio is explained through the segmented muscle model 3 proposed by Emanuel Azizi, where a muscle segment is shown as a single muscle fiber attached to the myosepta of a  Siren lacertina  an aquatic salamander at a certain acute, pennation angle. The model allows segments to bulge out differently in the horizontal, and vertical direction and was used to calculate the Architectural gear ratio of each segment. Preliminary models results show that with muscle bulging, the Architectural gear ratio will increase. Different bulging conditions were studied, and shown in Fig. 2 The model results show the more a muscle bulges in dorsoventral height, the further the muscle fibers shorten, therefore providing a higher Architectural gear ratio. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_83", "text": "In pennate muscles, segments with higher pennation angles put out less force per shortening muscle fiber. Therefore, the architectural gear ratio of a pennate muscle is higher than the architectural gear ratio of spindle like muscles (e.g. fusiform). A smaller fiber length neutralizes this higher architectural gear ratio if the muscle fibers must be squeezed into the same space. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_84", "text": "The  rotator cuff  comprises four pennate muscles, the  supraspinatus ,  infraspinatus ,  subscapularis  and  teres minor , and their accompanying tendons. These muscles form a cuff around the  glenohumeral joint  and function to stabilize and manipulate the shoulder. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_85", "text": "The  pennation angle  of the rotator cuff myofibers, the angle at which fibers connect to the associated tendon, affects the contractile properties and function of the whole pennate muscle. For example, the pennation angle determines the architectural gear ratio at which a pennate muscle operates. A large initial pennation angle results in a large AGR and velocity amplification. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_86", "text": "A 2011 study on human cadaveric shoulders suggests tendon tears may affect the pennation angle of the rotator cuff muscles. Researchers compared pennation angle between a control group and tear groups comprising either partial or complete-thickness tendon tears. Via dissection of ten injured and ten non-injured cadeveric shoulders, the study discovered a correlation between tendon tear size and an increase in pennation angle among two of the rotator cuff muscles. Pennation angle remained unaffected across all rotator cuff muscles in the partial tendon tear group, suggesting a threshold tear size must be exceeded to produce any changes in pennation angle. Full-thickness tendon tears did not affect the pennation angle of the subscapularis or teres minor muscles. However, a correlation between full-thickness rotator cuff tear size and the pennation angle of the supraspnatus and infraspinatus muscles was evident. The length of the full-thickness tendon tear strongly correlated with an increase in the pennation angle of the supraspinatus muscle. In addition, a moderately strong association between the area of the full-thickness tear and the resulting increase in pennation angle of the infraspinatus was visible. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_87", "text": "The increase in pennation angle may lead to changes in muscle structure. In a study utilizing sheep subjects, a chronic rotator cuff tear resulted in an increase in both the pennation angle and separation between myofibers of the rotator cuff muscles. Fat cells then populated the rearranged muscle. This phenomenon was also evident in the aforementioned human experiment. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_88", "text": "The increase in pennation angle following full-thickness tendon tears will result in a change to the PCSA of the supraspinatus and infraspinutus muscles. This would reduce the force producing capacity of these muscles. However, partial tendon tears, which did not result in a change to pennation in any of the rotator cuff muscles, may not impair the force producing properties of the muscles. [ 5 ]  Azizi's observations on variable gearing in pennate muscles further suggests tendon tears will affect the AGR of the supraspinatus and infraspinutus. The greater pennation angle could result in an increased AGR. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_89", "text": "Some scientists suggest patch grafts ought to be applied to irreparable rotator cuff tears. Though this practice lessens pain, muscle strength is not fully recovered. The abovementioned human rotator cuff study correlates pennation angle with tear length in the supraspinatus muscle. Therefore, a patch graft may not resolve the length change necessary to restore pennation angle; retraction of the torn tendon may lessen the post-tear pennation angle and restore muscle strength to a greater extent. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_90", "text": "Intrafasciular strain showed that the muscle was nonuniform, and that the architectural gear ratio is the highest at the proximal region of the muscle but then decreases towards the distal region. \u201c It is currently not possible to determine the precise distribution of stress throughout a muscle, but it seems reasonable to assume that the total (integrated) force at any cross section of the muscle and tendon remains fairly constant along the proximodistal axis. The smaller cross-sectional areas as the muscle thins and becomes tendon will thus result in a higher stress concentration to accommodate the same stress over a smaller area and therefore potentially higher strains if material properties remained constant.\" [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_91", "text": "The  muscle architecture  of pennate muscles, such as the human  quadriceps , is highly plastic and strongly influences contractile properties. [ 6 ]  Changes to pennate muscle architectural properties, such as pennation angle and thereby the PCSA, can alter the muscle's force-producing capabilities as well as the AGR at which the muscle operates. Parallelogram models predict that total PCSA of bipennate muscles increases in proportion to sin(\u03b8pennation) while total force exerted on the associated aponeurosis decreases with cos(\u03b8pennation). This theorizes that pennate muscle force generation increases until a 45 degree pennation angle is achieved. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_92", "text": "A 2001 study, conducted by Aagaard  et al. , utilized MRI, ultrasonography and muscle biopsy techniques to examine the relationship between muscle architecture, contractile strength and pennation angle in the human quadriceps muscle after 14 weeks of resistance training. Upon completion of the training program, Aagaard  et al.  noticed a symmetrical increase in quadriceps CSA and volume, as each increased 10.2 and 10.3 percent respectively; however, these parameters increased disproportionately to quadriceps PCSA, which grew 16 percent. The rapid increase in PCSA was accompanied by a 35.5% increase in the fascicle pennation angle of the vastus lateris, one of the major quadriceps muscles, as well as a 16% increase in myofiber CSA. The increase in pennation angle in the vastus lateris resulted in an increase to the muscle's PCSA, a measure proportional to the contractile force a pennate muscle is capable of producing. [ 7 ]  Work by Azizi  et al.  suggests this increase in pennation angle of the vastus lateris following resistance training generates an increase in the muscle's AGR, a property which allows the whole muscle to contract with a higher velocity. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_93", "text": "A 2007 study, conducted by Blazevich  et al. , reiterated and added an extra dimension to Aagaard  et al. \u2019s conclusions. [ 6 ] [ 7 ]  Blazevich  et al.  examined the effect of 10-week concentric or eccentric knee extension training on architectural properties of the human quadriceps with the purpose of uncovering the mechanical stimulus involved in architecture adaptation. Both modes of exercise resulted in increased peak concentric and eccentric strength. Concentric training, however, results in higher peak concentric strength. Ultrasonography suggests vastus medialus and vastus lateris muscle fiber length increase similarly following eccentric and concentric training, with the changes occurring abruptly over the first 5 weeks of the training program. Because fiber length was independent of training type, Blazevich  et al.  believe distance of operation determines the optimal fiber length. This muscle property is important in determining the  angle-torque  relationship of a muscle. The study supported the pennation angle trends uncovered by Aagaard  et al. ; in addition, Blazevich  et al.  concluded that the vastus lateris fascicle angle changes are independent of training type and modulates strongly with volume. This suggests fiber length and pennation angle modifications occur via separate mechanical stimuli, i.e. distance of operation and muscle volume respectively. Furthermore, these angle changes occur over a relatively long time scale as the pennation angle increased until the cessation of the training program at week 10. Blazevich  et al.  predict the increase in pennation angle seen after eccentric or concentric training allow the pennate muscle to attach more fibers to the associated aponeurosis as well as increase PCSA and AGR. Architectural modifications to pennate muscles shift the position at which the muscle operates on the force-velocity and force-length curves to regions best suited for the muscle's function. An increase in pennation angle theoretically increases both the PCSA and AGR of a given pennate muscle, allowing the muscle to generate higher forces while operating at higher optimal speeds. An increase to fiber length would allow the muscle to function at longer lengths. [ 6 ] [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_94", "text": "A 2009 study utilizing  magnetic resonance imaging  and  ultrasonography  discovered strain and pennation angle heterogeneity within the  medial gastrocnemius  pennate muscle during differing modes of contraction. Parameters of fascicle location and contraction type (eccentric or passive), determined the magnitude of strain experienced by differing regions of the MG. [ 6 ] \n Fascicle  ends nearest the deep MG  aponeurosis  (Achilles tendon) showed an increase in strain from the  proximal to distal  portions of the MG muscle. The converse was seen in the fascicle ends adjacent to the superficial aponeurosis, which decreased in fiber strain from proximal to distal portions of the MG muscle. These trends may have been due to changes in CSA of the muscle at the proximal and distal ends of the MG, resulting in regions of high stress and strain concentration. [ 6 ] \nThis regional variability in strain was accompanied by a statistically significant increase in AGR and resting pennation angle from distal to proximal portions of the muscle. Furthermore, greater changes in pennation angle were visible at the proximal end of the MG. The experimental AGR values modulated positively with the pennation angle as well as the distance between the deep and superficial apopneuroses and may have been affected by regional patterns in orthogonal bulging. These trends highlight the complexity of muscle physiology, as different regions of muscles may contract with diverse contractile properties, such as strain and AGR. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_95", "text": "Arm recoil  is a  neurological examination  of  neonate  for detecting the  muscle tone . [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_96", "text": "The baby is placed supine, with forearm flexed at elbow. The elbow (forearm) is extended by pulling the hand; then released. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_97", "text": "How quickly the forearm returns to flexed original position and the amount of flexion will designate a score. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_98", "text": "The greater the tone development (flexor tone), the brisker the recoil will be. [ 1 ]  This correlates to more advanced gestational age on the  Ballard Scale . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_99", "text": "Leg recoil can be assessed following the same principle. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_100", "text": "This  muscle  article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_101", "text": "This  medical  diagnostic article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_102", "text": "The  arrector pili muscles , also known as  hair erector muscles , [ 1 ]  are small muscles attached to  hair follicles  in  mammals . Contraction of these muscles causes the hairs to stand on end, [ 2 ]  known colloquially as  goose bumps  (piloerection). [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_103", "text": "Each arrector pili is composed of a bundle of  smooth muscle  fibres which attach to several follicles (a follicular unit). [ 4 ]  Each is innervated by the sympathetic division of the  autonomic nervous system . [ 4 ]  The muscle attaches to the follicular stem cell niche in the follicular bulge, [ 3 ] [ 4 ] [ 5 ]  splitting at their deep end to encircle the follicle. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_104", "text": "The contraction of the muscle is involuntary. Stresses such as  cold ,  fear  etc. may stimulate the  sympathetic nervous system , and thus cause muscle contraction. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_105", "text": "Contraction of arrector pili muscles have a principal function in the majority of mammals of providing thermal insulation. [ 4 ]  Air becomes trapped between the erect hairs, helping the animal retain heat."}
{"_id": "WikiPedia_Muscular_system$$$corpus_106", "text": "Many animals experience contraction of the arrector pili muscle in response to a perceived threat. This helps the animal seem more larger and more intimidating as a result. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_107", "text": "Pressure exerted by the muscle may cause  sebum  to be forced along the hair follicle towards the surface, protecting the hair. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_108", "text": "Arrector pili muscles also stabilise the base of the  hair follicle . [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_109", "text": "Skin conditions such as  leprosy  can damage arrector pili muscles, preventing their contraction. [ 9 ]  Inducing contraction of the arrector pili muscles via an  \u03b11-adrenergic receptor  agonist has been shown to reduce hair shedding as a result of  traction alopecia [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_110", "text": "The term \"arrector pili\" comes from Latin. It translates to \"hair erector\". [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_111", "text": "Asynchronous muscles  are muscles in which there is no one-to-one relationship between electrical stimulation and mechanical contraction. These muscles are found in 75% of  flying insects  and have  convergently evolved  7-10 times. [ 1 ]  Unlike their synchronous counterparts that contract once per neural signal, mechanical oscillations trigger force production in asynchronous muscles. Typically, the rate of mechanical contraction is an order of magnitude greater than electrical signals. [ 1 ]  Although they achieve greater force output and higher efficiency at high frequencies, they have limited applications because of their dependence on mechanical stretch."}
{"_id": "WikiPedia_Muscular_system$$$corpus_112", "text": "The exact molecular mechanisms used by asynchronous muscles are unknown, but it is believed that asynchronous muscles have no unique molecular structures as compared to their synchronous counterparts. A study investigating the asynchronous power muscles in  bumblebees  with  X-ray diffraction  videos showed that  actin  and  myosin  alone are sufficient for generating asynchronous behavior. [ 2 ]  This finding helps explain how asynchronous muscles independently evolved across insect  taxa . [ 1 ]  More recent work using similar X-ray diffraction techniques in  Lethocerus  discovered that troponin bridges may play a critical role in stretch activation. As the muscle is stretched, these bridges move tropomyosin to reveal myosin-actin binding sites. [ 3 ]  The muscle can only produce force when these sites are activated."}
{"_id": "WikiPedia_Muscular_system$$$corpus_113", "text": "Several changes to asynchronous muscles' macroscopic structure provide it with high force production and efficiency at high contraction frequencies. A critical adaptation is that asynchronous muscles maintain a tonic level of calcium instead of cycling calcium between contractions. This is evident in their  long twitch duration . This is due to relatively spare  sarcoplasmic reticulum . Because of requirements for high force production,  myofiber  and  myofibril  diameters are increased and the large amount of ATP necessary leads to high  mitochondria  densities. [ 1 ]  In  Cotinus mutabilis ,  asynchronous muscles are composed of 58.1% myofibril, 36.7% mitochondria, and 1.6%  sarcoplasmic reticulum . In comparison, synchronous muscles in  Schistocerca americana  are composed of 65% myofibril, 23.5% mitochondria and 9.6% sarcoplasmic reticulum. [ 1 ]  Although synchronous muscle has a higher percentage of myofibril, the cross-sectional area of asynchronous myofibril is 3.7\u00a0\u03bcm 2  as opposed to 0.82\u00a0\u03bcm 2  in synchronous muscle for the previously described species. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_114", "text": "The defining characteristic of asynchronous muscles is that there is no direct relationship between neural activation and  muscle contraction . Typically, the number of muscle contractions is an order of magnitude greater than the number of action potentials sent to the muscle. Instead of directly controlling force generation, neural signals maintain [Ca 2+ ] above a threshold for stretch-activation to occur. [ 4 ]  For asynchronous muscles, neural inputs are typically thought of as an \"on-off\" switch while mechanical stimulus leads to individual muscle contractions. However, recent studies using genetically engineered  Drosophila  revealed correlations between [Ca 2+ ] and force production. [ 5 ]  Further work has shown bilateral calcium asymmetries in  Drosophila . [ 4 ]  These results indicate that there is some level of neural control beyond a simple \"on\" or \"off\" state."}
{"_id": "WikiPedia_Muscular_system$$$corpus_115", "text": "Delayed stretch activation and delayed shortening deactivation allow asynchronous muscles to generate positive work under cyclic  oscillations . [ 6 ]  When the muscle shortens, force drops and continues dropping even when the muscle length remains constant. Similarly, when the muscle lengthens, force increases and continues increasing after the muscle length remains constant. [ 1 ]  Because of these delays, the work produced by the muscle during shortening is greater than the work absorbed during lengthening, therefore producing positive work. In contrast, synchronous muscles absorb work under similar conditions. [ 1 ]  Both types of muscles consume ATP to drive force production and produce work. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_116", "text": "Long twitch duration is a functional consequence of the macroscopic properties of asynchronous muscle. Because asynchronous muscle can generate power without cycling calcium between contractions, the required rate of calcium regulation is significantly slower. In addition to the reduction in sarcoplasmic reticulum, relatively large myofibril diameters lead to increased diffusion times of Ca 2+ .Under isometric twitch experiments, asynchronous muscle in  Cotinus mutabilis  were found to have a twitch duration of 125 ms. In the same study, synchronous muscle in  Schistocerca americana  had a twitch duration of 40 ms. [ 1 ]  Therefore, asynchronous muscles respond slowly to neural stimulus. In the case of insect flight, electrical stimulation alone is too slow for muscle control. For  Cotinus mutabilis , the twitch duration is ten times as long as a wingbeat period. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_117", "text": "Asynchronous muscles produce work when they undergo mechanical oscillations provided there is sufficient Ca 2+ . [ 1 ] [ 6 ]  This can be achieved in one of two ways. First, two antagonistic muscles can be configured with elastic structures such that the contraction of one muscle stretches the other, causing it to activate and vice versa. This configuration is found in the power muscles of flying insects. [ 7 ]  Second, a single asynchronous muscle can deform an elastic element which then stretches the muscle and causes the muscle to contract again. This setup is used by  Drosophila  to oscillate mechanosensory organs known as  halteres . [ 8 ]  As long as neural stimulus turn the muscles \"on\", both systems will continue to oscillate. These systems can be thought of as  resonant  systems, for which the oscillation frequency is dependent on the  elasticity ,  damping , and force applied to the system. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_118", "text": "In a simplified case, this can be thought of as a linearly damped  harmonic oscillator , for which the damped resonant frequency is"}
{"_id": "WikiPedia_Muscular_system$$$corpus_119", "text": "\u03c9 \n = \n \n \n \n \n ( \n \n \n \n \n k \n m \n \n \n \n \n ) \n \n \n ( \n 1 \n \u2212 \n \n \u03b6 \n \n 2 \n \n \n ) \n \n \n . \n \n \n {\\displaystyle \\omega ={\\sqrt {{\\bigg (}{\\frac {k}{m}}{\\bigg )}(1-\\zeta ^{2})}}.}"}
{"_id": "WikiPedia_Muscular_system$$$corpus_120", "text": "The damping ratio,  \u03b6 ,  is dependent on c, the damping coefficient, m, the mass of the system, and k, the stiffness of the system as shown"}
{"_id": "WikiPedia_Muscular_system$$$corpus_121", "text": "\u03b6 \n = \n \n \n c \n \n 2 \n \n \n m \n k \n \n \n \n \n \n . \n \n \n {\\displaystyle \\zeta ={\\frac {c}{2{\\sqrt {mk}}}}.}"}
{"_id": "WikiPedia_Muscular_system$$$corpus_122", "text": "Asynchronous muscles sacrifice neural control and flexibility in exchange for high force production and efficiency. Given the long twitch duration of asynchronous muscle, neural control is too slow to power flight. For instance, the asynchronous muscles in  Cotinus mutabilis  contract ten times faster than expected given their twitch duration. [ 1 ]  Because these muscles rely on stretch activation, they must be configured such that they can be stretched by an external force. Furthermore, they are only useful when evolutionary pressures select for a muscle that reactively contracts against an imposed stretch. For example, in grasping tasks, it would be detrimental for antagonist muscles to spontaneously contract. Despite these disadvantages, asynchronous muscles are beneficial for high frequency oscillations. They are more efficient than synchronous muscles because they do not require costly calcium regulation. [ 6 ]  This allows for changes in their  macroscopic structure  for increased force production."}
{"_id": "WikiPedia_Muscular_system$$$corpus_123", "text": "Miniaturization of  insects  leads to high wingbeat frequencies with  midges  reaching wingbeat frequencies of 1000\u00a0Hz. [ 10 ]  Because of their high force production and efficiency, asynchronous muscles are used to power  insect flight  in 75% of species. These insects possess two pairs of  antagonistic  asynchronous muscles that produce the majority of the power required for flight. These muscles are oriented such that as one pair contracts, it deforms the thorax and stretches the other pair, causing the second pair to contract. [ 7 ]  The same thoracic deformations oscillate the wings. By utilizing the elastic thorax to store and return energy during wing deceleration and subsequent acceleration,  Drosophila  is able to reduce energetic costs by 10%. [ 11 ]  This leads to a highly-efficient resonant system."}
{"_id": "WikiPedia_Muscular_system$$$corpus_124", "text": "When wingbeat frequencies match the resonant frequency of the muscle-thorax system, flight is most efficient. In order to change wingbeat frequencies to avoid obstacles or generate more lift, insects use smaller \"control\" muscles such as the pleurosternal muscles to stiffen the thorax. [ 9 ]  From the equations in the  Resonant properties  section, it is clear that the natural frequency of the system increases with stiffness. Therefore, modulating the stiffness of the thorax leads to changes in wingbeat frequency."}
{"_id": "WikiPedia_Muscular_system$$$corpus_125", "text": "Although heart muscles are not strictly asynchronous, they exhibit delayed stretch activation properties. As  cardiac muscle  is lengthened, there is an instantaneous rise in force caused by elastic, spring-like elements in the muscle. After a time delay, the muscle generates a second rise in force, which is caused by delayed stretch activation as seen in purely asynchronous muscle. [ 12 ]  This property benefits heart function by maintaining  papillary muscle  tension during the entire  systolic  cycle well after the electrical wave has passed. [ 12 ]  Through stretch activation, the heart can rapidly adapt to changes in heart rates."}
{"_id": "WikiPedia_Muscular_system$$$corpus_126", "text": "Because of challenges arising from miniaturization such as poor scaling of electric motors, researchers have turned towards insects to develop centimeter-scale flying robots. [ 13 ]  Although the actuators in the  RoboBee  are not asynchronous, they use elastic elements to transmit forces from its \"muscles\" ( piezoelectric  actuators) to flap the wings. Similar to flying insects, they exploit resonance to improve efficiency by 50%. [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_127", "text": "The  axillary spaces  are  anatomic spaces . [ 1 ]  through which axillary contents leave the axilla. [ 2 ]  They consist of the  quadrangular space ,  triangular space , and  triangular interval . It is bounded by  teres major ,  teres minor , medial border of the  humerus , and long head of  triceps brachii . [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_128", "text": "They should not be confused with the true \"axillary space\" within the borders of the axilla."}
{"_id": "WikiPedia_Muscular_system$$$corpus_129", "text": "The true axilla is a conical space with its apex at the Cervico-axillary Canal, Base at the axillary fascia and skin of the armpit.  When viewed in an axillary plane (axillary cut), it is more triangle with:  Medial Wall:  Serratus Anterior,  Anterior Wall:   pectoral muscles,  Posterior Wall:  subscapularis muscle, where the \"apex\" of the triangle is the humerus [ 4 ] [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_130", "text": "This space is in the posterior wall of the axilla.  It is a quadrangular space bounded laterally by surgical neck of the humerus, medially by long head of triceps brachii and inferiorly by  teres major . It is bounded superiorly by  subscapularis  in front, capsule of the shoulder joint in the middle, and behind by  teres minor . The  axillary nerve  and  posterior humeral circumflex artery  and vein pass through this space. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_131", "text": "This space (sin.  medial triangular space ) is also in the posterior wall of the axilla.  It is a triangular space bounded medially by teres minor, laterally by long head of triceps brachii, and inferiorly by teres major. The  scapular circumflex artery  and scapular circumflex vein pass through this space. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_132", "text": "This space (a.k.a.  lateral triangular space ) is in the inferior to the posterior wall of the axilla. The  triangular interval  is bounded medially by long head of triceps brachii, laterally by medial border of humerus (some say the lateral head of the triceps), and superiorly by teres major. The  radial nerve  and  profunda brachii artery   and vein passes through this space. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_133", "text": "The  Axioappendicular muscles  are the muscles that extend between the  axial  and (superior or inferior)  appendicular skeletons . There are two groups, the  anterior axioappendicular muscles  and the  posterior axioappendicular muscles ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_134", "text": "The anterior axioappendicular muscles are the: [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_135", "text": "The posterior axioappendicular muscles are described as two sub-groups: [ 1 ] [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_136", "text": "Ballistic movement  can be defined as  muscle  contractions that exhibit maximum velocities and accelerations over a very short period of time. They exhibit high firing rates, high force production, and very brief contraction times."}
{"_id": "WikiPedia_Muscular_system$$$corpus_137", "text": "The  muscle contraction  of a ballistic muscle movement can exhibit a  muscle coactivation  of concurrent agonist  [ 1 ]  and antagonist muscles or the characteristic triphasic agonist/antagonist/agonist muscle activation. [ 2 ]   Electromyography  (EMG) recordings of demonstrate the triphasic muscle activation begins with a brief agonist motor unit activation signal with firing rates of 60 to 120\u00a0Hz that may last for 100ms and occurs 50 to 100ms before movement begins.  The firing rates of  ballistic movements are much higher than that of slow ramp movements (5\u201315\u00a0Hz). The brief agonist muscle contraction is thus followed by antagonist muscle unit activation. The degree of antagonist muscle unit activation is dependent on the task at hand unlike the first agonist muscle activation which is independent to environmental stimuli. The function of the antagonist muscle contraction is believed to control the amplitude and timing of ballistic movements. Antagonist muscle contraction may serve to prevent injury to joints by preventing the limb from overextending itself and also function to control the distance and time the limb is being moved. Experiments involving ballistic movement of small amplitudes show a marked increase in antagonist muscle activation and experiments where distance moved is not controlled antagonist muscle activation was decreased or absent. [ 2 ]  The second agonist muscle activation is suggested to terminate the negative acceleration of the antagonist muscle contraction and thus the ballistic movement."}
{"_id": "WikiPedia_Muscular_system$$$corpus_138", "text": "Ballistic movements are often powered through  elastic energy  storage and subsequent recovery mechanisms.  The  power  required to produce the extremely rapid velocities of ballistic movements is made possible through muscle work being stored in elastic elements (such as  tendons ,  aponeuroses , or even muscle).  Muscle work is applied to these elastic elements over a relatively slow period of time, and is released very rapidly. [ 3 ]  Higher power output is produced because the energy is released in a much shorter amount of time than it is stored.  In this sense the power of the muscles is actually amplified.  When energy is produced by muscle contraction, stored in a tendon, then released to increase mechanical energy of the body (or body segment), muscle power is amplified. It is important to note, however, that the term power \u2018amplification\u2019 may be deceptive. In animals,  elastic mechanisms  never add energy to the system; they amplify power in the sense that the energy is released more rapidly than it is stored. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_139", "text": "Ballistic systems are capable of power outputs that are significantly greater than that of the muscles associated with the actual movement.  One prime example of this is tongue projection in  salamanders . [ 5 ]   This decoupling of muscle work from body/limb work is a major benefit of elastic energy storage mechanisms.  Another benefit resulting from this decoupling is decreased thermal dependence of ballistic movement. [ 6 ]  Deban and Lappin analyzed the prey capture behavior of  toads  (Bufo terrestris), which involves two types of movement: elastically powered, ballistic movement (mouth opening and tongue projection) and muscle-powered movement (tongue retraction and mouth closing). The toad feeding was observed across a range of temperatures (11\u201335\u00a0\u00b0C), and the kinematic, dynamic, and electromyographic variables were measured and analyzed. Over the 11\u201335\u00a0\u00b0C temperature range, the ballistic movements had  Q 10  values very close to 1 (Q 10  = 0.99\u20131.25), signifying thermal independence and supporting the main hypothesis. The muscle-powered movements had a higher temperature coefficient (Q 10  = 1.77\u20132.26), signifying thermal dependence."}
{"_id": "WikiPedia_Muscular_system$$$corpus_140", "text": "Another example of a thermally independent ballistic movement is tongue projection in  chameleons . [ 7 ]  It was discovered that veiled chameleons (Chamaeleo calyptratus) were able to perform this high-performance tongue projection, and successful prey capture, across a wide range of temperatures (15\u00a0\u00b0C\u201335\u00a0\u00b0C).  Anderson and Deban also found a contrast between thermal dependence of tongue projection and retraction (which is not elastically-powered).  This further supports the hypothesis that the elastic recoil mechanism is responsible for the decreased thermal dependence of ballistic tongue projection."}
{"_id": "WikiPedia_Muscular_system$$$corpus_141", "text": "In trap-jaw ants ( Odontomachus  bauri) ballistic movement can be seen in their extremely rapid mandible strikes. The trap-jaw ants mandible has an average closing speed of 38.4\u00a0m/s and can produce forces that are 371-504 times the weight of the ant. The ants use these extremely powerful mandible strikes in several novel ways. When the ant attacks a larger animal it will strike the animal and at the same time use the force from the strike to propel itself away from the animal. When facing prey of similar size such as another ant the strike actually results in both animals being propelled away from each other. When the ant is trying to flee from a predator it will strike at the substrate and propel itself vertically into the air. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_142", "text": "In crickets ( Acheta domesticus ) ballistic movements can be seen in the way they jump. The kicks that propel the cricket occur over a period of only 2-6ms, but during the 18-40ms prior to the kick the potential energy required is built up by the co-contraction of the antagonistic extensor and flexor tibiae. The crickets can also use these same ballistic movements for swimming. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_143", "text": "In the cone snail ( Conus catus ) ballistic movement can be seen in the way that it fires is harpoon-like radular tooth into its prey. After the cone snail\u2019s proboscis comes in contact with its prey the tooth is ejected 240-295 ms later. It is believed that the propulsion of the tooth is accomplished by pressurizing the fluid space behind the tooth. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_144", "text": "In  Salamanders ,  Toads , and  Chameleons  ballistic movement can be seen in their tongue projection which is controlled by an elastic recoil mechanism. The orientation of the muscle fibers is significant because it is what allows ballistic movements to be possible.  In chameleons, the  muscle fibers  used for ballistic tongue movements were found to be in a spiral orientation, with an equal amount of fibers oriented clockwise and anti-clockwise to prevent torsional movement of the tongue during projection.  The internal fiber angles are approximately 45 degrees, which is the theoretical optimum to create an equal strain throughout the accelerator muscles. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_145", "text": "In salamanders of the genus  Hydromantes , the pattern of muscle activation has been mapped.   The main muscles used for ballistic tongue movements in these salamanders are the subarcualis rectus (SAR) muscles.  These SAR muscles can be further divided into anterior (SARA) and posterior (SARP).  The first muscle to be activated is the SARA, which is located near the back of the head.  The SARA remains active until the tongue makes contact with the prey.  Next, the posterior SARP, located further back on the medial and lateral sides of the salamander is activated.  Then the middle SARP is activated and the anterior SARP is the last to be activated.  The time between activation shortens and duration of activation increases with increasing prey distance. Ballistic tongues have evolved two times previously in the Hemidactyliini and Bolitoglossini genera.  The exact mechanisms of tongue projection vary slightly throughout the taxa, but the resulting projections have remained relatively constant. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_146", "text": "Frogs  do not have a specialized muscular structure for tongue projection.  They are able to bypass this issue by using very rapid jaw movement to project the tongue forward.  Present in all frogs are the two mandibular muscles that are used to control the jaw and, therefore, tongue projection.  The m. genioglossus is used to protract the tongue and the m.hyoglossus is the tongue retractor.  Both of these muscles have longitudinally oriented fibers, which is in contrast to the spiral oriented fibers of the chameleon. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_147", "text": "In human, ballistic movements involve spontaneous propulsion of the limbs. [ 14 ]  This can be seen in daily routines such as reach and strike reactions, which are atomic by nature. Pointing gestures and placing an object are reach reactions; they have low acceleration and deceleration. On the other hand, punching and throwing are strike reactions; they are characterized by high acceleration and deceleration. These movements have highly variable target locations, and they are referred to as \u201cballistic\u201d in  kinesiology . During ballistic movement an initial impulse is needed to accelerate the limb (hand/foot) toward the target, then a decelerating impulse act as a brake to stop the movement.  These movements are characterized by a bell-shaped velocity profile. The Bayesian Model (see  Bayesian network ), which was developed to perform recognition without pose-tracking, explains human ballistic movement as a sequence of movements between objects and the environment. Each movement is independent from precedent and subsequent one, in varying context. Fast single joints movement in humans is controlled by a series of activation of agonist, antagonist and then agonist muscles; this process is called triphasic activation.  Those movements are executed \u201cwith a pattern of bursts in the agonist and antagonist muscles of fairly constant duration but different amplitude\u2026\u201d (Acornero et al. 1984). [ 15 ]  Any ballistic movement involving two joints will require an agonist and an antagonist burst; this can be viewed as the building blocks for different types of ballistic movements."}
{"_id": "WikiPedia_Muscular_system$$$corpus_148", "text": "Balloonist theory  was a theory in early  neuroscience  that attempted to explain  muscle  movement by asserting that muscles contract by inflating with air or fluid. The Roman and Greek physician  Galen  believed that muscles contracted due to a fluid flowing into them, and for 1500 years afterward, it was believed that nerves were hollow and that they carried fluid. [ 1 ]   Ren\u00e9 Descartes , who was interested in  hydraulics  and used fluid pressure to explain various aspects of  physiology  such as the  reflex arc , proposed that \"animal spirits\" flowed into muscle and were responsible for their contraction. [ 2 ]  In the model, which Descartes used to explain  reflexes , the spirits would flow from the  ventricles of the brain , through the nerves, and to the muscles to animate the latter. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_149", "text": "In 1667,  Thomas Willis  proposed that muscles may expand by the reaction of animal spirits with vital spirits.  He hypothesized that this reaction would produce air in a manner similar to the reaction that causes an explosion, causing muscles to swell and produce movement.\nThis theory has now been  superseded  by the mainstream scientific community due to the establishment of neuroscience, which is supported by empirical evidence."}
{"_id": "WikiPedia_Muscular_system$$$corpus_150", "text": "In 1667,  Jan Swammerdam , a Dutch  anatomist  famous for working with insects, struck the first important blow against the balloonist theory.  Swammerdam, who was the first to experiment on  nerve-muscle preparations , showed that muscles do not increase in size when they contract (and he supposed if a substance such as animal spirits flowed into muscles, their volume should increase when they contract).  Swammerdam placed severed frog thigh muscle in an airtight syringe with a small amount of water in the tip. [ 3 ]   He could thus determine whether there was a change the volume of the muscle when it contracted by observing a change in the level of the water (image at right). [ 3 ]  When Swammerdam caused the muscle to contract by irritating the nerve, the water level did not rise but rather was lowered by a minute amount; this showed that no air or fluid could be flowing into the muscle. [ 3 ]   Swammerdam did not believe the results of his own experiment, suggesting that they were the result of artifact. [ 3 ]   However, he concluded in his book  The Book of Nature II  that \"motion or irritation of the nerve alone is necessary to produce muscular motion\". [ 3 ]  This idea was an important step toward the current understanding of how nerves actually cause muscle contraction. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_151", "text": "Balloonist theory took a second hit from  Francis Glisson  who performed an experiment in which a man flexed a muscle under water. The water level did not go up (in fact it went down slightly), further supporting the conclusion that no air or fluid could be entering the muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_152", "text": "Giovanni Alfonso Borelli  performed an experiment to test the idea that muscle is inflated by air. He slit the muscle of an animal under water and watched to see whether bubbles of air would rise to the surface. Since no bubbles were seen to rise, this experiment helped to refute the balloonist theory."}
{"_id": "WikiPedia_Muscular_system$$$corpus_153", "text": "The invention of the  microscope  allowed preparations of nerves to be viewed at high magnification, showing that they are not hollow."}
{"_id": "WikiPedia_Muscular_system$$$corpus_154", "text": "In 1791,  Luigi Galvani  learned that frogs' muscles could be made to move by the application of  electricity .  This finding provided a basis for the current understanding that electrical energy (carried by  ions ), and not air or fluid, is the impetus behind muscle movement."}
{"_id": "WikiPedia_Muscular_system$$$corpus_155", "text": "Biarticular muscles  are  muscles  that cross two  joints  rather than just one, such as the  hamstrings  which cross both the  hip  and the  knee . The function of these muscles is complex and often depends upon both their anatomy and the activity of other muscles at the joints in question. Their role in movement is poorly understood."}
{"_id": "WikiPedia_Muscular_system$$$corpus_156", "text": "Biarticular muscles cross two joints in series, usually in a limb. The details of the origin (proximal attachment) and insertion (distal attachment) can play a large role in determining muscle function. For instance, the human  gastrocnemius  technically spans both the knee and ankle joints.  However, the origin point of the muscle is so close to the axis of rotation of the knee joint that the muscle's effective  lever arm  would be very small, especially compared to its large lever arm at the ankle. [ citation needed ]  As a result, even though it spans two joints, the strong bias in lever arms allows it to function primarily as an ankle plantar flexor. Other muscles, such as the  hamstrings , do not display such biases, so their function is not immediately evident from anatomy alone. Another important concept of biarticular muscles (consider the rectus femoris muscle for this example) is the change in muscle length when motion at the proximal and distal ends of the muscle is happening. For example, in the propulsive phase of a jump, the thigh is extended at the coxal joint, and the shank (lower leg) is extended at the tibiofemoral joint. These joint positions cause the rectus femoris muscle to remain unchanged in net length, because the proximal (Eccentric action) and distal (concentric action) attachments are contradicting one another."}
{"_id": "WikiPedia_Muscular_system$$$corpus_157", "text": "Biarticular muscles can fulfill a range of functions during movement.  By contracting  isometrically  (without changing length), they put the joint into a  four-bar linkage , allowing the contraction of muscles at one joint to move the other by a fixed amount.  Unlike four-bar linkages in which all elements are bone and angle relationships are fixed by the relative bone lengths, the biarticular muscle can hold the joint at many different lengths, creating a range of four-bar properties as needed."}
{"_id": "WikiPedia_Muscular_system$$$corpus_158", "text": "Biarticular muscles can also transfer mechanical power between distal and proximal joints, though the direction and magnitude of this transfer varies with anatomy, muscle activity level, and joint angles.  This is a crucial consideration when analyzing an organism's movement using  inverse dynamics ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_159", "text": "Calcium-induced calcium release  ( CICR ) describes a biological process whereby  calcium  is able to activate calcium release from intracellular Ca 2+  stores (e.g.,  endoplasmic reticulum  or  sarcoplasmic reticulum ). Although CICR was first proposed for  skeletal muscle  in the 1970s, [ 1 ]  it is now known that CICR is unlikely to be the primary mechanism for activating  SR  calcium release. Instead, CICR is thought to be crucial for  excitation-contraction coupling  in  cardiac muscle . [ 2 ]  It is now obvious that CICR is a widely occurring cellular signaling process present even in many non-muscle cells, such as in the insulin-secreting pancreatic  beta cells , [ 3 ]  epithelium, and many other cells. [ 4 ]  Since CICR is a  positive-feedback system , it has been of great interest to elucidate the mechanism(s) responsible for its termination."}
{"_id": "WikiPedia_Muscular_system$$$corpus_160", "text": "Excitation-contraction coupling  in myocardium relies on sarcolemma depolarization and subsequent Ca 2+  entry  to trigger Ca 2+  release from the  sarcoplasmic reticulum . When an  action potential  depolarizes the cell membrane, voltage-gated Ca 2+  channels (e.g.,  L-type calcium channels ) are activated. CICR occurs when the resulting Ca 2+  influx activates  ryanodine receptors  on the  SR  membrane, which causes more Ca 2+  to be released into the cytosol. [ 4 ] [ 5 ]  In cardiac muscle, the result of CICR is observed as a spatio-temporally restricted  Ca 2+  spark . The result of CICR across the cell causes the significant increase in cytosolic Ca 2+  that is important in activating muscle contraction."}
{"_id": "WikiPedia_Muscular_system$$$corpus_161", "text": "Cardiac muscle  (also called  heart muscle  or  myocardium ) is one of three types of  vertebrate   muscle tissues , the others being  skeletal muscle  and  smooth muscle . It is an involuntary,  striated muscle  that constitutes the main tissue of the  wall of the heart . The cardiac muscle (myocardium) forms a thick middle layer between the outer layer of the heart wall (the  pericardium ) and the inner layer (the  endocardium ), with blood supplied via the  coronary circulation .  It is composed of individual cardiac muscle cells joined by  intercalated discs , and encased by  collagen fibers  and other substances that form the  extracellular matrix ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_162", "text": "Cardiac muscle  contracts  in a similar manner to  skeletal muscle , although with some important differences.  Electrical stimulation in the form of a  cardiac action potential   triggers the release of calcium from the cell's internal calcium store, the  sarcoplasmic reticulum .  The rise in calcium causes the cell's  myofilaments  to slide past each other in a process called  excitation-contraction coupling .\nDiseases of the heart muscle known as  cardiomyopathies  are of major importance.  These include  ischemic  conditions caused by a restricted blood supply to the muscle such as  angina , and  myocardial infarction ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_163", "text": "Cardiac muscle tissue or myocardium forms the bulk of the heart. The heart wall is a three-layered structure with a thick layer of myocardium sandwiched between the inner  endocardium  and the outer  epicardium  (also known as the visceral pericardium). The inner endocardium lines the cardiac chambers, covers the  cardiac valves , and joins with the  endothelium  that lines the blood vessels that connect to the heart. On the outer aspect of the myocardium is the  epicardium  which forms part of the  pericardial sac  that surrounds, protects, and lubricates the heart. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_164", "text": "Within the myocardium, there are several sheets of cardiac muscle cells or cardiomyocytes.  The sheets of muscle that wrap around the left ventricle closest to the endocardium are oriented perpendicularly to those closest to the epicardium.  When these sheets contract in a coordinated manner they allow the ventricle to squeeze in several directions simultaneously \u2013 longitudinally (becoming shorter from apex to base), radially (becoming narrower from side to side), and with a twisting motion (similar to wringing out a damp cloth) to squeeze the maximum possible amount of blood out of the heart with each heartbeat. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_165", "text": "Contracting heart muscle uses a lot of energy, and therefore requires a constant flow of blood to provide  oxygen  and nutrients.   Blood  is brought to the myocardium by the  coronary arteries .  These originate from the  aortic root  and lie on the outer or epicardial surface of the heart.  Blood is then drained away by the  coronary veins  into the  right atrium . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_166", "text": "Cardiac muscle cells  (also called  cardiomyocytes ) are the contractile  myocytes  of the cardiac muscle. The cells are surrounded by an  extracellular matrix  produced by supporting  fibroblast  cells. Specialised modified cardiomyocytes known as  pacemaker cells , set the rhythm of the heart contractions. The pacemaker cells are only weakly contractile without sarcomeres, and are connected to neighboring contractile cells via  gap junctions . [ 3 ]  They are located in the  sinoatrial node  (the primary pacemaker) positioned on the wall of the  right atrium , near the entrance of the  superior vena cava . [ 4 ]  Other pacemaker cells are found in the atrioventricular node (secondary pacemaker)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_167", "text": "Pacemaker cells carry the impulses that are responsible for the beating of the heart.  They are distributed throughout the heart and are responsible for several functions.  First, they are responsible for being able to  spontaneously generate  and send out  electrical impulses .  They also must be able to receive and respond to electrical impulses from the brain.  Lastly, they must be able to transfer electrical impulses from cell to cell. [ 5 ]  Pacemaker cells in the sinoatrial node, and atrioventricular node are smaller and conduct at a relatively slow rate between the cells. Specialized conductive cells in the  bundle of His , and the  Purkinje fibers  are larger in diameter and conduct signals at a fast rate. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_168", "text": "The Purkinje fibers rapidly conduct electrical signals;  coronary arteries  to bring nutrients to the muscle cells, and  veins  and a  capillary  network to take away waste products. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_169", "text": "Cardiac muscle cells are the contracting cells that allow the heart to pump.  Each cardiomyocyte needs to contract in coordination with its neighboring cells - known as a  functional syncytium  - working to efficiently pump blood from the heart, and if this coordination breaks down then \u2013 despite individual cells contracting \u2013 the heart may not pump at all, such as may occur during  abnormal heart rhythms  such as  ventricular fibrillation . [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_170", "text": "Viewed through a microscope, cardiac muscle cells are roughly rectangular, measuring 100\u2013150\u03bcm by 30\u201340\u03bcm. [ 9 ]  Individual cardiac muscle cells are joined at their ends by  intercalated discs  to form long fibers.  Each cell contains  myofibrils , specialized protein contractile fibers of  actin  and  myosin  that slide past each other.  These are organized into  sarcomeres , the fundamental contractile units of muscle cells.  The regular organization of myofibrils into sarcomeres gives cardiac muscle cells a striped or  striated  appearance when looked at through a microscope, similar to skeletal muscle. These striations are caused by lighter  I bands  composed mainly of actin, and darker  A bands  composed mainly of myosin. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_171", "text": "Cardiomyocytes contain  T-tubules , pouches of  cell membrane  that run from the cell surface to the cell's interior which help to improve the efficiency of contraction.  The majority of these cells contain only one  nucleus  (some may have two central nuclei), unlike skeletal muscle cells which contain  many nuclei . Cardiac muscle cells contain many  mitochondria  which provide the energy needed for the cell in the form of  adenosine triphosphate  (ATP), making them highly resistant to fatigue. [ 9 ] [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_172", "text": "T-tubules  are microscopic tubes that run from the cell surface to deep within the cell.  They are continuous with the cell membrane, are composed of the same  phospholipid bilayer , and are open at the cell surface to the  extracellular fluid  that surrounds the cell. T-tubules in cardiac muscle are bigger and wider than those in  skeletal muscle , but fewer in number. [ 9 ]  In the centre of the cell they join, running into and along the cell as a transverse-axial network.  Inside the cell they lie close to the cell's internal calcium store, the  sarcoplasmic reticulum .  Here, a single tubule pairs with part of the sarcoplasmic reticulum called a terminal cisterna in a combination known as a  diad . [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_173", "text": "The functions of T-tubules include rapidly transmitting electrical impulses known as  action potentials  from the cell surface to the cell's core, and helping to regulate the concentration of calcium within the cell in a process known as  excitation-contraction coupling . [ 9 ]  They are also involved in mechano-electric feedback, [ 11 ]  as evident from cell contraction induced T-tubular content exchange (advection-assisted diffusion), [ 12 ]  which was confirmed by confocal and 3D electron tomography observations. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_174", "text": "The  cardiac syncytium  is a network of cardiomyocytes connected by  intercalated discs  that enable the rapid transmission of electrical impulses through the network, enabling the syncytium to act in a coordinated contraction of the myocardium. There is an  atrial syncytium  and a  ventricular syncytium  that are connected by cardiac connection fibres. [ 14 ]  Electrical resistance through intercalated discs is very low, thus allowing free diffusion of ions. The ease of ion movement along cardiac muscle fibers axes is such that action potentials are able to travel from one cardiac muscle cell to the next, facing only slight resistance. Each syncytium obeys the  all or none law . [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_175", "text": "Intercalated discs are complex adhering structures that connect the single cardiomyocytes to an electrochemical  syncytium  (in contrast to the skeletal muscle, which becomes a multicellular syncytium during  embryonic development ). The discs are responsible mainly for force transmission during muscle contraction.  Intercalated discs consist of three different types of cell-cell junctions: the actin filament anchoring  fascia adherens junctions , the intermediate filament anchoring  desmosomes , and  gap junctions . [ 16 ]  They allow action potentials to spread between cardiac cells by permitting the passage of ions between cells, producing depolarization of the heart muscle. The three types of junction act together as a single  area composita . [ 16 ] [ 17 ] [ 18 ] [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_176", "text": "Under  light microscopy , intercalated discs appear as thin, typically dark-staining lines dividing adjacent cardiac muscle cells. The intercalated discs run perpendicular to the direction of muscle fibers. Under electron microscopy, an intercalated disc's path appears more complex. At low magnification, this may appear as a convoluted electron dense structure overlying the location of the obscured Z-line. At high magnification, the intercalated disc's path appears even more convoluted, with both longitudinal and transverse areas appearing in longitudinal section. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_177", "text": "Cardiac fibroblasts are vital supporting cells within cardiac muscle.  They are unable to provide forceful contractions like  cardiomyocytes , but instead are largely responsible for creating and maintaining the extracellular matrix which surrounds the cardiomyocytes. [ 7 ]   Fibroblasts play a crucial role in responding to injury, such as a  myocardial infarction .  Following injury, fibroblasts can become activated and turn into  myofibroblasts  \u2013 cells which exhibit behaviour somewhere between a fibroblast (generating extracellular matrix) and a  smooth muscle cell  (ability to contract).  In this capacity, fibroblasts can repair an injury by creating collagen while gently contracting to pull the edges of the injured area together. [ 21 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_178", "text": "Fibroblasts are smaller but more numerous than cardiomyocytes, and several fibroblasts can be attached to a cardiomyocyte at once.  When attached to a cardiomyocyte they can influence the electrical currents passing across the muscle cell's surface membrane, and in the context are referred to as being electrically coupled, [ 22 ]  as originally shown in vitro in the 1960s, [ 23 ]  and ultimately confirmed in native cardiac tissue with the help of optogenetic techniques. [ 24 ]  Other potential roles for fibroblasts include electrical insulation of the  cardiac conduction system , and the ability to transform into other cell types including cardiomyocytes  and  adipocytes . [ 21 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_179", "text": "The  extracellular matrix  (ECM) surrounds the cardiomyocyte and fibroblasts.  The ECM is composed of proteins including  collagen  and  elastin  along with  polysaccharides  (sugar chains) known as  glycosaminoglycans . [ 7 ]  Together, these substances give support and strength to the muscle cells, create elasticity in cardiac muscle, and keep the muscle cells hydrated by binding water molecules."}
{"_id": "WikiPedia_Muscular_system$$$corpus_180", "text": "The matrix in immediate contact with the muscle cells is referred to as the  basement membrane , mainly composed of  type IV collagen  and  laminin .  Cardiomyocytes are linked to the basement membrane via specialised  glycoproteins  called  integrins . [ 25 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_181", "text": "Humans are born with a set number of heart muscle cells, or cardiomyocytes, which increase in size as the heart grows larger during childhood development. Evidence suggests that cardiomyocytes are slowly turned over during aging, but less than 50% of the cardiomyocytes present at birth are replaced during a normal life span. [ 26 ]  The growth of individual cardiomyocytes not only occurs during normal heart development, it also occurs in response to extensive exercise ( athletic heart syndrome ), heart disease, or heart muscle injury such as after a myocardial infarction. A healthy adult cardiomyocyte has a cylindrical shape that is approximately 100\u03bcm long and 10\u201325\u03bcm in diameter.  Cardiomyocyte hypertrophy occurs through sarcomerogenesis, the creation of new sarcomere units in the cell.  During heart volume overload, cardiomyocytes grow through eccentric hypertrophy. [ 27 ]  The cardiomyocytes extend lengthwise but have the same diameter, resulting in ventricular dilation.  During heart pressure overload, cardiomyocytes grow through concentric hypertrophy. [ 27 ]  The cardiomyocytes grow larger in diameter but have the same length, resulting in heart wall thickening."}
{"_id": "WikiPedia_Muscular_system$$$corpus_182", "text": "The physiology of cardiac muscle shares many similarities with that of  skeletal muscle .  The primary function of both muscle types is to contract, and in both cases, a contraction begins with a characteristic flow of  ions  across the  cell membrane  known as an  action potential .  The  cardiac action potential  subsequently triggers muscle contraction by increasing the concentration of  calcium  within the cytosol."}
{"_id": "WikiPedia_Muscular_system$$$corpus_183", "text": "The  cardiac cycle  is the performance of the human heart from the beginning of one heartbeat to the beginning of the next. It consists of two periods: one during which the heart muscle relaxes and refills with blood, called  diastole , following a period of robust contraction and pumping of blood, dubbed  systole . After emptying, the heart immediately relaxes and expands to receive another influx of blood returning from the lungs and other systems of the body, before again contracting to pump blood to the lungs and those systems. A normally performing heart must be fully expanded before it can efficiently pump again."}
{"_id": "WikiPedia_Muscular_system$$$corpus_184", "text": "The rest phase is considered polarized. The  resting potential  during this phase of the beat separates the ions such as sodium, potassium, and calcium. Myocardial cells possess the property of automaticity or spontaneous  depolarization . This is the direct result of a membrane which allows sodium ions to slowly enter the cell until the threshold is reached for depolarization. Calcium ions follow and extend the depolarization even further. Once calcium stops moving inward, potassium ions move out slowly to produce repolarization. The very slow repolarization of the CMC membrane is responsible for the long refractory period. [ 28 ] [ 29 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_185", "text": "However, the mechanism by which calcium concentrations within the cytosol rise differ between skeletal and cardiac muscle.  In cardiac muscle, the action potential comprises an inward flow of both sodium and calcium ions.  The flow of sodium ions is rapid but very short-lived, while the flow of calcium is sustained and gives the plateau phase characteristic of cardiac muscle action potentials.  The comparatively small flow of calcium through the  L-type calcium channels  triggers a much larger release of calcium from the sarcoplasmic reticulum in a phenomenon known as   calcium-induced calcium release .  In contrast, in skeletal muscle, minimal calcium flows into the cell during action potential and instead the sarcoplasmic reticulum in these cells is directly coupled to the surface membrane.  This difference can be illustrated by the observation that cardiac muscle fibers require calcium to be present in the solution surrounding the cell to contract, while skeletal muscle fibers will contract without extracellular calcium."}
{"_id": "WikiPedia_Muscular_system$$$corpus_186", "text": "During contraction of a cardiac muscle cell, the long protein  myofilaments  oriented along the length of the cell slide over each other in what is known as the  sliding filament theory .  There are two kinds of myofilaments, thick filaments composed of the protein  myosin , and thin filaments composed of the proteins  actin ,  troponin  and  tropomyosin .  As the thick and thin filaments slide past each other the cell becomes shorter and fatter.  In a mechanism known as  cross-bridge cycling , calcium ions bind to the protein troponin, which along with tropomyosin then uncover key binding sites on actin.  Myosin, in the thick filament, can then bind to actin, pulling the thick filaments along the thin filaments.  When the concentration of calcium within the cell falls, troponin and tropomyosin once again cover the binding sites on actin, causing the cell to relax."}
{"_id": "WikiPedia_Muscular_system$$$corpus_187", "text": "It was commonly believed that cardiac muscle cells could not be regenerated. However, this was contradicted by a report published in 2009. [ 30 ]  Olaf Bergmann and his colleagues at the  Karolinska Institute  in  Stockholm  tested samples of heart muscle from people born before 1955 who had very little cardiac muscle around their heart, many showing with disabilities from this abnormality.  By using DNA samples from many hearts, the researchers estimated that a 4-year-old renews about 20% of heart muscle cells per year, and about 69% of the heart muscle cells of a 50-year-old were generated after they were born. [ 30 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_188", "text": "One way that cardiomyocyte regeneration occurs is through the division of pre-existing cardiomyocytes during the normal aging process. [ 31 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_189", "text": "In the 2000s, the discovery of adult endogenous cardiac stem cells was reported, and studies were published that claimed that various stem cell lineages, including  bone marrow stem cells  were able to differentiate into cardiomyocytes, and could be used to treat  heart failure . [ 32 ] [ 33 ] \nHowever, other teams were unable to replicate these findings, and many of the original studies were later  retracted  for scientific fraud. [ 34 ] [ 35 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_190", "text": "Cardiac muscle forms both the atria and the ventricles of the heart.  Although this muscle tissue is very similar between cardiac chambers, some differences exist.  The myocardium found in the ventricles is thick to allow forceful contractions, while the myocardium in the atria is much thinner. The individual myocytes that make up the myocardium also differ between cardiac chambers.  Ventricular cardiomyocytes are longer and wider, with a denser  T-tubule  network.  Although the fundamental mechanisms of calcium handling are similar between ventricular and atrial cardiomyocytes, the calcium transient is smaller and decays more rapidly in atrial myocytes, with a corresponding increase in  calcium buffering  capacity. [ 36 ]  The complement of ion channels differs between chambers, leading to longer action potential durations and effective refractory periods in the ventricles. Certain ion currents such as  I K(UR)  are highly specific to atrial cardiomyocytes, making them a potential target for treatments for  atrial fibrillation . [ 37 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_191", "text": "Diseases affecting cardiac muscle, known as  cardiomyopathies , are the leading cause of death in  developed countries . [ 38 ]  The most common condition is  coronary artery disease , in which the  blood supply to the heart is reduced . The  coronary arteries  become narrowed by  the formation of atherosclerotic plaques . [ 39 ]  If these narrowings become severe enough to partially restrict blood flow, the syndrome of  angina  pectoris may occur. [ 39 ]  This typically causes chest pain during exertion that is relieved by rest. If a coronary artery suddenly becomes very narrowed or completely blocked, interrupting or severely reducing blood flow through the vessel, a  myocardial infarction  or heart attack occurs. [ 40 ]  If the blockage is not relieved promptly by  medication ,  percutaneous coronary intervention , or  surgery , then a heart muscle region may become permanently scarred and damaged. [ 41 ]  Specific cardiomyopathies include: increased  left ventricular mass  ( hypertrophic cardiomyopathy ), [ 42 ]  abnormally large ( dilated cardiomyopathy ), [ 43 ]  or abnormally stiff ( restrictive cardiomyopathy ). [ 44 ]  Some of these conditions are caused by genetic mutations and can be inherited. [ 45 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_192", "text": "Heart muscle can also become damaged despite a normal blood supply. The heart muscle may become inflamed in a condition called  myocarditis , [ 46 ]  most commonly caused by a viral infection [ 47 ]  but sometimes caused by the body's own  immune system . [ 48 ]  Heart muscle can also be damaged by drugs such as alcohol, long standing high blood pressure or  hypertension , or persistent abnormal  heart racing . [ 49 ] \nMany of these conditions, if severe enough, can damage the heart so much that the pumping function of the heart is reduced. If the heart is no longer able to pump enough blood to meet the body's needs, this is described as  heart failure . [ 49 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_193", "text": "Significant damage to cardiac muscle cells is referred to as  myocytolysis  which is considered a type of cellular  necrosis  defined as either coagulative or colliquative. [ 50 ] [ 51 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_194", "text": "The  central  governor  is a proposed process in the brain that regulates exercise in regard to a neurally calculated safe  exertion by the body. In particular, physical activity is controlled so that its intensity cannot threaten the body\u2019s  homeostasis  by causing  anoxic  damage to the  heart muscle . The central governor limits exercise by reducing the neural recruitment of muscle fibers. This reduced recruitment causes the sensation of  fatigue . The existence of a central governor was suggested to explain fatigue after prolonged strenuous exercise in long-distance running and other endurance sports, but its ideas could also apply to other causes of exertion-induced fatigue."}
{"_id": "WikiPedia_Muscular_system$$$corpus_195", "text": "The existence of a central governor was proposed by  Tim Noakes  in 1997, but a similar idea was suggested in 1924 by  Archibald Hill . It was first published as a full theory by Tim Noakes, Alan St Clair Gibson and Vicki Lambert in five linked articles in the British Journal of Sports Medicine in 2004-2005 [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_196", "text": "In contrast to this idea is the one that fatigue is due to peripheral \"limitation\" or \"catastrophe.\" In this view, regulation by fatigue occurs as a consequence of a failure of homeostasis directly in muscles."}
{"_id": "WikiPedia_Muscular_system$$$corpus_197", "text": "The 1922  Nobel Prize in Physiology or Medicine  winner  Archibald Hill  proposed in 1924 that the heart was protected from anoxia in strenuous exercise by the existence of a governor."}
{"_id": "WikiPedia_Muscular_system$$$corpus_198", "text": "the heart is able to regulate its output, to some extent, in accordance with the degree of saturation of the arterial blood ... we suggest that, in the body (either in the heart muscle itself or in the nervous system), there is some mechanism which causes a slowing of the circulation as soon as a serious degree of unsaturation occurs, and  vice versa . This mechanism would tend, to some degree, to act as a \u2018governor\u2019, maintaining a reasonably high degree of saturation of the blood: the breathing of a gas mixture rich in oxygen would produce a greater degree of saturation of the blood and so allow the output to increase until the \u2018governor\u2019 stopped it again. We realise the danger of a hypothesis partly suggested by teleological reasoning: in this case, however, we can see no other explanation of our experimental results pp. 163 [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_199", "text": "This hypothesis was disregarded and further research upon exercise fatigue was modeled in terms of it being due to a mechanical failure of the exercising muscles (\"peripheral muscle fatigue\"). This failure was caused either by an inadequate oxygen supply to the exercising muscles, lactic acid buildup, or total energy depletion in the exhausted muscles. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_200", "text": "Tim Noakes , a professor of exercise and sports science at the  University of Cape Town , in 1997 [ 4 ]  has renewed Hill\u2019s argument on the basis of modern research. Along with collaborators Alan St Clair Gibson and Vicki Lambert, they suggested that the power output by muscles during exercise is continuously adjusted in regard to calculations made by the brain in regard to a safe level of exertion. These neural calculations factor in earlier experience with strenuous exercise, the planning duration of the exercise, and the present metabolic state of the body. These brain models [ 5 ]  ensure that body homeostasis is protected, and an emergency reserve margin is maintained. [ 6 ] [ 7 ] [ 8 ] [ 9 ]  This neural control adjusts the number of activated skeletal muscle motor units, a control which is subjectively experienced as  fatigue . This process, though occurring in the brain, is outside conscious control."}
{"_id": "WikiPedia_Muscular_system$$$corpus_201", "text": "the rising perception of discomfort produced by exhausting exercise progressively reduces the conscious desire to over-ride this control mechanism, which, if it were to be reduced, would lead to the recruitment of more motor units. Thus the presence of conscious over-ride would be undesirable because it would increase or maintain the exercise intensity, thereby threatening homoeostasis ... as exercise performance is centrally regulated by the CNS, then fatigue should no longer be considered a physical event but rather a sensation or emotion, separate from an overt physical manifestation\u2014for example, the reduction in force output by the active muscles. Rather we now suggest that the physical manifestation of any increasing perception of fatigue may simply be an alteration in the subconsciously regulated pace at which the exercise is performed. Hence the novel suggestion is that the conventional understanding of fatigue is flawed because it makes no distinction between the sensation itself and the physical expression of that sensation which, we suggest, is the alteration in the subconsciously regulated pacing strategy consequent on changing motor unit recruitment/derecruitment by the CNS. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_202", "text": "Noakes, St Clair Gibson and Lambert created the idea of the central governor in the context of prolonged endurance exercise. However, they have noted that the central processes involved might also underlie the existence of other kinds of fatigue:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_203", "text": "This new interpretation is the first to allow a more reasonable description of a number of phenomena that defy rational explanation according to the traditional \u2018\u2018limitations\u2019\u2019 models of fatigue. These include, among many others, the chronic fatigue syndrome, in which affected individuals experience evident fatigue at rest, and the role of psychological and motivational factors,  centrally (brain) acting pharmaceutical agents,  hypnosis, shouting or sudden unexpected gunshots,  or other forms of distraction including music or premeditated deception on human exercise performance. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_204", "text": "In support of this, placebos (which must be mediated by a central process) have a powerful effect upon not only fatigue in prolonged exercise, [ 12 ] [ 13 ]  but also upon short term endurance exercise such as sprint speed, [ 14 ]  the maximum weight that could be lifted with leg extension, [ 15 ]  and the tolerance of  ischemic  pain and power when a tourniqueted hand squeezes a spring exerciser 12 times. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_205", "text": "The existence of a central governor over physiology has been questioned since \u2018physiological catastrophes\u2019 can and do occur in athletes (important examples in  marathons  have been  Dorando Pietri ,  Jim Peters  and  Gabriela Andersen-Schiess ). This suggests that humans can over-ride \u2018the central governor\u2019. [ 17 ]  Moreover, a variety of peripheral factors in addition to those such as lactic acid build up can impair muscle power and might act to protect against \"catastrophe\". [ 18 ]  Another objection is that models incorporating conscious control also provide an alternative explanation  [ 19 ]  (see Noakes\u2019 reply). [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_206", "text": "Exercise fatigue has also been attributed to the direct effects of exercise upon the brain such as increased cerebral levels of  serotonin , reduced level of  glutamate  secondary to uptake of ammonia in the brain, brain hyperthermia, and  glycogen  depletion in brain cells. [ 21 ] [ 22 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_207", "text": "Composite  or  hybrid muscles  are those muscles which have more than one set of fibers but perform the same function and are usually supplied by different nerves for different set of fibers. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_208", "text": "Certain muscles are commonly confused with composite muscles which they are not. Examples are:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_209", "text": "Concentric hypertrophy  is a  hypertrophic  growth of a  hollow organ  without overall enlargement, [ 1 ]  in which the walls of the organ are thickened and its capacity or volume is diminished."}
{"_id": "WikiPedia_Muscular_system$$$corpus_210", "text": "Sarcomeres  are added in parallel, as for example occurs in  hypertrophic cardiomyopathy . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_211", "text": "In the  heart , concentric hypertrophy is related to increased  pressure overload  of the heart, often due to  hypertension  and/or  aortic stenosis . The consequence is a decrease in  ventricular  compliance and  diastolic dysfunction , followed eventually by  ventricular failure  and  systolic dysfunction . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_212", "text": "Laplace's law  for a sphere states wall stress (T) is proportionate to the product of the  transmural pressure  (P) and cavitary radius (r) and inversely proportionate to wall thickness (W): In response to the pressure overload left ventricular wall thickness markedly increases\u2014while the cavitary radius remains relatively unchanged. These compensatory changes, termed \"concentric hypertrophy,\" reduce the increase in wall tension observed in aortic stenosis. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_213", "text": "This article related to  pathology  is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_214", "text": "also known as superior tendon of abdominal cavity."}
{"_id": "WikiPedia_Muscular_system$$$corpus_215", "text": "The  conjoint tendon  (previously known as the  inguinal aponeurotic falx ) is a sheath of  connective tissue  formed from the lower part of the common  aponeurosis  of the  abdominal internal oblique muscle  and the  transversus abdominis muscle , joining the muscle to the  pelvis . It forms the medial part of the posterior wall of the  inguinal canal ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_216", "text": "The conjoint tendon is formed from the lower part of the common aponeurosis of the  abdominal internal oblique muscle  and the  transversus abdominis muscle . [ 1 ]  It inserts into the  pubic crest  and the  pectineal line  immediately behind the  superficial inguinal ring . [ 1 ]  It is usually conjoint with the tendon of the  internal oblique muscle , but they may be separate as well. It forms the medial part of the posterior wall of the  inguinal canal . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_217", "text": "The conjoint tendon serves to protect what would otherwise be a weak point in the  abdominal wall . [ 1 ]  A weakening of the conjoint tendon can precipitate a direct inguinal hernia. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_218", "text": "A  direct inguinal hernia  will protrude through  Hesselbach's triangle , whose borders are the  rectus abdominis  (medially),  inferior epigastric artery  and  inferior epigastric vein  (superolaterally), and the  inguinal ligament  (inferiorly).  The hernia lies medial to the inferior epigastric artery. [ 3 ]  This is in contrast to an  indirect inguinal hernia , which will protrude laterally to the inferior epigastric artery and is most commonly due to an embryological defect in the closure of the deep inguinal ring."}
{"_id": "WikiPedia_Muscular_system$$$corpus_219", "text": "The conjoint tendon is also known as the inguinal aponeurotic falx, and Henle's ligament. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_220", "text": "This  human musculoskeletal system  article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_221", "text": "The  core  or  trunk  is the  axial  (central) part of an  organism 's  body . In common parlance, the term is broadly considered to be synonymous with the  torso , but academically it also includes the  head  and  neck .   Functional movements  are highly dependent on this part of the body, and lack of core muscular development can result in a predisposition to injury. [ 1 ]  The major muscles of the core reside in the area of the belly and the mid- and lower back (not the shoulders), and peripherally include [ clarification needed ]  the hips, the shoulders and the neck."}
{"_id": "WikiPedia_Muscular_system$$$corpus_222", "text": "Major muscles included are the  pelvic floor  muscles,  transversus abdominis ,  multifidus ,  internal  and  external obliques ,  rectus abdominis ,  erector spinae  (sacrospinalis) especially the  longissimus thoracis , and the  diaphragm .  The lumbar muscles, quadratus Lumborum (deep portion), deep rotators, as well as cervical muscles, rectus capitus anterior and lateralis, longus coli may also be considered members of the core group. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_223", "text": "Minor core muscles include the  latissimus dorsi ,  gluteus maximus , and  trapezius ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_224", "text": "The core is used to stabilize the thorax and the pelvis during dynamic movement and it also provides internal pressure to expel substances (vomit, feces, carbon-laden air, etc.)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_225", "text": "The core is traditionally assumed to originate most full-body functional movement, including most sports.  In addition, the core determines to a large part a person's  posture .  In all, the human anatomy is built to take force upon the bones and direct autonomic force, through various joints, in the desired direction.  The core muscles align the  spine ,  ribs , and  pelvis  of a person to resist a specific force, whether static or dynamic.  [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_226", "text": "Static core functionality is the ability of one's core to align the skeleton to resist a force that does not change."}
{"_id": "WikiPedia_Muscular_system$$$corpus_227", "text": "An example of static core function is firing a rifle in the  prone position . To maintain accuracy, the shooter must be able to transfer their body weight and the weight of the rifle into the earth.  Any attempt of the shooter to create a dynamic motion of the sights (muscle the sights onto the target vs. allowing the posture to aim) will result in a jerky posture where the sights do not sit still on the target. For the shooter to maintain accuracy, the muscles cannot exert force on the rifle, and the skeleton must be aligned to set the rifle (and therefore the sights) onto the target.  The core, while resting on the ground and relatively far away from the rifle, is nevertheless aligning the spine and pelvis to which the shoulder and arms and neck are connected.  For these peripheral elements to remain static,  and not move unnecessarily, the spine, pelvis, and rib cage must be aligned towards this end.  Thus the core muscles provide support of the  axial skeleton  (skull, spine, and tailbone) in an alignment where the upper body can provide a steady, solid base for the rifle to remain motionless."}
{"_id": "WikiPedia_Muscular_system$$$corpus_228", "text": "The nature of dynamic movement must take into account our skeletal structure (as a lever) in addition to the force of external resistance, and consequently incorporates a vastly different complex of muscles and joints versus a static position."}
{"_id": "WikiPedia_Muscular_system$$$corpus_229", "text": "Because of this functional design, during dynamic movement there is more dependence on core musculature than just skeletal rigidity as in a static situation.  This is because the purpose of the movement is not to resist a static, unchanging resistance, but to resist a force that changes its  plane of motion .  By incorporating movement, the bones of the body must absorb the resistance in a fluid manner, and thus tendons, ligaments, muscles, and innervation take on different responsibilities.  These responsibilities include postural reactions to changes in speed (quickness of a contraction), motion (reaction time of a contraction), and power (amount of resistance resisted in a period of time)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_230", "text": "An example of this is walking on a slope.  The body must resist gravity while moving in a direction, and balancing itself on uneven ground.  This forces the body to align the bones in a way that balances the body while at the same time achieving momentum through pushing against the ground in the opposite direction of the desired movement.  Initially, it may seem that the legs are the prime movers of this action, but without balance, the legs will only cause the person to fall over.  Therefore, the prime mover of walking is achieving core stability, and then the legs move this stable core by using the leg muscles."}
{"_id": "WikiPedia_Muscular_system$$$corpus_231", "text": "Within the muscle tissue of animals and humans, contraction and relaxation of the muscle cells ( myocytes ) is a highly regulated and rhythmic process. In cardiomyocytes, or cardiac muscle cells, muscular contraction takes place due to movement at a structure referred to as the  diad , sometimes spelled \"dyad.\" The dyad is the connection of transverse- tubules ( t-tubules ) and the junctional  sarcoplasmic reticulum  (jSR). [ 1 ]  Like skeletal muscle contractions, Calcium (Ca 2+ ) ions are required for  polarization  and  depolarization  through a  voltage-gated calcium channel . The rapid influx of calcium into the cell signals for the cells to contract. When the calcium intake travels through an entire muscle, it will trigger a united muscular contraction. This process is known as  excitation-contraction coupling . [ 2 ]  This contraction pushes blood inside the heart and from the heart to other regions of the body."}
{"_id": "WikiPedia_Muscular_system$$$corpus_232", "text": "Myocytes  are incredibly specialized cells with only a select number of different organelle types. A myocyte is composed of multiple  myofibrils , which contain the \u201ccontractile units\u201d of the muscle known as a  sarcomere . [ 3 ]  These sarcomeres are arranged in adjacent formations along the myofibrils. Similarly to the plasma membrane of other cells, the  sarcolemma  protects and surrounds the myocytes. The two cellular components that perform the \u201csliding filament\u201d contraction are  myosin  and  actin , also referred to as the thick and thin filaments respectively [ 2 ]  The striations viewed using microscopy of the cardiac muscle are a result of the contrast between the thick and thin filaments. The z-line defines the borders of each sarcomere and act as the connection point between the thin filaments. The t-tubules and sarcoplasmic reticulum are used in conjunction to receive and direct the calcium ions and cause contraction. Once contracted, the clear H-zone between the actin filaments disappears as the filaments move towards each other."}
{"_id": "WikiPedia_Muscular_system$$$corpus_233", "text": "Cardiomyocytes  are a particular form of myocyte, only present in heart tissue. Along with the basic myocyte elements, these cells also contain one to four nuclei and a large amount of  Adenosine Triphosphate  (ATP). [ 2 ]  These additions aid in the heart's resistance to fatigue to consistently pump blood throughout the body to deliver oxygen. Most muscle cells contain a  triad , which is a joining of 2 terminal cisternae of the sarcoplasmic reticulum and one t- tubule. However, cardiac muscle cells contain a  diad , which is a linking of only one sarcoplasmic reticulum with its respective t-tubule. Another notable distinction between all muscle cells and cardiac muscle cells is the presence of  intercalated discs . These tight connections between the cardiomyocytes allows for the accelerated sending of action potential signals to perform the rapid, rhythmic contraction of the heart muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_234", "text": "One of the most incredible attributes of cardiac muscle is the ability to automatically beat. This means that even when isolated, for example on a petri dish in an in- vitro setting, the tissue is able to contract and release. This is due to the presence of \u201c pacemaker cells ,\u201d which originate from the  sinoatrial node . This structure allows for spontaneous depolarization, sending signals throughout the tissue."}
{"_id": "WikiPedia_Muscular_system$$$corpus_235", "text": "Within the sarcolemma of the myocyte, there are specific invaginations referred to as  transverse- tubules . These structures attached to the sarcomere z-lines help to promote interaction between the  extracellular space  and the interior of the cell. [ 1 ]  Connecting these tubules to the Z line allows for a closer range of excitation- contraction coupling within the cell. [ 1 ]  Within the t-tubules, distinct ion channels and cellular proteins are present within the t- tubule bilayer that allow movement of calcium influx from the extracellular space into the myocyte to initiate depolarization and contraction. Once traveling through the t- tubules, the calcium arrives at the sarcoplasmic reticulum."}
{"_id": "WikiPedia_Muscular_system$$$corpus_236", "text": "Within the lumen of the cardiac myocyte, the  sarcoplasmic reticulum  serves as the area of controlling the amount of calcium influx into the interior of the cell. [ 4 ]  After traveling through the t- tubule, the calcium is stored in the sarcoplasmic reticulum to maintain low concentration of calcium inside the lumen. Upon contraction of this muscle, the cell is depolarized and the calcium is released into the lumen to create the  excitation-contraction coupling . Once the initial calcium is released, a wave of additional calcium is discharged from the sarcoplasmic reticulum to maintain the contraction integrity."}
{"_id": "WikiPedia_Muscular_system$$$corpus_237", "text": "The tension felt in muscles from prolonged contraction can be attributed to extended release of calcium ions through the sarcoplasmic reticulum. By absorbing calcium ions after contraction, the sarcoplasmic reticulum can regulate muscle fatigue and prevent overuse damage within the body."}
{"_id": "WikiPedia_Muscular_system$$$corpus_238", "text": "Voltage- gated calcium channels  play a critical role in controlling the influx of calcium ions into the myocyte in response to the changing  action potential  of the sarcoplasmic membrane. [ 5 ]  The increase in action potential of the cell indicates depolarization of the cell, directly opening the ion channels to cause muscular contraction. When the action potential decreases, the ion channels close, preventing any calcium influx and further muscular contraction. This fluctuation within the myocyte contributes to the rhythmic \u201cpacemaking\u201d of the cardiac tissue."}
{"_id": "WikiPedia_Muscular_system$$$corpus_239", "text": "There are two classes of voltage- gated calcium channels,  L- type  and  T- type . [ 5 ]   L-type calcium channels  are more commonly found in myocardial tissue throughout the heart whereas  T-type calcium channels  are more concentrated in the pacemaker cells of the  sinoatrial node . These channels also have slightly different activation levels. The L- type responds to a more positive action potential while the T- type channels are triggered at a more negative action potential. Discrepancies and/ or malfunctioning of these gates can contribute to a number of cardiac conditions, such as bradycardia."}
{"_id": "WikiPedia_Muscular_system$$$corpus_240", "text": "Because the structural organization of the myocyte is very complex and specific, changes to their arrangement and/ or function can cause  cardiac illnesses  or  defects . For example, a leading cause of  heart failure  can be attributed to the lack of t- tubule and sarcoplasmic reticulum junctions or a decreased distance between the structures. [ 6 ]  This change in structure causes the excitation- coupling response in the myocyte to either lessen significantly or be completely diminished. Therefore, few to no heart contractions would take place causing heart failure. On the contrary, an increase in the distance of the junction can create an increased excitation- coupling response, shown in both  hypertension  and  cardiomyopathy . [ 6 ]  These conditions are proof that even the smallest changes in a complex structure can have long- range consequences."}
{"_id": "WikiPedia_Muscular_system$$$corpus_241", "text": "Elastic mechanisms in animals  are very important in the movement of  vertebrate  animals. The  muscles  that control vertebrate locomotion are affiliated with tissues that are springy, such as  tendons , which lie within the muscles and connective tissue. A  spring  can be a mechanism for different actions involved in hopping, running, walking, and serve in other diverse functions such as  metabolic energy conservation, attenuation of muscle power production, and amplification of muscle power production. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_242", "text": "When a body is running, walking or hopping, it uses springs as a way to store energy which indicates that elastic mechanisms have a great influence on its dynamics. [ 2 ]  When a force is applied to a spring it bends and stores energy in the form of elastic  strain energy  and when it recoils after the force has been released,  this energy is released as well. [ 1 ]  Elastic proteins provide the property of elasticity which gives the spring the ability to bend reversibly without the loss of energy, and the ability to bend to large strains with small force. [ 3 ]  Elastic proteins also contain high resilience and low stiffness which helps with the function of elastic strain energy."}
{"_id": "WikiPedia_Muscular_system$$$corpus_243", "text": "While running, tendons are able to reduce the metabolic rate of muscle activity by reducing the volume of the muscle that is active to produce force. The timing of muscle activation is very important for utilizing the mechanical and energetic benefits of tendon elasticity. [ 4 ]  Power  attenuation  by the use of the tendons can allow the muscle-tendon system the ability to absorb energy at a rate beyond the muscles maximum capacity to absorb energy. Power amplification mechanisms are able to work because the spring and muscles contain different intrinsic limits of power. Muscles in a skeletal system can be limited in their maximum power production. Power  amplification  by the use of the tendons allows the muscle to produce power beyond the muscle's capacity. [ 1 ]  The mechanical functions of tendons contain a structural basis and are not subjected to limitation of power production."}
{"_id": "WikiPedia_Muscular_system$$$corpus_244", "text": "From previous experimental studies on large animals, it was noted that during active locomotion mammals save much of the energy they would otherwise need for running by means of elastic structures in their legs. Measurements been made of the rates of oxygen consumption of various animals, as they walked, ran or hopped, revealed that at high speeds animals seem to save more than a half the metabolic energy they would otherwise need for locomotion. [ 5 ]  A notable example is jumping in kangaroos. When hopping at slow speeds, their uses of energy increase linearly, but at high speeds, kangaroos can move as cheaply (from an energetic perspective) as if they were moving at slower speeds. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_245", "text": "Deep research into the anatomy of large mammals such as, kangaroos and other large  ungulates   such as deer and gazelle, suggests strongly that some sort of elastic mechanism is important for this energetic savings. [ 6 ]  Previous combination of careful experiments, with anatomical (e.g. tendon dimensions), mechanical (e.g. force plate recordings) and mathematical calculations revealed that a significant fraction of the work done with each step could be provided by the spring-like action of tendons, rather than by muscle work. [ 1 ] \nWhen the animal's foot contacts the surface of the ground during high speed locomotion, the  tendon  or  ligament  is pressed tightly together, storing  elastic energy  much like a compressed spring. As the foot gets of the ground, the pressure on the compressed tendons and ligaments is released, and elastic recoil from these spring like structures provides additional force to propel the animal thus resulting in energetic savings. [ 6 ]  Simple calculations based kangaroo hopping and forces involved in hopping show how storage of elastic strain energy can save twenty to thirty percent of metabolic energy required for hopping. Measurements of oxygen consumption with fluctuations of kinetic and  gravitational potential energy , indicate elastic savings of at least fifty four percent at high speeds. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_246", "text": "It is important to take under consideration that metabolic benefits of elastic structures are probably most apparent for larger animals, rather than small organisms such as insects. This results from a simple fact, that larger animals can exert much higher forces on their tendons and ligaments during movement, compared to small animals. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_247", "text": "In  eccentric contractions , elastic tendons have the ability to operate as power  attenuation . Tendons exhibit power attenuation that allows the muscle-tendon systems to absorb energy. This rate exceeds the muscle's maximum capacity for energy. In comparison, power amplification of tendons allow for greater output of power that can exceed the capacity of their respective muscle. This elastic mechanism can lead to the following reductions by lengthening muscles: peak  power  input, lengthening  velocity , and  force . Muscle damage has been correlated with these factors. However, the shuttling of energy through tendons before it is absorbed by muscles has been shown to provide a protective mechanism against that damage. [ 1 ]  However, large accumulations of elastic energy storage over time may negatively affect the timing of recoil. This results in power attenuation. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_248", "text": "Though muscles produce and absorb mechanical power, tendons still have an integral role for dissipation of  mechanical energy .  This action is essential for activities like deceleration, when landing from a jump or downhill running. R.I. Griffiths conducted cross-experiments of isolated muscle-tendon preparations with  in vivo  studies in 1991 to keep muscles  isometric  during muscle-tendon unit lengthening. This was achieved with the practice of rapid stretches applied to muscle-tendon units which are then absorbed by the stretch of tendons. Experimenters explain this phenomenon by the idea that muscles are susceptible to damage when actively lengthened and this practice acts as a mechanical buffer against it. [ 1 ]  In addition,  in vivo  experiments it has been found that the elastic mechanism gives protection to musculoskeletal structure exceeding the  sarcomere . Due to this fact, forces developed in active muscles eventually decide the forces on tendons such as bones, joints, and  ligaments . [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_249", "text": "Similarly, tendons are unable to entirely insulate muscles from dynamic extension. Tendons affect muscles when muscles lengthen, which affects peak forces experienced due to energy absorbing actions in the muscle tendon unit. Active lengthening of muscle fibers results in both an accumulation and loss of energy. Even though energy is briefly stored in stretched elastic elements are also released, there is an overall net gain. This shows that muscle fibers are effective in both power production and for energy consumption utilized by the body or individual body segments with muscle-tendon units. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_250", "text": "Tendons,  connective tissues , and molecular structures within a skeletal system can act as power amplifiers by storing energy gradually and releasing it rapidly. This  amplification  process is possible because spring-like tendons are not limited by the same rate limits imposed upon muscles by their intrinsic enzymatic processes. The process of amplification begins when a muscle contracts steadily, storing elastic strain energy in the tendon. Once the energy is completely stored, the tendon releases it in a much shorter time span than was required to create it within the muscle. The tendon is actually producing energy at a level slightly below the work done by the contracting muscle, but because power is equivalent to work over time, the considerably shorter time increases the power significantly. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_251", "text": "This phenomenon has been observed in numerous  vertebrate  behaviors, one of the most notable being jumping. Observed in kangaroos, bush babies, birds, frogs, and various species of antelope, jumping relies on this system because the action is inherently limited in the time that is available to produce power once the body has begun to accelerate. Once the body loses contact with the ground there is no way for the organism to continue to produce force. [ 6 ]  Substantial improvement in acceleration resulting from these mechanisms have been observed in jumping fleas, accelerating turkeys, the striking of mantis shrimp, and the running of horses whose bicep brachii power output is amplified fifty times by the use of catapult-like behavior of the tendon. [ 1 ] [ 6 ] [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_252", "text": "Feeding mechanisms also benefit from spring-like power amplifiers within the skeletal system. The depressor mandibulae of toads rely on this mechanism to produce catapult-like tongue projection. [ 1 ]   More dramatically, the  ballistic  tongue projection utilized by chameleons and some salamanders utilize elastic mechanisms to produce mass-specific power outputs more than five times higher than those reported for most fast muscles. [ 9 ] [ 10 ] [ 11 ]  In chameleons, it is significant to note that the retractor muscles utilized in prey capture decreased in power output by 600% over a 20\u00a0\u00b0C temperature range while the  tongue  projection mechanism, which utilizes the elastic energy storage, decreased a mere 50%, demonstrating that these elastic mechanisms do not simply amplify the power output, but they also extend the temperature range in which power outputs may be amplified. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_253", "text": "The  endomysium , meaning  within the muscle , is a wispy layer of  areolar connective tissue  that ensheaths each individual  muscle fiber , or  muscle cell . [ 1 ] [ 2 ] [ 3 ]  It also contains  capillaries  and  nerves . It overlies the muscle fiber's  cell membrane : the  sarcolemma . Endomysium is the deepest and smallest component of  muscle connective tissue . This thin layer helps provide an appropriate chemical environment for the exchange of  calcium ,  sodium , and  potassium , which is essential for the excitation and subsequent contraction of a muscle fiber."}
{"_id": "WikiPedia_Muscular_system$$$corpus_254", "text": "Endomysium combines with  perimysium  and  epimysium  to create the collagen fibers of  tendons , providing the tissue connection between muscles and bones by indirect attachment. [ 4 ]  It connects with perimysium using intermittent perimysial junction plates. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_255", "text": "Collagen  is the major protein that composes connective tissues like endomysium. [ 6 ]  Endomysium has been shown to contain mainly  type I  and  type III  collagen components, and  type IV  and  type V  in very minor amounts. [ 7 ]  Others have found type IV and type V more common. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_256", "text": "The term  cardiac skeleton  is sometimes considered synonymous with endomysium in the  heart , but cardiac skeleton also refers to the combination of the endomysium and  perimysium ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_257", "text": "Anti-endomysial antibodies  (EMA) are present in  celiac disease . [ 8 ]  They do not cause any direct symptoms to muscles, but detection of EMA is useful in the diagnosis of the disease. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_258", "text": "In adult  vertebrates , trunk muscles can be broadly divided into  hypaxial  muscles, which lie  ventral  to the horizontal  septum  of the  vertebrae  and  epaxial  muscles, which lie  dorsal  to the septum. [ 1 ]  Hypaxial muscles include some vertebral muscles, the  diaphragm , the abdominal muscles, and all limb muscles.  The  serratus posterior inferior  and  serratus posterior superior  are innervated by the  ventral primary ramus  and are hypaxial muscles. Epaxial muscles include other (dorsal) muscles associated with the vertebrae, ribs, and base of the skull.  In humans, the  erector spinae , the  transversospinales   (including the  multifidus ,  semispinalis  and  rotatores ), the  splenius  and  suboccipital  muscles are the only epaxial muscles."}
{"_id": "WikiPedia_Muscular_system$$$corpus_259", "text": "Hypaxial and epaxial muscles develop directly from  somitic  cells. Differentiation of hypaxial and epaxial muscles is postulated to have evolved as a new trait in vertebrate animals. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_260", "text": "The hypaxial muscles are located on the ventral side of the body, often below the horizontal  septum  in many species (primarily fish and amphibians). In all species, the hypaxial muscles are  innervated  by the  ventral ramus  (branch) of the spinal nerves, while the epaxial muscles are innervated by the  dorsal ramus . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_261", "text": "Epimysium  ( plural   epimysia [ 1 ] ) (Greek  epi-  for on, upon, or above + Greek  mys  for muscle) is the fibrous tissue envelope that surrounds  muscle . [ 2 ]  It is a layer of  dense irregular connective tissue  which ensheaths the entire  muscle  and protects muscles from friction against other muscles and bones. [ 3 ]  It also allows a muscle to contract and move powerfully while maintaining its structural integrity. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_262", "text": "It is continuous with  fascia  and other connective tissue wrappings of muscle including the  endomysium  and  perimysium . It is also continuous with tendons, where it becomes thicker and  collagenous ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_263", "text": "While the epimysium is irregular on muscles, it is regular on tendons."}
{"_id": "WikiPedia_Muscular_system$$$corpus_264", "text": "An  extensor expansion  ( extensor hood , [ 1 ]   dorsal expansion ,  dorsal hood ,  dorsal aponeurosis [ citation needed ] ) is the special connective attachments by which the  extensor tendons  insert into the  phalanges ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_265", "text": "These flattened tendons ( aponeurosis ) of extensor muscles span the proximal and middle phalanges. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_266", "text": "At the distal end of the  metacarpal , the extensor tendon will expand to form a hood, which covers the back and sides of the head of the metacarpal and the proximal  phalanx ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_267", "text": "The expansion soon divides into three bands:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_268", "text": "The extensor expansion allows for contractile forces from the  extensor compartment  muscles to be transferred to the phalanges. It also balances the forces across the phalanges. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_269", "text": "The  external anal sphincter  (or  sphincter ani externus ) is an oval tube of  skeletal muscle fibers . [ 1 ]  Distally, it is adherent to the  skin  surrounding the margin of the  anus . [ 2 ]  It exhibits a resting state of tonical contraction [ 1 ]  and also contracts during the  bulbospongiosus reflex . [ 3 ] [ 4 ] [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_270", "text": "The external anal sphincter is far more substantial than the internal anal sphincter. The proximal portion of external anal sphincter overlaps the internal anal sphincter (which terminates distally a little distance proximal to the anal orifice) superficially; where the two overlap, they are separated by the intervening  conjoint longitudinal muscle . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_271", "text": "Historically, the sphincter was described as consisting of three parts (deep, superficial, and subcontinuous). This is not supported by current anatomical knowledge. Some sources still describe it in two layers, deep (or proximal) and superficial (or distal or subcutaneous). [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_272", "text": "Some of the muscles fibres decussate at the anterior midline and posterior midline, so forming an anterior commissure and posterior commissure. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_273", "text": "The muscle attaches anteriorly onto the  perineal body , and posteriorly onto the anococcygeal ligament. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_274", "text": "The sphincter receives innervation from the bilaterally paired  inferior anal nerve  (each a branch of the  pudendal nerve  which is derived from ventral rami of S2-S4). It may also receive additional motor innervation from the  nerve to levator ani . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_275", "text": "The sphincter consists mostly of  slow twitch fibers  that allow extended continuous contraction. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_276", "text": "This article incorporates text in the  public domain  from  page 425  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_277", "text": "Extrafusal muscle fibers  are the standard  skeletal muscle fibers  that are innervated by  alpha motor neurons  and generate tension by contracting, thereby allowing for skeletal movement. They make up the large mass of skeletal  striated muscle tissue  and are attached to bone by fibrous tissue extensions ( tendons )."}
{"_id": "WikiPedia_Muscular_system$$$corpus_278", "text": "Each alpha motor neuron and the extrafusal muscle fibers innervated by it make up a  motor unit . [ 1 ]  The connection between the alpha motor neuron and the extrafusal muscle fiber is a  neuromuscular junction , where the neuron's signal, the  action potential , is transduced to the muscle fiber by the  neurotransmitter   acetylcholine ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_279", "text": "Extrafusal muscle fibers are not to be confused with  intrafusal muscle fibers , which are innervated by sensory nerve endings in central noncontractile parts and by  gamma motor neurons  in contractile ends and thus serve as a sensory  proprioceptor ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_280", "text": "Extrafusal muscle fibers can be generated in vitro (in a dish) from   pluripotent stem cells  through  directed differentiation . [ 2 ]  This allows study of their formation and physiology."}
{"_id": "WikiPedia_Muscular_system$$$corpus_281", "text": "Galvanism  is a term invented by the late 18th-century physicist and chemist  Alessandro Volta  to refer to the generation of electric current by chemical action. [ 2 ]  The term also came to refer to the discoveries of its namesake,  Luigi Galvani , specifically the generation of electric current within biological organisms and the contraction/convulsion of biological muscle tissue upon contact with electric current. [ 3 ]  While Volta theorized and later demonstrated the phenomenon of his \"Galvanism\" to be replicable with otherwise inert materials, Galvani thought his discovery to be a confirmation of the existence of \"animal electricity,\" a vital force which gave life to organic matter. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_282", "text": "Galvanic phenomena were described in the literature before it was understood that they were of an electrical nature. In 1752, when the Swiss mathematician and physicist  Johann Georg Sulzer  placed his tongue between a piece of lead and a piece of silver, joined at their edges, he perceived a taste similar to that of  iron(II) sulfate . Neither of the metals alone produced this taste. He realized that the contact between the metals probably did not produce a solution of either on the tongue. He did, however, not realize that this was an electrical phenomenon. [ 5 ]  He concluded that the contact between the metals caused their particles to vibrate, producing this taste by stimulating the nerves of the tongue. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_283", "text": "If we join two pieces, one of lead, and the other of silver, so that the two edges join, and if we approach them with the tongue we will feel some taste, quite similar to the taste of vitriol of iron [iron(II) sulfate], while each piece apart gives no trace of this taste. It is not probable that through this junction of the two metals, any solution of one or the other occurs, and that the dissolved particles penetrate the tongue. We must therefore conclude that the junction of these metals produces in one or the other, or in both, a vibration in their particles, and that this vibration, which must necessarily affect the nerves of the tongue, produces there the taste mentioned."}
{"_id": "WikiPedia_Muscular_system$$$corpus_284", "text": "According to popular legend, Galvani discovered the effects of electricity on muscle tissue when investigating an unrelated phenomenon which required skinned frogs in the 1780s and 1790s. His assistant is claimed to have accidentally touched a scalpel to the sciatic nerve of the frog and this resulted in a spark and animation of its legs. [ 7 ]  This was building on the theories of  Giovanni Battista Beccaria ,  Felice Fontana ,  Leopoldo Marco Antonio Caldani , and  Tommaso Laghi \u00a0[ it ] . [ 3 ]  Galvani was investigating the effects of distant atmospheric electricity (lightning) on prepared frog legs when he discovered the legs convulsed not only when lightning struck but also when he pressed the brass hooks attached to the frog's spinal cord to the iron railing they were suspended from. [ 8 ]  In his laboratory, Galvani later discovered that he could replicate this phenomenon by touching metal electrodes of brass connected to the frog's spinal cord to an iron plate. He concluded that this was proof of \"animal electricity,\" the electric power which animated living things. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_285", "text": "Alessandro Volta, a contemporary physicist, believed that the effect was explicable not by any vital force but rather it was the presence of two different metals that was generating the electricity. Volta demonstrated his theory by creating the first chemical electric battery. [ 9 ]  Despite their differences in opinion, Volta named the phenomenon of the chemical generation of electricity \"Galvanism\" after Galvani. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_286", "text": "On March 27, 1791, Galvani published a book about his work on animal electricity. It contained comprehensive details of his 11 years of research and experimentation on the topic. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_287", "text": "The 1797 edition of  Gren \u2019s Grundriss der Naturlehre  provides the first explicit definition of 'galvanism' as clearly reflecting Volta\u2019s opinion in the following terms:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_288", "text": "Galvani from Bologna was the first to observe muscular motions elicited by the contact between two different metals; after him, the phenomena of this sort were termed and included under the name of Galvanism. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_289", "text": "Giovanni Aldini , Galvani's nephew, continued his uncle's work after Luigi Galvani died in 1798. [ 12 ]  In 1803, Aldini performed a famous public demonstration of the electro-stimulation technique of deceased limbs on the corpse of an executed criminal  George Foster  at  Newgate  in  London . [ 13 ] [ 14 ]  The Newgate Calendar describes what happened when the galvanic process was used on the body:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_290", "text": "On the first application of the process to the face, the jaws of the deceased criminal began to quiver, and the adjoining muscles were horribly contorted, and one eye was actually opened. In the subsequent part of the process the right hand was raised and clenched, and the legs and thighs were set in motion. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_291", "text": "Galvani has been called the father of  electrophysiology . The debate between Galvani and Volta \"would result in the creation of electrophysiology, electromagnetism, electrochemistry and the electric battery.\" [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_292", "text": "Mary Shelley's   Frankenstein , wherein a man stitches together a human body from corpses and brings it to life, was inspired in part by the theory and demonstrations of Galvanism which may have been conducted by  James Lind . [ 17 ] [ 18 ]  Although the Creature was described in later works as a composite of whole body parts grafted together from cadavers and reanimated by the use of electricity, this description is not consistent with Shelley's work; [ 19 ]  both the use of electricity and the cobbled-together image of Frankenstein's monster were more the result of James Whale's popular  1931 film adaptation of the story ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_293", "text": "Galvanism influenced metaphysical thought in the domain of  abiogenesis , the underlying process of the generation of living forms. In 1836,  Andrew Crosse  recorded what he referred to as \"the perfect insect, standing erect on a few bristles which formed its tail,\" as having appeared during an experiment wherein he used electricity to produce mineral crystals. While Crosse himself never claimed to have generated the insects, even in private, the scientific world at the time viewed the connection between life and electricity to be sufficiently clear that he received threats against his life for this \"blasphemy.\" [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_294", "text": "Giovanni Aldini is claimed to have applied Galvanic principles (application of electricity to biological organisms) in successfully alleviating the symptoms of \"several cases of insanity\", and with \"complete success\". [ 21 ]  Today,  electroconvulsive therapy  is used as a treatment option for severely depressed pregnant mothers [ 22 ]  (as it is the least harmful for the developing fetus)\u00a0and people suffering treatment-resistant  major depressive disorder . It is found to be effective for half of those who receive treatment while the other half may relapse within 12 months. [ 23 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_295", "text": "The modern application of electricity to the human body for medical diagnostics and treatments is practiced under the term  electrophysiology . This includes the monitoring of the electric activity of the heart, muscles, and even the brain, respectively termed  electrocardiography ,  electromyography , and  electrocorticography ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_296", "text": "Halo-gravity traction  (HGT) is a type of  traction  device utilized to treat spinal deformities such as  scoliosis , [ 1 ] [ 2 ]   congenital  spine deformities,  cervical instability ,  basilar invagination , and  kyphosis . [ 3 ]  It is used prior to surgical treatment to reduce the difficulty of the following surgery and the need for a more dangerous surgery. [ 4 ] [ 5 ] [ 6 ]  The device works by applying weight to the spine in order to stretch and straighten it. Patients are capable of remaining somewhat active using a  wheelchair  or a walker whilst undergoing treatment. Most of the research suggests that HGT is a safe treatment, and it can even improve patients'  nutrition  or  respiratory functioning . However, some patients may experience side effects such as  headaches  or neurological complications.  The halo device itself was invented in the 1960s by doctors working at the  Rancho Los Amigos hospital . [ 7 ] [ 8 ] [ 9 ]  Their work was published in a paper entitled \"The Halo: A Spinal Skeletal Traction Fixation Device.\" [ 10 ]  The clinician  Pierre Stagnara  utilized the device to develop Halo-Gravity traction. [ 11 ] [ 12 ] [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_297", "text": "Halo-gravity traction works by straightening and stretching the compressed  spine . [ 14 ] [ 15 ]  It relies on the  viscoelastic  properties of  vertebrae . This means vertebrae can stretch over time. Doctors will apply weight to the spine, and gradually increase it over time, slowly straightening and stretching it. [ 16 ]  Patients undergoing the procedure will typically spend the entire course of the treatment, which is usually three to eight weeks, in a  hospital . Usually, halo-gravity traction is the first step in the treatment plan for a child with severe spinal deformity. Following the procedure, it is common for a surgical operation such as  spinal fusion surgery  to be performed afterward to permanently mend the issue. [ 14 ] [ 17 ]  It is utilized before the operation to reduce the need for a more dangerous surgery and to reduce the risk of damage to the soft  tissues  or  nerves  that surround the spine during the surgery. [ 15 ] [ 18 ] [ 19 ]  In addition, HGT has also been found to reduce the risk of complications during the following surgery. [ 20 ] [ 21 ] [ 22 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_298", "text": "To perform halo-traction therapy a surgeon will use six to ten small pins to attach a \"halo\" made of a metal ring to the patient's skull. [ 23 ] [ 24 ] [ 25 ]  Doctors will typically leave one to two centimeters of distance between the halo and the patient's head. It is common for older patients to be given eight pins while younger patients are given 10. Prior to pin placement, some patients may undergo hair removal. It is not required for successful treatment, but it can help to reduce the risk of pin infection from hair getting caught in a pin or  scalp necrosis . [ 7 ]  The pins will be placed into the  forehead   bones  to prevent the head from moving. Pin placement is determined using a  CT scan . The chosen area will be cleaned with  betadine  swabs. Usually, two to three pins are placed in the  frontal  and  occipital  areas. Pins placed on the occipital area will have to be placed one centimeter above and behind the  auricle  of the ear. Pins placed on the  anterior  of the head will likely be placed one centimeter to above the sides of the eyebrow to avert potential damage to the  supraorbital  and the  supratrochlear nerves , and potential  muscle  damage.  Parietal  placements are generally avoided as the skull around this area is generally softer, which risks the pins puncturing the  temporal artery . Typically, the pins will tightened to a  torque  equivalent to the age of the child using a  torque wrench . Adults can withstand tighter torques than children can. [ 26 ]  Whilst this operation is being performed the child will be given general  anesthesia . [ 7 ]  In  infant  children, significantly less torque is required to tighten the pins. This allows for the pins to be placed in more areas than they could be placed in older patients. [ 27 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_299", "text": "Afterward, the halo will be attached to a  pulley system  which is attached to the patient's bed,  walker , or  wheelchair . [ 28 ]  Spring-type pulleys are typically used as they allow for the patient to self-regulate the weight applied to the pulley, which improves the safety of the device. [ 29 ] :\u200a390\u200a  Spring-based HGT devices are also cheaper and easier to build than other methods of construction. [ 30 ]  It is common for patients to begin the procedure with 5-10 pounds of weight on the pulley system. [ 29 ] :\u200a387\u200a  Over the next few weeks, clinicians will add weight to the pulley, which will slowly straighten the patient's spine over time. Eventually, a weight greater than 50% of the patient's body weight may be achieved. [ 23 ] [ 31 ]  Doctors will monitor the movements and strength and will take  x-rays  of the patient to track their progress. They will adjust the amount of weight on the pulley system based on the results. All patients will undergo  cranial nerve  testing during the procedure. [ 23 ]  After the spine has reached its optimal position, spinal fusion surgery will be performed on the patient. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_300", "text": "Whilst undergoing the procedure, patients are encouraged to remain as active as possible. Activities such as low-impact play, walking, or standing can all increase the benefits of halo-traction therapy. However, patients are limited to leaving the traction for only a short time span. They can leave for activities such as repositioning, changing clothes, daily medical care,  showering , or using the  toilet .  Baby shampoo  is required to be used for bathing purposes as other shampoos could contain chemicals that react negatively with the metal halo. Patients will be required to utilize a special bed for  sleeping  whilst in the traction. After ending treatment the patient is required to avoid strenuous activities for a few months as their spine and muscles will still need to recover. Some patients may wear an orthopedic vest or a  halo vest . [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_301", "text": "Halo-gravity traction has been found to be almost completely safe. [ 29 ] :\u200a385\u200a [ 32 ]  Patients who have undergone the procedure report that they have a greater ability to stand upright, an increased appetite, and an improved  body image . [ 33 ]  It can improve  respiratory  functioning by relieving pressure on the lungs caused by a deformed spine. [ 13 ] [ 34 ] [ 35 ]  Patients often  gain weight  and have improved  nutrition  following HGT. [ 36 ]  This may occur since HGT can correct issues associated with spinal deformities, such as  exercise ,  comorbid   metabolic disorders , and  gastrointestinal  malformations. These issues are associated with malnutrition and low weight, and HGT can lead to weight gain by correcting them. [ 37 ]  When in combination with surgical release, HGT may improve the  flexibility  of the spine and lead to more spinal correction. [ 38 ] [ 39 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_302", "text": "Patients may experience pain from the pins, which is usually caused by the loosening of the pins. This can be remedied by tightening them. Up to 20% of patients may experience  infections  at the site where the pins were applied. These infections are typically treated with  antibiotics . One rare, but serious complication of the procedure can be the development of intra-cranial  abscesses  due to  septic  contamination of the pin site. [ 13 ]  Some patients experience  headaches  around the area where the pins were applied for a short while after the halo is attached. It is common for patients to recover from this pain in less than 24 hours. [ 29 ] :\u200a384\u200a  Halo therapy will leave small  lesions  in the skin when the pins are first removed. Typically, they will turn into  scabs  after a few days. Patients who have undergone the procedure will also have small  scars  on their foreheads. These scars will typically fade over time. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_303", "text": "If the traction that is applied is greater than the tolerable amount, the patient may feel  cervical pain ,  cranial nerve lesions ,  nausea ,  vertigo , [ 40 ]  or  dizziness . These side effects are treated by lowering the level of weight applied. [ 41 ]  Some patients may suffer from  motor paresis  after the application of the device. Typically it is present in patients with preexisting spinal cord abnormalities. [ 29 ] :\u200a389\u200a  Generally, HGT does not cause neurological side effects due to the slow progression of traction. The spine adjusts slowly over time, and as a result, consequences are generally limited. Children are less likely than adolescents or adults to experience neurological side effects, due to the softness and flexibility of their spine, as well as their low weight. [ 42 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_304", "text": "Erb's palsy  has been identified as a rare neurological side effect of HGT. [ 43 ]  One 2006 study published in the journal \"Studies in Health Technology and Informatics\" found that in extremely rare cases HGT could induce  Erb's palsy , ulnar nerve paralysis, and  median nerve palsy  in cases. In the seven cases identified by the study, all patients had fully recovered within a few months of treatment. The likelihood of developing Erb's palsy due to HGT is associated with the weight of the traction. [ 44 ]  Another study published in the  Journal of Spinal Disorders & Techniques  found that patients may experience Erb's palsy or  sensory loss  during or after treatment. However, none of the patients who had experienced these side effects reported in this study had permanent neurological loss. [ 45 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_305", "text": "One 2016 clinical study published in  BioMed Research International  found that HGT resulted in reduced bone density among patients with kyphoscoliosis. [ 46 ]  However, little other research has investigated this potential side effect or found any evidence to support this claim. [ 37 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_306", "text": "Patients with bone conditions such as  fibrous dysplasia  or  osteogenesis imperfecta  may be unsuitable for treatment if the pins are not capable of safely being applied to the bone. [ 29 ] :\u200a385\u200a   Osteoporosis  is considered a contraindication that sometimes may prevent treatment,  however, doctors may avert complications by utilizing more pins with a lower torque. [ 40 ]   Absolute contraindications  for halo-gravity traction include the presence of a  stenotic segment , an  intradural or extradural lesion , lesions in the skull by the sites of pin application, [ 12 ]  any lesion or  tumor  by the spine cord, [ 23 ]  severe skull deformity, and  spine instability . [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_307", "text": "Most of the research conducted on HGT found that it is mostly a safe, [ 47 ]  reliable, [ 47 ]  and effective treatment. [ 48 ] [ 49 ] [ 50 ]  The average correction rate of HGT has been shown to be 19.4% for  sagittal curves  and 24.1%  coronal  curvature. [ 12 ]  One 2013 study on 33 patients published in the journal  Spine Deformity  found an average correction rate of 33% for coronal curves and 35% for sagittal. [ 51 ]  According to a  cohort study  conducted on 75 subjects investigating the efficacy of Halo traction therapy found an improvement rate of 31% to 66% for the spine. They found a  coronal  curvature improvement of 19.6% for adolescents, and 12% for adults. Kyphosis had improved at a rate of 23.9% for adolescents. Afterward, spinal surgery performed on people who had undergone the procedure had a greater than 50% chance of success. [ 52 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_308", "text": "One study conducted on 20 patients with either scoliosis, kyphosis, or kyphoscoliosis found that the most improvement occurred within the first 3 weeks of treatment. According to this study, the spinal curve had improved by 63.7% during the first two weeks, which decreased to 24.3% at 3 weeks, and to 15.9% at 4 weeks. [ 38 ]  Other studies have found similar results. One study conducted on 21 patients found that 45% of improvement occurred within the first 3 weeks. [ 53 ]  Another study on 24 patients found that a mean improvement of 82% occurred during the first three weeks. [ 54 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_309", "text": "Much of the research utilized as evidence of the efficacy of HGT has been criticized for a lack of a  control group  and a small  sample size . [ 55 ]  Some research has suggested that HGT leads to  statistically insignificant  improvement. [ 56 ]   Paul Sponseller, an  Orthopedic surgeon  at  Johns Hopkins University , claims in his study \"The use of traction in the treatment of severe spinal deformity\" that his research found \"no statistically significant difference in main coronal curve correction (62% vs. 59%), operative time, blood loss, and total complication rate (27% vs. 52%).\" However, his data did showcase that people who had not undergone HGT required  surgical resection  30% more often. [ 55 ]  In a study on 25 patients with severe spinal deformities who had been treated with spinal surgery, a mean correction of 44 degrees was found in patients who had not undergone HGT prior to the operation, and a mean correction of 52 was found in patients who had been treated with HGT. The researchers concluded that this difference was not statistically significant, and therefore HGT should not be used as the general treatment for these issues, and should be reserved for specific cases. [ 57 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_310", "text": "Some research suggests that HGT may be less effective than other forms of traction, such as Halo-femoral traction or Halo-pelvic traction. [ 58 ] [ 59 ]  HGT also has been found to require lengthy hospital stays, which many patients dislike about the treatment. [ 60 ]  In the study by Paul Sponsellor, he found that patients who had undergone HGT spent almost twice the amount of time hospitalized as those who had not received the treatment. [ 55 ]  HGT is significantly safer than other forms of traction. It is less likely to produce significant complications such as  blood loss , [ 59 ] [ 61 ]  neurological side effects, and spine stiffness or degeneration. [ 62 ]  HGT also allows patients to remain social and active, whilst other forms of traction severely restrict movement. [ 63 ]  These reasons have led to HGT becoming the standard preoperative treatment for patients with severe spinal deformities. [ 64 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_311", "text": "Henneman\u2019s size principle  describes relationships between properties of  motor neurons  and the  muscle fibers  they innervate and thus control, which together are called  motor units . Motor neurons with large cell bodies tend to innervate fast-twitch, high-force, less fatigue-resistant  muscle fibers , whereas motor neurons with small cell bodies tend to innervate  slow-twitch , low-force, fatigue-resistant muscle fibers. In order to contract a particular muscle, motor neurons with small cell bodies are recruited (i.e. begin to fire action potentials) before motor neurons with large cell bodies. It was proposed by  Elwood Henneman ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_312", "text": "At the time of Henneman\u2019s initial study of motor neuron recruitment, [ 1 ]  it was known that neurons varied greatly in size, that is in the diameter and extent of the dendritic arbor, size of the soma, and diameter of axon. However, the functional significance of neuron size was not yet known. In 1965, Henneman and colleagues published five papers describing the firing patterns of motor neurons innervating two muscles in a cat's leg, the  soleus muscle  and the  gastrocnemius muscle  (the \"calf\" in a cat's hindleg). [ 2 ] [ 3 ] [ 4 ] [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_313", "text": "The  soleus muscle  is composed of \"red\" muscle which was revealed to indicate that muscle fibers were fatigue-resistant but created small forces when contracting. The gastrocnemius muscle is heterogeneous, composed of both \"red\" and \"pale\" muscle, and thus containing fast-twitch high force fibers. Henneman's and colleagues took advantage of the differences between the soleus and gastrocnemius muscles to show that the neurons innervating the soleus muscle:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_314", "text": "Together, these relationship were termed the \"size principle\". Decades of research elaborated on these initial finding on motor neuron properties and recruitment of motor units (neuron + muscle fibers), [ 7 ]  and the relationship between neuron excitability and its size became a central focus of neurophysiology. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_315", "text": "A neuron's size is related to its electrical excitability, and so it was hypothesized that neuron size was the causal mechanism for the recruitment order. An alternative hypothesis is that the structure of spinal circuits and inputs to motor neurons controls recruitment. Both likely contribute and reflect the astounding coordinated development of neural circuit and cellular properties in motor neurons and muscle. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_316", "text": "A relationship between force production and recruitment order is a common feature across motor systems (vertebrates examples: human, cat, zebrafish; invertebrate examples: stick insect, drosophila, crayfish). This proposed to confer a number of computational and energetic advantages. Recruitment of additional motor units increases force nonlinearly, overcoming suppressive nonlinearities in spike rates and muscle force production. Furthermore, the relative increase in force does not decrease with successive recruitment, as it would if all motor units produced similar amounts of force. Thus, much like  Weber\u2019s law  describes the constant sensitivity to relative stimulus intensity, a recruitment hierarchy maximizes the resolution of motor unit force while also simplifying the dimensionality of the motor system. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_317", "text": "The size principle states that as more force is needed, motor units are recruited in a precise order according to the magnitude of their force output, with small units being recruited first, thus exhibiting task-appropriate recruitment. This has two very important physiological benefits. First, it minimizes the amount of fatigue an organism experiences by using fatigue-resistant muscle fibers first and only using fatigable fibers when high forces are needed. Secondly, the relative change in force produced by additional recruitment remains relatively constant. For counterexample, if all motor units produced similar force, then recruiting an additional unit might increase force by 10% when only 10 motor units are active, but produce only 1% increase when 100 are active. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_318", "text": "From the time of Henneman and his discovery of size principle, many studies have been done to see if his theory holds up to the results of multiple experiments. An experiment of the  quadriceps femoris  found that motor units are in fact recruited in an orderly manner according to the size principle. [ 12 ]  The study looked at average motor unit size and firing rate in relationships with force productions of the quadriceps femoris by using a clinical  electromyograph  (EMG). [ 12 ]  Results showed the size of motor units increased linearly with increased force production, and firing rate remained constant to 30% maximum force and then increased with greater generation of force. [ 12 ]  When viewing motor unit potential during muscle contraction on an EMG, as the force generated increases, the amplitude (strength) and frequency (firing rate) increases. [ 13 ]  The motor units are being recruited in an order from slow, low force to fast, high force."}
{"_id": "WikiPedia_Muscular_system$$$corpus_319", "text": "The concept of size principle can be applied to therapeutic techniques. It was shown that the use of electrical stimulation of muscles for motor control would stimulate large, fatigable motor unit first. [ 14 ]  For many years it has been believed that the use of  electromyostimulation  (EMS) to stimulate muscle contraction creates a reversal of the general size principle recruitment order, due to the larger motor unit axons having a lower resistance to  electric current . [ 15 ]  Recently, however, the results of the studies purporting this theory have come under some minor contention. In an article titled \u201cRecruitment Patterns in Human Skeletal Muscle During Electrical Stimulation\u201d, Professors Chris M. Gregory and C. Scott Bickel propose instead that the muscle fiber recruitment induced by EMS is non-selective pattern that is both spatially fixed and temporally synchronous. [ 15 ]  They back this claim with physiological data, metabolic data, mechanical data, and even by re-examining the results of other studies which claimed the reverse size principle paradigm."}
{"_id": "WikiPedia_Muscular_system$$$corpus_320", "text": "Despite the debate, orderly recruitment of motor units can be achieved under optical control in vivo. Thus, the use of optical control with  microbial opsins  has been shown to promote normal physiological order of recruitment. [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_321", "text": "In 1986, a study comparing factors such as conduction velocity, twitch torque, twitch rise time, and half-relaxation of stimulated tibial muscle found evidence that the conduction velocity of individual muscle fibers types may be another parameter to include in the size principle. [ 16 ]  The data from the experiments showed a high degree of correlation between the four factors, which were consistent with a similar study performed several years prior. In that study, an increase in muscle fiber conduction velocity was observed when there was a higher level of voluntary muscle contraction, which agrees with the gradual recruitment of higher-force muscle types. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_322", "text": "In Wistar rats, it was found that cell size is the crucial property in determining neuronal recruitment. [ 17 ]  Motor neurons of different sizes have similar voltage thresholds. Smaller neurons have higher membrane resistance and require lower depolarizing current to reach spike threshold. The cell size contribution to recruitment in motor neurons during postnatal development is investigated in this experiment. Experiments were done on 1- to 7-day-old Wistar rats and 20- to 30-day-old Wistar rats as well. The 1- to 7-day-old Wistar rats were selected because early after birth, the rats show an increase in cell size. In 20- to 30-day-old Wistar rats, the physiological and anatomical features of oculomotor nucleus motor neurons remain unchanged. Rat oculomotor nucleus motor neurons were intracellularly labelled and tested using electrophysical properties. The size principle applies to the recruitment order in neonatal motor neurons and also in the adult oculomotor nucleus. The increase in size of motor neurons led to a decrease in input resistance with a strong linear relationship in both age groups."}
{"_id": "WikiPedia_Muscular_system$$$corpus_323", "text": "Hypertrophy  is the increase in the volume of an organ or tissue due to the enlargement of its component  cells . [ 1 ]  It is distinguished from  hyperplasia , in which the cells remain approximately the same size but increase in number. [ 2 ]  Although hypertrophy and hyperplasia are two distinct processes, they frequently occur together, such as in the case of the  hormonally  induced proliferation and enlargement of the cells of the  uterus  during  pregnancy ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_324", "text": "Eccentric hypertrophy  is a type of hypertrophy where the walls and chamber of a hollow organ undergo growth in which the overall size and volume are enlarged. It is applied especially to the  left ventricle  of heart. [ 3 ]   Sarcomeres  are added in series, as for example in  dilated cardiomyopathy  (in contrast to  hypertrophic cardiomyopathy , a type of  concentric hypertrophy , where sarcomeres are added in parallel)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_325", "text": "The  hypothenar muscles  are a group of three muscles of the  palm  that control the motion of the  little finger ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_326", "text": "The three muscles are: [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_327", "text": "The muscles of hypothenar eminence are from medial to lateral:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_328", "text": "The intrinsic muscles of hand can be remembered using the  mnemonic ,  \"A OF A OF A\"  for,  A bductor pollicis brevis,  O pponens pollicis,  F lexor pollicis brevis (the three thenar muscles),  A dductor pollicis, and the three hypothenar muscles,  O pponens digiti minimi,  F lexor digiti minimi brevis,  A bductor digiti minimi. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_329", "text": "\"Hypothenar atrophy\" is associated with the lesion of the  ulnar nerve , which supplies the three hypothenar muscles."}
{"_id": "WikiPedia_Muscular_system$$$corpus_330", "text": "Hypothenar hammer syndrome  is a vascular occlusion of this region. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_331", "text": "Hysterical strength  refers to a display of extreme  physical strength  by  humans , beyond what is believed to be within their capacity, usually occurring when people are in \u2014 or perceive themselves, or others, to be in \u2014  life-or-death situations . [ 1 ] [ 2 ]  It was also reported to be present during situations of  altered states of consciousness , such as  trance  and alleged  possession . Its description is mostly based on  anecdotal evidence ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_332", "text": "The name refers to  hysteria , a  nosological  category that included bouts of  superhuman strength  as one of the possible  symptoms , but in  Europe  this had also been an attribution in previous cases of alleged  demonic possession . [ 3 ] [ 4 ] [ 5 ]   Charcot  imputed to the phase of hysterical attacks called  clownism  the presence of strength and agility not consistent with the age and sex of the person, which before in the Catholic ritual of  exorcism  was attributed to demonic force. Thus, the cause of the phenomenon began at that time to be addressed by the investigation of  insanity . [ 5 ]  During that period in the 19th century, the term  hysterical strength  could also be found in the intersection of such fields, scientific and religious, for instance appearing in a statement by a physician for the  Society for Psychical Research . [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_333", "text": "It was also described in reports of  trance  or  possession  in several other cultures, as for example in the  New Testament  ( Mark 5 :4) or in  shamanic  practices. [ 7 ] [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_334", "text": "Unexpected strength is claimed to occur during  excited delirium . [ 9 ] [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_335", "text": "The most common  anecdotal  examples based on  hearsay  are of parents lifting vehicles to rescue their children, and when people are in life-and-death situations. Periods of increased strength are short-lived, usually no longer than a few minutes, and might lead to muscle injuries and exhaustion later. It is not known if there are any reliable examples of this  phenomenon . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_336", "text": "Early experiments showed that  adrenaline  increases twitch, but not  tetanic force  and  rate of force development  in muscles. [ 38 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_337", "text": "One proposed explanation is  Tim Noakes ' \" central governor \" theory, which states that higher instances in the  central nervous system  dynamically and subconsciously control the number of active  motor units  in the muscle. Normally, in order to guarantee  homeostasis , the entire motor neural capacity is not activated and, therefore, the total capacity of the muscle during performances outside of an emergency situation remains inaccessible: this would lead to exhaustion of energy resources and even physical injuries. However, in life-threatening situations, it is adaptive for the central governor limits to be removed or modified. [ 1 ]  People in high load  weightlifting  training are able to activate more motor units, which ensures more strength and efficiency in muscle contraction, even though they had the same amount of  muscle mass  compared to people in low load training. [ 39 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_338", "text": "Exercise physiologist Robert Girandola has pointed out that most cars have a 60/40  weight distribution , as the engine block puts the center of mass slightly towards the front of the car. In most instances, the individual is lifting one or two wheels of the car from the back. Therefore, they are only actually lifting a small fraction of the vehicle's weight. While the fight or flight response allows for increased lifting capacity, it would be hundreds of pounds rather than thousands. [ 40 ] [ 41 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_339", "text": "In vitro  muscle testing  is a method used to characterize properties of living  muscle  tissue after removing it from an organism, which allows more extensive and precise quantification of its properties than  in vivo  testing.  In vitro  muscle testing has provided the bulk of scientific knowledge of muscle structure and physiology, and how both relate to organismal performance. Stem cell research relies on  in vitro  muscle testing to establish sole muscle cell function and its individual behavior apart from muscle cells in the presence of nonmuscle cells seen in  in vitro  studies. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_340", "text": "Once an appropriate animal has been selected\u2014whether for a specific locomotor function (i.e.  frogs  for jumping); or a specific animal strain, to answer a research question\u2014a specific muscle is identified based on its  in vivo  function and fibre type distribution. Following ethical approval, and if necessary, government approval, the animal is humanely euthanised. Humane methods differ by country, with the most appropriate based on ethical approval and researcher skill level. A number of further criteria should be followed to ensure the animal is completely dead without the possibility of recovery, which includes cessation of blood flow via the removal of the heart from the circulatory system and/or complete destruction of the brain and spinal column. Following this, common measures of animal morphology are usually rapidly obtained, such as animal length, body mass, and other biomechanical markers that may be of importance. The animal is then prepared for harvesting of the target muscle. In isolated muscles, these tend to be muscles of the hind limbs, such as the  soleus  or EDL of mammals, or the  plantaris  or iliotibialis of amphibians. Other muscles that have been examined  in vitro  include the diaphragm and the  papillary muscle ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_341", "text": "For the successful isolation of skeletal muscles, specific conditions are required. The tissue should be isolated in frequently changed, chilled  Ringer's solution  or  Krebs-Henseleit solution  to ensure metabolic conditions are slowed down, hence the need for chilled dissecting medium, and to prevent the tissue from dying due to lack of substrates within the medium, hence the requirement for the solutions to be changed frequently. The dissecting solution should be continually oxygenated with the appropriate concentration of oxygen and carbon dioxide for the tissue that is being prepared. Typically, non-mammalian tissues are prepared in a gaseous solution bubbled through with 98% oxygen, 2% carbon dioxide whilst mammalian tissues in a solution bubbled through with 95% oxygen, 5% carbon dioxide. A microscope with an appropriate magnification level is required due to the dexterity required for isolation of muscles. An external, fibre optic light source is also beneficial to provide sufficient light without the emission of heat."}
{"_id": "WikiPedia_Muscular_system$$$corpus_342", "text": "There is no correct approach for the preparation of muscles for testing, as long as the muscle is not damaged during preparation, the muscle-tendon unit is intact and there is something that can be used to anchor the muscle within the testing rig. Pieces of bone can be left at the proximal and/or distal end of skeletal muscles to allow for anchoring. In addition, silk sutures or aluminium T-foil clips can be used to wrap around the tendon of the muscle to provide both support at the tendon and to be used for anchoring in the mechanics rig."}
{"_id": "WikiPedia_Muscular_system$$$corpus_343", "text": "In vitro  muscle testing typically requires a dual-mode servomotor, which can both control and detect changes in force and length. Should a dual-mode system be unavailable, then an independent force transducer and motor arm can be used. One end of the sample tissue is anchored in place, via a needle if sutured or crocodile clip if prepared with aluminium T-foil clips, while the other end is attached to the servomotor. The entire muscle is bathed in  Ringer's solution  or  Krebs-Henseleit solution  with oxygen bubbling through in order to keep the tissue alive and metabolically active. The solution is heated, usually via an external heater/cooler water bath, to an appropriate test temperature for the muscle that is being tested. Muscles are stimulated to contract by applying electric current to either the nerve which innervates the muscle or via platinum electrodes placed in the circulating solution to evoke a response of the entire muscle. The servomotor detects changes in force and/or length due to  muscle contraction . Stimulation level is often set to the level which ensures maximal  motor unit  recruitment. The servomotor can be programmed to maintain a given force while allowing the muscle to change length, vice versa, or the muscle may be subject to more complex testing, such as in  work loops . When  pennate muscles  are used,  sonomicrometry  is often used to accurately determine fiber length during the test."}
{"_id": "WikiPedia_Muscular_system$$$corpus_344", "text": "In vitro  muscle testing can be done on any scale of muscle organization - entire groups of  muscles  (provided they share a common insertion or origin, as in the human quadriceps), a single muscle, a \"bundle\" of  muscle fibers , a single muscle fiber, a single myofibril, a single  sarcomere , a  cardiomyocyte  or even a half-sarcomere.  Muscle fibers may be intact, or may be \"skinned\", a process which removes the cell membrane, sarcoplasmic reticulum, and cytoplasm, allowing greater access to the contractile components of the sarcomere."}
{"_id": "WikiPedia_Muscular_system$$$corpus_345", "text": "Several properties are commonly tested, and a given experiment will often use a subset of these properties, including twitch times, tetanic force, force-length relationship, force velocity relationship,  work loops , fatigue trials, fusion frequency, and energetic cost."}
{"_id": "WikiPedia_Muscular_system$$$corpus_346", "text": "A hybrid approach between  in vitro  and  in vivo  has recently been used, called  in situ , in which the organism is put under terminal anesthesia, and  in vivo  tests are performed with the muscle still attached to the organism. This ensures the muscle is kept at the right temperature and amply supplied with nutrients and oxygen by the blood, but the procedure is more difficult and some tests may not be possible. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_347", "text": "In vitro  muscle testing is almost never used in humans, with the exception of small sections of muscle removed via biopsy or while undergoing surgery for other ailments.  Testing is generally more difficult in mammals and birds because of the high temperature and oxygen requirements of the muscle, leading to rapid cell death once muscle tissue is removed from the organism. Mammalian skeletal muscles are commonly tested at ~25\u00b0C to prolong the test protocol for as long as reasonably possible. A test temperature of ~37\u00b0C can also been used during testing of whole isolated mammalian skeletal muscles to better replicate the temperature found in  in vivo . Moreover, it is important to consider the thermal specialisation of skeletal muscles, with core muscles more susceptible to changes in mechanical performance with small temperature changes than peripheral muscles. [ 3 ]  In ectotherms (reptiles, amphibians, fish, and invertebrates), the muscle tissue can survive outside of the organism for hours or even days, depending on the temperature and organism. Many experiments are conducted at or near 0\u00b0C to prolong the usable life of the muscle.  Additionally, in fish and amphibians, it is possible to separate out a single muscle fiber while keeping it intact, but in other species, this is usually not possible."}
{"_id": "WikiPedia_Muscular_system$$$corpus_348", "text": "Isolating muscle tissue  in vitro  allows individual data of muscle cell function without the presence of signaling nonmuscle cells nearby. [ 1 ]   In vitro  testing allows for exact stimulation of the muscle, providing precise data on innate tissue behavior. [ 4 ]  Isolated muscle testing limits other factors on the environment around the tissue such as substrates.  In vitro  isolated muscle testing is a beneficial procedure based on its ideal accuracy, precision, and reproducibly. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_349", "text": "Lateral to the  conjoint tendon , previously known as the inguinal aponeurotic falx, there is a ligamentous band originating from the lower margin of the  transversalis fascia [ 1 ]  and extending down in front of the  inferior epigastric artery  to the  superior ramus  of the  pubis ; it is termed the  interfoveolar ligament of Hesselbach  and sometimes contains a few muscular fibers."}
{"_id": "WikiPedia_Muscular_system$$$corpus_350", "text": "It is named for  Franz Kaspar Hesselbach . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_351", "text": "This article incorporates text in the  public domain  from  page 416  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_352", "text": "This  ligament -related article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_353", "text": "Intermediate fibers , also known as  fast oxidative-glycolytic fibers , are  fast twitch muscle fibers  which have been converted via endurance training. These fibers are slightly larger in diameter, have more  mitochondria  as well as a greater blood supply and more endurance than typical fast twitch fibers. Most of the body's muscles are composed of these intermediate fibers."}
{"_id": "WikiPedia_Muscular_system$$$corpus_354", "text": "Intermuscular coordination  describes the coordination within different  muscles  and groups of muscles. These are used for sceletoral movement, stabilisation of joints, as well as stabilisation of body positioning. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_355", "text": "central nervous system  is controlling positioning of joints via anticipatory and correcting adaptions of posture, that work against occurring intersegmental forces. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_356", "text": "The specific role and hierarchy of certain muscles and their meaning for certain movements is further differentiated within literature. [ 3 ] [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_357", "text": "Joints are stabilised by interacting muscles, so called  synergist muscle . Different synergists feature partial similar functions. Therefore, a certain movement can be formed out of different combinations and participations of muscles acting on a certain joint."}
{"_id": "WikiPedia_Muscular_system$$$corpus_358", "text": "Even muscles not being in a direct connection towards a certain joint can fulfill a stabilising function for that very joint. For a clear specification of any muscles function it is necessary to measure precisely muscular function of not directly involved muscles within certain movements via  elktromyografia . [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_359", "text": "Complex movement structures are coordinated within the  cerebellum  via  somatosensoric feedback  via  psychomotoric learning ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_360", "text": "This  anatomy  article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_361", "text": "Interossei  refer to muscles between certain bones.  There are many interossei in a human body. Specific interossei include:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_362", "text": "Intrafusal muscle fibers  are  skeletal muscle fibers  that serve as specialized  sensory organs  ( proprioceptors ). [ 1 ] [ 2 ]  They detect the amount and rate of change in length of a  muscle . [ 1 ]  They constitute the  muscle spindle , [ 2 ]  and are innervated by both sensory (afferent) and motor (efferent) fibers. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_363", "text": "Intrafusal muscle fibers are not to be confused with  extrafusal muscle fibers , which contract, generating skeletal movement and are innervated by  alpha motor neurons . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_364", "text": "There are two types of intrafusal muscle fibers:  nuclear bag fibers  and  nuclear chain fibers . [ 3 ]  They bear two types of sensory ending, known as annulospiral and flower-spray endings. Both ends of these fibers contract, but the central region only stretches and does not contract."}
{"_id": "WikiPedia_Muscular_system$$$corpus_365", "text": "Intrafusal muscle fibers are walled off from the rest of the muscle by an outer  connective tissue  sheath consisting of flattened  fibroblasts  and  collagen . [ 5 ]  This sheath has a spindle or \"fusiform\" shape, hence the name \"intrafusal\". [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_366", "text": "They are innervated by  gamma motor neurons  and  beta motor neurons . [ 3 ]  Gamma efferents from small  multipolar neurons  from anterior gray column innervate it. These form a part of  neuromuscular spindles ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_367", "text": "Intrafusal muscle fibers detect the amount and rate of change in muscle length. [ 1 ]  It is by the sensory information from gamma motor neurons and beta motor neurons that an individual is able to judge the position of their muscles. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_368", "text": "Intramuscular injection , often abbreviated  IM , is the  injection  of a substance into a  muscle . In  medicine , it is one of several methods for  parenteral administration  of medications. Intramuscular injection may be preferred because muscles have larger and more numerous  blood vessels  than subcutaneous tissue, leading to faster absorption than  subcutaneous  or  intradermal injections . Medication administered via intramuscular injection is not subject to the  first-pass metabolism  effect which affects oral medications."}
{"_id": "WikiPedia_Muscular_system$$$corpus_369", "text": "Common sites for intramuscular injections include the  deltoid muscle  of the upper arm and the  gluteal muscle  of the buttock. In infants, the  vastus lateralis muscle  of the thigh is commonly used. The injection site must be cleaned before administering the injection, and the injection is then administered in a fast, darting motion to decrease the discomfort to the individual. The volume to be injected in the muscle is usually limited to 2\u20135  milliliters , depending on injection site. A site with signs of infection or muscle atrophy should not be chosen. Intramuscular injections should not be used in people with  myopathies  or those with trouble clotting."}
{"_id": "WikiPedia_Muscular_system$$$corpus_370", "text": "Intramuscular injections commonly result in pain, redness, and swelling or  inflammation  around the injection site. These side effects are generally mild and last no more than a few days at most. Rarely,  nerves  or blood vessels around the injection site can be damaged, resulting in severe pain or  paralysis . If proper technique is not followed, intramuscular injections can result in localized infections such as  abscesses  and  gangrene . While historically aspiration, or pulling back on the syringe before injection, was recommended to prevent inadvertent administration into a vein, it is no longer recommended for most injection sites by some countries."}
{"_id": "WikiPedia_Muscular_system$$$corpus_371", "text": "Intramuscular injection is commonly used for medication administration. Medication administered in the muscle is generally quickly absorbed in the bloodstream, and avoids the  first pass metabolism  which occurs with oral administration. [ 1 ]  The medication may not be considered 100%  bioavailable  as it must still be absorbed from the muscle, which occurs over time. [ 2 ] :\u200a102\u2013103\u200a  An intramuscular injection is less invasive than an intravenous injection and also generally takes less time, as the site of injection (a muscle versus a vein) is much larger. Medications administered in the muscle may also be administered as  depot injections , which provide slow, continuous release of medicine over a longer period of time. [ 3 ]  Certain substances, including  ketamine , may be injected intramuscularly for  recreational  purposes. [ 4 ]  Disadvantages of intramuscular administration include skill and technique required, pain from injection, anxiety or fear (especially in children), and difficulty in self-administration which limits its use in  outpatient medicine . [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_372", "text": "Vaccines , especially  inactivated vaccines , are commonly administered via intramuscular injection. [ 6 ]  However, it has been estimated that for every vaccine injected intramuscularly, 20 injections are given to administer drugs or other therapy. [ 6 ]  This can include medications such as  antibiotics ,  immunoglobulin , and  hormones  such as testosterone and  medroxyprogesterone . [ 5 ]  In a case of severe allergic reaction, or  anaphylaxis , a person may use an  epinephrine   autoinjector  to self-administer epinephrine into the muscle. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_373", "text": "Because an intramuscular injection can be used to administer many types of medications, specific  contraindications  depend in large part on the medication being administered. [ 8 ]  Injections of medications are necessarily more invasive than other forms of administration such as by mouth or topical and require training to perform appropriately, without which complications can arise regardless of the medication being administered. For this reason, unless there are desired differences in rate of absorption, time to onset, or other pharmacokinetic parameters in the specific situation, a less invasive form of drug administration (usually by mouth) is preferred. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_374", "text": "Intramuscular injections are generally avoided in people with  low platelet count  or clotting problems, to prevent harm due to potential damage to blood vessels during the injection. They are also not recommended in people who are in  hypovolemic shock , or have myopathy or  muscle atrophy , as these conditions may alter the absorption of the medication. [ 5 ]  The damage to the muscle caused by an intramuscular injections may interfere with the accuracy of certain cardiac tests for people with suspected  myocardial infarction  and for this reason other methods of administration are preferred in such instances. [ 5 ]  In people with an active myocardial infarction, the decrease in circulation may result in slower absorption from an IM injection. [ 9 ] :\u200a368\u2013369\u200a  Specific sites of administration may also be contraindicated if the desired injection site has an infection, swelling, or inflammation. [ 9 ] :\u200a368\u2013369\u200a  Within a specific site of administration, the injection should not be given directly over irritation or redness, birthmarks or moles, or areas with scar tissue. [ 9 ] :\u200a368\u2013369"}
{"_id": "WikiPedia_Muscular_system$$$corpus_375", "text": "As an injection necessitates piercing the skin, there is a risk of infection from  bacteria  or other organisms present in the environment or on the skin before the injection. This risk is minimized by using proper  aseptic technique  in preparing the injection and sanitizing the injection site before administration. [ 9 ] :\u200a369\u200a  Intramuscular injections may also cause an abscess or gangrene at the injection site, depending on the specific medication and amount administered. There is also a risk of nerve or vascular injury if a nerve or blood vessel is inadvertently hit during injection. If single-use or sterilized equipment is not used, there is the risk of transmission of infectious disease between users, or to a practitioner who inadvertently injures themselves with a used needle, termed a  needlestick injury . [ 5 ] [ 9 ] :\u200a372"}
{"_id": "WikiPedia_Muscular_system$$$corpus_376", "text": "Injections into the deltoid site in the arm can result in unintentional damage to the  radial  and  axillary nerves . In rare cases when not performed properly, the injection may result in shoulder dysfunction. [ 10 ]  The most frequent complications of a deltoid injection include pain, redness, and inflammation around the injection site, which are almost always mild and last only a few days at most. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_377", "text": "The dorsogluteal site of injection is associated with a higher risk of skin and tissue trauma, muscle  fibrosis  or  contracture ,  hematoma , nerve  palsy ,  paralysis , and infections such as  abscesses  and  gangrene . [ 12 ]  Furthermore, injection in the gluteal muscle poses a risk for damage to the  sciatic nerve , which may cause shooting pain or a sensation of burning. Sciatic nerve damage can also affect a person's ability to move their foot on the affected side, and other parts of the body controlled by the nerve. Damage to the sciatic nerve can be prevented by using the ventrogluteal site instead, and by selecting an appropriate size and length of needle for the injection. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_378", "text": "An intramuscular injection can be administered in multiple different muscles of the body. Common sites for intramuscular injection include:  deltoid ,  dorsogluteal ,  rectus femoris ,  vastus lateralis  and  ventrogluteal  muscles. [ 12 ] [ 14 ]  Sites that are bruised, tender, red, swollen, inflamed or scarred are generally avoided. [ 15 ]  The specific medication and amount being administered will influence the decision of the specific muscle chosen for injection."}
{"_id": "WikiPedia_Muscular_system$$$corpus_379", "text": "The injection site is first cleaned using an antimicrobial and allowed to dry. The injection is performed in a quick, darting motion perpendicular to the skin, at an angle between 72 and 90 degrees. The practitioner will stabilize the needle with one hand while using their other hand to depress the plunger to slowly inject the medication \u2013 a rapid injection causes more discomfort. The needle is withdrawn at the same angle inserted. Gentle pressure may be applied with gauze if bleeding occurs. [ 16 ]  Pressure or gentle massage of the muscle following injection may reduce the risk of pain. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_380", "text": "Aspirating for blood to rule out injecting into a blood vessel is not recommended by the US  CDC ,  Public Health Agency of Canada , or  Norway Institute of Public Health , as the injection sites do not contain large blood vessels and aspiration results in greater pain. [ 18 ] [ 19 ] [ 20 ]  There is no evidence that aspiration is useful to increase safety of intramuscular injections when injecting in a site other than the dorsogluteal site. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_381", "text": "Aspiration was recommended by the  Danish Health Authority  for  COVID-19 vaccines  for a time to investigate the potential rare risk of blood clotting and bleeding, but it is no longer a recommendation. [ 21 ] [ 22 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_382", "text": "The Z-track method is a method of administering an IM injection that prevents the medication being tracked through the subcutaneous tissue, sealing the medication in the muscle, and minimizing irritation from the medication. Using the Z-track technique, the skin is pulled laterally, away from the injection site, before the injection; then the medication is injected, the needle is withdrawn, and the skin is released. This method can be used if the overlying tissue can be displaced. [ 23 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_383", "text": "The deltoid muscle in the outer portion of the upper arm is used for injections of small volume, usually equal to or less than 1\u00a0mL. This includes most intramuscular vaccinations. [ 12 ]  It is not recommended to use the deltoid for repeated injections due to its small area, which makes it difficult to space out injections from each other. [ 12 ]  The deltoid site is located by locating the lower edge of the  acromion process , and injecting in the area which forms an upside down triangle with its base at the acromion process and its midpoint in line with the  armpit . [ 15 ]  An injection into the deltoid muscle is commonly administered using a 1-inch long needle, but may use a  5 \u2044 8 -inch long needle for younger people or very frail elderly people. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_384", "text": "The ventrogluteal site on the hip is used for injections which require a larger volume to be administered, greater than 1\u00a0mL, and for medications which are known to be irritating, viscous, or oily. It is also used to administer  narcotic  medications,  antibiotics ,  sedatives  and  anti-emetics . [ 12 ]  The ventrogluteal site is located in a triangle formed by the  anterior superior iliac spine  and the  iliac crest , and may be located using a hand as a guide. [ 15 ]  The ventrogluteal site is less painful for injection than other sites such as the deltoid site. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_385", "text": "The  vastus lateralis  site is used for infants less than 7 months old and people who are unable to walk or who have loss of muscular tone. [ 12 ]  The site is located by dividing the front  thigh  into thirds vertically and horizontally to form nine squares; the injection is administered in the outer middle square. [ 15 ]  This site is also the usual site of administration for  epinephrine autoinjectors , which are used in the outer thigh, corresponding to the location of the vastus lateralis muscle. [ 24 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_386", "text": "The dorsogluteal site of the buttock site is not routinely used due to its location near major  blood vessels  and  nerves , as well as having inconsistent depth of  adipose tissue . [ 25 ]  Many injections in this site do not penetrate deep enough under the skin to be correctly administered in the muscle. [ 12 ] [ 26 ]  While current  evidence-based practice  recommends against using this site, many healthcare providers still use this site, often due to a lack of knowledge about alternative sites for injection. [ 27 ]  \nThis site is located by dividing the buttock into four using a cross shape, and administering the injection in the upper outer quadrant. This is the only intramuscular injection site for which aspiration is recommended of the syringe before injection, due to higher likelihood of accidental  intravenous administration  in this area. [ 12 ]  However, aspiration is not recommended by the  Centers for Disease Control and Prevention , which considers it outdated for any intramuscular injection. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_387", "text": "Some populations require a different injection site, needle length, or technique. In very young or weak elderly patients, a normal-length needle may be too long to inject properly. In these patients, a shorter needle is indicated to avoid injecting too deeply. [ 28 ]  It is also recommended to consider using the anterolateral thigh as an injection site in infants under one year old. [ 28 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_388", "text": "To help infants and children cooperate with injection administration, the  Advisory Committee on Immunization Practices  in the United States recommends using distractions, giving something sweet, and rocking the baby side to side. In people who are overweight, a 1.5-inch needle may be used to ensure the injection is given below the  subcutaneous  layer of skin, while a  5 \u2044 8 -inch needle may be used for people who weigh under 60 kilograms (130\u00a0lb). In any case, the skin does not need to be pinched up before injecting when the appropriate length needle is used. [ 29 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_389", "text": "Injections into muscular tissue may have taken place as early as the year 500 AD. Beginning in the late 1800s, the procedure began to be described in more detail and techniques began to be developed by physicians. In the early days of intramuscular injections, the procedure was performed almost exclusively by physicians. [ 8 ]  After the introduction of  antibiotics  in the middle of the 20th century, nurses began preparing equipment for intramuscular injections as part of their delegated duties from physicians, and by 1961 they had \"essentially taken over the procedure\". [ 8 ]  Until this delegation became virtually universal, there were no uniform procedures or education for nurses in proper administration of intramuscular injections, and complications from improper injection were common. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_390", "text": "Intramuscular injections began to be used for administration of vaccines for  diphtheria  in 1923,  whooping cough  in 1926, and  tetanus  in 1927. [ 30 ]  By the 1970s, researchers and instructors began forming guidance on injection site and technique to reduce the risk of injection complications and side effects such as pain. [ 8 ]  Also in the early 1970s,  botulinum toxin  began to be injected into muscles to intentionally paralyze them for therapeutic reasons, and later for cosmetic reasons. [ 31 ]  Until the 2000s, aspiration after inserting the needle was recommended as a safety measure, to ensure the injection was being administered in a muscle and not inadvertently in a vein. However, this is no longer recommended as evidence shows no safety benefit and it lengthens the time taken for injection, which causes more pain. [ 29 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_391", "text": "In animals common sites for intramuscular injection include the  quadriceps , the lumbodorsal muscles, and the triceps muscle. [ 32 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_392", "text": "The  iris dilator muscle  ( pupil dilator muscle ,  pupillary dilator ,  radial muscle of iris ,  radiating fibers ), is a  smooth muscle [ 2 ]  of the  eye , running radially in the  iris  and therefore fit as a dilator. The pupillary dilator consists of a spokelike arrangement of modified contractile cells called  myoepithelial cells . These cells are stimulated by the sympathetic nervous system. [ 3 ]  When stimulated, the cells contract, widening the pupil and allowing more light to enter the eye."}
{"_id": "WikiPedia_Muscular_system$$$corpus_393", "text": "The  ciliary muscle ,  pupillary sphincter muscle  and  pupillary dilator muscle  sometimes are called  intrinsic ocular muscles [ 4 ]  or  intraocular muscles . [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_394", "text": "It is innervated by the sympathetic system, which acts by releasing  noradrenaline , which acts on  \u03b11-receptors . [ 6 ]  Thus, when presented with a threatening stimulus that activates the  fight-or-flight response , this innervation contracts the muscle and dilates the  pupil , thus temporarily letting more light reach the  retina ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_395", "text": "The dilator muscle is innervated more specifically by  postganglionic  sympathetic nerves arising from the  superior cervical ganglion  as the  sympathetic root of ciliary ganglion . From there, they travel via the  internal carotid artery  through the  carotid canal  to  foramen lacerum . They then enter the  middle cranial fossa  above foramen lacerum, travel through the  cavernous sinus  in the middle cranial fossa and then travel with the  ophthalmic artery  in the  optic canal  or on the  ophthalmic nerve  through the  superior orbital fissure . From there, they travel with the  nasociliary nerve  and then the  long ciliary nerve . They then pierce the  sclera , travel between sclera and  choroid  to reach the iris dilator muscle. They will also pass through ciliary ganglion and travel in  short ciliary nerves  to reach the iris dilator muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_396", "text": "The pupillary dilator acts to increase the size of the pupil to allow more light to enter the eye. It works in opposition to the pupillary constrictor. [ 7 ]  Pupil dilation occurs when there is insufficient light for the normal function of the eye, and during heightened sympathetic activity, for example in the \"fight-or-flight reflex\". [ 7 ] [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_397", "text": "The English name  dilator pupillae muscle [ 9 ]  as currently used in the list of English equivalents of the  Terminologia Anatomica , the reference-work of the official anatomic nomenclature, [ 10 ]  can be considered as a corruption [ 11 ]  of the full Latin expression  musculus dilatator pupillae . [ 12 ]  The full Latin expression exhibits three words that each can be traced back to  Roman antiquity . The  Classical Latin  name  musculus  is actually a diminutive of the Classical Latin name  mus , [ 13 ]  and can be translated as  little mouse . [ 13 ]  In the medical writings of  Aulus Cornelius Celsus  we can also find this specific name to refer to a muscle instead of its literal meaning. [ 13 ]  Latin  musculus  can be explained by the fact that a muscle looks like a little mouse that moves under the skin. [ 14 ]  In the writings of Greek  philosopher   Aristotle  the Ancient Greek word for  mouse , i.e. \u03bc\u1fe6\u03c2 [ 15 ]  is also used to refer to a muscle. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_398", "text": "Dilatator  in the Latin expression  musculus dilatator pupillae  is derived from the classical Latin verb  dilatare , [ 16 ]  to dilate, to spread out. [ 13 ]  Two possible explanations exist concerning the etymological derivation of this verb. The first explanation considers  dilatare  as frequentative of  differere . [ 13 ]  The Latin verb  differe  can mean,  to carry different ways ,  to spread abroad ,  to scatter , [ 13 ]  but also  to delay . [ 13 ]  The other explanation [ 14 ]  considers  dilatare  as a compound from  di-  and  latus , with the latter word meaning,  broad  or  wide , [ 13 ]  hence the German name  Erweiterer  for Latin  dilatator . [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_399", "text": "The expression  dilator pupillae muscle , as used in the list of English equivalents of the  Terminologia Anatomica , is actually partly Latin, i.e.  dilator pupillae , with  pupillae  (=of the pupil [ 13 ] ), a noun in the genitive case modifying  dilator , a noun in the nominative case, and partly English, i.e.  muscle . In previous editions ( Nomina Anatomica ) this muscle was officially called the  musculus dilator pupillae , [ 17 ] [ 18 ] [ 19 ] [ 20 ] [ 21 ]  The  Nomina Anatomica  as authorized in 1895 in  Basel [ 12 ]  and in 1935 in  Jena [ 22 ] [ 23 ]  used the full Latin expression."}
{"_id": "WikiPedia_Muscular_system$$$corpus_400", "text": "The  iris sphincter muscle  ( pupillary sphincter ,  pupillary constrictor ,  circular muscle of iris ,  circular fibers ) is a  muscle  in the part of the  eye  called the  iris . It encircles the  pupil  of the iris, appropriate to its function as a constrictor of the pupil."}
{"_id": "WikiPedia_Muscular_system$$$corpus_401", "text": "The  ciliary muscle ,  pupillary sphincter muscle  and  pupillary dilator muscle  sometimes are called  intrinsic ocular muscles [ 2 ]  or  intraocular muscles . [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_402", "text": "This structure is found in  vertebrates  and in some  cephalopods . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_403", "text": "All the  myocytes  are of the  smooth muscle  type. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_404", "text": "Its dimensions are about 0.75\u00a0mm wide by 0.15\u00a0mm thick. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_405", "text": "In humans, it functions to constrict the  pupil  in bright light ( pupillary light reflex ) or during  accommodation . [ citation needed ]  In lower animals, the muscle cells themselves are photosensitive causing iris action without brain input. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_406", "text": "It is controlled by  parasympathetic  postganglionic fibers releasing acetylcholine acting primarily on the  muscarinic acetylcholine receptor  (M3) of iris sphincter muscle. [ 6 ]  Preganglionic fibers originate from the  Edinger\u2013Westphal nucleus , travel along the  oculomotor nerve  (CN III), and make nicotinic cholinergic synapses on neurons in the  ciliary ganglion . [ 7 ]  Those neurons' postganglionic parasympathetic fibers then enter the eye through the  short ciliary nerves . The short ciliary nerves then run forward and pierce the  sclera  at the back of the eye, traveling between the sclera and the  choroid  to innervate the iris sphincter muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_407", "text": "Isopotential muscle  refers to  muscle fibers  which are fewer than two times the  length constant ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_408", "text": "In an  isotonic contraction , tension remains the same, whilst the muscle's length changes. Isotonic contractions differ from  isokinetic  contractions in that in isokinetic contractions the muscle speed remains constant.  While superficially identical, as the muscle's force changes via the  length-tension relationship  during a contraction, an isotonic contraction will keep force constant while velocity changes, but an isokinetic contraction will keep velocity constant while force changes.  A near isotonic contraction is known as Auxotonic contraction."}
{"_id": "WikiPedia_Muscular_system$$$corpus_409", "text": "There are two types of isotonic contractions: (1) concentric and (2) eccentric. In a concentric contraction, the muscle tension rises to meet the resistance, then remains the same as the muscle shortens.  In eccentric, the muscle lengthens due to the resistance being greater than the force the muscle is producing. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_410", "text": "This type is typical of most exercise. The external force on the muscle is less than the force the muscle is generating - a  shortening  contraction. The effect is not visible during the classic biceps curl, which is in fact auxotonic because the resistance ( torque  due to the weight being lifted) does not remain the same through the exercise. Tension is highest at a parallel to the floor level, and eases off above and below this point. Therefore, tension changes as well as muscle length. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_411", "text": "There are two main features to note regarding eccentric contractions. First, the absolute tensions achieved can be very high relative to the muscle's maximum tetanic tension generating capacity (you can set down a much heavier object than you can lift [ 1 ] ). Second, the absolute tension is relatively independent of lengthening velocity."}
{"_id": "WikiPedia_Muscular_system$$$corpus_412", "text": "Muscle injury and soreness are selectively associated with eccentric contraction. [ 2 ] [ 3 ] [ 4 ]  Muscle strengthening using exercises that involve eccentric contractions is lower than using concentric exercises. [ 5 ]  However because higher levels of tension are easier to attain during exercises that involve eccentric contractions it may be that, by generating higher signals for muscle strengthening,  muscle hypertrophy is better than exercises that involve concentric contractions, albeit at a higher level of resistance. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_413", "text": "This is almost an isotonic contraction because there is some fluctuation towards the end of the contraction. For example, the heart's ventricles contract to expel blood into the pulmonary artery and aorta. As the blood flows out, the previous built-up load is decreased and hence less force is required to expel the rest of the blood. Thus the tension is reduced. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_414", "text": "In  physiology ,  isotropic bands  (better known as  I bands ) are the lighter bands of skeletal muscle cells (a.k.a.  muscle fibers ). Isotropic bands contain only  actin -containing  thin filaments . [ 1 ]  The thin filaments are placed between 2 myosin filaments and contain only the  actin filaments  of neighboring  sarcomeres . Bisecting the I band and serving as an anchoring point for the two adjacent actin filaments is the Z disc. During muscle contraction, the I band will shorten, while an A band will maintain its width. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_415", "text": "The darker bands within skeletal muscle, known as anisotropic bands (A bands), encompass both thick and thin filaments and constitute the central region of the sarcomere, extending across the H-zone. Collectively, the A bands and the I bands create the distinctive striped appearance of skeletal muscle tissue. [ 3 ]  Tropomyosin, a protein, shields the myosin-binding sites, hindering actin from binding to myosin. It attaches to  troponin , which secures it in place. During muscle relaxation, the troponin-tropomyosin complex inhibits  myosin  heads from binding to the active sites on actin microfilaments. Troponin also possesses a calcium ion binding site. These two regulatory proteins cooperate in response to calcium levels, overseeing sarcomere contraction. During muscle contraction,  tropomyosin  shifts to expose the myosin-binding site on an actin filament, allowing the interaction between actin and myosin microfilaments to occur. The initiation of contraction involves calcium ions binding to troponin, prompting a reaction that displaces tropomyosin from the actin filament binding sites. Consequently, myosin heads can attach to these exposed sites, forming cross-bridges and initiating muscle contraction. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_416", "text": "A key component in  lateral force transmission in skeletal muscle  is the  extracellular matrix  (ECM).   Skeletal muscle  is a complex biological material that is composed of muscle fibers and an ECM consisting of the  epimysium ,  perimysium , and  endomysium .  It can be described as a  collagen   fiber-reinforced composite .  The ECM has at least three functions: (1) to provide a framework binding muscle fibers together and ensure their proper alignment, (2) to transmit the forces, either from active muscle contraction or ones passively imposed on it, and (3) providing lubricated surfaces between muscle fibers and bundles enabling the muscle to change shape. [ 1 ]   The mechanical properties of skeletal muscle depend on both the properties of muscle fibers and the ECM, and the interaction between the two.  Contractile forces are transmitted laterally within intramuscular connective tissue to the epimysium and then to the  tendon .  Due to the nature of skeletal muscle, direct measurements are not possible, but many indirect studies and analyses have shown that the ECM is an important part of force transmission during muscle contraction. [ 2 ] [ 3 ] [ 4 ] [ 5 ] [ 6 ] [ 7 ] [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_417", "text": "The muscle fibers within a fascicle are surrounded by the  endomysium .  The structure of the endomysium is generally equivalent for all skeletal muscle from different muscles and species.  Many of the muscle fibers end within the muscle and do not connect to the  tendon  directly, thus necessitating a force transmission pathway via the endomysium.  The planar network of the  collagen  fibers appears to be randomly distributed at first glance, but detailed analysis has shown that the network is not truly random and that there is a preferred direction that changes with muscle length. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_418", "text": "Any linkage transmitting force from the muscle fibers to the tendon must be non-compliant (i.e. high  stiffness ) in order to be efficient.  Experimental force-length measurements showed that the passive tensile properties of relaxed muscle were mainly from the elastic resistance of the myofibrils and not the connective tissue. [ 9 ]   Also, analysis of the non-linear tensile properties of the endomysium showed that under normal physiological conditions the collagen networks were too compliant in tension to act as efficient force transmitters in tension. [ 4 ]  Therefore, the concept of shear linkage between adjacent muscle fibers in the endomysium was introduced. [ 10 ]   The figure to the right is a model consisting of two parallel muscle cells with the endomysium sandwiched between them.  Assuming the simplest linear models, the  shear stress  (F/LW) and the shear strain (\u0394L/H) in the endomysium can be related to the  shear modulus  (G) by the following equation:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_419", "text": "G \n = \n \n \n F \n \n \u0394 \n L \n \n \n \n \n \n H \n \n L \n W \n \n \n \n \n \n {\\displaystyle G={\\frac {F}{\\Delta L}}{\\frac {H}{LW}}}"}
{"_id": "WikiPedia_Muscular_system$$$corpus_420", "text": "where"}
{"_id": "WikiPedia_Muscular_system$$$corpus_421", "text": "If the change in length (\u0394L) is approximated as the longitudinal tensile displacement, the apparent tensile modulus (E app ) becomes:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_422", "text": "E \n \n a \n p \n p \n \n \n = \n G \n \n \n ( \n \n \n L \n H \n \n \n ) \n \n \n 2 \n \n \n \n \n {\\displaystyle E_{app}=G\\left({\\frac {L}{H}}\\right)^{2}}"}
{"_id": "WikiPedia_Muscular_system$$$corpus_423", "text": "The length of the muscle fiber (L) is orders of magnitude larger than the thickness (H), making the term (L/H) 2  very large.  Therefore, the apparent longitudinal modulus much greater than the true shear modulus.  Because the endomysium is so thin, even large shear strains would only result in minute tensile elongations.  If the apparent longitudinal modulus is represented in series with the fibers, the modulus of the composite structure (E c ) is:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_424", "text": "1 \n \n E \n \n c \n \n \n \n \n = \n \n \n 1 \n \n E \n \n f \n \n \n \n \n + \n \n \n 1 \n \n E \n \n a \n p \n p \n \n \n \n \n \n \n {\\displaystyle {\\frac {1}{E_{c}}}={\\frac {1}{E_{f}}}+{\\frac {1}{E_{app}}}}"}
{"_id": "WikiPedia_Muscular_system$$$corpus_425", "text": "and is dictated by the fiber modulus E f , because E app  is many orders of magnitude higher.  This shear force transmission pathway from one muscle cell to its neighbors is highly efficient and because it has low tensile stiffness, it does not restrict changes in muscle fiber length and diameter during muscle contraction. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_426", "text": "Unlike the  endomysium , the  perimysium  has large variations in quantity and organization from one muscle group to another. [ 12 ]  Muscles contain far more perimysial than endomysial connective tissue, and it has also been observed that the ratio of the dry mass of perimysium to that of endomysium ranges between 2.8-1 and 64\u20131. [ 13 ]   The anatomical arrangement of the connective tissue at each level of organization influences the function of the muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_427", "text": "The  collagen  fibers in the perimysium usually orient between 45 and 60 degrees to the long axis of the muscle fibers in their relaxed state. [ 1 ]   Well defined contact regions between the endomysium and perimysium were observed and coined the perimysial junctional plate (PJP). [ 14 ]   These sites were hypothesized to be a focal region for delivery of tension during muscle contraction.  To test the possibility of tensile force transmission via the perimysium, it was experimentally shown that cutting of the  aponeurosis  in a pennate muscle did not prevent tension generation further along towards the  tendon . [ 6 ]   Also, in a separate study it was clearly demonstrated that the perimysium could transmit force if tendons normally transmitting force from distinct parts of the  extensor digitorum longus muscle  were cut. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_428", "text": "Although a lot of evidence may seem to point to lateral force transmission via the perimysium in tension, the experiments were conducted at very high loads.  Under sufficient stress, the collagen fibers of the perimysium begin to orient parallel to the stress direction.  The stretching and reorientation of the perimysium makes it much stiffer and able to transmit tensile force.   Scanning electron microscope  images have shown that the perimysium has an organized crimped structure. [ 1 ]   The crimped structure of the perimysium makes it very compliant in tension under normal physiological conditions allowing the muscle to change shape, thus rendering it unfeasible for tensile force transmission. [ 11 ]   Although strong efforts have been made to demonstrate the mechanical role of the perimysium as a force transmission pathway during active contraction of the muscle, an accepted model has yet to be derived."}
{"_id": "WikiPedia_Muscular_system$$$corpus_429", "text": "It can also be suggested that the perimysium could transmit force generated in fascicles to neighboring fascicles by shear, similar to the endomysium described above.  The perimysium is significantly thicker than the endomysium.  Even if the  shear modulus  of the perimysium were within an order of magnitude of the endomysium, the perimysium would still be a lot more compliant in shear than the endomysium, also making it an inefficient force transmission pathway. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_430", "text": "There are alternate theories on the role of the perimysium being strictly for distributing passive forces imposed on the muscle and that the perimysial network's main purpose is to prevent over-stretching of the muscle fascicles. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_431", "text": "This is a table of  skeletal muscles  of the  human anatomy , with muscle counts and other information."}
{"_id": "WikiPedia_Muscular_system$$$corpus_432", "text": "sensory :  cervical nerves   C3  and  C4"}
{"_id": "WikiPedia_Muscular_system$$$corpus_433", "text": "medial head does not function at  shoulder ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_434", "text": "medial belly :  muscular branches of ulnar nerve"}
{"_id": "WikiPedia_Muscular_system$$$corpus_435", "text": "lateral head : lateral sesamoid bone of  metatarsophalangeal joint , proximal phalanx of great toe"}
{"_id": "WikiPedia_Muscular_system$$$corpus_436", "text": "transverse head :  metatarsophalangeal joints , ligaments of lateral 3 toes"}
{"_id": "WikiPedia_Muscular_system$$$corpus_437", "text": "The muscles are described using  anatomical terminology . The columns are as follows:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_438", "text": "For Origin, Insertion and Action please name a specific Rib, Thoracic vertebrae or Cervical vertebrae, by using C1-7, T1-12 or R1-12."}
{"_id": "WikiPedia_Muscular_system$$$corpus_439", "text": "There does not appear to be a definitive source counting all skeletal muscles. Different sources group muscles differently, regarding physical features as different parts of a single muscle or as several muscles. There are also  vestigial muscles  that are present in some people but absent in others, such as the  palmaris longus muscle . [ 14 ] [ 15 ]  There are between 600 and 840 muscles within the typical human body, depending on how they are counted. [ 16 ] [ 17 ] [ 18 ]  In the present table, using statistical counts of the instances of each muscle, and ignoring gender-specific muscles, there are 753 skeletal muscles. Sometimes male and females have the same muscle but with different purposes [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_440", "text": "Muscles are often paired as agonistic and antagonistic muscles. [ 20 ]  This can be a bit misleading as, in general, it is groups of muscles working together to either make or cancel a movement. [ 21 ]  The present table lists some well-known relationships but is not at all complete."}
{"_id": "WikiPedia_Muscular_system$$$corpus_441", "text": "Lombard's paradox  describes a paradoxical  muscular contraction  in humans. When rising to stand from a  sitting  or  squatting position , both the  hamstrings  and  quadriceps  contract at the same time, despite them being  antagonists  to each other."}
{"_id": "WikiPedia_Muscular_system$$$corpus_442", "text": "The  rectus femoris   biarticular muscle  acting over the hip has a smaller hip  moment arm  than the hamstrings. However, the rectus femoris moment arm is greater over the knee than the hamstring knee moment. This means that contraction from both rectus femoris and hamstrings will result in hip and knee extension. Hip extension also adds a passive stretch component to rectus femoris, which results in a knee extension force. This paradox allows for efficient movement, especially during  gait ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_443", "text": "In facial anatomy, the  modiolus  is a dense, compact, mobile, fibromuscular tissue mass of facial muscles formed by the interlacing of a number of muscles just lateral to the angle of the mouth opposite the second upper premolar tooth."}
{"_id": "WikiPedia_Muscular_system$$$corpus_444", "text": "There are no precise histological boundaries because the modiolus is an irregular zone where dense, compact, interlacing tissue grades into the stems of individually recognizable muscles. It is contributed to by at least nine muscles:  orbicularis oris ,  buccinator ,  levator anguli oris ,  depressor anguli oris ,  zygomaticus major ,  zygomaticus minor ,  risorius ,  quadratus labii superioris ,  quadratus labii inferioris . [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_445", "text": "Its position and movements are important in moving the  mouth ,  facial expression  and in  prosthetic dentistry . It is extremely important in relation to stability of lower denture, because of the strength and variability of movement of the area. It derives its motor nerve supply from the  facial nerve , and its blood supply from labial branches of the  facial artery . [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_446", "text": "2.Al-Hoqail RA, Abdel Meguid EM. An anatomical and analytical study of the modiolus: enlightening its relevance to plastic surgery. Aesthetic Plast Surg. 2009;33(2):147\u2013152. doi:10.1007/s00266-008-9187-x"}
{"_id": "WikiPedia_Muscular_system$$$corpus_447", "text": "3.P\u00e9lissier P, Pistre V, Bustamante K, Martin D, Baudet J. Le modiolus. Anatomie compar\u00e9e, rappels embryologique et physiologique, int\u00e9r\u00eat chirurgical [The modiolus. Comparative anatomy, embryological and physiological review, surgical importance]. Ann Chir Plast Esthet. 2000;45(1):41\u201347."}
{"_id": "WikiPedia_Muscular_system$$$corpus_448", "text": "4.Yu SK, Lee MH, Kim HS, Park JT, Kim HJ, Kim HJ. Histomorphologic approach for the modiolus with reference to reconstructive and aesthetic surgery. J Craniofac Surg. 2013;24(4):1414\u20131417. doi:10.1097/SCS.0b013e318292c939"}
{"_id": "WikiPedia_Muscular_system$$$corpus_449", "text": "Muscle  is a  soft tissue , one of the four basic types of  animal tissue . Muscle tissue gives  skeletal muscles  the ability to  contract . Muscle is formed during  embryonic development , in a process known as  myogenesis . Muscle tissue contains special  contractile proteins  called  actin  and  myosin  which interact to cause movement. Among many other muscle proteins, present are two  regulatory proteins ,  troponin  and  tropomyosin . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_450", "text": "Muscle tissue varies with function and location in the body."}
{"_id": "WikiPedia_Muscular_system$$$corpus_451", "text": "In  vertebrates , the three types are:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_452", "text": "Skeletal muscle tissue  consists of elongated, multinucleate  muscle cells  called  muscle fibers , and is responsible for movements of the body. Other tissues in skeletal muscle include  tendons  and  perimysium . [ 3 ]  Smooth and cardiac muscle contract involuntarily, without conscious intervention. These muscle types may be activated both through the interaction of the  central nervous system  as well as by receiving innervation from peripheral  plexus  or  endocrine  (hormonal) activation. Striated or skeletal muscle only contracts voluntarily, upon the influence of the central nervous system.  Reflexes  are a form of non-conscious activation of skeletal muscles, but nonetheless arise through activation of the central nervous system, albeit not engaging  cortical  structures until after the contraction has occurred. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_453", "text": "The different muscle types vary in their response to  neurotransmitters  and  hormones  such as  acetylcholine ,  noradrenaline ,  adrenaline , and  nitric oxide  depending on muscle type and the exact location of the muscle. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_454", "text": "Sub-categorization of muscle tissue is also possible, depending on among other things the content of  myoglobin ,  mitochondria , and  myosin ATPase  etc. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_455", "text": "The word  muscle  comes from Latin  musculus , diminutive of  mus  meaning  mouse , because the appearance of the flexed biceps resembles the back of a mouse."}
{"_id": "WikiPedia_Muscular_system$$$corpus_456", "text": "The same phenomenon occurred in  Greek , in which \u03bc\u1fe6\u03c2,  m\u0233s , means both \"mouse\" and \"muscle\"."}
{"_id": "WikiPedia_Muscular_system$$$corpus_457", "text": "There are three types of muscle tissue in vertebrates:  skeletal ,  cardiac , and  smooth . Skeletal and cardiac muscle are types of  striated muscle tissue . [ 2 ]  Smooth muscle is non-striated."}
{"_id": "WikiPedia_Muscular_system$$$corpus_458", "text": "There are three types of muscle tissue in  invertebrates  that are based on their pattern of striation: transversely striated, obliquely striated, and smooth muscle. In arthropods there is no smooth muscle. The transversely striated type is the most similar to the skeletal muscle in vertebrates. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_459", "text": "Vertebrate skeletal muscle tissue is an elongated, striated muscle tissue, with the fibres ranging from 3-8 micrometers in width and from 18 to 200 micrometers in breadth. In the uterine wall, during pregnancy, they enlarge in length from 70 to 500 micrometers. [ 5 ]  Skeletal striated muscle tissue is arranged in regular, parallel bundles of  myofibrils , which contain many contractile units known as  sarcomeres , which give the tissue its striated (striped) appearance. Skeletal muscle is voluntary muscle, anchored by  tendons  or sometimes by  aponeuroses  to  bones , and is used to effect  skeletal  movement such as  locomotion  and to  maintain posture . Postural control is generally maintained as an unconscious reflex, but the responsible muscles can also react to conscious control. The body mass of an average adult man is made up of 42% of skeletal muscle, and an average adult woman is made up of 36%. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_460", "text": "Cardiac muscle tissue is found only in the walls of the  heart  as  myocardium , and it is an involuntary muscle controlled by the  autonomic nervous system . Cardiac muscle tissue is striated like skeletal muscle, containing sarcomeres in highly regular arrangements of bundles. While skeletal muscles are arranged in regular, parallel bundles, cardiac muscle connects at branching, irregular angles known as  intercalated discs ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_461", "text": "Smooth muscle tissue is non-striated and involuntary. Smooth muscle is found within the walls of organs and structures such as the  esophagus ,  stomach ,  intestines ,  bronchi ,  uterus ,  urethra ,  bladder ,  blood vessels , and the  arrector pili  in the skin that control the erection of body hair."}
{"_id": "WikiPedia_Muscular_system$$$corpus_462", "text": "Skeletal muscle is broadly classified into two fiber types:  type I  (slow-twitch) and  type II  (fast-twitch)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_463", "text": "The  density  of mammalian skeletal muscle tissue is about 1.06\u00a0kg/liter. [ 11 ]  This can be contrasted with the density of  adipose tissue  (fat), which is 0.9196\u00a0kg/liter. [ 12 ]  This makes muscle tissue approximately 15% denser than fat tissue."}
{"_id": "WikiPedia_Muscular_system$$$corpus_464", "text": "Skeletal muscle  is a highly oxygen-consuming tissue, and  oxidative DNA damage  that is induced by  reactive oxygen species  tends to accumulate with  age . [ 13 ]   The oxidative DNA damage  8-OHdG  accumulates in  heart  and skeletal muscle of both mouse and rat with age. [ 14 ]   Also, DNA double-strand breaks accumulate with age in the skeletal muscle of mice. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_465", "text": "Smooth muscle  is involuntary and non-striated. It is divided into two subgroups: the  single-unit  (unitary) and  multiunit smooth muscle . Within single-unit cells, the whole bundle or sheet contracts as a  syncytium  (i.e. a  multinucleate  mass of  cytoplasm  that is not separated into cells). Multiunit smooth muscle tissues  innervate  individual cells; as such, they allow for fine control and gradual responses, much like  motor unit recruitment  in skeletal muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_466", "text": "Smooth muscle is found within the walls of  blood vessels  (such smooth muscle specifically being termed  vascular smooth muscle ) such as in the  tunica media  layer of the large ( aorta ) and small  arteries ,  arterioles  and  veins . Smooth muscle is also found in lymphatic vessels, the  urinary bladder ,  uterus  (termed  uterine smooth muscle ), male and female  reproductive tracts , the  gastrointestinal tract , the  respiratory tract , the arrector pili of  skin , the  ciliary muscle , and the  iris of the eye . The structure and function is basically the same in smooth muscle cells in different organs, but the inducing stimuli differ substantially, in order to perform individual actions in the body at individual times. In addition, the  glomeruli  of the kidneys contain smooth muscle-like cells called  mesangial cells ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_467", "text": "Cardiac muscle is involuntary,  striated muscle  that is found in the walls and the  histological  foundation of the  heart , specifically the myocardium. The  cardiac muscle cells , (also called cardiomyocytes or myocardiocytes), predominantly contain only one nucleus, although populations with two to four nuclei do exist. [ 16 ] [ 17 ] [ page\u00a0needed ]  The  myocardium  is the muscle tissue of the heart and forms a thick middle layer between the outer  epicardium  layer and the inner  endocardium  layer."}
{"_id": "WikiPedia_Muscular_system$$$corpus_468", "text": "Coordinated  contractions  of cardiac muscle cells in the heart propel  blood  out of the  atria  and  ventricles  to the blood vessels of the left/body/systemic and right/lungs/pulmonary  circulatory systems . This complex mechanism illustrates  systole  of the heart."}
{"_id": "WikiPedia_Muscular_system$$$corpus_469", "text": "Cardiac muscle cells, unlike most other tissues in the body, rely on an available blood and electrical supply to deliver oxygen and nutrients and to remove waste products such as  carbon dioxide . The  coronary arteries  help fulfill this function."}
{"_id": "WikiPedia_Muscular_system$$$corpus_470", "text": "All muscles are derived from  paraxial mesoderm . The paraxial mesoderm is divided along the  embryo 's length into  somites , corresponding to the  segmentation  of the body (most obviously seen in the  vertebral column . [ 18 ]  Each somite has three divisions,  sclerotome  (which forms  vertebrae ),  dermatome  (which forms skin), and  myotome  (which forms muscle). The myotome is divided into two sections, the epimere and hypomere, which form  epaxial and hypaxial muscles , respectively. The only epaxial muscles in humans are the  erector spinae  and small intervertebral muscles, and are innervated by the dorsal rami of the  spinal nerves . All other muscles, including those of the limbs are hypaxial, and innervated by the  ventral rami  of the spinal nerves. [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_471", "text": "During development,  myoblasts  (muscle progenitor cells) either remain in the somite to form muscles associated with the vertebral column or migrate out into the body to form all other muscles. Myoblast migration is preceded by the formation of  connective tissue  frameworks, usually formed from the somatic  lateral plate mesoderm . Myoblasts follow chemical signals to the appropriate locations, where they fuse into elongate skeletal muscle cells. [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_472", "text": "The primary function of muscle tissue is  contraction . The three types of muscle tissue (skeletal, cardiac and smooth) have significant differences. However, all three use the movement of  actin  against  myosin  to create contraction."}
{"_id": "WikiPedia_Muscular_system$$$corpus_473", "text": "In skeletal muscle, contraction is stimulated by  electrical impulses  transmitted by the  motor nerves . Cardiac and smooth muscle contractions are stimulated by internal pacemaker cells which regularly contract, and propagate contractions to other muscle cells they are in contact with. All skeletal muscle and many smooth muscle contractions are facilitated by the  neurotransmitter   acetylcholine . [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_474", "text": "Smooth muscle is found in almost all  organ systems  such as  hollow organs  including the  stomach , and  bladder ; in tubular structures such as  blood  and  lymph vessels , and  bile ducts ; in sphincters such as in the uterus, and the eye. In addition, it plays an important role in the ducts of exocrine glands. It fulfills various tasks such as sealing orifices (e.g. pylorus, uterine os) or the transport of the chyme through wavelike contractions of the intestinal tube. Smooth muscle cells contract more slowly than skeletal muscle cells, but they are stronger, more sustained and require less energy. Smooth muscle is also involuntary, unlike skeletal muscle, which requires a stimulus."}
{"_id": "WikiPedia_Muscular_system$$$corpus_475", "text": "Cardiac muscle is the muscle of the heart. It is self-contracting,  autonomically regulated  and must continue to contract in a rhythmic fashion for the whole life of the organism. Hence it has special features. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_476", "text": "There are three types of muscle tissue in  invertebrates  that are based on their pattern of  striation : transversely striated, obliquely striated, and smooth muscle. In arthropods there is no smooth muscle. The transversely striated type is the most similar to the skeletal muscle in vertebrates. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_477", "text": "This template's  initial visibility currently defaults to  autocollapse , meaning that if there is another collapsible item on the page (a  navbox, sidebar , or  table with the collapsible attribute ), it is hidden apart from its title bar; if not, it is fully visible."}
{"_id": "WikiPedia_Muscular_system$$$corpus_478", "text": "To change this template's initial visibility, the  |state=   parameter  may be used:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_479", "text": "Muscle architecture  is the physical arrangement of  muscle fibers  at the macroscopic level that determines a  muscle's  mechanical function. There are several different muscle architecture types including: parallel, pennate and hydrostats. Force production and  gearing  vary depending on the different muscle parameters such as muscle length, fiber length, pennation angle, and the  physiological cross-sectional area  (PCSA). [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_480", "text": "Parallel and  pennate  (also known as pinnate) are two main types of muscle architecture. A third subcategory,  muscular hydrostats , can also be considered. Architecture type is determined by the direction in which the muscle fibers are oriented relative to the  force-generating axis . The force produced by a given muscle is proportional to the cross-sectional area, or the number of parallel sarcomeres present. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_481", "text": "The parallel muscle architecture is found in muscles where the fibers are parallel to the force-generating axis. [ 1 ]  These muscles are often used for fast or extensive movements and can be measured by the anatomical cross-sectional area (ACSA). [ 3 ]  Parallel muscles can be further defined into three main categories: strap, fusiform, or fan-shaped."}
{"_id": "WikiPedia_Muscular_system$$$corpus_482", "text": "Strap muscles are shaped like a strap or belt and have fibers that run longitudinally to the contraction direction. [ 4 ]  These muscles have broad attachments compared to other muscle types and can shorten to about 40\u201360% of their resting length. [ 3 ] [ 4 ]  Strap muscles, such as the  laryngeal muscles , have been thought to control the fundamental frequency used in speech production, as well as singing. [ 5 ]  Another example of this muscle is the longest muscle in the human body, the  sartorius ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_483", "text": "Fusiform muscles  are wider and cylindrically shaped in the center and taper off at the ends. This overall shape of fusiform muscles is often referred to as a spindle. The line of action in this muscle type runs in a straight line between the attachment points which are often tendons. Due to the shape, the force produced by fusiform muscles is concentrated into a small area. [ 3 ]  An example of this architecture type is the  biceps brachii  in humans."}
{"_id": "WikiPedia_Muscular_system$$$corpus_484", "text": "The fibers in convergent, or triangular muscles converge at one end (typically at a tendon) and spread over a broad area at the other end in a fan-shape. [ 3 ] [ 6 ] \nConvergent muscles, such as the  pectoralis major  in humans, have a weaker pull on the\nattachment site compared to other parallel fibers due to their broad nature. These\nmuscles are considered versatile because of their ability to change the direction of pull\ndepending on how the fibers are contracting. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_485", "text": "Typically, convergent muscles experience varying degrees of fiber strain. This is largely due to the different lengths and varying insertion points of the muscle fibers. Studies on ratfish have looked at the strain on these muscles that have a twisted tendon. It has been found that strain becomes uniform over the face of a convergent muscle with the presence of a twisted tendon. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_486", "text": "Unlike in parallel muscles, fibers in  pennate muscles  are at an angle to the force-generating axis (pennation angle) and usually insert into a central tendon. [ 3 ] [ 8 ]  Because of this structure, fewer  sarcomeres  can be found in series, resulting in a shorter fiber length. [ 2 ] [ 3 ]  This further allows for more fibers to be present in a given muscle; however, a trade-off exists between the number of fibers present and force transmission. [ 3 ] [ 8 ]  The force produced by pennate muscles is greater than the force produced by parallel muscles. [ 3 ]  Since pennate fibers insert at an angle, the anatomical cross-sectional area cannot be used as in parallel fibered muscles. Instead, the  physiological cross-sectional area  (PCSA) must be used for pennate muscles. Pennate muscles can be further divided into uni-, bi- or multipennate."}
{"_id": "WikiPedia_Muscular_system$$$corpus_487", "text": "Unipennate muscles are those where the muscle fibers are oriented at one fiber angle to the force-generating axis and are all on the same side of a tendon. [ 1 ]  The pennation angle in unipennate muscles has been measured at a variety of resting length and typically varies from 0\u00b0 to 30\u00b0. [ 1 ]  The  lateral gastrocnemius  is an example of this muscle architecture."}
{"_id": "WikiPedia_Muscular_system$$$corpus_488", "text": "Muscles that have fibers on two sides of a tendon are considered bipennate. [ 1 ]  The  stapedius  in the middle ear of humans, as well as the  rectus femoris  of the quadriceps are examples of bipennate muscles."}
{"_id": "WikiPedia_Muscular_system$$$corpus_489", "text": "The third type of pennate subgroup is known as the multipennate architecture. These muscles, such as the  deltoid  muscle in the shoulder of humans, have fibers that are oriented at multiple angles along the force-generating axis. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_490", "text": "Muscular hydrostats  function independently of a hardened skeletal system. Muscular hydrostats are typically supported by a membrane of connective tissue which holds the volume constant. Retaining a constant volume enables the fibers to stabilize the muscle's structure that would otherwise require skeletal support. [ 9 ]  Muscle fibers change the shape of the muscle by contracting along three general lines of action relative to the long axis: parallel, perpendicular and helical. These contractions can apply or resist compressive forces to the overall structure. [ 10 ]  A balance of synchronized, compressive and resistive forces along the  three lines of action, enable the muscle to move in diverse and complex ways. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_491", "text": "Contraction of helical fibers causes elongation and shortening of the hydrostat.  Unilateral contraction of these muscles can cause a bending movement. Helical fibers can oriented into either left or right-handed arrangements. Contraction of orthogonal fibers causes torsion or twisting of the hydrostat."}
{"_id": "WikiPedia_Muscular_system$$$corpus_492", "text": "Muscle architecture directly influences force production via muscle volume, fiber length, fiber type and pennation angle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_493", "text": "Muscle volume is determined by the cross-sectional area. Anatomical cross-sectional area is"}
{"_id": "WikiPedia_Muscular_system$$$corpus_494", "text": "C \n S \n A \n = \n \n \n V \n l \n \n \n \n \n {\\displaystyle CSA={\\frac {V}{l}}}"}
{"_id": "WikiPedia_Muscular_system$$$corpus_495", "text": "In muscles, a more accurate measurement of CSA is physiological CSA (PCSA) which takes into account fiber angle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_496", "text": "P \n C \n S \n A \n = \n \n \n \n m \n \u22c5 \n cos \n \u2061 \n \u03b8 \n \n \n l \n \u22c5 \n \u03c1 \n \n \n \n \n \n {\\displaystyle PCSA={\\frac {m\\cdot \\cos \\theta }{l\\cdot \\rho }}}"}
{"_id": "WikiPedia_Muscular_system$$$corpus_497", "text": "PCSA relates the force produced by the muscle to the summation of the forces produced along the force generating axis of each muscle fiber and is largely determined by the pennation angle. [ 3 ] [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_498", "text": "Fiber length is also a key variable in muscle anatomy. Fiber length is the product of both the number of sarcomeres in series in the fiber and their individual lengths.  As a fiber changes length, the individual sarcomeres shorten or lengthen, but the total number does not change (except on long timescales following exercise and conditioning). To standardize fiber length, length is measured at the peak of the length-tension relationship (L0), ensuring all sarcomeres are at the same length. Fiber length (at L0) does not affect force generation, much as the strength of a chain is unaffected by the length.  Similarly, increased fiber cross-section or multiple fibers increase the force, like having multiple chains in parallel.  Velocity is affected in the reverse manner\u00a0\u2013  because sarcomeres shorten at a certain percentage per second under a certain force, fibers with more sarcomeres will have higher absolute (but not relative) velocities. [ 11 ]  Muscles with short fibers will have higher PCSA per unit muscle mass, thus greater force production, while muscle with long fibers will have lower PCSA per unit muscle mass, thus lower force production. However, muscles with longer fibers will shorten at greater absolute speeds than a similar muscle with shorter fibers. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_499", "text": "The type of muscle fiber correlates to force production. Type I fibers are slow oxidative with a slow rise in force and an overall low force production. The type I fibers have a smaller fiber diameter and exhibit a slow contraction. Type IIa fibers are fast oxidative which exhibit fast contraction and a fast rise in force. These fibers have fast contraction times and maintain some, though not a great amount of their force production with repeated activity due to being moderately fatigue resistant. Type IIb fibers are fast glycolytic which also exhibit fast contraction and fast rise in force. These fibers display extremely large force production, but are easily fatigued and therefore unable to maintain force for more than a few contractions without rest."}
{"_id": "WikiPedia_Muscular_system$$$corpus_500", "text": "The  pennation angle  is the angle between the longitudinal axis of the entire muscle and its fibers. The longitudinal axis is the force generating axis of the muscle and pennate fibers lie at an oblique angle. As tension increases in the muscle fibers, the pennation angle also increases. A greater pennation angle results in a smaller force being transmitted to the tendon. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_501", "text": "Muscle architecture affects the force-velocity relationship. Components of this relationship are fiber length, number of sarcomeres and pennation angle. In pennate muscles, for example, as the fibers shorten, the pennation angle increases as the fibers pivot which effects the amount of force generated. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_502", "text": "Architectural gear ratio  (AGR) relates the contractile velocity of an entire muscle to the contractile velocity of a single muscle fiber. AGR is determined by the mechanical demands of a muscle during movement. Changes in pennation angle allow for variable gearing in pennate muscles. [ 12 ]  Variable pennation angle also influences whole-muscle geometry during contraction. The degree of fiber rotation determines the cross-sectional area during the course of the movement which can result in increases of the thickness or width of the muscle. [ 12 ]  Pennation angle can be modified through exercise interventions. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_503", "text": "A high gear ratio occurs when the contraction velocity of the whole muscle is much greater than that of an individual muscle fiber, resulting in a gear ratio that is greater than 1. A high gear ratio will result in low force, high velocity contractions of the entire muscle. The angle of pennation will increase during contraction accompanied by an increase in thickness. Thickness is defined as the area between the aponeuroses of the muscle. A low gear ratio occurs when the contraction velocity of the whole muscle and individual fibers is approximately the same, resulting in a gear ratio of 1. Conditions resulting in a low gear ratio include high force and low velocity contraction of the whole muscle. The pennation angle typically shows little variation. The muscle thickness will decrease."}
{"_id": "WikiPedia_Muscular_system$$$corpus_504", "text": "Muscle arms  are body wall  muscle  (BWM)  membrane  extensions that connect the BWMs to the motor axons of the  dorsal  and  ventral  nerve cords in the  nematode  worm  C. elegans . Muscle arms were first described in other nematode species by  Anton Schneider  (1831 \u2013 1890) in his \"Monographie der Nematoden\", published in 1866.  Subsequent work showed that muscle arms are found in C. elegans and that these structures are abnormal in unc-104, unc-5 and other mutants.  [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_505", "text": "Wormatlas  - a structural anatomy of muscles, including muscle arms."}
{"_id": "WikiPedia_Muscular_system$$$corpus_506", "text": "This  Secernentea  roundworm- related article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_507", "text": "In  medicine , a  muscle biopsy  is a procedure in which a piece of  muscle   tissue  is removed from an  organism  and examined  microscopically . A muscle biopsy can lead to the discovery of problems with the  nervous system ,  connective tissue ,  vascular system , or  musculoskeletal system ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_508", "text": "In humans with weakness and low muscle tone, a muscle biopsy can help distinguish between  myopathies  (where the pathology is in the muscle tissue itself) and  neuropathies  (where the pathology is at the nerves innervating those muscles). Muscle biopsies can also help to distinguish among various types of  myopathies , by microscopic analysis for differing characteristics when exposed to a variety of chemical reactions and stains. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_509", "text": "However, in some cases the muscle biopsy alone is inadequate to distinguish between certain myopathies. For example, a muscle biopsy showing the nucleus pathologically located in the center of the muscle cell would indicate \" centronuclear myopathy \", but research has shown that a variety of  myopathies  can cause these centronuclear biopsy appearance, and hence the specific  genetic testing  becomes increasingly important. [ 3 ] [ 4 ] \nAdditionally muscle biopsy is the only certain way to clarify ones muscle fiber types. I.e. by undergoing a muscle biopsy one can get a clear picture of which type of muscles dominates his/her body."}
{"_id": "WikiPedia_Muscular_system$$$corpus_510", "text": "A  biopsy needle  is usually inserted into a muscle, wherein a small amount of tissue remains. Alternatively, an \"open biopsy\" can be performed by obtaining the muscle tissue through a small surgical incision. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_511", "text": "Muscle coactivation  occurs when  agonist  and  antagonist muscles  (or  synergist muscles ) surrounding a joint contract simultaneously to provide joint stability, [ 1 ] [ 2 ]  and is suggested to depend crucially on supraspinal processes involved in the control of movement. [ 3 ]  It is also known as muscle cocontraction, since two muscle groups are  contracting  at the same time. It is able to be measured using  electromyography  (EMG) from the contractions that occur. The general mechanism of it is still widely unknown. It is believed to be important in joint stabilization, as well as general  motor control . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_512", "text": "Muscle coactivation allows muscle groups surrounding a joint to become more stable. This is due to both muscles (or sets of muscles) contracting at the same time, which produces compression on the joint. The joint is able to become stiffer and more stable due to this action. [ 4 ] [ 5 ]  For example, when the  biceps  and the  triceps  coactivate, the elbow becomes more stable. This stabilization mechanism is also important for unexpected loads impeded on the joint, allowing the muscles to quickly coactivate and provide stability to the joint. [ 1 ] [ 4 ]  This mechanism is controlled  neuromuscularly , which allows the muscle(s) to contract. [ 1 ]  This occurs through a  motor neuron  sending a signal (through creating  action potentials ) to the  muscle fiber  to contract by releasing  acetylcholine . [ 6 ]  When signals are sent to all muscle fibers in a muscle group, the muscle group will contract as a whole."}
{"_id": "WikiPedia_Muscular_system$$$corpus_513", "text": "In the upper limbs, the stability of muscle coactivation allows for precise low-level physical tasks. [ 1 ]   An example of this would be picking up a small object. By protecting the muscles at the end of their range of motion, the direction of the fine movements is able to be changed. [ 4 ]  In the lower limbs, stability is important in upright standing balance. The coactivation of different muscle groups allows for proper balance and the ability to adjust weight and to stay upright on uneven ground. [ 7 ]  It is also believed to be important for  postural control  by stabilizing the spine. [ 1 ]  Muscle coactivation is absolutely necessary for learning a fine motor skill or for any activity involving stability. [ 7 ]  In order for muscle coactivation to occur, it must inhibit  reciprocal innervation , which occurs when a muscle contracts and the  synergist muscle  relaxes. [ 5 ]  For muscle coactivation to occur, both the muscle and synergist muscle need to contract."}
{"_id": "WikiPedia_Muscular_system$$$corpus_514", "text": "Muscle coactivation is measured using a technique called  electromyography (EMG). [ 1 ]  This is performed by using surface EMG that responds to electrical activity of the muscle through the skin. [ 8 ]  Electrical activity is only present in the muscle when the muscle voluntarily contracts. [ 9 ]  When the muscle is contracted, the EMG is able to display the force of the contraction or how the nerves can respond to stimulation. [ 10 ]  An EMG of coactivation would display the agonist and antagonist muscle contracting simultaneously. Although it is believed many muscles are involved in the mechanism of coactivation, methods to measure coactivation are finite to specific instances or two muscle systems. Because of this, little is understood about the role of coactivation in a multiple muscle system. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_515", "text": "Muscle contraction  is the activation of  tension -generating sites within  muscle cells . [ 1 ] [ 2 ]  In  physiology , muscle contraction does not necessarily mean muscle shortening because muscle tension can be produced without changes in muscle length, such as when holding something heavy in the same position. [ 1 ]  The termination of muscle contraction is followed by  muscle relaxation , which is a return of the muscle fibers to their low tension-generating state. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_516", "text": "For the contractions to happen, the muscle cells must rely on the change in action of two types of  filaments : thin and thick filaments."}
{"_id": "WikiPedia_Muscular_system$$$corpus_517", "text": "The major constituent of thin filaments is a chain formed by helical coiling of two strands of  actin , and thick filaments dominantly consist of chains of the  motor-protein   myosin . Together, these two filaments form myofibrils - the basic functional organelles in the skeletal muscle system."}
{"_id": "WikiPedia_Muscular_system$$$corpus_518", "text": "In  vertebrates ,  skeletal muscle contractions  are  neurogenic  as they require  synaptic input  from  motor neurons . A single motor neuron is able to innervate multiple muscle fibers, thereby causing the fibers to contract at the same time. Once innervated, the protein filaments within each skeletal muscle fiber slide past each other to produce a contraction, which is explained by the  sliding filament theory . The contraction produced can be described as a  twitch , summation, or tetanus, depending on the frequency of  action potentials . In skeletal muscles, muscle tension is at its greatest when the muscle is stretched to an intermediate length as described by the length-tension relationship."}
{"_id": "WikiPedia_Muscular_system$$$corpus_519", "text": "Unlike skeletal muscle, the contractions of  smooth  and  cardiac muscles  are  myogenic  (meaning that they are initiated by the smooth or heart muscle cells themselves instead of being stimulated by an outside event such as nerve stimulation), although they can be modulated by stimuli from the  autonomic nervous system . The mechanisms of contraction in these  muscle tissues  are similar to those in skeletal muscle tissues."}
{"_id": "WikiPedia_Muscular_system$$$corpus_520", "text": "Muscle contraction can also be described in terms of two variables: length and tension. [ 1 ]  In natural movements that underlie  locomotor activity , muscle contractions are multifaceted as they are able to produce changes in length and tension in a time-varying manner. [ 3 ]  Therefore, neither length nor tension is likely to remain the same in  skeletal muscles  that contract during locomotion. Contractions can be described as  isometric  if the muscle tension changes but the muscle length remains the same. [ 1 ] [ 4 ] [ 5 ] [ 6 ]  In contrast, a muscle contraction is described as  isotonic  if muscle tension remains the same throughout the contraction. [ 1 ] [ 4 ] [ 5 ] [ 6 ]  If the muscle length shortens, the contraction is concentric; [ 1 ] [ 7 ]  if the muscle length lengthens, the contraction is eccentric."}
{"_id": "WikiPedia_Muscular_system$$$corpus_521", "text": "Muscle contractions can be described based on two variables: force and length. Force itself can be differentiated as either tension or load. Muscle tension is the force exerted by the muscle on an object whereas a load is the force exerted by an object on the muscle. [ 1 ]  When muscle tension changes without any corresponding changes in muscle length, the muscle contraction is described as isometric. [ 1 ] [ 4 ] [ 5 ] [ 6 ]  If the muscle length changes while muscle tension remains the same, then the muscle contraction is isotonic. [ 1 ] [ 4 ] [ 5 ] [ 6 ]  In an isotonic contraction, the muscle length can either shorten to produce a concentric contraction or lengthen to produce an eccentric contraction. [ 1 ] [ 7 ]  In natural movements that underlie locomotor activity, muscle contractions are multifaceted as they are able to produce changes in length and tension in a time-varying manner. [ 3 ]  Therefore, neither length nor tension is likely to remain constant when the muscle is active during locomotor activity."}
{"_id": "WikiPedia_Muscular_system$$$corpus_522", "text": "An isometric contraction of a muscle generates tension without changing length. [ 1 ] [ 4 ] [ 5 ] [ 6 ]  An example can be found when the muscles of the hand and  forearm  grip an object; the  joints  of the hand do not move, but muscles generate sufficient force to prevent the object from being dropped."}
{"_id": "WikiPedia_Muscular_system$$$corpus_523", "text": "In  isotonic contraction , the tension in the muscle remains constant despite a change in muscle length. [ 1 ] [ 4 ] [ 5 ] [ 6 ]  This occurs when a muscle's force of contraction matches the total load on the muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_524", "text": "In concentric contraction, muscle tension is sufficient to overcome the load, and the muscle shortens as it contracts. [ 8 ]  This occurs when the force generated by the muscle exceeds the load opposing its contraction."}
{"_id": "WikiPedia_Muscular_system$$$corpus_525", "text": "During a concentric contraction, a muscle is stimulated to contract according to the  sliding filament theory . This occurs throughout the length of the muscle, generating a force at the origin and insertion, causing the muscle to shorten and changing the angle of the joint. In relation to the  elbow , a concentric contraction of the  biceps  would cause the arm to bend at the elbow as the hand moved from the leg to the shoulder (a  biceps curl ). A concentric contraction of the  triceps  would change the angle of the joint in the opposite direction, straightening the arm and moving the hand towards the leg."}
{"_id": "WikiPedia_Muscular_system$$$corpus_526", "text": "In eccentric contraction, the tension generated while isometric is insufficient to overcome the external load on the muscle and the muscle fibers lengthen as they contract. [ 9 ]  Rather than working to pull a joint in the direction of the muscle contraction, the muscle acts to  decelerate  the joint at the end of a movement or otherwise control the repositioning of a load. This can occur involuntarily (e.g., when attempting to move a weight too heavy for the muscle to lift) or voluntarily (e.g., when the muscle is 'smoothing out' a movement or resisting gravity such as during downhill walking). Over the short-term,  strength training  involving both eccentric and concentric contractions appear to increase  muscular strength  more than training with concentric contractions alone. [ 10 ]  However, exercise-induced muscle damage is also greater during lengthening contractions. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_527", "text": "During an eccentric contraction of the  biceps muscle , the elbow starts the movement while bent and then straightens as the hand moves away from the  shoulder . During an eccentric contraction of the  triceps muscle , the elbow starts the movement straight and then bends as the hand moves towards the shoulder.  Desmin ,  titin , and other z-line  proteins  are involved in eccentric contractions, but their mechanism is poorly understood in comparison to  cross-bridge cycling  in concentric contractions. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_528", "text": "Though the muscle is doing a negative amount of  mechanical work , (work is being done  on  the muscle), chemical energy (of fat or  glucose , or temporarily stored in  ATP ) is nevertheless consumed, although less than would be consumed during a concentric contraction of the same force. For example, one expends more energy going up a flight of stairs than going down the same flight."}
{"_id": "WikiPedia_Muscular_system$$$corpus_529", "text": "Muscles undergoing heavy eccentric loading suffer greater damage when overloaded (such as during  muscle building  or  strength training  exercise) as compared to concentric loading. When eccentric contractions are used in weight training, they are normally called  negatives . During a concentric contraction, contractile muscle  myofilaments  of  myosin  and  actin  slide past each other, pulling the Z-lines together. During an eccentric contraction, the myofilaments slide past each other the opposite way, though the actual movement of the myosin heads during an eccentric contraction is not known. Exercise featuring a heavy eccentric load can actually support a greater weight (muscles are approximately 40% stronger during eccentric contractions than during concentric contractions) and also results in greater muscular damage and  delayed onset muscle soreness  one to two days after training. Exercise that incorporates both eccentric and concentric muscular contractions (i.e., involving a strong contraction and a controlled lowering of the weight) can produce greater gains in strength than concentric contractions alone. [ 10 ] [ 12 ]  While unaccustomed heavy eccentric contractions can easily lead to  overtraining , moderate training may confer protection against injury. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_530", "text": "Eccentric contractions normally occur as a braking force in opposition to a concentric contraction to protect joints from damage. During virtually any routine movement, eccentric contractions assist in keeping motions smooth, but can also slow rapid movements such as a punch or throw. Part of training for rapid movements such as  pitching  during baseball involves reducing eccentric braking allowing a greater power to be developed throughout the movement."}
{"_id": "WikiPedia_Muscular_system$$$corpus_531", "text": "Eccentric contractions are being researched for their ability to speed rehabilitation of weak or injured tendons.  Achilles tendinitis [ 13 ] [ 14 ]  and  patellar tendonitis [ 15 ]  (also known as jumper's knee or patellar tendonosis) have been shown to benefit from high-load eccentric contractions."}
{"_id": "WikiPedia_Muscular_system$$$corpus_532", "text": "In  vertebrate animals , there are three types of  muscle tissues : skeletal, smooth, and cardiac.  Skeletal muscle  constitutes the majority of muscle mass in the body and is responsible for locomotor activity.  Smooth muscle  forms  blood vessels , the  gastrointestinal tract , and other areas in the body that produce sustained contractions.  Cardiac muscle  makes up the heart, which pumps blood. Skeletal and cardiac muscles are called  striated muscle  because of their striped appearance under a microscope, which is due to the highly organized alternating pattern of A bands and I bands."}
{"_id": "WikiPedia_Muscular_system$$$corpus_533", "text": "Excluding reflexes, all  skeletal muscle  contractions occur as a result of signals originating in the brain. The brain sends electrochemical signals through the  nervous system  to the  motor neuron  that  innervates  several muscle fibers. [ 16 ]  In the case of some  reflexes , the signal to contract can originate in the  spinal cord  through a feedback loop with the grey matter. Other actions such as locomotion, breathing, and chewing have a reflex aspect to them: the contractions can be initiated either consciously or unconsciously."}
{"_id": "WikiPedia_Muscular_system$$$corpus_534", "text": "A  neuromuscular junction  is a  chemical synapse  formed by the contact between a  motor neuron  and a  muscle fiber . [ 17 ]  It is the site in which a motor neuron transmits a signal to a muscle fiber to initiate muscle contraction. The sequence of events that results in the depolarization of the muscle fiber at the neuromuscular junction begins when an action potential is initiated in the cell body of a motor neuron, which is then propagated by  saltatory conduction  along its axon toward the neuromuscular junction. Once it reaches the  terminal bouton , the action potential causes a  Ca 2+  ion  influx into the terminal by way of the  voltage-gated calcium channels . The  Ca 2+  influx  causes  synaptic vesicles  containing the neurotransmitter  acetylcholine  to fuse with the plasma membrane, releasing acetylcholine into the  synaptic cleft  between the motor neuron terminal and the neuromuscular junction of the skeletal muscle fiber. Acetylcholine diffuses across the synapse and binds to and activates  nicotinic acetylcholine receptors  on the neuromuscular junction. Activation of the nicotinic receptor opens its intrinsic  sodium / potassium  channel, causing sodium to rush in and potassium to trickle out. As a result, the  sarcolemma  reverses polarity and its voltage quickly jumps from the resting membrane potential of -90mV to as high as +75mV as sodium enters. The membrane potential then becomes hyperpolarized when potassium exits and is then adjusted back to the resting membrane potential. This rapid fluctuation is called the end-plate potential. [ 18 ]  The voltage-gated ion channels of the sarcolemma next to the end plate open in response to the end plate potential. They are sodium and potassium specific and only allow one through. This wave of ion movements creates the action potential that spreads from the motor end plate in all directions. [ 18 ]  If action potentials stop arriving, then acetylcholine ceases to be released from the terminal bouton. The remaining acetylcholine in the synaptic cleft is either degraded by active  acetylcholine esterase  or reabsorbed by the synaptic knob and none is left to replace the degraded acetylcholine."}
{"_id": "WikiPedia_Muscular_system$$$corpus_535", "text": "Excitation\u2013contraction coupling (ECC) is the process by which a  muscular action potential  in the muscle fiber causes  myofibrils  to contract. In skeletal muscles, excitation\u2013contraction coupling relies on a direct coupling between two key proteins, the  sarcoplasmic reticulum  (SR) calcium release channel identified as the  ryanodine receptor 1  (RYR1) and the  voltage-gated L-type calcium channel  identified as  dihydropyridine receptors , (DHPRs). DHPRs are located on the sarcolemma (which includes the surface sarcolemma and the  transverse tubules ), while the RyRs reside across the SR membrane. The close apposition of a transverse tubule and two SR regions containing RyRs is described as a triad and is predominantly where excitation\u2013contraction coupling takes place."}
{"_id": "WikiPedia_Muscular_system$$$corpus_536", "text": "Excitation\u2013contraction coupling (ECC) occurs when depolarization of skeletal muscles (usually through neural innervation) results in a muscle action potential. This action potential spreads across the muscle's surface and into the muscle fiber's network of  T-tubules , depolarizing the inner portion of the muscle fiber. This activates dihydropyridine receptors in the  terminal cisternae , which are in close proximity to ryanodine receptors in the adjacent  sarcoplasmic reticulum . The activated dihydropyridine receptors physically interact with ryanodine receptors to activate them via foot processes (involving conformational changes that allosterically activates the ryanodine receptors). As ryanodine receptors open, Ca 2+  is released from the sarcoplasmic reticulum into the local junctional space and diffuses into the bulk cytoplasm to cause a  calcium spark . [ 19 ]  The action potential creates a near synchronous activation of thousands of  calcium sparks  and causes a cell-wide increase in calcium giving rise to the upstroke of the  calcium transient . The Ca 2+  released into the cytosol binds to  Troponin C  by the  actin filaments . This bond allows the actin filaments to perform  cross-bridge cycling , producing force and, in some situations, motion."}
{"_id": "WikiPedia_Muscular_system$$$corpus_537", "text": "When the desired motion is accomplished, relaxation can be achieved quickly through numerous pathways. Relaxation is quickly achieved through a Ca 2+  buffer with various cytoplasmic proteins binding to Ca 2+  with very high affinity. [ 20 ]  These cytoplasmic proteins allow for quick relaxation in fast twitch muscles. Although slower, the  sarco/endoplasmic reticulum calcium-ATPase  (SERCA) actively pumps Ca 2+  back into the sarcoplasmic reticulum, resulting in a permanent relaxation until the next action potential arrives. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_538", "text": "Mitochondria also participate in Ca 2+  reuptake, ultimately delivering their gathered Ca 2+  to SERCA for storage in the sarcoplasmic reticulum. A few of the relaxation mechanisms (NCX, Ca2+ pumps and Ca2+ leak channels) move Ca2+ completely out of the cells as well. [ 21 ]  As Ca 2+  concentration declines to resting levels, Ca2+ releases from Troponin C, disallowing cross bridge-cycling, causing the force to decline and relaxation to occur. Once relaxation has fully occurred, the muscle is able to contract again, thus fully resetting the cycle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_539", "text": "The  sliding filament theory  describes a process used by  muscles  to contract. It is a cycle of repetitive events that cause a thin filament to slide over a thick filament and generate tension in the muscle. [ 22 ]  It was independently developed by  Andrew Huxley  and  Rolf Niedergerke  and by  Hugh Huxley  and  Jean Hanson  in 1954. [ 23 ] [ 24 ]  Physiologically, this contraction is not uniform across the sarcomere; the central position of the thick filaments becomes unstable and can shift during contraction but this is countered by the actions of the elastic myofilament of  titin . This fine myofilament maintains uniform tension across the sarcomere by pulling the thick filament into a central position. [ 25 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_540", "text": "Cross-bridge cycling is a sequence of molecular events that underlies the sliding filament theory. A  cross-bridge  is a myosin projection, consisting of two myosin heads, that extends from the thick filaments. [ 1 ]  Each myosin head has two binding sites: one for  adenosine triphosphate  (ATP) and another for actin. The binding of ATP to a myosin head detaches myosin from  actin , thereby allowing myosin to bind to another actin molecule. Once attached, the ATP is hydrolyzed by myosin, which uses the released energy to move into the \"cocked position\" whereby it binds weakly to a part of the actin binding site. The remainder of the actin binding site is blocked by  tropomyosin . [ 26 ]  With the ATP hydrolyzed, the cocked myosin head now contains  adenosine diphosphate  (ADP) +  P i . Two  Ca 2+  ions bind to  troponin C  on the actin filaments. The troponin- Ca 2+  complex causes tropomyosin to slide over and unblock the remainder of the actin binding site. Unblocking the rest of the actin binding sites allows the two myosin heads to close and myosin to bind strongly to actin. [ 26 ]  The myosin head then releases the inorganic phosphate and initiates a  power stroke,  which generates a force of 2 pN. The power stroke moves the actin filament inwards, thereby shortening the  sarcomere . Myosin then releases ADP but still remains tightly bound to actin. At the end of the power stroke, ADP is released from the myosin head, leaving myosin attached to actin in a rigor state until another ATP binds to myosin. A lack of ATP would result in the rigor state characteristic of  rigor mortis . Once another ATP binds to myosin, the myosin head will again detach from actin and another cross-bridge cycle occurs."}
{"_id": "WikiPedia_Muscular_system$$$corpus_541", "text": "Cross-bridge cycling is able to continue as long as there are sufficient amounts of ATP and  Ca 2+  in the cytoplasm. [ 26 ]  Termination of cross-bridge cycling can occur when  Ca 2+  is  actively pumped  back into the sarcoplasmic reticulum. When  Ca 2+  is no longer present on the thin filament, the tropomyosin changes conformation back to its previous state so as to block the binding sites again. The myosin ceases binding to the thin filament, and the muscle relaxes. The  Ca 2+  ions leave the troponin molecule to maintain the  Ca 2+  ion concentration in the sarcoplasm. The active pumping of  Ca 2+  ions into the sarcoplasmic reticulum creates a deficiency in the fluid around the myofibrils. This causes the removal of  Ca 2+  ions from the troponin. Thus, the tropomyosin-troponin complex again covers the binding sites on the actin filaments and contraction ceases."}
{"_id": "WikiPedia_Muscular_system$$$corpus_542", "text": "The strength of skeletal muscle contractions can be broadly separated into  twitch , summation, and  tetanus . A twitch is a single contraction and relaxation cycle produced by an action potential within the muscle fiber itself. [ 27 ]  The time between a stimulus to the motor nerve and the subsequent contraction of the innervated muscle is called the  latent period , which usually takes about 10 ms and is caused by the time taken for nerve action potential to propagate, the time for chemical transmission at the neuromuscular junction, then the subsequent steps in excitation-contraction coupling. [ 28 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_543", "text": "If another muscle action potential were to be produced before the complete relaxation of a muscle twitch, then the next twitch will simply sum onto the previous twitch, thereby producing a  summation . [ 29 ]  Summation can be achieved in two ways: [ 30 ]   frequency summation  and  multiple fiber summation . In  frequency summation , the force exerted by the skeletal muscle is controlled by varying the frequency at which  action potentials  are sent to muscle fibers. Action potentials do not arrive at muscles synchronously, and, during a contraction, some fraction of the fibers in the muscle will be firing at any given time. In a typical circumstance, when humans are exerting their muscles as hard as they are consciously able, roughly one-third of the fibers in each of those muscles will fire at once [ citation needed ] , though this ratio can be affected by various physiological and psychological factors (including  Golgi tendon organs  and  Renshaw cells ). This 'low' level of contraction is a protective mechanism to prevent  avulsion  of the tendon\u2014the force generated by a 95% contraction of all fibers is sufficient to damage the body. In  multiple fiber summation , if the central nervous system sends a weak signal to contract a muscle, the smaller  motor units , being more excitable than the larger ones, are stimulated first. As the  strength of the signal  increases, more motor units are excited in addition to larger ones, with the largest motor units having as much as 50 times the contractile strength as the smaller ones. As more and larger motor units are activated, the force of muscle contraction becomes progressively stronger. A concept known as the size principle, allows for a gradation of muscle force during weak contraction to occur in small steps, which then become progressively larger when greater amounts of force are required."}
{"_id": "WikiPedia_Muscular_system$$$corpus_544", "text": "Finally, if the frequency of muscle action potentials increases such that the muscle contraction reaches its peak force and plateaus at this level, then the contraction is a  tetanus ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_545", "text": "Length-tension relationship relates the strength of an isometric contraction to the length of the muscle at which the contraction occurs. Muscles operate with greatest active tension when close to an ideal length (often their resting length). When stretched or shortened beyond this (whether due to the action of the muscle itself or by an outside force), the maximum active tension generated decreases. [ 31 ]  This decrease is minimal for small deviations, but the tension drops off rapidly as the length deviates further from the ideal. Due to the presence of elastic proteins within a muscle cell (such as  titin ) and extracellular matrix, as the muscle is stretched beyond a given length, there is an entirely passive tension, which opposes lengthening. Combined, there is a strong resistance to lengthening an active muscle far beyond the peak of active tension."}
{"_id": "WikiPedia_Muscular_system$$$corpus_546", "text": "Force\u2013velocity relationship relates the speed at which a muscle changes its length (usually regulated by external forces, such as load or other muscles) to the amount of force that it generates. Force declines in a hyperbolic fashion relative to the isometric force as the shortening velocity increases, eventually reaching zero at some maximum velocity. The reverse holds true for when the muscle is stretched \u2013 force increases above isometric maximum, until finally reaching an absolute maximum. This intrinsic property of active muscle tissue plays a role in the active damping of joints that are actuated by simultaneously active opposing muscles. In such cases, the force-velocity profile enhances the force produced by the lengthening muscle at the expense of the shortening muscle. This favoring of whichever muscle returns the joint to equilibrium effectively increases the damping of the joint. Moreover, the strength of the damping increases with muscle force. The motor system can thus actively control joint damping via the simultaneous contraction (co-contraction) of opposing muscle groups. [ 32 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_547", "text": "Smooth muscles  can be divided into two subgroups:  single-unit  and  multiunit . Single-unit smooth muscle cells can be found in the gut and blood vessels. Because these cells are linked together by gap junctions, they are able to contract as a functional  syncytium . Single-unit smooth muscle cells contract myogenically, which can be modulated by the autonomic nervous system."}
{"_id": "WikiPedia_Muscular_system$$$corpus_548", "text": "Unlike single-unit smooth muscle cells, multiunit smooth muscle cells are found in the muscle of the eye and in the base of hair follicles. Multiunit smooth muscle cells contract by being separately stimulated by nerves of the autonomic nervous system. As such, they allow for fine control and gradual responses, much like  motor unit recruitment  in skeletal muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_549", "text": "The contractile activity of smooth muscle cells can be tonic (sustained) or phasic (transient) [ 33 ]  and is influenced by multiple inputs such as spontaneous electrical activity, neural and hormonal inputs, local changes in chemical composition, and stretch. [ 1 ]  This is in contrast to the contractile activity of skeletal muscle cells, which relies on a single neural input. Some types of smooth muscle cells are able to generate their own action potentials spontaneously, which usually occur following a  pacemaker potential  or a  slow wave potential . These action potentials are generated by the influx of extracellular  Ca 2+ , and not  Na + . Like skeletal muscles, cytosolic  Ca 2+  ions are also required for crossbridge cycling in smooth muscle cells."}
{"_id": "WikiPedia_Muscular_system$$$corpus_550", "text": "The two sources for cytosolic  Ca 2+  in smooth muscle cells are the extracellular  Ca 2+  entering through calcium channels and the  Ca 2+  ions that are released from the sarcoplasmic reticulum. The elevation of cytosolic  Ca 2+  results in more  Ca 2+  binding to  calmodulin , which then binds and activates  myosin light-chain kinase . The calcium-calmodulin-myosin light-chain kinase complex phosphorylates myosin on the 20  kilodalton  (kDa) myosin light chains on amino acid residue-serine 19, enabling the molecular interaction of myosin and actin, and initiating contraction and activating the  myosin ATPase .  Unlike skeletal muscle cells, smooth muscle cells lack troponin, even though they contain the thin filament protein tropomyosin and other notable proteins \u2013 caldesmon and calponin.  Thus, smooth muscle contractions are initiated by the  Ca 2+ -activated phosphorylation of myosin rather than  Ca 2+  binding to the troponin complex that regulates myosin binding sites on actin like in skeletal and cardiac muscles."}
{"_id": "WikiPedia_Muscular_system$$$corpus_551", "text": "Termination of crossbridge cycling (and leaving the muscle in latch-state) occurs when myosin light chain phosphatase removes the phosphate groups from the myosin heads. Phosphorylation of the 20 kDa myosin light chains correlates well with the shortening velocity of smooth muscle. During this period, there is a rapid burst of energy use as measured by oxygen consumption. Within a few minutes of initiation, the calcium level markedly decreases, the 20 kDa myosin light chains' phosphorylation decreases, and energy use decreases; however, force in tonic smooth muscle is maintained. During contraction of muscle, rapidly cycling crossbridges form between activated actin and phosphorylated myosin, generating force. It is hypothesized that the maintenance of force results from dephosphorylated \"latch-bridges\" that slowly cycle and maintain force. A number of kinases such as  rho kinase ,  DAPK3 , and  protein kinase C  are believed to participate in the sustained phase of contraction, and  Ca 2+  flux may be significant."}
{"_id": "WikiPedia_Muscular_system$$$corpus_552", "text": "Although smooth muscle contractions are myogenic, the rate and strength of their contractions can be modulated by the  autonomic nervous system .  Postganglionic nerve fibers  of  parasympathetic nervous system  release the neurotransmitter acetylcholine, which binds to  muscarinic acetylcholine receptors  (mAChRs) on smooth muscle cells. These receptors are  metabotropic , or G-protein coupled receptors that initiate a second messenger cascade. Conversely, postganglionic nerve fibers of the  sympathetic nervous system  release the neurotransmitters epinephrine and norepinephrine, which bind to adrenergic receptors that are also metabotropic. The exact effects on the smooth muscle depend on the specific characteristics of the receptor activated\u2014both parasympathetic input and sympathetic input can be either excitatory (contractile) or inhibitory (relaxing)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_553", "text": "There are two types of  cardiac muscle  cells: autorhythmic and contractile. Autorhythmic cells do not contract, but instead set the pace of contraction for other cardiac muscle cells, which can be modulated by the autonomic nervous system. In contrast, contractile muscle cells (cardiomyocytes) constitute the majority of the heart muscle and are able to contract."}
{"_id": "WikiPedia_Muscular_system$$$corpus_554", "text": "In both skeletal and cardiac muscle excitation-contraction (E-C) coupling, depolarization conduction and Ca 2+  release processes occur. However, though the proteins involved are similar, they are distinct in structure and regulation. The  dihydropyridine receptors  (DHPRs) are encoded by different genes, and the  ryanodine receptors  (RyRs) are distinct isoforms. Besides, DHPR contacts with  RyR1  (main RyR isoform in skeletal muscle) to regulate Ca 2+  release in skeletal muscle, while the  L-type calcium channel  (DHPR on cardiac myocytes) and  RyR2  (main RyR isoform in cardiac muscle) are not physically coupled in cardiac muscle, but face with each other by a junctional coupling. [ 34 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_555", "text": "Unlike skeletal muscle, E-C coupling in cardiac muscle is thought to depend primarily on a mechanism called  calcium-induced calcium release , [ 35 ]  which is based on the junctional structure between T-tubule and sarcoplasmic reticulum.  Junctophilin-2  (JPH2) is essential to maintain this structure, as well as the integrity of  T-tubule . [ 36 ] [ 37 ] [ 38 ]  Another protein,  receptor accessory protein 5  (REEP5), functions to keep the normal morphology of junctional SR. [ 39 ]  Defects of junctional coupling can result from deficiencies of either of the two proteins.  During the process of calcium-induced calcium release, RyR2s are activated by a calcium trigger, which is brought about by the flow of Ca 2+  through the L-type calcium channels. After this, cardiac muscle tends to exhibit  diad  structures, rather than  triads ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_556", "text": "Excitation-contraction coupling in cardiac muscle cells occurs when an action potential is initiated by pacemaker cells in the  sinoatrial node  or  atrioventricular node  and conducted to all cells in the heart via  gap junctions . The action potential travels along the surface membrane into  T-tubules  (the latter are not seen in all cardiac cell types) and the depolarisation causes extracellular  Ca 2+  to enter the cell via L-type calcium channels and possibly  sodium-calcium exchanger  (NCX) during the early part of the  plateau phase . Although this Ca 2+  influx only count for about 10% of the Ca 2+  needed for activation, it is relatively larger than that of skeletal muscle. This  Ca 2+  influx causes a small local increase in intracellular  Ca 2+ . The increase of intracellular  Ca 2+  is detected by RyR2 in the membrane of the sarcoplasmic reticulum, which releases  Ca 2+  in a  positive feedback  physiological response. This positive feedback is known as  calcium-induced calcium release [ 35 ]  and gives rise to  calcium sparks  ( Ca 2+  sparks [ 40 ] ). The spatial and temporal summation of ~30,000  Ca 2+  sparks gives a cell-wide increase in cytoplasmic calcium concentration. [ 41 ]  The increase in cytosolic calcium following the flow of calcium through the cell membrane and sarcoplasmic reticulum is moderated by  calcium buffers , which bind a large proportion of intracellular calcium.  As a result, a large increase in total calcium leads to a relatively small rise in free  Ca 2+ . [ 42 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_557", "text": "The cytoplasmic calcium binds to Troponin C, moving the tropomyosin complex off the actin binding site allowing the myosin head to bind to the actin filament. From this point on, the contractile mechanism is essentially the same as for skeletal muscle (above). Briefly, using ATP hydrolysis, the myosin head pulls the actin filament toward the centre of the sarcomere."}
{"_id": "WikiPedia_Muscular_system$$$corpus_558", "text": "Following systole, intracellular calcium is taken up by the  sarco/endoplasmic reticulum ATPase  (SERCA) pump back into the sarcoplasmic reticulum ready for the next cycle to begin. Calcium is also ejected from the cell mainly by the  sodium-calcium exchanger  (NCX) and, to a lesser extent, a plasma membrane  calcium ATPase .  Some calcium is also taken up by the mitochondria. [ 43 ]  An enzyme,  phospholamban , serves as a brake for SERCA. At low heart rates, phospholamban is active and slows down the activity of the ATPase so that  Ca 2+  does not have to leave the cell entirely. At high heart rates, phospholamban is phosphorylated and deactivated thus taking most  Ca 2+  from the cytoplasm back into the sarcoplasmic reticulum.  Once again,  calcium buffers  moderate this fall in  Ca 2+ concentration, permitting a relatively small decrease in free  Ca 2+ concentration in response to a large change in total calcium. The falling  Ca 2+ concentration allows the troponin complex to dissociate from the actin filament thereby ending contraction.  The heart relaxes, allowing the ventricles to fill with blood and begin the cardiac cycle again."}
{"_id": "WikiPedia_Muscular_system$$$corpus_559", "text": "In  annelids  such as  earthworms  and  leeches , circular and longitudinal muscles cells form the body wall of these animals and are responsible for their movement. [ 44 ]  In an earthworm that is moving through a soil, for example, contractions of circular and longitudinal muscles occur reciprocally while the  coelomic fluid  serves as a  hydroskeleton  by maintaining turgidity of the earthworm. [ 45 ]  When the circular muscles in the anterior segments contract, the anterior portion of animal's body begins to constrict radially, which pushes the incompressible coelomic fluid forward and increasing the length of the animal. As a result, the front end of the animal moves forward. As the front end of the earthworm becomes anchored and the circular muscles in the anterior segments become relaxed, a wave of longitudinal muscle contractions passes backwards, which pulls the rest of animal's trailing body forward. [ 44 ] [ 45 ]  These alternating waves of circular and longitudinal contractions is called  peristalsis , which underlies the creeping movement of earthworms."}
{"_id": "WikiPedia_Muscular_system$$$corpus_560", "text": "Invertebrates such as annelids,  mollusks , and  nematodes , possess obliquely striated muscles, which contain bands of thick and thin filaments that are arranged helically rather than transversely, like in vertebrate skeletal or cardiac muscles. [ 46 ]  In  bivalves , the obliquely striated muscles can maintain tension over long periods without using too much energy. Bivalves use these muscles to keep their shells closed."}
{"_id": "WikiPedia_Muscular_system$$$corpus_561", "text": "Advanced insects such as  wasps ,  flies ,  bees , and  beetles  possess  asynchronous muscles  that constitute the flight muscles in these animals. [ 46 ]  These flight muscles are often called  fibrillar muscles  because they contain myofibrils that are thick and conspicuous. [ 47 ]  A remarkable feature of these muscles is that they do not require stimulation for each muscle contraction. Hence, they are called  asynchronous muscles  because the number of contractions in these muscles do not correspond (or synchronize) with the number of action potentials. For example, a wing muscle of a tethered fly may receive action potentials at a frequency of 3\u00a0Hz but it is able to beat at a frequency of 120\u00a0Hz. [ 46 ]  The high frequency beating is made possible because the muscles are connected to a  resonant  system, which is driven to a natural frequency of vibration."}
{"_id": "WikiPedia_Muscular_system$$$corpus_562", "text": "In 1780,  Luigi Galvani  discovered that the muscles of dead frogs' legs twitched when struck by an electrical spark. [ 49 ]  This was one of the first forays into the study of  bioelectricity , a field that still studies the electrical patterns and signals in tissues such as nerves and muscles."}
{"_id": "WikiPedia_Muscular_system$$$corpus_563", "text": "In 1952, the term excitation\u2013contraction coupling was coined to describe the physiological process of converting an electrical stimulus to a mechanical response. [ 50 ]  This process is fundamental to muscle physiology, whereby the electrical stimulus is usually an action potential and the mechanical response is contraction. Excitation\u2013contraction coupling can be dysregulated in many diseases. Though excitation\u2013contraction coupling has been known for over half a century, it is still an active area of biomedical research. The general scheme is that an action potential arrives to depolarize the cell membrane. By mechanisms specific to the muscle type, this depolarization results in an increase in cytosolic  calcium  that is called a calcium transient. This increase in calcium activates calcium-sensitive contractile proteins that then use  ATP  to cause cell shortening."}
{"_id": "WikiPedia_Muscular_system$$$corpus_564", "text": "The mechanism for muscle contraction evaded scientists for years and requires continued research and updating. [ 51 ]  The sliding filament theory was independently developed by  Andrew F. Huxley  and  Rolf Niedergerke  and by  Hugh Huxley  and  Jean Hanson . Their findings were published as two consecutive papers published in the 22 May 1954 issue of  Nature  under the common theme \"Structural Changes in Muscle During Contraction\". [ 23 ] [ 24 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_565", "text": "Muscle contractures  can occur for many reasons, such as  paralysis ,  muscular atrophy , and forms of  muscular dystrophy . Fundamentally, the muscle and its tendons shorten, resulting in reduced flexibility."}
{"_id": "WikiPedia_Muscular_system$$$corpus_566", "text": "Various interventions can slow, stop, or even reverse muscle contractures, ranging from physical therapy to surgery."}
{"_id": "WikiPedia_Muscular_system$$$corpus_567", "text": "Joints are usually immobilized in a shortened position resulting in changes within the joint  connective tissue , and the length of the muscle and associated tendon. Prolonged immobilization facilitates tissue proliferation which impinges on the joint space. [ 1 ]  Maintaining a shortened position for a prolonged period of time leads to: fibrous adhesion formation, loss of  sarcomeres , and a loss of tissue extensibility. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_568", "text": "For example, after a fracture when immobilization is done by casting the limb in plaster of paris, the muscle length shortens because the muscle is not used for a large span of time."}
{"_id": "WikiPedia_Muscular_system$$$corpus_569", "text": "A common cause for having the ankle lose its flexibility in this manner is from having sheets tucked in at the foot of the bed when sleeping. The weight of the sheets keep the feet plantarflexed all night. By not tucking the sheets in at the foot of the bed, or by sleeping with the feet hanging off the bed when in the prone position, is part of correcting this imbalance."}
{"_id": "WikiPedia_Muscular_system$$$corpus_570", "text": "Due to sensory issues, some  autistic  people prefer to  toe walk  instead of their feet making full contact with the ground. Chronic toe walking leads to muscle contracture due to the lack of calf muscles being adequately stretched. Once the muscle contracture has developed, the voluntary toe walking then becomes involuntary. [ 2 ]  If someone has a disability that causes spasticity (such as  cerebral palsy ), they may walk on their toes involuntarily."}
{"_id": "WikiPedia_Muscular_system$$$corpus_571", "text": "If  spasticity  is left untreated, contractures can occur. A loss of muscle tone inhibition ( hypertonia ) causes a muscle to become hyperactive resulting in constant contraction, which reduces an individual\u2019s control of the affected area.  The joint will remain in a flexed state producing similar effects as listed in immobilization."}
{"_id": "WikiPedia_Muscular_system$$$corpus_572", "text": "A muscle imbalance between an  agonist and antagonist muscle  can occur due to a neurological disorder, spinal cord injury, myopathy, and our lifestyle/postural habits. [ 1 ] [ 3 ]  One muscle may be normal while the other is atrophic or hypertrophic; alternately, one muscle may be hypertrophic while the other is atrophic. [ 3 ]  A decrease in muscle tone leads to continuous disuse and eventually muscular atrophy. The constant contraction of the agonist muscle with minimal resistance can result in a contracture. Selective muscle hypertrophy may exacerbate contractures and postural instability. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_573", "text": "For example, in the case of partial paralysis (i.e.  poliomyelitis ) the loss of strength and muscle control tend to be greater in some muscles than in others, leading to an imbalance between the various muscle groups around specific joints.  Case in point: when the muscles which dorsiflex (flex the foot upward) are less functional than the muscles which plantarflex (flex the foot downward) a contracture occurs, giving the foot a progressively downward angle and loss of flexibility."}
{"_id": "WikiPedia_Muscular_system$$$corpus_574", "text": "In the  metabolic myopathies  of  GSD-V  (McArdle disease) and  GSD-VII  (Tarui disease), temporary muscle contractures develop in response to impending muscle damage associated with the  ATP  (energy) deficiency. [ 4 ]  The muscle contracts and fails to relax again, becoming hard or stiff, the muscle may swell up, and although temporary, it is longer lasting and generally more painful than muscle cramps. [ 4 ] [ 5 ]  These contractures are different from cramps, because they are not elicited by the nerve, but by intrinsic mechanisms in the muscle itself and are silent on electromyography. [ 4 ]  This type of transient contracture has also been called pseudomyotonia. [ 6 ] [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_575", "text": "In GSD-V and GSD-VII, a cramp or contracture is managed by cessation of the causal activity until pain resolves; however, repeated episodes can accumulate muscle damage  (see below under fibrosis) . [ 4 ]  Unlike stretching of muscle cramps, stretching of a muscle in contracture should be avoided as it may cause further muscle damage by tearing muscle fibres (i.e. resist uncurling the fingers of a \"clawed\" hand). [ 4 ] [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_576", "text": "Some  congenital muscular dystrophies , such as  Bethlem myopathy ,  Ullrich congenital muscular dystrophy , Merosin-deficient congenital muscular dystrophy (MDC1A) or LAMA2-related CMD,  rigid spine syndrome  and LMNA-related congenital muscular dystrophy cause muscle contractures to develop. [ 8 ] [ 9 ]  In  Bethlem myopathy  and  Ullrich congenital muscular dystrophy , mutations in  collagen  VI and XII genes result in deficient or dysfunctional microfibrillar collagen in the extracellular matrix of muscle and other connective tissues. [ 8 ] [ 10 ]  The potential effects on muscle include progressive dystrophic changes, fibrosis and evidence for increased apoptosis. In Bethlem myopathy 1, contractures presenting in infancy may resolve by age 2 years, but reoccur as the disease progresses, typically by late of the first decade or early teens. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_577", "text": "Congenital myopathy  such as, core myopathies, nemaline myopathies and centronuclear myopathies and so forth can result in muscle contractures of the extremities and spine. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_578", "text": "Following trauma (such as fractures, crush injuries, burns and arterial injuries),  ischemia  (restriction of blood flow) leads to the death of muscle tissue ( necrosis ) and can cause contracture, such as  Volkmann's contracture . [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_579", "text": "Adhesions  bind two separate tissues or organs together with fibrotic scar tissue, joining muscle fibres to facia, ligaments, or joints.  Fibrosis  occurs within the same organ, the fibrotic scar tissue within skeletal muscle known as myofibrosis, limits muscle contractibility and stiffens muscles. [ 13 ] [ 14 ] [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_580", "text": "Muscle injury (such as a large burn or surgery) can cause muscle contractures as internal scar tissue (adhesions and fibrosis) develops. Repetitive muscle injuries (e.g.  sports injuries , major  muscle strains ) and micro-injuries (e.g.  overuse injuries , minor muscle strains) can also cause this. Adhesions and fibrosis are made of dense fibrous tissue, which are strong and supportive, helping to prevent the injury or micro-injury from reoccurring. However, the fibrotic scar tissue causes the muscle tissue to become stuck together which restricts movement, causing pain, weakness, and limited joint mobility. [ 15 ] [ 16 ] [ 17 ] [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_581", "text": "Typically performed by physical therapists, passive stretching is a more beneficial preventative measure and tool to maintain available  range of motion  (ROM) rather than used as a treatment. [ 19 ]  It is very important to continually move the limb throughout its full range at a specific velocity but a passive stretch can\u2019t be maintained for the period of time required for optimal benefit."}
{"_id": "WikiPedia_Muscular_system$$$corpus_582", "text": "A 2017 Cochrane review found that stretching does not provide any short-term pain relief. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_583", "text": "A contracture corrective device (CCD) is a dynamic splint that provides a continuous stretch with a continuous force and operates based on the principles of  creep . [ 1 ]  It is the most advantageous splint but more research is required. Splints are used in long term treatments and must be removed in order to stretch the antagonist muscle to maintain range of motion (passive stretching)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_584", "text": "Electrical stimulation  improves passive range of motion but only temporarily. [ 1 ]  Once the treatment is withdrawn, all benefits are reduced.  It can play a critical role in muscle  atrophy  prevention."}
{"_id": "WikiPedia_Muscular_system$$$corpus_585", "text": "Surgery is a solution to muscle shortening but other complications may arise. Following muscle lengthening surgery,  force  production and  ROM  is usually reduced due to the shift in sarcomere locations between a muscle's maximal and minimal length. [ 1 ]  In adjunct with surgery, refractory muscle contracture can also be treated with  Botulinum toxins  A and B; however, the effectiveness of the toxin is slowly lost over time, and most patients need a single treatment to correct muscle contracture over the first few weeks after surgery. [ 21 ]  Shortening of the surgically lengthened muscle can re-occur."}
{"_id": "WikiPedia_Muscular_system$$$corpus_586", "text": "A  muscle fascicle  is a bundle of  skeletal muscle fibers  surrounded by  perimysium , a type of  connective tissue . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_587", "text": "Muscle cells  are grouped into muscle fascicles by enveloping  perimysium   connective tissue . [ 1 ]  Fascicles are bundled together by  epimysium  connective tissue. [ 1 ]  Muscle fascicles typically only contain one type of muscle cell (either  type I fibres  or  type II fibres ), but can contain a mixture of both types. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_588", "text": "In the  heart , specialized  cardiac muscle cells  transmit  electrical impulses  from the  atrioventricular node  (AV node) to the  Purkinje fibers  \u2013 fascicles, also referred to as bundle branches. [ citation needed ]  These start as a single fascicle of fibers at the AV node called the  bundle of His  that then splits into three bundle branches: the right fascicular branch, left anterior fascicular branch, and left posterior fascicular branch."}
{"_id": "WikiPedia_Muscular_system$$$corpus_589", "text": "Myositis  may cause  thickening  of the muscle fascicles. [ 3 ]  This may be detected with  ultrasound scans . [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_590", "text": "Muscle fascicle structure is a useful diagnostic tool for  dermatomyositis . Myocytes towards the edges of the muscle fascicle are typically narrower, while those at the centre of the muscle fascicle are a normal thickness. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_591", "text": "Muscle fascicles may be involved in  myokymia , although commonly only individual myocytes are involved. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_592", "text": "Muscle hypertrophy  or  muscle building  involves a  hypertrophy  or increase in size of  skeletal muscle  through a growth in size of its component  cells . Two factors contribute to hypertrophy:  sarcoplasmic  hypertrophy, which focuses more on increased muscle  glycogen  storage; and  myofibrillar  hypertrophy, which focuses more on increased myofibril size. [ 1 ]  It is the primary focus of  bodybuilding -related activities."}
{"_id": "WikiPedia_Muscular_system$$$corpus_593", "text": "A range of stimuli can increase the volume of muscle cells. These changes occur as an adaptive response that serves to increase the ability to generate  force  or resist  fatigue  in anaerobic conditions."}
{"_id": "WikiPedia_Muscular_system$$$corpus_594", "text": "Strength training  (resistance training) causes neural and muscular adaptations which increase the capacity of an athlete to exert force through voluntary muscular contraction: After an initial period of neuro-muscular adaptation, the muscle tissue expands by creating  sarcomeres  (contractile elements) and increasing non-contractile elements like  sarcoplasmic  fluid. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_595", "text": "Muscular hypertrophy can be induced by  progressive overload  (a strategy of progressively increasing resistance or repetitions over successive bouts of exercise to maintain a high  level of effort ). [ 3 ]   However, the precise mechanisms are not clearly understood; the current accepted theory is through the combination of mechanical tension, metabolic stress, and muscle damage. Although, there is insufficient evidence to suggest that metabolic stress has any significant effect on hypertrophy outcomes. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_596", "text": "Muscular hypertrophy plays an important role in competitive  bodybuilding  and strength sports like  powerlifting , American football, and  Olympic weightlifting ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_597", "text": "The best approach to specifically achieve muscle growth remains controversial (as opposed to focusing on gaining strength, power, or endurance); it was generally considered that consistent anaerobic strength training will produce hypertrophy over the long term, in addition to its effects on muscular strength and endurance. Muscular hypertrophy can be increased through  strength training  and other short-duration, high-intensity  anaerobic exercises . Lower-intensity, longer-duration  aerobic exercise  generally does not result in very effective tissue hypertrophy; instead, endurance athletes enhance storage of fats and  carbohydrates  within the muscles, [ 5 ]  as well as  neovascularization . [ 6 ] [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_598", "text": "During a workout, increased blood flow to metabolically active areas causes muscles to temporarily increase in size. This phenomenon is referred to as transient hypertrophy, or more commonly known as being \"pumped up\" or getting \"a pump.\" [ 8 ]  About two hours after a workout and typically for seven to eleven days, muscles swell due to an inflammation response as tissue damage is repaired. [ 9 ]  Longer-term hypertrophy occurs due to more permanent changes in muscle structure."}
{"_id": "WikiPedia_Muscular_system$$$corpus_599", "text": "Hirono et al. explained the causes of Muscle swelling: [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_600", "text": "\"Muscle swelling occurs as a result of the following:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_601", "text": "(a) resistance exercise can increase  phosphocreatine  and  hydrogen ion  accumulations due to  blood lactate  and  growth hormone  production, and"}
{"_id": "WikiPedia_Muscular_system$$$corpus_602", "text": "(b) the high lactate and hydrogen ion concentrations may accelerate water uptake in muscle cells according to  cell permeability  because the molecular weights of the lactate and hydrogen ions are smaller than that of muscle glycogen.\""}
{"_id": "WikiPedia_Muscular_system$$$corpus_603", "text": "Biological factors (such as  DNA  and sex), nutrition, and training variables can affect muscle hypertrophy. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_604", "text": "Individual differences in genetics account for a substantial portion of the variance in existing muscle mass. A classical twin study design (similar to those of behavioral genetics) estimated that about 53% of the variance in lean body mass is heritable, [ 12 ]  along with about 45% of the variance in muscle fiber proportion. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_605", "text": "During puberty in males, hypertrophy occurs at an increased rate. Natural hypertrophy normally stops at full growth in the late teens. As  testosterone  is one of the body's major growth hormones, on average, males find hypertrophy much easier (on an absolute scale) to achieve than females, and, on average, have about 60% more muscle mass than women. [ 14 ]  Taking additional testosterone, as in  anabolic steroids , will increase results. It is also considered a  performance-enhancing drug , the use of which can cause competitors to be suspended or banned from competitions. Testosterone is also a medically regulated substance in most [ 15 ] [ 16 ]  countries, making it illegal to possess without a  medical prescription . Anabolic steroid use can cause  testicular atrophy , cardiac arrest, [ 17 ]  and  gynecomastia . [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_606", "text": "In the long term, a positive energy balance, when more calories are consumed rather than burned, is helpful for  anabolism  and therefore muscle hypertrophy. An increased requirement for protein can help elevate protein synthesis, which is seen in athletes training for muscle hypertrophy. However, there is no scientific consensus on whether strength-training athletes have increased protein requirements. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_607", "text": "Training variables, in the context of strength training, such as frequency, intensity, and total volume also directly affect the increase of muscle hypertrophy. A gradual increase in all of these training variables will yield muscular hypertrophy. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_608", "text": "The message filters down to alter the pattern of  gene expression . The additional contractile proteins appear to be incorporated into existing myofibrils (the chains of  sarcomeres  within a muscle cell). There appears to be some limit to how large a myofibril can become: at some point, they split. These events appear to occur within each muscle fiber. That is hypertrophy results primarily from the growth of each muscle cell rather than an increase in the number of cells.  Skeletal muscle  cells are however unique in the body in that they can contain multiple nuclei, and the number of nuclei can increase. [ 21 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_609", "text": "Cortisol  decreases amino acid uptake by muscle tissue, and inhibits protein synthesis. [ 22 ]  The short-term increase in protein synthesis that occurs subsequent to resistance training returns to normal after approximately 28 hours in adequately fed male youths. [ 23 ]  Another study determined that muscle protein synthesis was elevated even 72 hours following training. [ 24 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_610", "text": "A small study performed on young and elderly found that ingestion of 340 grams of lean beef (90\u00a0g protein) did not increase muscle protein synthesis any more than ingestion of 113 grams of lean beef (30\u00a0g protein). In both groups, muscle protein synthesis increased by 50%. The study concluded that more than 30\u00a0g protein in a single meal did not further enhance the stimulation of muscle protein synthesis in young and elderly. [ 25 ]  However, this study didn't check protein synthesis in relation to training; therefore conclusions from this research are controversial. A 2018 review of the scientific literature [ 26 ]  concluded that for the purpose of building lean muscle tissue, a minimum of 1.6 g protein per kilogram of body weight is required, which can for example be divided over 4 meals or snacks and spread out over the day. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_611", "text": "It is not uncommon for bodybuilders to advise a protein intake as high as 2\u20134\u00a0g per kilogram of bodyweight per day. [ 27 ]  However, scientific literature has suggested this is higher than necessary, as protein intakes greater than 1.8\u00a0g per kilogram of body weight showed to have no greater effect on muscle hypertrophy. [ 28 ]  A study carried out by American College of Sports Medicine (2002) put the recommended daily protein intake for athletes at 1.2\u20131.8\u00a0g per kilogram of body weight. [ 28 ] [ 29 ] [ 30 ]  Conversely,  Di Pasquale  (2008), citing recent studies, recommends a minimum protein intake of 2.2 g/kg \"for anyone involved in competitive or intense recreational sports who wants to maximize lean body mass but does not wish to gain weight. However athletes involved in strength events (..) may need even more to maximize body composition and athletic performance. In those attempting to minimize body fat and thus maximize body composition, for example in sports with weight classes and in bodybuilding, it's possible that protein may well make up over 50% of their daily caloric intake.\" [ 31 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_612", "text": "Microtrauma is tiny damage to the muscle fibers. The precise relation between microtrauma and muscle growth is not entirely understood yet. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_613", "text": "One theory is that microtrauma plays a significant role in muscle growth. [ 32 ] [ 33 ]  When microtrauma occurs (from weight training or other strenuous activities), the body responds by overcompensating, replacing the damaged tissue and adding more, so that the risk of repeat damage is reduced. Damage to these fibers has been theorized as the possible cause for the symptoms of  delayed onset muscle soreness  (DOMS), and is why progressive overload is essential to continued improvement, as the body adapts and becomes more resistant to stress."}
{"_id": "WikiPedia_Muscular_system$$$corpus_614", "text": "However, other work examining the time course of changes in muscle protein synthesis and their relationship to hypertrophy showed that damage was unrelated to hypertrophy. [ 34 ]  In fact, in one study [ 34 ]  the authors showed that it was not until the damage subsided that protein synthesis was directed to muscle growth."}
{"_id": "WikiPedia_Muscular_system$$$corpus_615", "text": "In the bodybuilding and fitness community and even in some academic books skeletal muscle hypertrophy is described as being in one of two types: Sarcoplasmic or myofibrillar. [ qualify evidence ]  According to this hypothesis, during sarcoplasmic hypertrophy, the volume of  sarcoplasmic  fluid in the muscle cell increases with no accompanying increase in muscular strength, whereas during myofibrillar hypertrophy,  actin  and  myosin  contractile proteins increase in number and add to muscular strength as well as a small increase in the size of the muscle. Sarcoplasmic hypertrophy is greater in the muscles of  bodybuilders  because studies suggest sarcoplasmic hypertrophy shows a greater increase in muscle size while myofibrillar hypertrophy proves to increase overall muscular strength making it more dominant in  Olympic weightlifters . [ 35 ]  These two forms of adaptations rarely occur completely independently of one another; one can experience a large increase in fluid with a slight increase in proteins, a large increase in proteins with a small increase in fluid, or a relatively balanced combination of the two."}
{"_id": "WikiPedia_Muscular_system$$$corpus_616", "text": "Examples of increased muscle hypertrophy are seen in various professional sports, mainly strength related sports such as  boxing ,  olympic weightlifting ,  mixed martial arts ,  rugby ,  professional wrestling  and various forms of gymnastics. Athletes in other more skill-based sports such as basketball, baseball,  ice hockey , and football may also train for increased muscle hypertrophy to better suit their position of play. For example, a  center (basketball)  may want to be bigger and more muscular to better overpower their opponents in the low post. [ 36 ]  Athletes training for these sports train extensively not only in  strength  but also in  cardiovascular  and  muscular endurance  training. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_617", "text": "Some neuromuscular diseases result in true hypertrophy of one or more skeletal muscles, confirmed by MRI or muscle biopsy. As this muscle hypertrophy is not the result of resistance training nor heavy manual labour, this is why the muscle hypertrophy is described as a  pseudoathletic appearance ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_618", "text": "As muscle hypertrophy is a response to strenuous anaerobic activity, ordinary everyday activity would become strenuous in diseases that result in premature  muscle fatigue  (neural or metabolic), or disrupt the  excitation-contraction  coupling in muscle, or cause repetitive or sustained involuntary muscle contractions ( fasciculations ,  myotonia , or  spasticity ). [ 37 ] [ 38 ]  In  lipodystrophy , an abnormal deficit of subcutaneous fat accentuates the appearance of the muscles, though the muscles are quantifiably hypertrophic (possibly due to a metabolic abnormality). [ 39 ] [ 40 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_619", "text": "Diseases that result in true muscle hypertrophy include, but not limited to, select: muscular dystrophies, metabolic myopathies, endocrine myopathies, congenital myopathies, non-dystrophic myotonias and pseudomyotonias, denervation, spasticity, and lipodystrophy. The muscle hypertrophy may persist throughout the course of the disease, or may later atrophy, or become pseudohypertrophic (muscle atrophy with infiltration of fat or other tissue). For instance, Duchenne and Becker muscular dystrophy may start as true muscle hypertrophy, but later develop into pseudohypertrophy. [ 41 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_620", "text": "Muscle memory  in  strength training  and  weight-lifting  is the effect that trained athletes experience a rapid return of  muscle mass  and strength after long periods of inactivity. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_621", "text": "The mechanisms implied for the muscle memory suggest that it is mainly related to strength training, and a 2016 study conducted at  Karolinska Institutet  in  Stockholm ,  Sweden  failed to find a memory effect of endurance training. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_622", "text": "Until recently such effects were attributed solely to  muscle memory  in  motor learning  occurring in the central nervous system. Long-term effects of previous training on the muscle fibers themselves, however, have recently also been observed related to  strength training . [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_623", "text": "Until recently it was generally assumed that the effects of exercise on muscle was reversible, and that after a long period of de-training the muscle fibers returned to their previous state. For strength training this view was challenged in 2010 by using  in vivo   imaging  techniques revealing specific long lasting structural changes in muscle fibers after a strength-training episode. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_624", "text": "The notion of a memory mechanism residing in  muscle fibers  might have implications for health related exercise advice, and for exclusion times after  doping offences . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_625", "text": "Muscle memory is probably related to the  cell nuclei  residing inside the muscle fibers. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_626", "text": "The  muscle cells  are the largest cells in the body with a volume thousands of times larger than most other body cells. [ 4 ]  To support this large volume, the muscle cells are one of the very few in the mammalian body that contain several cell nuclei. Such multinucleated cells are called  syncytia . Strength-training increases muscle mass and force mainly by changing the caliber of each fiber rather than increasing the number of fibers. During such fiber enlargement muscle  stem cells  in the muscle tissue multiply and fuse with pre-existing fibers as to support the larger cellular volume. It has often been assumed that each nucleus can support a certain volume of  cytoplasm , and hence that there is a constant volume domain served by each nucleus, although recent evidence suggests that this is an oversimplification. Until 2008 it was believed that during  muscle wasting , muscle cells lost nuclei by a nuclear self-destruct mechanism called  apoptosis , but observations using time lapse in vivo imaging in mice do not support this model. Direct observation indicated that no nuclei are lost under such conditions, [ 5 ]  and the  apoptosis  observed in the muscle tissue were demonstrated to occur only in other cell nuclei in the tissue, e.g.  connective tissue  and muscle stem cells called  satellite cells . Since in vivo imaging has confirmed that cell nuclei are added during strength training and not lost upon subsequent detraining, [ 3 ]  the nuclei might provide a mechanism for muscle memory. Thus, upon retraining the extra nuclei are already there and can rapidly start synthesizing new proteins to build muscle mass and strength."}
{"_id": "WikiPedia_Muscular_system$$$corpus_627", "text": "The extra muscle nuclei obtained by a strength training episode seems to be very long lasting, perhaps permanent, even in muscles that are inactive for a long time. [ 3 ]  The ability to recruit new nuclei is impaired in the elderly, [ 6 ]  so it might be beneficial to strength train before  senescence ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_628", "text": "Doping with  anabolic steroids  also seem to act partly by recruiting new nuclei. [ 7 ] [ 8 ]  It was recently shown in mice [ 9 ]  that a brief exposure to anabolic steroids recruited new muscle nuclei. When the steroids were withdrawn, the muscle rapidly shrank to normal size, but the extra nuclei remained. After a waiting period of 3 months (about 15% of the mouse lifespan), overload exercise led to a muscle growth of 36% within 6 days in the steroid-exposed group, while control muscles that had never been exposed to steroids grew only insignificantly. Since nuclei are long lasting structures in muscle, this suggests that anabolic steroids might have long lasting if not permanent effects on the ability to grow muscle mass. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_629", "text": "Recent evidence has pointed towards epigenetics as a plausible mechanism by which muscle may remember an initial bout of resistance/strength training. Indeed, via the retention of hypomethylated modifications to DNA, a recent study identified an enhanced morphological adaptation to a 7 week bout of resistance exercise, following an initial 7 week training phase and detraining phase. [ 11 ] [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_630", "text": "In  physiology , medicine, and  anatomy ,  muscle tone  ( residual muscle tension  or  tonus ) is the continuous and passive partial  contraction of the muscles , or the muscle's resistance to passive stretch during resting state. [ 1 ] [ 2 ]  It helps to maintain  posture  and declines during  REM sleep . [ 3 ]  Muscle tone is regulated by the activity of the  motor neurons  and can be affected by various factors, including age, disease, and nerve damage."}
{"_id": "WikiPedia_Muscular_system$$$corpus_631", "text": "If a sudden  pull  or stretch occurs, the body responds by automatically increasing the muscle's tension, a reflex which helps guard against danger as well as helping maintain  balance .  Such near-continuous  innervation  can be thought of as a \"default\" or \"steady state\" condition for muscles. Both the  extensor  and  flexor  muscles are involved in the maintenance of a constant tone while at rest. In skeletal muscles, this helps maintain a normal posture."}
{"_id": "WikiPedia_Muscular_system$$$corpus_632", "text": "Resting muscle tone varies along a  bell-shaped curve .  Low tone is perceived as \"lax, flabby, floppy, mushy, dead weight\" and high tone is perceived as \"tight, light, strong\".  Muscles with high tone are not necessarily strong and muscles with low tone are not necessarily weak.  In general, low tone does increase flexibility and decrease strength, and high tone does decrease flexibility and increase strength, but with many exceptions.  A person with low tone will most likely not be able to engage in \"explosive\" movement such as needed in a sprinter or high jumper.  These athletes usually have high tone that is within normal limits. A person with high tone will usually not be flexible in activities such as dance and yoga.  Joint laxity contributes greatly to flexibility, especially with flexibility in one or a few areas, instead of overall flexibility."}
{"_id": "WikiPedia_Muscular_system$$$corpus_633", "text": "For example, a person can be high tone with normal to poor flexibility in most areas, but be able to put the palms of the hands on the floor with straight knees due to hypermobile sacroiliac joints. [ citation needed ]  It is important to assess several areas before deciding if a person has high, low, or normal muscle tone.  A fairly reliable assessment item is how the person feels when picked up. [ citation needed ]   For example, small children with low tone can feel heavy while larger, high tone children feel light, which corresponds with the description of \"dead weight\". [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_634", "text": "Physical disorders can result in abnormally low ( hypotonia ) or high ( hypertonia ) muscle tone. [ 4 ]  Another form of hypertonia is  paratonia , which is associated with  dementia . [ 5 ]  Hypotonia is seen in lower motor neuron disease like  poliomyelitis . Hypotonia can present clinically as muscle  flaccidity , where the limbs appear floppy,  stretch reflex  responses are decreased, and the limb's resistance to passive movement is also decreased. [ 1 ]  Hypertonia is seen in upper motor neuron diseases like lesions in pyramidal tract and extrapyramidal tract. Hypertonia can present clinically as either  spasticity  or  rigidity . While  spasticity  is velocity-dependent resistance to passive stretch (e.g., passively moving an elbow quickly will elicit increased muscle tone, but passively moving elbow slowly may not elicit increased muscle tone),  rigidity  is velocity-independent resistance to passive stretch (i.e. there is uniform increased tone whether the elbow is passively moved quickly or slowly). [ 1 ] \n Spasticity  can be in the form of the  clasp-knife response , in which there is increased resistance only at the beginning or at the end of the movement. Rigidity can be of the leadpipe type, in which there is resistance throughout to passive movement, or it may be of cogwheel type, in which the resistance to passive movement is in a jerky manner."}
{"_id": "WikiPedia_Muscular_system$$$corpus_635", "text": "In  ophthalmology , tonus may be a central consideration in  eye surgery , as in the manipulation of  extraocular muscles  to repair  strabismus . Tonicity aberrations are associated with many diseases of the eye (e.g.  Adie syndrome ). [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_636", "text": "Normally, people are unaware of their muscle tone in their daily activities. The body maintains the balance between the tone of flexor and extensor muscle groups. Sometimes, in normal, healthy people, that tone is lost either in flexors or extensor muscle groups in isolation, temporarily and intermittently resulting in  muscle cramps . Treating these extensor or flexor group of muscles in isolation can be difficult. Generally,  muscle relaxants  or  quinine  can help with cramps and is warranted when they become troublesome. But these medication cause their relaxing effect in both groups by moderating their tone. The cause of disproportionate intermittent contractions of either flexors or extensors or the cause of cramps is unknown. The stimulus for muscle cramps may originate in the cerebral cortex, the spinal cord, or the muscle itself. This could indicate developing pathology or other problems in the future."}
{"_id": "WikiPedia_Muscular_system$$$corpus_637", "text": "In  human anatomy , the  muscles of the hip joint  are those  muscles  that cause movement in the  hip . Most modern anatomists define 17 of these muscles, although some additional muscles may sometimes be considered. These are often divided into four groups according to their orientation around the hip joint: the  gluteal group ; the  lateral rotator group ; the  adductor group ; and the  iliopsoas group ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_638", "text": "The muscles of the hip consist of four main groups"}
{"_id": "WikiPedia_Muscular_system$$$corpus_639", "text": "The gluteal muscles include the  gluteus maximus ,  gluteus medius ,  gluteus minimus , and  tensor fasciae latae . They cover the lateral surface of the  ilium . The gluteus maximus, which forms most of the muscle of the  buttocks , originates primarily on the ilium and  sacrum  and inserts on the  gluteal tuberosity  of the  femur  as well as the  iliotibial tract , a tract of strong  fibrous tissue  that runs along the lateral  thigh  to the  tibia  and  fibula . The gluteus medius and gluteus minimus originate anterior to the gluteus maximus on the ilium and both insert on the  greater trochanter  of the femur. The tensor fasciae latae shares its origin with the gluteus maximus at the ilium and also shares the insertion at the iliotibial tract."}
{"_id": "WikiPedia_Muscular_system$$$corpus_640", "text": "The  adductor brevis ,  adductor longus ,  adductor magnus ,  pectineus , and  gracilis  make up the adductor group. The adductors all originate on the  pubis  and insert on the medial, posterior surface of the femur, with the exception of the gracilis which inserts just below the  medial condyle  of the tibia."}
{"_id": "WikiPedia_Muscular_system$$$corpus_641", "text": "The  iliacus  and  psoas major  comprise the iliopsoas group. The psoas major is a large muscle that runs from the bodies and disc of the L1 to L5  vertebrae , joins with the iliacus via its  tendon , and connects to the  lesser trochanter  of the femur. The iliacus originates on the  iliac fossa  of the ilium. Together these muscles are commonly referred to as the \"iliopsoas\"."}
{"_id": "WikiPedia_Muscular_system$$$corpus_642", "text": "This group consists of the  externus  and  internus obturators , the  piriformis , the  superior  and  inferior gemelli , and the  quadratus femoris . These six originate at or below the  acetabulum  of the ilium and insert on or near the greater trochanter of the femur."}
{"_id": "WikiPedia_Muscular_system$$$corpus_643", "text": "Additional muscles, such as the  rectus femoris  and the  sartorius , can cause some movement in the hip joint. However these muscles primarily move the  knee , and are not generally classified as muscles of the hip."}
{"_id": "WikiPedia_Muscular_system$$$corpus_644", "text": "The  hamstring  muscles, which originate mostly from the  ischial tuberosity  inserting on the tibia/fibula, have a large  moment  assisting with hip extension."}
{"_id": "WikiPedia_Muscular_system$$$corpus_645", "text": "Movements of the hip occur because multiple muscles activate at once. Most muscles are also responsible for more than one type of movement."}
{"_id": "WikiPedia_Muscular_system$$$corpus_646", "text": "Movements of the hip are described in  anatomical terminology  using  anatomical terms of motion . The movement that brings the thighs close to the abdomen is called \"flexion\". When the legs open, such as in the  lotus posture  of  yoga , this is called \"lateral rotation\", with the opposite movement called \"medial rotation\". Hip  abduction  occurs when the femur moves outward to the side, as in taking the thighs apart. Hip  adduction  occurs when the femur moves back to the midline. Many muscles contribute to these movements:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_647", "text": "Hip muscles also play a role in maintaining the standing posture. These muscles work in an integrated system with muscles of the shoulder, neck, core, lower leg, and supporting muscles of the spine, to provide the ability to stand with good posture. [ 1 ]  These muscles include the  gluteus medius  and  gluteus minimus  which abduct the thigh, prevent swaying of hips, stabilize pelvic region while keeping hips level, and shift an individual's weight in order to adjust body placement to increase one's overall body stability. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_648", "text": "The  muscular lacuna  (Latin:  lacuna musculorum ) is the lateral compartment of the thigh beneath the  inguinal ligament . It is separated from the medial  vascular lacuna  by the  iliopectineal arch . It is occupied/traversed by the  iliopsoas muscle , and  femoral nerve . [ 1 ]  The  lateral cutaneous nerve of the thigh  may pass through the muscular lacuna, [ 2 ]  or it may pierce the inguinal ligament itself. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_649", "text": "This template is a  navigation box  relating to  anatomy  that provides links to related topics."}
{"_id": "WikiPedia_Muscular_system$$$corpus_650", "text": "When editing the links in this template:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_651", "text": "Help can be found at:  Template talk:Medicine navs  or by posting at  the talk page for WikiProject Anatomy ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_652", "text": "A full list can be found in the  {{ list of anatomy templates }} ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_653", "text": "Myogenesis  is the formation of  skeletal muscular tissue , particularly during  embryonic development ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_654", "text": "Muscle fibers  generally form through the fusion of  precursor   myoblasts  into  multinucleated  fibers called  myotubes . In the early development of an  embryo , myoblasts can either  proliferate , or  differentiate  into a myotube.  What controls this choice in vivo is generally unclear. If placed in cell culture, most myoblasts will proliferate if enough  fibroblast growth factor  (FGF) or another growth factor is present in the medium surrounding the cells. When the growth factor runs out, the myoblasts cease division and undergo terminal differentiation into myotubes.  Myoblast differentiation proceeds in stages.  The first stage involves cell cycle exit and the commencement of expression of certain genes."}
{"_id": "WikiPedia_Muscular_system$$$corpus_655", "text": "The second stage of differentiation involves the alignment of the myoblasts with one another. Studies have shown that even rat and chick myoblasts can recognise and align with one another, suggesting evolutionary conservation of the mechanisms involved. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_656", "text": "The third stage is the actual  cell fusion  itself. In this stage, the presence of  calcium  ions is critical. Fusion in humans is aided by a set of  metalloproteinases  coded for by the  ADAM12   gene , and a variety of other proteins. Fusion involves recruitment of  actin  to the  plasma membrane , followed by close apposition and creation of a pore that subsequently rapidly widens."}
{"_id": "WikiPedia_Muscular_system$$$corpus_657", "text": "Novel genes and their protein products that are expressed during the process are under active investigation in many laboratories.  They include:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_658", "text": "There are a number of stages (listed below) of muscle development, or myogenesis. [ 4 ]  Each stage has various associated genetic factors lack of which will result in muscular defects."}
{"_id": "WikiPedia_Muscular_system$$$corpus_659", "text": "Associated Genetic Factors:   PAX3  and  c-Met \nMutations in PAX3 can cause a failure in c-Met expression. Such a mutation would result in a lack of lateral migration."}
{"_id": "WikiPedia_Muscular_system$$$corpus_660", "text": "PAX3 mediates the transcription of c-Met and is responsible for the activation of MyoD expression\u2014one of the functions of MyoD is to promote the regenerative ability of  satellite cells  (described below). [ 4 ]  PAX3 is generally expressed at its highest levels during  embryonic development  and is expressed at a lesser degree during the fetal stages; it is expressed in migrating hypaxial cells and dermomyotome cells, but is not expressed at all during the development of  facial muscle . [ 4 ]  Mutations in Pax3 can cause a variety of complications including  Waardenburg syndrome  I and III as well as  craniofacial-deafness-hand syndrome . [ 4 ]  Waardenburg syndrome is most often associated with congenital disorders involving the intestinal tract and spine, an elevation of the scapula, among other symptoms. Each stage has various associated genetic factors without which will result in muscular defects. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_661", "text": "Associated Genetic Factors:   c-Met / HGF  and  LBX1 \nMutations in these genetic factors causes a lack of migration."}
{"_id": "WikiPedia_Muscular_system$$$corpus_662", "text": "LBX1 is responsible for the development and organization of muscles in the dorsal forelimb as well as the movement of dorsal muscles into the limb following  delamination . [ 4 ]  Without LBX1, limb muscles will fail to form properly; studies have shown that hindlimb muscles are severely affected by this deletion while only flexor muscles form in the forelimb muscles as a result of ventral muscle migration. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_663", "text": "c-Met is a  tyrosine kinase receptor  that is required for the survival and proliferation of migrating myoblasts. A lack of c-Met disrupts secondary myogenesis and\u2014as in LBX1\u2014prevents the formation of limb musculature. [ 4 ]  It is clear that c-Met plays an important role in delamination and proliferation in addition to migration. PAX3 is needed for the transcription of c-Met. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_664", "text": "Associated Genetic Factors:   PAX3 ,  c-Met ,  Mox2 ,  MSX1 , Six,  Myf5 , and  MyoD"}
{"_id": "WikiPedia_Muscular_system$$$corpus_665", "text": "Mox2 (also referred to as MEOX-2) plays an important role in the induction of  mesoderm  and  regional specification . [ 4 ]  Impairing the function of Mox2 will prevent the proliferation of  myogenic precursors  and will cause abnormal patterning of limb muscles. [ 5 ]  Specifically, studies have shown that hindlimbs are severely reduced in size while specific forelimb muscles will fail to form. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_666", "text": "Myf5 is required for proper myoblast proliferation. [ 4 ]  Studies have shown that mice muscle development in the intercostal and paraspinal regions can be delayed by inactivating Myf-5. [ 4 ]  Myf5 is considered to be the earliest expressed regulatory factor gene in myogenesis. If Myf-5 and MyoD are both inactivated, there will be a complete absence of skeletal muscle. [ 4 ]  These consequences further reveal the complexity of myogenesis and the importance of each genetic factor in proper muscle development."}
{"_id": "WikiPedia_Muscular_system$$$corpus_667", "text": "Associated Genetic Factors:   Myf5  and  MyoD \nOne of the most important stages in myogenesis determination requires both Myf5 and MyoD to function properly in order for myogenic cells to progress normally. Mutations in either associated genetic factor will cause the cells to adopt non-muscular phenotypes. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_668", "text": "As stated earlier, the combination of Myf5 and MyoD is crucial to the success of myogenesis. Both MyoD and Myf5 are members of the myogenic bHLH (basic helix-loop-helix) proteins transcription factor family. [ 6 ]  Cells that make myogenic  bHLH transcription factors  (including MyoD or Myf5) are committed to development as a muscle cell. [ 7 ]  Consequently, the simultaneous deletion of Myf5 and MyoD also results in a complete lack of  skeletal muscle  formation. [ 7 ]  Research has shown that MyoD directly activates its own gene; this means that the protein made binds the  myoD  gene and continues a cycle of MyoD protein production. [ 7 ]  Meanwhile, Myf5 expression is regulated by  Sonic hedgehog ,  Wnt1 , and MyoD itself. [ 4 ]  By noting the role of MyoD in regulating Myf5, the crucial interconnectedness of the two genetic factors becomes clear. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_669", "text": "Associated genetic factors:   Myogenin ,  Mcf2 , Six,  MyoD , and  Myf6 \nMutations in these associated genetic factors will prevent myocytes from advancing and maturing."}
{"_id": "WikiPedia_Muscular_system$$$corpus_670", "text": "Myogenin  (also known as Myf4) is required for the fusion of myogenic precursor cells to either new or previously existing fibers. [ 4 ]  In general, myogenin is associated with amplifying expression of genes that are already being expressed in the organism. Deleting myogenin results in nearly complete loss of differentiated muscle fibers and severe loss of skeletal muscle mass in the lateral/ventral body wall. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_671", "text": "Myf-6 (also known as  MRF4  or Herculin) is important to myotube differentiation and is specific to skeletal muscle. [ 4 ]  Mutations in Myf-6 can provoke disorders including  centronuclear myopathy  and  Becker muscular dystrophy . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_672", "text": "Associated genetic factors:   LBX1  and  Mox2 \nIn specific muscle formation, mutations in associated genetic factors begin to affect specific muscular regions. Because of its large responsibility in the movement of dorsal muscles into the limb following delamination, mutation or deletion of Lbx1 results in defects in extensor and hindlimb muscles. [ 4 ]  As stated in the Proliferation section, Mox2 deletion or mutation causes abnormal patterning of limb muscles. The consequences of this abnormal patterning include severe reduction in size of hindlimbs and complete absence of forelimb muscles. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_673", "text": "Associated genetic factors:   PAX7 \nMutations in Pax7 will prevent the formation of satellite cells and, in turn, prevent postnatal muscle growth. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_674", "text": "Satellite cells  are described as quiescent myoblasts and neighbor muscle fiber  sarcolemma . [ 4 ]  They are crucial for the repair of muscle, but have a very limited ability to replicate. Activated by stimuli such as injury or high mechanical load, satellite cells are required for  muscle regeneration  in adult organisms. [ 4 ]  In addition, satellite cells have the capability to also differentiate into bone or fat. In this way, satellite cells have an important role in not only muscle development, but in the maintenance of muscle through adulthood. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_675", "text": "During  embryogenesis , the  dermomyotome  and/or  myotome  in the  somites  contain the myogenic progenitor cells that will evolve into the prospective skeletal muscle. [ 8 ]   The determination of dermomyotome and myotome is regulated by a gene regulatory network that includes a member of the  T-box  family, tbx6, ripply1, and mesp-ba. [ 9 ]    Skeletal myogenesis depends on the strict regulation of various gene subsets in order to differentiate the myogenic progenitors into myofibers.  Basic helix-loop-helix (bHLH) transcription factors, MyoD, Myf5, myogenin, and MRF4 are critical to its formation. MyoD and Myf5 enable the differentiation of myogenic progenitors into myoblasts, followed by myogenin, which differentiates the myoblast into myotubes. [ 8 ]  MRF4 is important for blocking the transcription of muscle-specific promoters, enabling skeletal muscle progenitors to grow and proliferate before differentiating."}
{"_id": "WikiPedia_Muscular_system$$$corpus_676", "text": "There are a number of events that occur in order to propel the specification of muscle cells in the somite. For both the lateral and medial regions of the somite,  paracrine  factors induce myotome cells to produce MyoD protein\u2014thereby causing them to develop as muscle cells. [ 10 ]  A transcription factor ( TCF4 ) of connective tissue  fibroblasts  is involved in the regulation of myogenesis. Specifically, it regulates the type of muscle fiber developed and its maturations. [ 4 ]  Low levels of TCF4 promote both slow and fast myogenesis, overall promoting the maturation of muscle fiber type. Thereby this shows the close relationship of muscle with connective tissue during the embryonic development. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_677", "text": "Regulation of myogenic differentiation is controlled by two pathways: the  phosphatidylinositol 3-kinase /Akt pathway and the  Notch /Hes pathway, which work in a collaborative manner to suppress MyoD transcription. [ 6 ]  The O subfamily of the forkhead proteins ( FOXO ) play a critical role in regulation of myogenic differentiation as they stabilize Notch/Hes binding. Research has shown that knockout of FOXO1 in mice increases MyoD expression, altering the distribution of  fast-twitch  and slow-twitch fibers. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_678", "text": "Primary muscle fibers originate from  primary myoblasts  and tend to develop into slow muscle fibers. [ 4 ]  Secondary muscle fibers then form around the primary fibers near the time of innervation. These muscle fibers form from secondary myoblasts and usually develop as fast muscle fibers. Finally, the muscle fibers that form later arise from satellite cells. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_679", "text": "Two genes significant in muscle fusion are  Mef2  and the  twist transcription factor .  Studies have shown knockouts for Mef2C in mice lead to muscle defects in cardiac and smooth muscle development, particularly in fusion. [ 12 ]   The twist gene plays a role in muscle differentiation."}
{"_id": "WikiPedia_Muscular_system$$$corpus_680", "text": "The  SIX1  gene plays a critical role in  hypaxial muscle  differentiation in myogenesis. In mice lacking this gene, severe muscle  hypoplasia  affected most of the body muscles, specifically hypaxial muscles. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_681", "text": "In myoblasts, PtdIns5P, produced by the lipid phosphatase MTM1, is rapidly metabolized by PI5P 4-kinase \u03b1 into PI(4,5)P2, which accumulates at the plasma membrane. This accumulation facilitates the formation of podosome-like protrusions, where the fusogen Myomaker is localized, playing a crucial role in the spatiotemporal regulation of myoblast fusion. [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_682", "text": "There are 3 types of proteins produced during myogenesis. [ 5 ]   Class A proteins are the most abundant and are synthesized continuously throughout myogenesis.  Class B proteins are proteins that are initiated during myogenesis and continued throughout development.  Class C proteins are those synthesized at specific times during development.  Also 3 different forms of  actin  were identified during myogenesis."}
{"_id": "WikiPedia_Muscular_system$$$corpus_683", "text": "Sim2 , a  BHLH-Pas transcription factor , inhibits transcription by active repression and displays enhanced expression in ventral limb muscle masses during chick and mouse embryonic development.  It accomplishes this by repressing MyoD transcription by binding to the enhancer region, and prevents premature myogenesis. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_684", "text": "Delta1  expression in  neural crest cells  is necessary for muscle differentiation of the  somites , through the  Notch signaling pathway .  Gain and loss of this ligand in  neural crest cells  results in delayed or premature myogenesis. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_685", "text": "The significance of  alternative splicing  was elucidated using  microarrary analysis  of differentiating  C2C12  myoblasts. [ 17 ]  95 alternative splicing events occur during  C2C12  differentiation in myogenesis. Therefore,  alternative splicing  is necessary in myogenesis."}
{"_id": "WikiPedia_Muscular_system$$$corpus_686", "text": "Systems approach is a method used to study myogenesis, which manipulates a number of different techniques like  high-throughput screening  technologies, genome wide cell-based  assays , and  bioinformatics , to identify different factors of a system. [ 8 ]  This has been specifically used in the investigation of skeletal muscle development and the identification of its regulatory network."}
{"_id": "WikiPedia_Muscular_system$$$corpus_687", "text": "Systems approach  using  high-throughput sequencing  and  ChIP-chip  analysis has been essential in elucidating the targets of myogenic regulatory factors like MyoD and myogenin, their inter-related targets, and how MyoD acts to alter the epigenome in myoblasts and myotubes. [ 8 ]  This has also revealed the significance of PAX3 in myogenesis, and that it ensures the survival of myogenic progenitors. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_688", "text": "This approach, using cell based high-throughput transfection assay and whole-mount  in situ hybridization , was used in identifying the myogenetic regulator RP58, and the tendon differentiation gene, Mohawk homeobox. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_689", "text": "Myomeres  are blocks of skeletal muscle tissue arranged in sequence, commonly found in  aquatic   chordates . Myomeres are separated from adjacent myomeres by  connective   fascia  (myosepta) and most easily seen in  larval   fishes  or in the  olm . Myomere counts are sometimes used for identifying specimens, since their number corresponds to the number of vertebrae in the adults. Location varies, with some species containing these only near the tails, while some have them located near the scapular or pelvic girdles. Depending on the species, myomeres could be arranged in an epaxial or hypaxial manner. Hypaxial refers to ventral muscles and related structures while epaxial refers to more dorsal muscles. The horizontal septum divides these two regions in vertebrates from cyclostomes to gnathostomes. In  terrestrial chordates , the myomeres become fused as well as indistinct, due to the disappearance of myosepta."}
{"_id": "WikiPedia_Muscular_system$$$corpus_690", "text": "The shape of myomeres varies by species. Myomeres are commonly zig-zag, \"V\" (lancelets), \"W\" (fishes), or straight (tetrapods)\u2013 shaped muscle fibers. Generally, cyclostome myomeres are arranged in vertical strips while those of jawed fishes are folded in a complex matter due to swimming capability evolution. Specifically, myomeres of elasmobranchs and eels are W-shaped. Contrastingly, myomeres of tetrapods run vertically and do not display complex folding. Another species with simply-lain myomeres are mudpuppies. Myomeres overlap each other in succession, meaning myomere activation also allows neighboring myomeres to activate. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_691", "text": "Myomeres are made up of myoglobin-rich dark muscle as well as white muscle. Dark muscle, generally, functions as slow-twitch muscle fibers while white muscle is composed of fast-twitch fibers."}
{"_id": "WikiPedia_Muscular_system$$$corpus_692", "text": "Specifically, three types of myomeres in fish-like chordates include amphioxine (lancelet), cyclostomine (jawless fish), and gnathostomine (jawed fish). A common function shared by all of these is that they function to flex the body laterally into concavity to provide force for locomotion. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_693", "text": "Since myomeres are composed of multinucleated myofibers (contractile cells), force can be generated via muscle contraction that gets transmitted by the intricate connective tissue (myosepta) network."}
{"_id": "WikiPedia_Muscular_system$$$corpus_694", "text": "The folded shape of each myomere as V- or W-shaped extends over various axial segments, allowing fibers control over a large amount of the body. Specifically, myomeres are overlapping cones bound by connective tissue. Myomeres compose most of the lateral musculature and provide propulsive force to travel along the line of travel. In this sense, they cause flexion to either side in order to produce locomotor force. Myomeres attach to centra of vertebrae, and neural and haemal spines."}
{"_id": "WikiPedia_Muscular_system$$$corpus_695", "text": "Further, myomeres of fish are divided by a horizontal septum into dorsal (epaxial) and ventral (hypaxial) sections as mentioned in previous paragraphs. Further, spinal nerves pass into each myomere. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_696", "text": "There are different variations of myomere activation depending on the type of swimming or movement. For example, high loading situations such as fast-starts and turning require almost maximal myomere activation in teleost fish. Further, if swim speeds are lower and movement is in one plane, there is less activation of myomeres. Further, research has discovered that fish are able to spatially restrict axial myomeres during different swimming behaviors. [ 3 ] [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_697", "text": "Some research theorizes that myomeres play additional roles in for the fish beyond force generation for swimming. For example, this microdissection and polarized light microscopy research suggests that anterior myomeres have elongated and reinforced dorsal posterior cones that allow epaxial muscle force to be transmitted to the neurocranium for elevation during suction feeding."}
{"_id": "WikiPedia_Muscular_system$$$corpus_698", "text": "Published information on  Pikaia gracilens  (a well-known  Cambrian fossil ) explains evolution of swimming ability in chordates related to myomere shape and function. Specifically, myomeres in this species possessed minimal overlap between successive ones and myosepta dividing them were gently curved. In a biomechanical evaluation, it is presumed that  Pikaia  were not capable of rapid swimming like in living chordates. Several theories for this idea include lacking fast-twitch muscle fibers, ancestral muscle fiber types more like modern slow-twitch fibers, and less tension on myosepta due to less overlap between successive myomeres. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_699", "text": "Larval fish and  amphioxus  myomeres are V-shaped. They are involved in the specialized notochord of amphioxus. There are muscle cells within myomeres that send, and synapse cytoplasmic extensions of muscle cells with contractile fibrils to the nerve cord surface."}
{"_id": "WikiPedia_Muscular_system$$$corpus_700", "text": "In amphioxus, myomeres run longitudinally along the length of the body in a \"V\"-shape. As sequential contraction for swimming occurs, force from the myomeres is transmitted via connective tissues to the notochord."}
{"_id": "WikiPedia_Muscular_system$$$corpus_701", "text": "The tail-bending maneuver generated by myomeres in zebrafish requires innervation from motor neurons for both the hypaxial and epaxial muscle regions. It has been found that timing/intensity of neurons firing in these two regions varies, respectively. This process is mediated by a circuit that controls motor neuron activation during swimming behaviors, which, in turn, affects force generation. Similar to this idea, one study found that hypaxial and epaxial myomere activation did not always correlate with myomeric fibers closer to the horizontal septum itself. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_702", "text": "Myomeres run vertically and do not undergo folding like in bony fishes. Further, in higher order vertebrates, myomeres are fused and run longitudinally. Myosepta that divides myomeres are completely obsolete in amniotes."}
{"_id": "WikiPedia_Muscular_system$$$corpus_703", "text": "Myomeres also play a role in swimming in adult newts. Specifically, epaxial myomeres located opposite to each other at the same longitudinal site alternate rhythmic contraction. During stepping on the ground, the myomeres of the mid-trunk undergo bursts of contraction that are synchronized in contrast to double bursting patterns (in opposite directions) expressed in the anterior and posterior trunks. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_704", "text": "In salamanders, hypaxial muscles, myomeres, and myosepta run in a straight line mid-laterally to mid-ventrally. Specifically, the orientation of collagen fibers within these myomeres runs mediolateral. It is also theorized that, in salamanders, myosepta increase the amplification of strain of angled muscle fibers. This controls  how myomeres bulge during contraction in what is called the 'bulge control hypothesis'. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_705", "text": "Eel  myomeres are W-shaped and cover the entire body. Within these is a mucosal-like matrix that is a-cellular. Superficial to these myomeres is an epithelial layer."}
{"_id": "WikiPedia_Muscular_system$$$corpus_706", "text": "Salamanders in the genus  Necturus  (mudpuppies) are a salamander species with simply-lain myomeres, unlike the complex nature of bony fishes. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_707", "text": "The myomeres of some  Chondrichthyes , specifically sharks, are W-shaped. Thus, function in Chondrichthyes is similar to that of bony fish, where myomeres contribute to propulsive force for locomotion."}
{"_id": "WikiPedia_Muscular_system$$$corpus_708", "text": "Leptocephalus  myomeres are W-shaped and extend from head all the way to the tail. Distinguishing eels can be done through evaluation of the number of myomeres (European has 112-119 while American has 103\u201311)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_709", "text": "Myotoxins  are small, basic  peptides  found in  snake   venoms  (e.g.  rattlesnakes ) [ 2 ] [ 3 ]  and  lizard  venoms (e.g.  Mexican beaded lizard ). [ 4 ]  This involves a non-enzymatic mechanism that leads to severe  muscle   necrosis . These peptides act very quickly, causing instantaneous  paralysis  to prevent  prey  from escaping and eventually death due to  diaphragmatic  paralysis."}
{"_id": "WikiPedia_Muscular_system$$$corpus_710", "text": "The first myotoxin to be identified and isolated was  crotamine , from the venom of  Crotalus durissus terrificus , a tropical South American rattlesnake, by  Brazilian   scientist   Jos\u00e9 Moura Gon\u00e7alves , in the 1950s. Its biological actions,  molecular structure  and  gene  responsible for its synthesis were all elucidated in the last two decades."}
{"_id": "WikiPedia_Muscular_system$$$corpus_711", "text": "Neuromuscular-blocking drugs , or  Neuromuscular blocking agents  ( NMBAs ), block transmission at the  neuromuscular junction , [ 1 ]  causing  paralysis  of the affected  skeletal muscles . This is accomplished via their action on the post-synaptic acetylcholine (Nm) receptors."}
{"_id": "WikiPedia_Muscular_system$$$corpus_712", "text": "In clinical use, neuromuscular block is used adjunctively to  anesthesia  to produce  paralysis , firstly to paralyze the vocal cords, and permit  endotracheal intubation , [ 2 ]  and secondly to optimize the surgical field by inhibiting spontaneous ventilation, and causing relaxation of skeletal muscles.  Because the appropriate dose of neuromuscular-blocking drug may paralyze muscles required for breathing (i.e., the diaphragm),  mechanical ventilation  should be available to maintain adequate  respiration ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_713", "text": "This  class  of  medications  helps  to  reduce  patient  movement,  breathing,  or  ventilator  dyssynchrony  and  allows  lower  insufflation  pressures  during  laparoscopy. [ 3 ] [ 4 ]  It has several indications for use in the intense care unit.  It can help reduce hoarseness in voice as well as injury to the vocal cord during intubation. In addition, it plays an important role in facilitating  mechanical ventilation  in patients with poor lung function."}
{"_id": "WikiPedia_Muscular_system$$$corpus_714", "text": "Patients are still aware of pain even after full  conduction block  has occurred; hence,  general anesthetics  and/or  analgesics  must also be given to prevent  anesthesia awareness ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_715", "text": "Neuromuscular blocking drugs are often classified into two broad classes:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_716", "text": "It is also common to classify them based on their chemical structure."}
{"_id": "WikiPedia_Muscular_system$$$corpus_717", "text": "Suxamethonium  was synthesised by connecting two  acetylcholine   molecules  and has  the same number of heavy  atoms  between methonium heads as  decamethonium .  Just like acetylcholine, succinylcholine, decamethonium and other  polymethylene  chains, of the appropriate length and with two methonium, heads have small  trimethyl   onium  heads and flexible links. They all exhibit a depolarizing block."}
{"_id": "WikiPedia_Muscular_system$$$corpus_718", "text": "Pancuronium ,  vecuronium ,  rocuronium ,  rapacuronium ,  dacuronium ,  malou\u00e8tine ,  dihydrochandonium ,  dipyrandium ,  pipecuronium ,  chandonium  (HS-310),  HS-342  and other HS- compounds are aminosteroidal agents. They have in  common the  steroid  structural base, which provides a rigid and bulky body. Most of the agents in this category would also be classified as non-depolarizing."}
{"_id": "WikiPedia_Muscular_system$$$corpus_719", "text": "Compounds based on the  tetrahydroisoquinoline  moiety such as  atracurium ,  mivacurium , and  doxacurium  would fall in this category. They have a long and flexible chain between the  onium  heads, except for the double bond of  mivacurium .  D-tubocurarine  and  dimethyltubocurarine  are also in this category. Most of the agents in this category would be classified as non-depolarizing."}
{"_id": "WikiPedia_Muscular_system$$$corpus_720", "text": "Gallamine  is a trisquaternary ether with three ethonium heads attached to a  phenyl  ring through an ether linkage. Many other different structures have been used for their muscle relaxant effect such as  alcuronium  (alloferin),  anatruxonium ,  diadonium ,  fazadinium  (AH8165) and  tropeinium ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_721", "text": "In recent years much research has been devoted to new types of quaternary ammonium muscle relaxants. These are asymmetrical diester  isoquinolinium  compounds and bis-benzyltropinium compounds that are bistropinium salts of various  diacids .  These classes have been developed to create  muscle relaxants  that are faster and shorter acting. Both the asymmetric structure of diester isoquinolinium compounds and the acyloxylated benzyl groups on the bisbenzyltropiniums destabilizes them and can lead to spontaneous breakdown and therefore possibly a shorter duration of action. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_722", "text": "These drugs fall into two groups:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_723", "text": "A  neuromuscular non-depolarizing agent  is a form of  neuromuscular blocker  that does not depolarize the  motor end plate . [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_724", "text": "The quaternary ammonium muscle relaxants belong to this class. Quaternary ammonium muscle relaxants are  quaternary ammonium salts  used as  drugs  for  muscle relaxation , most commonly in  anesthesia . It is necessary to prevent spontaneous movement of muscle during  surgical operations . Muscle relaxants inhibit  neuron  transmission to muscle by blocking the  nicotinic acetylcholine receptor . What they have in common, and is necessary for their effect, is the structural presence of quaternary ammonium groups, usually two. Some of them are found in nature and others are  synthesized  molecules. [ 9 ] [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_725", "text": "Below are some more common agents that act as  competitive antagonists  against acetylcholine at the site of postsynaptic acetylcholine receptors."}
{"_id": "WikiPedia_Muscular_system$$$corpus_726", "text": "Tubocurarine , found in  curare  of the South American plant Pareira,  Chondrodendron tomentosum , is the prototypical non-depolarizing neuromuscular blocker. It has a slow onset (<5 min) and a long  duration of action  (30 mins). Side-effects include  hypotension , which is partially explained by its effect of increasing  histamine  release, a  vasodilator , [ 10 ]  as well as its effect of blocking  autonomic ganglia . [ 11 ]   It is excreted in the  urine ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_727", "text": "This drug needs to block about 70\u201380% of the ACh receptors for neuromuscular conduction to fail, and hence for effective blockade to occur. At this stage,  end-plate potentials  (EPPs) can still be detected, but are too small to reach the  threshold potential  needed for activation of muscle fiber contraction."}
{"_id": "WikiPedia_Muscular_system$$$corpus_728", "text": "The speed of onset depends on the potency of the drug, greater potency is associated with slower onset of block. Rocuronium, with an ED 95  of 0.3 mg/kg IV has a more rapid onset than Vecuronium with an ED 95  of 0.05mg/kg. [ 12 ]  Steroidal compounds, such as rocuronium and vecuronium, are intermediate-acting drugs while Pancuronium and  pipecuronium  are long-acting drugs. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_729", "text": "(no hypotension) [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_730", "text": "In larger clinical dose, some of the blocking agent can access the pore of the ion channel and cause blockage. This weakens neuromuscular transmission and diminishes the effect of  acetylcholinesterase inhibitors  (e.g.  neostigmine ). [ 14 ]  Nondepolarizing NBAs may also block prejunctional sodium channels which interfere with the mobilization of acetylcholine at the nerve ending. [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_731", "text": "A  depolarizing neuromuscular blocking agent  is a form of  neuromuscular blocker  that depolarizes the  motor end plate . [ 15 ]  An example is  succinylcholine . Depolarizing blocking agents work by depolarizing the plasma membrane of the muscle fiber, similar to  acetylcholine .  However, these agents are more resistant to degradation by  acetylcholinesterase , the enzyme responsible for degrading acetylcholine, and can thus more persistently depolarize the muscle fibers. This differs from acetylcholine, which is rapidly degraded and only transiently depolarizes the muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_732", "text": "There are two phases to the depolarizing block. During phase I ( depolarizing phase ), succinylcholine interacts with nicotinic receptor to open the channel and cause  depolarization  of the  end plate , which later spread to and result in depolarization of adjacent membranes. As a result, there is disorganisation of contraction of muscle motor unit. [ 14 ]  This causes muscular  fasciculations  (muscle twitches) while they are depolarizing the muscle fibers.  Eventually, after sufficient depolarization has occurred, phase II ( desensitizing phase ) sets in and the muscle is no longer responsive to acetylcholine released by the  motoneurons . [ 14 ]  At this point, full neuromuscular block has been achieved. Phase I block effect can be increased by  cholinesterase inhibitors  which further delay the action of metabolism and removal by cholinesterase. [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_733", "text": "Under continuous exposure to succinylcholine, the initial end plate depolarization is reduced, and repolarisation process is initiated. [ 14 ]  As a result of the widespread sustained depolarization the synapses ultimately begin  repolarization . Once repolarized, the membrane is still less susceptible to additional depolarization (phase II block). [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_734", "text": "The prototypical depolarizing blocking drug is  succinylcholine  (suxamethonium). It is the only such drug used clinically. It has a rapid onset (30 seconds) but very short duration of action (5\u201310 minutes) because of hydrolysis by various cholinesterases (such as  butyrylcholinesterase  in the blood). The patient will experience  fasciculation  due to the depolarisation of muscle neurone fibres and seconds later,  flaccid paralysis  will occur. [ 12 ]  Succinylcholine was originally known as diacetylcholine because structurally it is composed of two acetylcholine molecules joined with a methyl group.  Decamethonium  is sometimes, but rarely, used in clinical practice."}
{"_id": "WikiPedia_Muscular_system$$$corpus_735", "text": "It is indicated for rapid sequence intubation."}
{"_id": "WikiPedia_Muscular_system$$$corpus_736", "text": "IV dose 1-1.5mg/kg or 3 to 5 x ED 95"}
{"_id": "WikiPedia_Muscular_system$$$corpus_737", "text": "Paralysis occurs in one to two minutes."}
{"_id": "WikiPedia_Muscular_system$$$corpus_738", "text": "Clinical duration of action (time from drug administration to recovery of single twich to 25% of baseline) is 7-12 minutes."}
{"_id": "WikiPedia_Muscular_system$$$corpus_739", "text": "If IV access is unavailable, intramuscular administration 3-4mg/kg. Paralysis occurs at 4 minutes."}
{"_id": "WikiPedia_Muscular_system$$$corpus_740", "text": "Use of succinylcholine infusion or repeated  bolus administration  increase the risk of Phase II block and prolonged paralysis. Phase II block occurs after large doses (>4mg/kg). This occurs when the post-synaptic membrane action potential returns to baseline in spite of the presence of succinylcholine and causes continued activation of nicotinic acetylcholine receptors. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_741", "text": "The main difference is in the reversal of these two types of neuromuscular-blocking drugs."}
{"_id": "WikiPedia_Muscular_system$$$corpus_742", "text": "The  tetanic fade  is the failure of muscles to maintain a fused  tetany  at sufficiently high frequencies of electrical stimulation."}
{"_id": "WikiPedia_Muscular_system$$$corpus_743", "text": "This discrepancy is diagnostically useful in case of intoxication of an unknown neuromuscular-blocking drug. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_744", "text": "(fade)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_745", "text": "(not fade)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_746", "text": "Neuromuscular blocking agents exert their effect by modulating the signal transmission in skeletal muscles. An action potential is, in other words, a depolarisation in neurone membrane due to a change in membrane potential greater than the  threshold potential  leads to an electrical impulse generation. The electrical impulse travels along the pre-synaptic neurone axon to synapse with the muscle at the neuromuscular junction (NMJ) to cause muscle contraction. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_747", "text": "When the action potential reaches the axon terminal, it triggers the opening of the  calcium ion gated channels , which causes the influx of Ca 2+ . Ca 2+  will stimulate the release of neurotransmitter in the neurotransmitter containing vesicles by  exocytosis  (vesicle fuses with the pre-synpatic membrane). [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_748", "text": "The neurotransmitter, acetylcholine(ACh) binds to the nicotinic receptors on the motor end plate, which is a specialised area of the muscle fibre's post-synaptic membrane. This binding causes the nicotinic receptor channels to open and allow the influx of Na +  into the muscle fibre. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_749", "text": "Fifty percent of the released ACh is hydrolysed by acetylcholinesterase (AChE) and the remaining bind to the nicotinic receptors on the motor end plate. When ACh is degraded by AChE, the receptors are no longer stimulated and the muscle cannot be depolarized. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_750", "text": "If enough Na +  enter the muscle fibre, it causes an increase in the membrane potential from its  resting potential  of -95mV to -50mV (above the threshold potential -55mV) which causes an action potential to spread throughout the fibre. This potential travels along the surface of the  sarcolemma . The sarcolemma is an excitable membrane that surrounds the contractile structures known as  myofibrils  that are located deep in the muscle fibre. For the action potential to reach the myofibrils, the action potential travels along the  transverse tubules  (T-tubules) that connects the sarcolemma and center of the fibre. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_751", "text": "Later, action potential reaches the  sarcoplasmic reticulum  which stores the Ca 2+   needed for muscle contraction and causes Ca 2+  to be released from the sarcoplasmic reticulum. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_752", "text": "Quaternary muscle relaxants bind to the  nicotinic acetylcholine receptor  and inhibit or interfere with the binding and effect of  ACh  to the  receptor . Each  ACh-receptor  has two receptive sites and activation of the receptor requires binding to both of them. Each receptor site is located at one of the two \u03b1-subunits of the receptor. Each receptive site has two subsites, an  anionic  site that binds to the  cationic   ammonium  head and a site that binds to the blocking agent by donating a  hydrogen bond . [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_753", "text": "Non-depolarizing agents \nA decrease in binding of acetylcholine leads to a decrease in its effect and  neuron  transmission to the  muscle  is less likely to occur. It is generally accepted that non-depolarizing agents block by acting as reversible competitive  inhibitors . That is, they bind to the receptor as  antagonists  and that leaves fewer receptors available for acetylcholine to bind. [ 5 ] [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_754", "text": "Depolarizing agents \n Depolarizing  agents produce their block by binding to and activating the ACh receptor, at first causing muscle contraction, then paralysis. They bind to the receptor and cause depolarization by opening channels just like acetylcholine does. This causes repetitive excitation that lasts longer than a normal acetylcholine excitation and is most likely explained by the resistance of depolarizing agents to the  enzyme   acetylcholinesterase . The constant depolarization and triggering of the receptors keeps the endplate resistant to activation by acetylcholine. Therefore, a normal neuron transmission to muscle cannot cause contraction of the muscle because the endplate is depolarized and thereby the muscle paralysed. [ 5 ] [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_755", "text": "Binding to the  nicotinic receptor   \nShorter molecules like acetylcholine need two molecules to activate the receptor, one at each receptive site. Decamethonium congeners, which prefer straight line conformations (their lowest energy state), usually span the two receptive sites with one molecule (binding inter-site). Longer congeners must bend when fitting receptive sites."}
{"_id": "WikiPedia_Muscular_system$$$corpus_756", "text": "The greater energy a molecule needs to bend and fit usually results in lower potency. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_757", "text": "Conformational study on  neuromuscular blocking drugs  is relatively new and developing. Traditional  SAR  studies do not specify environmental factors on molecules.  Computer -based conformational searches assume that the molecules are  in vacuo , which is not the case  in vivo . Solvation models take into account the effect of a solvent on the conformation of the molecule. However, no system of solvation can mimic the effect of the complex fluid composition of the body. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_758", "text": "The division of  muscle relaxants  to rigid and non-rigid is at most qualitative. The  energy  required for conformational changes may give a more precise and quantitative picture. Energy required for reducing  onium  head distance in the longer muscle relaxant chains may quantify their ability to bend and fit its receptive sites. [ 19 ]  Using computers it is possible to calculate the lowest energy state conformer and thus most populated and best representing the molecule. This state is referred to as the global minimum. The global minimum for some simple molecules can be discovered quite easily with certainty. Such as for  decamethonium  the straight line conformer is clearly the lowest energy state. Some molecules, on the other hand, have many rotatable bonds and their global minimum can only be approximated. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_759", "text": "Neuromuscular blocking agents need to fit in a space close to 2 nanometres, which resembles the molecular length of decamethonium. [ 19 ]  Some molecules of decamethonium congeners may bind only to one receptive site. Flexible molecules have a greater chance of fitting receptive sites. However, the most populated conformation may not be the best-fitted one. Very flexible molecules are, in fact, weak neuromuscular inhibitors with flat dose-response curves. On the other hand, stiff or rigid molecules tend to fit well or not at all. If the lowest-energy conformation fits, the compound has high potency because there is a great concentration of molecules close to the lowest-energy conformation. Molecules can be thin but yet rigid. [ 20 ]  Decamethonium for example needs relatively high energy to change the  N - N  distance. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_760", "text": "In general, molecular rigidity contributes to potency, while size affects whether a muscle relaxant shows a  polarizing  or a  depolarizing  effect. [ 6 ]   Cations  must be able to flow through the trans-membrane tube of the  ion-channel  to depolarize the endplate. [ 20 ]  Small molecules may be rigid and potent but unable to occupy or block the area between the receptive sites. [ 6 ]  Large molecules, on the other hand, may bind to both receptive sites and hinder depolarizing cations independent of whether the ion-channel is open or closed below. Having a  lipophilic  surface pointed towards the synapse enhances this effect by repelling cations. The importance of this effect varies between different muscle relaxants and classifying depolarizing from non-depolarizing blocks is a complex issue. The onium heads are usually kept small and the chains connecting the heads usually keep the N-N distance at 10 N or O atoms. Keeping the distance in mind the structure of the chain can vary (double bonded, cyclohexyl, benzyl, etc.) [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_761", "text": "Succinylcholine  has a 10- atom  distance between its  N  atoms, like decamethonium. Yet it has been reported that it takes two molecules, as with acetylcholine, to open one  nicotinic ion channel . The conformational explanation for this is that each  acetylcholine  moiety of succinylcholine prefers the  gauche  (bent, cis) state. The attraction between the N and  O  atoms is greater than the onium head repulsion. In this most populated state, the N-N distance is shorter than the optimal distance of  ten carbon atoms and too short to occupy both receptive sites. This similarity between succinyl- and acetyl-choline also explains its acetylcholine-like side-effects. [ 20 ] \nComparing molecular lengths, the pachycurares  dimethyltubocurarine  and d-tubocurarine both are very rigid and measure close to 1.8\u00a0nm in total length.  Pancuronium  and  vecuronium  measure 1.9\u00a0nm, whereas  pipecuronium  is 2.1\u00a0nm. The potency of these compounds follows the same rank of order as their length. Likewise, the leptocurares prefer a similar length. Decamethonium, which measures 2\u00a0nm, is the most potent in its category, whereas C11 is slightly too long.  Gallamine  despite having low bulk and rigidity is the most potent in its class, and it measures 1.9\u00a0nm. [ 6 ] [ 19 ]  Based on this information one can conclude that the optimum length for neuromuscular blocking agents, depolarizing or not, should be 2 to 2.1\u00a0nm. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_762", "text": "The CAR for long-chain bisquaternary tetrahydroisoquinolines like atracurium, cisatracurium, mivacurium, and doxacurium is hard to determine because of their bulky onium heads and large number of rotatable  bonds  and  groups . These agents must follow the same  receptive  topology as others, which means that they do not fit between the receptive sites without bending. [ 19 ]   Mivacurium  for example has a molecular length of 3.6\u00a0nm when stretched out, far from the 2 to 2.1\u00a0nm optimum. Mivacurium, atracurium, and  doxacurium  have greater N-N distance and molecular length than d-tubocurarine even when bent. To make them fit, they have flexible connections that give their onium heads a chance to position themselves beneficially. This bent N-N scenario probably does not apply to  laudexium  and  decamethylene bisatropium , which prefer a straight conformation. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_763", "text": "It has been concluded that acetylcholine and related compounds must be in the  gauche  (bent) configuration when bound to the nicotinic receptor. [ 21 ]  Beers and Reich's studies on cholinergic receptors in 1970 showed a relationship affecting whether a compound was  muscarinic  or  nicotinic . They showed that the distance from the centre of the quaternary N atom to the  van der Waals  extension of the respective O atom (or an equivalent H-bond acceptor) is a determining factor. If the distance is 0.44\u00a0nm, the compound shows muscarinic properties\u2014and if the distance is 0.59\u00a0nm, nicotinic properties dominate. [ 22 ] )"}
{"_id": "WikiPedia_Muscular_system$$$corpus_764", "text": "Pancuronium remains one of the few muscle relaxants logically and rationally designed from structure-action / effects relationship data. A  steroid  skeleton was chosen because of its appropriate size and rigidness. Acetylcholine moieties were inserted to increase receptor affinity. Although having many unwanted side-effects, a slow onset of action and recovery rate it was a big success and at the time the most potent  neuromuscular drug  available. Pancuronium and some other neuromuscular blocking agents block  M2-receptors  and therefore affect the  vagus nerve , leading to  hypotension  and  tachycardia . This muscarinic blocking effect is related to the acetylcholine moiety on the A ring on pancuronium. Making the N atom on the A ring tertiary, the ring loses its acetylcholine moiety, and the resulting compound, vecuronium, has nearly 100 times less affinity to muscarin receptors while maintaining its nicotinic affinity and a similar duration of action. Vecuronium is, therefore, free from cardiovascular effects. [ 5 ]  The D ring shows excellent properties validating Beers and Reich's rule with great precision. As a result, vecuronium has the greatest potency and specificity of all mono-quaternary compounds. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_765", "text": "Two functional groups contribute significantly to  aminosteroidal  neuromuscular blocking potency, it is presumed to enable them to bind the receptor at two points. A bis-quaternary two point arrangement on A and D-ring (binding inter-site) or a D-ring acetylcholine moiety (binding at two points intra-site) are most likely to succeed. A third group can have variable effects. [ 20 ]  The quaternary and acetyl groups on the A and D ring of pipecuronium prevent it from binding intra-site (binding to two points at the same site). Instead, it must bind as bis-quaternary (inter-site). [ 6 ]  These structures are very dissimilar from acetylcholine and free pipecuronium from nicotinic or muscarinic side-effects linked to acetylcholine moiety. Also, they protect the molecule from hydrolysis by cholinesterases, which explain its nature of kidney excretion. The four  methyl-groups  on the quaternary N atoms make it less lipophilic than most aminosteroids. This also affects pipecuroniums metabolism by resisting hepatic uptake, metabolism, and  biliary  excretion. The length of the molecule (2.1\u00a0nm, close to ideal) and its rigidness make pipecuronium the most potent and clean one-bulk bis-quaternary. Even though the N-N distance (1.6\u00a0nm) is far away from what is considered ideal, its onium heads are well-exposed, and the quaternary groups help to bring together the onium heads to the anionic centers of the receptors without chirality issues. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_766", "text": "Adding more than two onium heads in general does not add to potency. Though the third onium head in gallamine seems to help position the two outside heads near the optimum molecular length, it can interfere unfavorably and gallamine turns out to be a weak muscle relaxant, like all multi-quaternary compounds.\nConsidering acetylcholine a quaternizing group larger than methyl and an acyl group larger than acetyl would reduce the molecule's potency. The charged N and the  carbonyl  O atoms are distanced from structures they bind to on receptive sites and, thus, decrease potency. The carbonyl O in vecuronium for example is thrust outward to appose the  H-bond  donor of the receptive site. This also helps explain why gallamine, rocuronium, and rapacuronium are of relatively low potency. [ 20 ] \nIn general, methyl quaternization is optimal for potency but, opposing this rule, the trimethyl derivatives of gallamine are of lower potency than gallamine. The reason for this is that gallamine has a suboptimal N-N distance. Substituting the ethyl groups with methyl groups would make the molecular length also shorter than optimal.  Methoxylation  of tetrahydroisoquinolinium agents seems to improve their potency. How methoxylation improves potency is still unclear. \n Histamine  release is a common attribute of benzylisoquinolinium muscle relaxants. This problem generally decreases with increased potency and smaller doses. The need for larger doses increases the degree of this side-effect. Conformational or structural explanations for histamine release are not clear. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_767", "text": "Metabolism and Hofmann elimination"}
{"_id": "WikiPedia_Muscular_system$$$corpus_768", "text": "Deacetylating   vecuronium  at position 3 results in a very active metabolite. [ 23 ]   In the case of  rapacuronium  the 3- deacylated   metabolite  is even more potent than rapacuronium. As long as the D-ring  acetylcholine  moiety is unchanged they retain their muscle relaxing effect.  Mono -quaternary   aminosteroids  produced with  deacylation  in position 17 on the other hand are generally weak muscle relaxants. [ 20 ]  In the development of  atracurium  the main idea was to make use of  Hofmann elimination  of the muscle relaxant  in vivo . When working with bisbenzyl-isoquinolinium types of molecules, inserting proper features into the molecule such as an appropriate  electron  withdrawing group then  Hofmann elimination  should occur at conditions  in vivo . Atracurium, the resulting  molecule , breaks down spontaneously in the body to inactive  compounds  and being especially useful in patients with  kidney  or  liver  failure.  Cis -atracurium  is very similar to atracurium except it is more potent and has a weaker tendency to cause  histamine  release. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_769", "text": "Structure relations to onset time"}
{"_id": "WikiPedia_Muscular_system$$$corpus_770", "text": "The effect of structure on the  onset of action  is not very well known except that the time of onset appears inversely related to potency. [ 24 ]  In general  mono -quaternary aminosteroids are faster than  bis -quaternary  compounds, which means they are also of lower potency. A possible explanation for this effect is that drug delivery and receptor binding are of a different timescale. Weaker muscle relaxants are given in larger doses so more molecules in the  central compartment  must diffuse into the  effect compartment , which is the space within the mouth of the receptor, of the body. After delivery to the effect compartment then all  molecules  act quickly. [ 25 ]  Therapeutically this relationship is very inconvenient because low potency, often meaning low specificity can decrease the safety margin thus increasing the chances of  side-effects . In addition, even though low potency usually accelerates  onset of action , it does not guaranty a fast onset.  Gallamine , for example, is weak and slow. When fast onset is necessary then  succinylcholine  or  rocuronium  are usually preferable. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_771", "text": "Elimination"}
{"_id": "WikiPedia_Muscular_system$$$corpus_772", "text": "Muscle relaxants  can have very different  metabolic pathways  and it is important that the drug does not accumulate if certain elimination pathways are not active, for example in  kidney  failure."}
{"_id": "WikiPedia_Muscular_system$$$corpus_773", "text": "Administration of neuromuscular blocking agents (NMBA) during  anesthesia  can facilitate  endotracheal intubation . [ 12 ]  This can decrease the incidence of postintubation hoarseness and airway injury. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_774", "text": "Short-acting neuromuscular blocking agents are chosen for endotracheal intubation for short procedures (< 30minutes), and neuromonitoring is required soon after intubation. [ 12 ]  Options include  succinylcholine , rocuronium or vecuronium if  sugammadex  is available for rapid reversal block. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_775", "text": "Any short or intermediate acting neuromuscular blocking agents can be applied for endotracheal intubation for long procedures (\u2265 30 minutes). [ 12 ]  Options include succinylcholine, rocuronium, vecuronium,  mivacurium , atracurium and  cisatracurium . [ 12 ]  The choice among these NMBA depends on availability, cost and patient parameters that affect  drug metabolism ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_776", "text": "Intraoperative relaxation can be maintained as necessary with additional dose of nondepolarizing NMBA. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_777", "text": "Among all NMBA, Succinylcholine establish the most stable and fastest intubating conditions, thus is considered as the preferred NMBA for rapid sequence induction and intubation (RSII). [ 12 ]  Alternatives for succinylcholine for RSII include high dose rocuronium (1.2mg/kg which is a 4 X ED95 dose), or avoidance of NMBAs with a high dose  remifentanil  intubation. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_778", "text": "Nondepolarizing NMBAs can be used to induce muscle relaxation that improves surgical conditions, including  laparoscopic ,  robotic ,  abdominal  and  thoracic  procedures. [ 12 ]  It can reduce patient movement, muscle tone, breathing or coughing against ventilator and allow lower  insufflation  pressure during laparoscopy. [ 12 ]  Administration of NMBAs should be individualized according to patient\u2019s parameters. However, many operations can be performed without the need to apply any NMBAs as adequate anesthesia during surgery can achieve many of the theoretical benefits of neuromuscular blockage. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_779", "text": "Since these drugs may cause  paralysis  of the  diaphragm , mechanical ventilation should be at hand to provide respiration."}
{"_id": "WikiPedia_Muscular_system$$$corpus_780", "text": "In addition, these drugs may exhibit  cardiovascular  effects, since they are not fully selective for the  nicotinic receptor  and hence may have effects on  muscarinic receptors . [ 11 ]   If nicotinic receptors of the  autonomic ganglia  or  adrenal medulla  are blocked, these drugs may cause autonomic symptoms.  Also, neuromuscular blockers may facilitate  histamine  release, which causes hypotension,  flushing , and tachycardia."}
{"_id": "WikiPedia_Muscular_system$$$corpus_781", "text": "Succinylcholine may also trigger  malignant hyperthermia  in rare cases in patients who may be susceptible."}
{"_id": "WikiPedia_Muscular_system$$$corpus_782", "text": "In depolarizing the musculature, suxamethonium may trigger a transient release of large amounts of  potassium  from muscle fibers.  This puts the patient at risk for life-threatening complications, such as  hyperkalemia  and  cardiac arrhythmias . Other effects include  myalgia , increased intragastric pressure, increased intraocular pressure, increased intracranial pressure,  cardiac dysrhythmias  ( bradycardia  is the most common type) and  allergic reactions . [ 12 ]  As a result, it is contraindicated for patients with susceptibility to malignant hyperthermia,  denervating conditions , major burns after 48 hours, and severe hyperkalemia."}
{"_id": "WikiPedia_Muscular_system$$$corpus_783", "text": "For nondepolarizing NMBAs except vecuronium, pipecuronium, doxacurium, cisatracurium, rocuronium and rapacuronium, they produce certain extent of cardiovascular effect. [ 14 ]  Moreover, Tubocurarine can produce  hypotension  effect while Pancuronium can lead to moderate increase in heart rate and small increase in cardiac output with little or no increase in  systemic vascular resistance , which is unique in nondeploarizing NMBAs. [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_784", "text": "Certain drugs such as  aminoglycoside  antibiotics and  polymyxin  and some  fluoroquinolones  also have neuromuscular blocking action as their side-effect. [ 26 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_785", "text": "Some drugs enhance or inhibit the response to NMBAs which require the dosage adjustment guided by monitoring."}
{"_id": "WikiPedia_Muscular_system$$$corpus_786", "text": "In some clinical circumstances,  succinylcholine  may be administered before and after a nondepolarising NMBA or two different nondepolarising NMBAs are administered in sequence. [ 12 ]  Combining different NMBAs can result in different degrees of neuromuscular block and management should be guided with the use of a  neuromuscular function monitor ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_787", "text": "The administration of nondepolarising neuromuscular blocking agent has an  antagonistic effect  on the subsequent depolarising block induced by succinylcholine. [ 12 ]  If a nondepolarising NMBA is administered prior to succinycholine, the dose of succinylcholine must be increased."}
{"_id": "WikiPedia_Muscular_system$$$corpus_788", "text": "The administration of succinylcholine on the subsequent administration of a nondepolarising neuromuscular block depends on the drug used. Studies have shown that administration of succinylcholien before a nondepolarising NMBA does not affect the potency of  mivacurium  or  rocuronium . [ 12 ]  But for  vecuronium  and  cisatracurium , it speeds up the onset, increases the potency and prolongs the duration of action. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_789", "text": "Combining two nondepolarising NMBAs of the same chemical class (e.g. rocuronium and vecuronium) produces an additive effect, while combining two nondepolarising NMBAs of different chemical class (e.g. rocuronium and cisatracurium) produces a synergistic response. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_790", "text": "Inhaled anesthetics inhibit nicotinic acetylcholine receptors (nAChRs) and potentiate neuromuscular blockage with nondepolarising NMBAs. [ 12 ]  It depends on the type of  volatile anesthetic  ( desflurane  >  sevoflurane  >  isoflurane  >  nitrous oxide ), the concentration and the duration of exposure. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_791", "text": "Tetracycline ,  aminoglycosides ,  polymyxins  and  clindamycin  potentiate neuromuscular blockage by inhibiting ACh release or  desensitisation  of post-synpatic nAChRs to ACh. [ 12 ]  This interaction happens mostly during maintenance of anesthesia. As antibiotics typically are given after a dose of NMBA, this interaction needs to be considered when re-dosing NMBA. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_792", "text": "Patients receiving chronic treatment are relatively resistance to nondepolarising NMBAs due to the accelerated  clearance . [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_793", "text": "Lithium is structurally similar to other cations such as sodium, potassium, magnesium and calcium, this causes lithium to activate potassium channels which inhibit neuromuscular transmission. [ 12 ]  Patients who take lithium can have a prolonged response to both depolarising and nondepolarising NMBAs."}
{"_id": "WikiPedia_Muscular_system$$$corpus_794", "text": "Sertraline  and  amitriptyline  inhibit  butyrylcholinesterase  and cause prolonged  paralysis . [ 12 ]  Mivacurium causes prolonged paralysis for patients chronically taking sertraline. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_795", "text": "LAs  may enhance the effects of depolarisation and nondepolarising NMBAs through pre and post-synaptic interactions at the NMJ. [ 12 ]  It may result in blood levels high enough to potentiate NMBA-induced neuromuscular block. [ 12 ]  Epidurally administered  levobupivacaine  and  mepivacaine  potentiate  amino-steroidal NMBAs  and delay recovery from neuromuscular blockade. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_796", "text": "Methods for estimating the degree of neuromuscular block include valuation of muscular response to stimuli from surface electrodes, such as in the  train-of-four  test, wherein four such stimuli are given in rapid succession. With no neuromuscular blockade, the resultant muscle contractions are of equal strength, but gradually decrease in case of neuromuscular blockade. [ 27 ]  It is recommended during use of continuous-infusion neuromuscular blocking agents in  intensive care . [ 28 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_797", "text": "The effect of non-depolarizing neuromuscular-blocking drugs may be reversed with  acetylcholinesterase inhibitors ,  neostigmine , and  edrophonium , as commonly used examples. Of these, edrophonium has a faster onset of action than neostigmine, but it is unreliable when used to antagonize deep neuromuscular block. [ 29 ]  Acetylcholinesterase inhibitors increase the amount of acetylcholine in the neuromuscular junction, so a prerequisite for their effect is that the neuromuscular block is not complete, because in case every acetylcholine receptor is blocked then it does not matter how much acetylcholine is present."}
{"_id": "WikiPedia_Muscular_system$$$corpus_798", "text": "Sugammadex  is a newer drug for reversing neuromuscular block by  rocuronium  and vecuronium in  general anaesthesia . It is the first  selective relaxant binding agent  (SRBA). [ 30 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_799", "text": "Curare  is a crude  extract  from certain South American plants in the genera  Strychnos  and  Chondrodendron , originally brought to Europe by explorers such as  Walter Raleigh [ 31 ]   Edward Bancroft , a chemist and physician in the 16th century brought samples of crude curare from  South America  back to the Old-World. The effect of curare was experimented with by  Sir Benjamin Brodie  when he injected small animals with  curare , and found that the animals stopped breathing but could be kept alive by inflating their lungs with  bellows . This observation led to the conclusion that curare can paralyse the respiratory muscles. It was also experimented by  Charles Waterton  in 1814 when he injected three donkeys with curare. The first donkey was injected in the shoulder and died afterward. The second donkey had a  tourniquet  applied to the foreleg and was injected distal to the tourniquet. The donkey lived while the tourniquet was in place but died after it was removed. The third donkey after injected with curare appeared to be dead but was resuscitated using bellows. Charles Waterton's experiment confirmed the paralytic effect of curare."}
{"_id": "WikiPedia_Muscular_system$$$corpus_800", "text": "It was known in the 19th century to have a  paralysing effect , due in part to the studies of scientists like  Claude Bernard . [ 32 ]   D-tubocurarine  a  mono -quaternary  alkaloid  was isolated from  Chondrodendron tomentosum  in 1942, and it was shown to be the major constituent in curare responsible for producing the paralysing effect. At that time, it was known that curare and, therefore, d-tubocurarine worked at the  neuromuscular junction . The isolation of tubocurarine and its marketing as the drug  Intocostrin  led to more research in the field of neuromuscular-blocking drugs. Scientists figured out that the potency of tubocurarine was related to the separation distance between the two  quaternary ammonium  heads. [ 9 ] [ 33 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_801", "text": "Neurologist  Walter Freeman  learned about curare and suggested to  Richard Gill , a patient suffering from  multiple sclerosis , that he try using it. Gill brought 25 pounds of raw curare from Ecuador. The raw curare was then given to  Squibb and Sons  to derive an effective antidote to curare. In 1942, Wintersteiner and Dutcher (two scientists working for Squibb and Sons) isolated the alkaloid  d-tubocurarine . Soon after, they developed a preparation of curare called  Intocostrin ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_802", "text": "At the same time in Montreal,  Harold Randall Griffith  and his resident Enid Johnson at the Homeopathic Hospital administered curare to a young patient undergoing  appendectomy . This was the first use of NMBA as muscle relaxant in anesthesia."}
{"_id": "WikiPedia_Muscular_system$$$corpus_803", "text": "The 1940s, 1950s and 1960s saw the rapid development of several synthetic NMBA.  Gallamine  was the first synthetic NMBA used clinically. Further research led to the development of  synthesized  molecules with different curariform effects, depending on the distance between the  quaternary ammonium  groups. One of the synthesized  bis -quaternaries was  decamethonium  a 10- carbon   bis -quaternary compound. Following research with decamethonium, scientists developed  suxamethonium , which is a double acetylcholine molecule that was connected at the  acetyl  end. The discovery and development of suxamethonium lead to a  Nobel Prize in medicine  in 1957. Suxamethonium showed different blocking effect in that its effect was achieved more quickly and augmented a response in the  muscle  before block. Also, tubocurarine effects were known to be reversible by  acetylcholinesterase inhibitors , whereas decamethonium and suxamethonium block were not reversible. [ 9 ] [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_804", "text": "Another compound  malou\u00e9tine  that was a  bis -quaternary steroid was isolated from the plant  Malouetia bequaertiana  and showed curariform activity. This led to the synthetic drug  pancuronium , a  bis -quaternary steroid, and subsequently other drugs that had better pharmacological properties. [ 9 ] [ 34 ]  Research on these molecules helped improve understanding of the  physiology  of  neurons  and  receptors ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_805", "text": "Gallamine triethiodide  is originally developed for preventing muscle contractions during surgical procedures. However, it is no longer marketed in the United States according to the  FDA orange book ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_806", "text": "A  nuclear bag fiber  is a type of  intrafusal muscle fiber  that lies in the center of a  muscle spindle . [ 1 ]  Each has many  nuclei  concentrated in bags and they cause excitation of the  primary sensory fibers . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_807", "text": "There are two kinds of bag fibers based upon contraction speed and motor innervation."}
{"_id": "WikiPedia_Muscular_system$$$corpus_808", "text": "Both bag types extend beyond the spindle capsule."}
{"_id": "WikiPedia_Muscular_system$$$corpus_809", "text": "These sense dynamic length of the muscle. They are sensitive to length and velocity."}
{"_id": "WikiPedia_Muscular_system$$$corpus_810", "text": "This  neuroscience  article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_811", "text": "A  nuclear chain fiber  is a specialized  sensory   organ  contained within a  muscle .  Nuclear chain fibers are  intrafusal fibers  that, along with  nuclear bag fibers , make up the  muscle spindle  responsible for the detection of changes in muscle length."}
{"_id": "WikiPedia_Muscular_system$$$corpus_812", "text": "There are 3\u20139  nuclear chain fibers  per muscle spindle that are half the size of the  nuclear bag fibers . Their nuclei are aligned in a chain and they excite the secondary nerve. [ clarification needed ]  They are static, whereas the nuclear bag fibers are dynamic in comparison. [ clarification needed ]   The name \"nuclear chain\" refers to the structure of the central region of the fiber, where the sensory axons wrap around the  intrafusal fibers ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_813", "text": "The secondary nerve association involves an efferent and afferent pathway that measure the stress and strain placed on the muscle (usually the  extrafusal fibers  connected from the muscle portion to a bone).  The afferent pathway resembles a spring wrapping around the nuclear chain fiber and connecting to one of its ends away from the bone.  Again, depending on the stress and strain the muscles sustains, this afferent and efferent coordination will measure the \"stretch of the spring\" and communicate the results to the  central nervous system ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_814", "text": "A similar structure attaching one end to muscle and the other end to a tendon is known as a  Golgi tendon organ .  However, Golgi tendon organs differ from nuclear chain and  nuclear bag fibers  in that they are considered  in series  rather than  in parallel  to the muscle fibers."}
{"_id": "WikiPedia_Muscular_system$$$corpus_815", "text": "As  intrafusal muscle fibers ,  nuclear chain fibers  are innervated by both  sensory afferents  and  motor efferents .  The afferent innervation is via  type Ia sensory fibers  and  type II sensory fibers . These project to the  nucleus proprius  in the  dorsal horn  of the  spinal cord .  Efferent innervation is via  static \u03b3 motor neurons .  Stimulation of \u03b3 neurons causes the nuclear chain to shorten along with the  extrafusal muscle fibers .  This shortening allows the nuclear chain fiber to be sensitive to changes in  length while its corresponding muscle is contracted."}
{"_id": "WikiPedia_Muscular_system$$$corpus_816", "text": "List of distinct cell types in the adult human body"}
{"_id": "WikiPedia_Muscular_system$$$corpus_817", "text": "Orthotics  ( Greek :  \u039f\u03c1\u03b8\u03cc\u03c2 ,  romanized :\u00a0 ortho ,  lit. \u2009 'to straighten, to align') is a  medical specialty  that focuses on the design and application of  orthoses , sometimes known as braces, calipers, or splints. [ 1 ]  An  orthosis  is \"an externally applied device used to influence the structural and functional characteristics of the  neuromuscular  and  skeletal systems .\" [ 2 ]   Orthotists  are medical professionals who specialize in designing orthotic devices such as braces or foot orthoses."}
{"_id": "WikiPedia_Muscular_system$$$corpus_818", "text": "Orthotic devices are classified into four areas of the body according to the international classification system (ICS): [ 2 ]  orthotics of the  lower extremities , orthotics of the  upper extremities , orthotics for the  trunk , and orthotics for the head. Orthoses are also classified by function: paralysis orthoses and relief orthoses. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_819", "text": "Under the  International Standard  terminology, orthoses are classified by an acronym describing the anatomical joints they support. [ 2 ]  Some examples include KAFO, or knee-ankle-foot orthoses, which span the knee, ankle, and foot; TLSO, or thoracic-lumbar-sacral orthoses, supporting the  thoracic ,  lumbar  and   sacral  regions of the  spine . The use of the International Standard is promoted to reduce the widespread variation in the description of orthoses, which is often a barrier to interpreting research studies. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_820", "text": "The transition from an orthosis to a  prosthesis  can be fluid. An example is compensating for a leg length discrepancy, equivalent to replacing a missing part of a limb. Another example is the replacement of the forefoot after a forefoot  amputation . This treatment is often made from a combination of a prosthesis to replace the forefoot and an orthosis to replace the lost muscular function (ortho prosthesis). [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_821", "text": "An orthotist is a specialist responsible for the customising, manufacture, and repair of orthotic devices (orthoses). [ 5 ]  The manufacture of modern orthoses requires both artistic skills in modeling body shapes and manual skills in processing traditional and innovative materials\u2014  CAD / CAM ,  CNC machines  and  3D printing  are involved in orthotic manufacture. [ 6 ]  Orthotics also combines knowledge of anatomy and physiology,  pathophysiology ,  biomechanics  and engineering. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_822", "text": "In the United States, while orthotists require a prescription from a licensed healthcare provider, physical therapists are not legally authorized to prescribe orthoses. In the U.K., orthotists will often accept referrals from doctors or other healthcare professionals for orthotic assessment without requiring a prescription. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_823", "text": "Orthoses are offered as:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_824", "text": "Both custom-fabricated products and semi-finished products are used in long-term care and are manufactured or adapted by the orthotist or by trained orthopedic technicians according to the prescription. In many countries the physician or clinician defines the functional deviations in his prescription, e.g. paralysis ( paresis ) of the calf muscles ( M. Triceps Surae ) and derives the indication from this, e.g. orthotic to restore safety when standing and walking after a  stroke . The orthotist creates another detailed physical examination and compares it with the prescription from the physician. The orthotist describes the configuration of the orthosis, which shows which orthotic functions are required to compensate for the functional deviation of the neuromuscular or skeletal system and which functional elements must be integrated into the orthosis for this. Ideally, the necessary orthotic functions and the functional elements to be integrated are discussed in an interdisciplinary team between physician,  physical therapist , orthotist and patient."}
{"_id": "WikiPedia_Muscular_system$$$corpus_825", "text": "All orthoses that affect the foot, the ankle joint, the lower leg, the knee joint, the thigh or the hip joint belong to the category of orthoses for the lower extremities. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_826", "text": "Paralysis  orthoses are used for partial or complete paralysis, as well as complete functional failure of muscles or muscle groups, or incomplete paralysis ( paresis ). They are intended to correct or improve functional limitations or to replace functions that have been lost as a result of the paralysis. Functional leg length differences caused by paralysis can be compensated for by using orthosis. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_827", "text": "For the quality and function of a paralysis orthosis, it is important that the orthotic shell is in total-contact  with the patient's leg to create an optimal fit, which is why a custom-made orthotic is often preferred. As reducing the weight of an orthosis significantly lessens the energy needed to walk with it, the use of light weight and highly resilient materials such as  carbon fiber ,  titanium  and  aluminum  is indispensable for the manufacture of a custom-made orthosis. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_828", "text": "The production of a custom-made orthotic also allows the integration of orthotic joints, which means the dynamics of the orthotic can be matched exactly with the pivot points of the patient's anatomical joints. As a result, the dynamics of the orthosis take place exactly where dictated by the patient's anatomy. Since the dynamics of the orthosis are executed via the orthotic joints, it is possible to manufacture the orthotic shells as stable and torsion-resistant, which is necessary for the quality and function of the orthosis. The orthosis thus offers the necessary stability to regain the security that has been lost due to paralysis when standing and walking. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_829", "text": "In addition, an orthosis can be individually configured through the use of orthosis joints. In this way, the combination of the orthotic joints and the adjustability of the functional elements can be adjusted to compensate for any existing functional deviations that have resulted from the muscle weakness. [ 12 ] [ 13 ] [ 14 ] [ 15 ] [ 16 ] [ 17 ]  The goal of a high-quality orthotic fitting is to adjust the functional elements so precisely that the orthosis provides the necessary support while restricting the dynamics of the lower extremities as little as possible to preserve the remaining functionality of the muscles. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_830", "text": "In the case of paralysis due to disease or injury to the spinal/peripheral nervous system, a  physical examination  is needed to determine the strength levels of the affected leg's six major muscle groups and the orthosis's necessary functions."}
{"_id": "WikiPedia_Muscular_system$$$corpus_831", "text": "According to Vladimir Janda, a muscle function test is carried out to determine strength levels. [ 18 ]  The degree of paralysis is given for each muscle group on a scale from 0 to 5, with the value 0 indicating complete paralysis (0%) and the value 5 indicating normal strength (100%). The values between 0 and 5 indicate a percentage reduction in muscle function. All strength levels below five are called  muscle weakness ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_832", "text": "The combination of strength levels of the muscle groups determines the type of orthosis (AFO or KAFO) and the functional elements necessary to compensate for restrictions caused by the reduced muscular strength levels. [ medical citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_833", "text": "Paralysis may be caused by injury to the spinal or peripheral nervous system after  spinal cord injury , or by diseases such as  spina bifida ,  poliomyelitis  and  Charcot-Marie-Tooth disease . In these patients, knowledge of the strength levels of the large muscle groups is necessary to configure the orthotic  for the necessary functions. [ medical citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_834", "text": "Paralysis caused by diseases or injuries to the central nervous system (e.g.  cerebral palsy ,  traumatic brain injury ,  stroke , and  multiple sclerosis ) can cause incorrect motor impulses that often result in clearly visible deviations in gait. [ 19 ] [ 20 ]  The usefulness of muscle strength tests is therefore limited, as even with high degrees of strength, disturbances to the gait pattern can occur due to the incorrect control of the central nervous system."}
{"_id": "WikiPedia_Muscular_system$$$corpus_835", "text": "In  ambulatory  patients with paralysis due to  cerebral palsy  or  traumatic brain injury ,  the gait pattern is analysed as part of the  physical examination  in order to determine the necessary functions of an orthosis. [ 21 ] [ 22 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_836", "text": "One way of classifying gait is according to the \"Amsterdam Gait Classification\", which describes five gait types. To assess the gait pattern, the patient is viewed directly, or via a video recording, from the side of the leg being assessed. At the point when the leg is   mid-stance  the knee angle and the contact of the foot with the ground are assessed. [ 21 ]  The five gait types are:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_837", "text": "Patients with paralysis due to cerebral palsy or traumatic brain injury are usually treated with an ankle-foot orthosis (AFO). Although in these patients the muscles are not paralyzed but being sent the wrong impulses from the brain, the functional elements used in the orthotics are the same for both groups. The compensatory gait is an unconscious reaction to the lack of security when standing or walking that usually worsens with increasing age; [ 20 ]  if the right functional elements are integrated into the orthosis to counter this, and maintain physiological mobility, the right motor impulses are sent to create new cerebral connections. [ 23 ]  The goal of an orthotic is the best possible approximation of the physiological gait pattern. [ 24 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_838", "text": "In the case of paralysis after a  stroke , rapid care with an orthosis is necessary. Often areas of the brain are affected that contain \"programs\" for controlling the musculoskeletal system. [ 25 ] [ 26 ] [ 27 ]  With the help of an orthosis, physiological standing and walking can be relearned, preventing long term health consequences caused by an abnormal gait pattern. [ 28 ]  According to Vladimir Janda, when configuring the orthotic it is important to understand that the muscle groups are not paralyzed, but are controlled by the brain with wrong impulses, and this is why a muscle function test can lead to incorrect results when assessing the ability to stand and walk. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_839", "text": "An important basic requirement for regaining the ability to walk is that the patient trains early on to stand on both legs safely and well balanced. An orthosis with functional elements to support balance and safety when standing and walking can be integrated into physical therapy from the first standing exercises, and this makes the work of mobilizing the patient at an early stage easier. With the right functional elements that maintain physiological mobility and provide security when standing and walking, the necessary motor impulses to create new cerebral connections can occur. [ 23 ]  Clinical studies confirm the importance of orthoses in stroke rehabilitation. [ 29 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_840", "text": "Patients with paralysis after a stroke are often treated with an ankle-foot orthosis (AFO), as after a stroke stumbling can occur if only the  dorsiflexors  are supplied with incorrect impulses from the central nervous system. This can lead to insufficient foot lifting during swing phase of walking, and in these cases, an orthosis that only has functional elements to support the dorsiflexors can be helpful. Such an orthosis is also called drop foot orthosis. When configuring a foot lifter orthosis, adjustable functional elements for setting the resistance can be included, which make it possible to adapt the passive lowering of the forefoot (plantar flexion) to the  eccentric work  of the dorsal flexors during loading response. [ 12 ] [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_841", "text": "In cases where the muscle group of the  plantar flexors  is supplied with wrong impulses from the central nervous system, which leads to uncertainty when standing and walking, an unconscious compensatory gait can occur. [ 20 ]  When configuring an orthosis functional elements that can restore safety when standing and walking must be used in these cases; a foot lifter orthosis is not suitable as it only compensates for the functional deviations caused by weakness of the dorsiflexors."}
{"_id": "WikiPedia_Muscular_system$$$corpus_842", "text": "Patients with paralysis after stroke who are able to walk have the option of analysing the gait pattern in order to determine the optimal function of an orthosis. One way of assessing is the classification according to the \"N.A.P. Gait Classification\", which is a physiotherapeutic treatment concept. [ 30 ]  According to this classification, the gait pattern is assessed in the mid-stance phase and described as one of four possible gait types."}
{"_id": "WikiPedia_Muscular_system$$$corpus_843", "text": "This assessment is a two step process; in the first step, the patient is viewed from the side of the leg to be assessed, either directly or via a video recording. In gait type 1 the knee angle is hyperextended, while in type 2, the knee angle is flexed. In the second step, the patient is viewed from the front to determine if the foot is  inverted , if it is the letter \"a\" is added to the gait. This is associated with a  varus deformity  of the knee. If instead the patient stands on the inner edge of the foot (eversion), which is associated with a  valgus deformity  of the knee, the letter \"b\" is added to the gait type. Patients are thus classified as gait types 1a, 1b, 2a or 2b. The goal of orthotic fitting for patients who are able to walk is the best possible approximation of the physiological gait pattern. [ medical citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_844", "text": "In the case of paralysis due to  multiple sclerosis , the degree of strength of the six major muscle groups of the affected leg should be determined as part of the  physical examination  in order to determine the necessary functions of an orthosis, just as in the case of diseases or injuries to the spinal/peripheral nervous system. However, patients with multiple sclerosis may experience muscular fatigue as well. The fatigue can be more or less pronounced and, depending on the severity, can lead to considerable restrictions in everyday life. Persistent stress, such as from walking, causes a deterioration in muscle function and has a significant effect on the spatial and temporal parameters of walking, for example by significantly reducing the cadence and walking speed. [ 31 ] [ 32 ] [ 33 ]  Fatigue can be measured as  muscle weakness . When determining the strength levels of the six major muscle groups as part of the patient's medical history, fatigue can be taken into account by using a standardized six-minute walking test. [ 34 ]  According to Vladimir Janda the muscle function test is carried out in combination with the six-minute walk test in the following steps:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_845", "text": "This sequence of muscle function test and six-minute walk test is used to determine whether muscular fatigue can be induced. If the test reveals muscular fatigue, the strength levels and measured fatigue should be included in the planning of an orthosis, and when determining the functional elements. [ medical citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_846", "text": "Paralysis of the dorsiflexors \u00a0\u2013  weakness  of the  dorsiflexors  results in a  drop foot . The patient's foot cannot be sufficiently lifted during the swing phase while walking, as the necessary concentric work of the dorsiflexors can not be activated. [ 35 ]  There is a risk of stumbling, and the patient cannot influence the shock absorption when walking (gait phase, loading response), as the  eccentric work  of the dorsiflexors is limited. [ 35 ]  After initial heel contact the forefoot either slaps too quickly on the floor via the heel rocker, which creates an audible noise, or the foot does touch the floor with forefoot first, which disrupts gait development. [ 36 ] :\u200a178\u2013181\u200a [ 37 ] :\u200a44\u201345,\u200a50\u201354 and 126\u200a [ 38 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_847", "text": "Paralysis of the plantar flexors \u00a0\u2013 If the  plantar flexors  are weak, the muscles of the forefoot lever are either inadequately activated or not activated at all. The patient has no balance when standing and has to support themself with aids such as  crutches . The forefoot lever required for energy-saving walking in the gait phases from mid-stance to pre-swing cannot be activated by the plantar flexors. This leads to excessive dorsiflexion in the ankle joint in terminal stance and a loss of energy while walking. The center of gravity of the body lowers towards the end of the stance phase and the knee of the contralateral leg is flexed excessively. With each step, the center of gravity must be raised above the leg by straightening the excessively flexed knee. Since the plantar flexors originate above the knee joint, they also have a knee-extension effect in the stance phase. [ 36 ] :\u200a177\u2013210\u200a [ 37 ] :\u200a72\u200a [ 38 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_848", "text": "Paralysis of the knee extensors \u00a0\u2013 if the  knee extensors  are weak, there is an increased risk of falling when walking, as between loading response to the mid-stance the knee extensors control knee flexion inadequately, or not at all. To control the knee, the patient develops compensatory mechanisms that lead to an incorrect gait pattern, for example by exaggerated activation of the plantar flexors, leading into hyperextension of the knee, or when initial contact is with the forefoot and not the heel in order to prevent the knee-flexing effect of the heel rocker. [ 36 ] :\u200a222,\u200a226\u200a [ 37 ] :\u200a132,\u200a143,\u200a148\u2013149\u200a [ 38 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_849", "text": "Paralysis of the knee flexors \u00a0\u2013 if the knee flexors are weak, it is more difficult to flex the knee in pre-swing. [ 36 ] :\u200a220\u200a [ 37 ] :\u200a154\u200a [ 38 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_850", "text": "Paralysis of the hip flexors \u00a0\u2013 if the hip flexors are weak, it is more difficult to flex the knee in pre-swing. [ 36 ] :\u200a221\u200a [ 37 ] :\u200a154\u200a [ 38 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_851", "text": "Paralysis of the hip extensors \u00a0\u2013 the  hip extensors  help control of the knee against unwanted flexion when walking between loading response and mid-stance. [ 36 ] :\u200a216\u201317\u200a [ 37 ] :\u200a45\u201346\u200a [ 38 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_852", "text": "The functional elements of an orthosis ensure the flexion and extension movements of the ankle, knee and  hip joints. They correct and control the movements and secure the joints against undesired incorrect movements, and help avoid falls when standing or walking. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_853", "text": "Functional elements in paralysis of the dorsiflexors \u00a0\u2013 if the  dorsiflexors  are weak, an orthosis should lift the forefoot during the swing phase in order to reduce the risk of the patient stumbling. An orthosis that has only one functional element for lifting the forefoot in order to compensate for a weakness in the dorsiflexors is also known as a drop foot orthosis. An AFO of the drop foot orthosis type is therefore not suitable for the care of patients with weakness in other muscle groups, as these patients require additional functional elements to be taken into account. Initial contact with the heel should be achieved by lifting the foot through the orthosis, and if the dorsiflexors are very weak, control of the rapid drop of the forefoot should be taken over by dynamic functional elements that allow for adjustable resistance of  plantar flexion . Orthoses should be adapted to the functional deviation of the dorsiflexors in order to correct the shock absorption of the heel rocker lever during loading response, but should not block plantar flexion of the ankle joint as this leads to excessive flexion in the knee and hip and an increase in the energy needed for walking. This is why static functional elements are not recommended when there are newer technical alternatives. [ 12 ] [ 36 ] :\u200a105\u200a [ 37 ] :\u200a134\u200a [ 38 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_854", "text": "Functional elements in paralysis of the plantar flexors \u00a0\u2013 in order to compensate for a  weakness  of the  plantar flexors , the orthosis has to transfer large forces that the strong muscle group would otherwise take over. These forces are transmitted in a similar way to a ski boot during downhill skiing via the functional elements of the foot part, ankle joint and lower leg shell. Dynamic functional elements are preferable for the ankle joint as static functional elements would completely block the dorsiflexion, which would have to be compensated for by the upper body, resulting in an increased energy cost when walking. [ 15 ]  The functional element's resistance to protect against unwanted dorsiflexion should be able to be adapted according to the weakness of the plantar flexors. In the case of very weak plantar flexors, the functional element's resistance against undesired dorsiflexion must be very high in order to compensate for the functional deviations this causes. [ 39 ] [ 16 ]  Adjustable functional elements allow the resistance to be adjusted exactly to the weakness of the muscle, and scientific studies recommend adjustable resistance in patients with paralysis or weakness of the plantar flexors. [ 13 ] [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_855", "text": "Functional elements in paralysis of knee extensors and hip extensors \u00a0\u2013 in the case of weak  knee extensors  or  hip extensors , the orthosis must take over the stability and stance phase control when walking. Different knee-securing functional elements are needed depending on the weakness of these muscles. In order to compensate for functional deviations with slightly weakness of these muscle groups, a free moving mechanical knee joint with the mechanical pivot point behind the anatomical knee pivot point can be sufficient. In the case of significant weakness, knee flexion when walking must be controlled by functional elements that mechanically secure the knee joint during the early stance phases between loading response and mid stance. Stance phase control knee joints which lock the knee in the early stance phases and release it for knee flexion during the swing phase can be used here, with these joints, a natural gait pattern can be achieved despite mechanically securing against unwanted knee flexion. In these cases, locked knee joints are often used, and while they have a good safety function, the knee joint remains mechanically locked during the swing phase while walking. Patients with locked knee joints have to manage the swing phase with a stiff leg, which only works if the patient develops compensatory mechanisms, such as by raising the body's center of gravity in the swing phase ( Duchenne  limping) or by swinging the orthotic leg to the side ( circumduction ). Stance phase control knee joints and locked joints can both be mechanically \"unlocked\" so the knee can be flexed to sit down. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_856", "text": "AFO is the abbreviation for ankle-foot orthoses, which is the English name for an orthosis that spans the ankle and foot. [ 2 ]  In the treatment of paralyzed patients, they are mainly used when there is a  weakness  of the  dorsiflexors  or  plantar flexors . [ 40 ] [ 41 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_857", "text": "Through the use of modern materials, such as carbon fibers and  aramid  fibers, and new knowledge about processing these materials into composite materials, the weight of orthotics has been reduced significantly. In addition to the weight reduction, these materials and technologies have created the possibility of making some areas of an orthosis so rigid that it can take over the forces of the weakened muscles (e.g. the connection from the ankle joint to the frontal contact surface on the shin), while at the same time leaving areas requiring less support very flexible (e.g. the flexible part of the forefoot). [ 42 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_858", "text": "It is now possible to combine the required rigidity of the orthotic shells with the dynamics in the ankle, [ 43 ]  with this, other new technologies, and the possibility of producing lightweight but rigid orthoses, new demands have been made of orthotics: [ 44 ] [ 45 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_859", "text": "A custom-made AFO can compensate for functional deviations of muscle groups, it should be configured according to the patient data through a function and load calculation so that it meets the functional and load requirements. In calculating or configuring an AFO, variants are optimally matched to individual requirements for the functional elements of the ankle joint, for the stiffness of the foot shell, and for the shape of the lower leg shell. The size of these components is selected by matching their resilience to the load data. [ medical citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_860", "text": "An ankle joint based on new technology is the connection between the foot shell and the lower leg shell and at the same time contains all the necessary adjustable functional elements of an AFO. [ clarification needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_861", "text": "Depending on the combination of the degree of paralysis of the  dorsiflexors  or  plantar flexors , different functional elements to compensate for their weakness can be integrated into the ankle joint; if both muscle groups are affected, the elements should be integrated into one orthotic joint. The necessary dynamics and resistance to movements in the ankle can be adapted via adjustable functional elements in the ankle joint of the orthosis, which allows it to compensate for muscle weaknesses, provide safety when standing and walking, and still allow as much mobility as possible. For example, adjustable spring units with pre-compression can enable an exact adaptation of both static and dynamic resistance to the measured degree of muscle weakness. Studies show the positive effects of these new technologies. [ 12 ] [ 14 ] [ 15 ] [ 39 ] [ 16 ]  It is of great advantage if the resistances for these two functional elements can be set separately. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_862", "text": "An AFO with functional elements to compensate for a weakness of the  plantar flexors  can also be used for slight weakness of the knee-securing muscle groups, the  knee extensors  and the  hip extensors . [ medical citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_863", "text": "A drop foot orthosis is an AFO that only has one functional element for lifting the forefoot in order to compensate for a weakness in the dorsiflexors. [ 46 ]  If other muscle groups, such as the plantar flexors, are weak, additional functional elements must be taken into account, making a drop foot orthosis unsuitable for patients with weakness in other muscle groups."}
{"_id": "WikiPedia_Muscular_system$$$corpus_864", "text": "In 2006, before these new technologies were available, the  International Committee of the Red Cross  published in its 2006 Manufacturing Guidelines for Ankle-Foot Orthoses, with the aim of providing people with disabilities worldwide standardized processes for the production of high-quality, modern, durable and economical devices. [ 47 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_865", "text": "Because new technologies are not widely used, AFOs are often made from polypropylene-based plastic, mostly in the shape of a continuous \"L\" shape, with the upright part behind the calf and the lower part under the foot, however, this only offers the rigidity of the material. AFOs made of polypropylene are still called \"DAFO\" (dynamic ankle-foot orthosis), \"SAFO\" (solid ankle-foot orthosis) or \"Hinged AFO\". DAFOs are not stable enough to transfer the high forces required to balance the weak plantar flexors when standing and walking, and SAFOs block the mobility of the ankle joint. A \"Hinged AFO\"  only allowed for the compensation that could be achieved with the orthotic joints of the time, for example, they commonly block plantar flexion, as the joints cannot simultaneously transmit the large forces that are required to compensate for muscle deviations while also  offering the necessary dynamics. [ medical citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_866", "text": "While there was a multitude of AFOs with differing designs in clinical practice, there was also a clear lack of details regarding the design and the materials used for manufacture, leading Eddison and  Chockalingam  to call for a new standardization of the terminology. [ 48 ] [ 49 ]  With a focus on caring for children with cerebral palsy there is a recommendation to investigate the potential for gait pattern improvement via the design and manufacture of orthotics made of polypropylene. [ 50 ]  On the other hand, integrating orthotic joints with modern functional elements into the  production of older technologies using polypropylene is unusual because the orthotic shells made of polypropylene either could not transfer the high forces or would be too soft. [ medical citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_867", "text": "New studies now show the better possibilities for improving the gait pattern through the new technologies. [ 12 ] [ 15 ] [ 39 ] [ 16 ] [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_868", "text": "The International Committee of the Red Cross published its manufacturing guidelines for ankle\u2013foot orthoses in 2006, and, unfortunately, today's terminologies are still based those guidelines and therefore require a particularly high level of explanation. [ 47 ]  The intent was to provide standardized procedures for the manufacture of high-quality modern, durable and economical devices to people with disabilities throughout the world. However, with the new technologies available, the main types mentioned are in need of revision today."}
{"_id": "WikiPedia_Muscular_system$$$corpus_869", "text": "plus the body parts included in the orthosis fitting: ankle and foot, English abbreviation: AFO for ankle-foot orthoses"}
{"_id": "WikiPedia_Muscular_system$$$corpus_870", "text": "\"SAFO\""}
{"_id": "WikiPedia_Muscular_system$$$corpus_871", "text": "Rigid AFO [ 47 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_872", "text": "\"DAFO\""}
{"_id": "WikiPedia_Muscular_system$$$corpus_873", "text": "Flexible AFO [ 47 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_874", "text": "\"Hinged-AFO\""}
{"_id": "WikiPedia_Muscular_system$$$corpus_875", "text": "\"Hinged\" simply means a flexible connection between the two parts of the orthosis. The joint itself does not offer any further functional elements."}
{"_id": "WikiPedia_Muscular_system$$$corpus_876", "text": "AFO with Tamarack Flexure Joint"}
{"_id": "WikiPedia_Muscular_system$$$corpus_877", "text": "\"Posterior Leaf Spring\""}
{"_id": "WikiPedia_Muscular_system$$$corpus_878", "text": "Spring made from flexible material behind (posterior) the ankle"}
{"_id": "WikiPedia_Muscular_system$$$corpus_879", "text": "A DAFO often also known as \"Posterior Leaf Spring\""}
{"_id": "WikiPedia_Muscular_system$$$corpus_880", "text": "FR for Floor reaction"}
{"_id": "WikiPedia_Muscular_system$$$corpus_881", "text": "\"FRAFO\""}
{"_id": "WikiPedia_Muscular_system$$$corpus_882", "text": "Designation is misleading as other orthoses also have this function"}
{"_id": "WikiPedia_Muscular_system$$$corpus_883", "text": "Plus further descriptions, such as:\n - ventral shell with torsionally rigid reinforcement to focus the dynamics on the ankle joint\n - dynamic ankle joint with precompressed spring elements to control plantarflexion and dorsiflexion"}
{"_id": "WikiPedia_Muscular_system$$$corpus_884", "text": "KAFO is the abbreviation for knee-ankle-foot orthoses, which spans the knee, ankle and foot. [ 51 ]  In the treatment of paralyzed patients, a KAFO is used when there is a  weakness  of the knee  or hip extensors. [ 17 ] [ 40 ] [ 41 ]  They have two orthotic joints: an ankle joint between the foot and lower leg shells and a knee joint between the lower leg and thigh shells. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_885", "text": "KAFOs can be roughly divided into three variants, depending on whether the mechanical knee joint is: locked, unlocked or locked and unlocked. [ medical citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_886", "text": "KAFO with locked knee joint -  The mechanical knee joint is locked both when standing and also when walking (in both the stance and swing phases) in order to achieve the necessary stability. To sit, the user can unlock the knee joint. When walking with a locked knee joint it is difficult for the user to swing the leg forward and, in order to not stumble, the leg must be swung forward and out in a circular arc (circumduction) or the hip must be raised unnaturally to swing the stiff leg. Each of these incorrect gait patterns can lead to secondary diseases in the bone and muscle system, and such compensatory movement patterns lead to increased energy consumption when walking. The film  Forrest Gump  impressively shows how the main character  Forrest Gump  is additionally hindered in his urge to move by such orthoses. [ relevant? ]  For centuries, KAFOs were built with mechanical knee joints that stiffened the knee of the paralyzed leg, and even today, such orthotic fittings are still common. Typical designations for a KAFO with a locked knee joint include \"KAFO with Swiss lock\" or \"KAFO with drop lock lock\". [ medical citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_887", "text": "KAFO with unlocked knee joint -  An unlocked knee joint can move freely both when standing and when walking, both in the stance phase and in the swing phase. In order for the leg to swing through without stumbling, knee flexion of approximately 60\u00b0 is allowed; the user does not need to unlock the knee joint to sit. As a KAFO with an unlocked knee joint can provide only minor compensation for paralysis-related issues while standing and walking, an orthotic knee joint with a rearward displacement of the pivot point can be installed in order to increase safety. However, even with this, a KAFO with a non-locked knee joint should only be used in cases of minor paralysis of the knee and hip extensors. With more severe paralysis and low levels of strength in these muscle groups, there is a significant risk of falling. A typical designation for a KAFO with a unlocked knee joint is, among other things, \"KAFO with knee joint for movement control\". [ medical citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_888", "text": "KAFO with locked and unlocked knee joint -  The mechanical knee joint of a KAFO with locked and unlocked knee joint is locked when walking in the stance phase, [ 52 ]  providing the necessary stability and security for the user. The knee joint is then automatically unlocked in the swing phase, allowing the leg to be swung through without stumbling. In order to be able to walk efficiently, without stumbling, and without compensating mechanisms, the joint should allow  knee flexion of approximately 60\u00b0 in the swing phase. The first promising developments of automatic knee joints, or stance phase locking knee joints, emerged in the 1990s. In the beginning there were automatic mechanical constructions that took over the locking and unlocking, now [ when? ]  automatic electromechanical and automatic  electrohydraulic  systems are available that make standing and walking safer and more comfortable. Various terms are used for a KAFO with a locked and unlocked knee joint. Typical designations are \"KAFO with automatic knee joint\" or \"KAFO with stance phase control knee joint\". In scientific articles, the English term Stance Control Orthoses SCO is often used, but as this term differs from the ICS classification, one of the first two terms is preferable."}
{"_id": "WikiPedia_Muscular_system$$$corpus_889", "text": "Different functional elements to compensate for weakness of the  dorsiflexors  or  plantar flexors  can be integrated into the ankle joint of the orthosis depending on the degree of paralysis of the two muscle groups. It is of great advantage if the resistances for these two functional elements can be set separately. [ 13 ]  The functional elements to compensate for paralysis of the knee-securing muscle groups of the  knee  and  hip extensors  are integrated into the knee joint of the orthosis via knee-securing functional elements. A KAFO can use a variety of combinations of different variants in the stiffness of the foot shell, the different variants of the functional elements of a dynamic ankle joint, the variants in the shape of the lower leg shell, and the functional elements of a knee joint to compensate for the user's limitations. [ 41 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_890", "text": "HKAFO is the abbreviation for hip-knee-ankle-foot orthoses; which is the English name for an orthosis that spans the hip, the knee, the ankle and the foot. [ 51 ]  In the treatment of paralyzed patients, a HKAFO is used when there is a  weakness  of the pelvic stabilizing trunk muscles. [ 41 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_891", "text": "Relief Orthoses are used when there is degeneration to a joint (from \"wear and tear\" for example) or after an injury such as a torn ligament. [ 53 ]  Relief orthoses are also used after operations such as operations on the joint ligaments, other bony, muscular structures, or after a complete replacement of a joint. [ 54 ] [ 55 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_892", "text": "Relief orthosis may also be used to: [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_893", "text": "A custom-made ankle/foot orthosis can be used for the treatment of patients with foot ulcers, it is a rigid L-shaped support member with a rigid anterior support shell on an articulated hinge. The plantar portion of the L-shaped member has at least one ulcer-protecting hollow to allow the user to transfer their weight away from the ulcer to facilitate treatment. The anterior support shell is designed with a lateral hinged attachment to take advantage of the medial tibial flare structure to enhance the weight-bearing properties of the orthosis. A flexible, polyethylene hinge attaches the support shell to the L-shaped member and straps securely attach the anterior support shell to the user's lower leg. [ 56 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_894", "text": "Foot orthoses (commonly called  orthotics ) are devices inserted into shoes to provide support for the foot by redistributing  ground reaction forces  acting on the foot joints while standing, walking or running. They may be either pre-moulded (also called pre-fabricated) or custom made according to a cast or impression of the foot. They are used by everyone from athletes to the elderly to accommodate biomechanical deformities and a variety of soft tissue conditions. Foot orthoses are effective at reducing pain for people with painful  high-arched feet , and may be effective for people with  rheumatoid arthritis ,  plantar fasciitis , first  metatarsophalangeal  (MTP) joint pain [ 57 ]  or  hallux valgus  (bunions). For children with  juvenile idiopathic arthritis  (JIA) custom-made and pre-fabricated foot orthoses may also reduce foot pain. [ 58 ]  Foot orthoses may also be used in conjunction with properly fitted orthopedic footwear in the prevention of  diabetic foot ulcers . [ 59 ] [ 60 ]  A real-time weight bearing orthotic can be created using a neutral position casting device and the Vertical Foot Alignment System VFAS. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_895", "text": "An AFO can also be used to immobilize the ankle and lower leg in the presence of arthritis or a fracture. Ankle\u2013foot orthoses are the most commonly used orthoses, making up about 26% of all orthoses provided in the United States. [ 61 ]  According to a review of Medicare payments from 2001 to 2006, the base cost of an AFO was about $500 to $700. [ 62 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_896", "text": "A knee orthosis (KO) or knee brace extends above and below the knee joint and is generally worn to support or align the knee. In the case of diseases causing neurological or muscular impairment of muscles surrounding the knee, a KO can prevent flexion, extension, or instability of the knee. If the ligaments or cartilage of the knee are affected, a KO can provide stabilization to the knee by replacing their functions. For instance, knee braces can be used to relieve pressure from diseases such as  arthritis  or  osteoarthritis  by realigning the knee joint. In this way a KO may help reduce osteoarthritis pain, [ 63 ]  however, there is no clear evidence about the most effective orthosis or the best approach to rehabilitation. [ 64 ]  A knee brace is not meant to treat an injury or disease on its own, but is used as a component of treatment along with drugs, physical therapy and possibly surgery. When used properly, a knee brace may help an individual to stay active by enhancing the position and movement of the knee or reducing pain. [ medical citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_897", "text": "Prophylactic braces are used primarily by athletes participating in contact sports. Evidence indicates that prophylactic knee braces, like the ones football linemen wear that are often rigid with a knee hinge, are ineffective in reducing anterior cruciate ligament tears, but may be helpful in resisting medial and lateral collateral ligament tears. [ 65 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_898", "text": "Functional braces are designed for use by people who have already experienced a knee injury and need support while recovering from it, or to help people who have pain associated with arthritis. They are intended to reduce the rotation of the knee, support stability, reduce the chance of hyperextension, and increase the agility and strength of the knee. The majority of these are made of elastic. They are the least expensive of all braces and are easily found in a variety of sizes. [ medical citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_899", "text": "Rehabilitation braces are used to limit the movement of the knee in both medial and lateral directions, these braces often have an adjustable range of motion, and can be used to limit flexion and extension following ACL reconstruction. They are primarily used after injury or surgery to immobilize the leg and are larger in size than other braces, due to their function."}
{"_id": "WikiPedia_Muscular_system$$$corpus_900", "text": "A soft brace, sometimes called soft support or a bandage, belong to the field of orthoses and are supposed to protect the joints from excessive loads.\nSoft braces are also classified according to regions of the body. In sport, bandages are used to protect bones and joints, and prevent and protect injuries. [ 66 ]  Bandages should also allow  proprioception . They mostly consist of textiles, some of which have supportive elements. The supporting functions are low compared to paralysis and relief orthoses, though they are sometimes used  prophylactically  or to optimize performance in sport. [ 67 ]  At present, the scientific literature does not provide sufficient high quality research to allow for strong conclusions on their effectiveness and cost-effectiveness. [ 68 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_901", "text": "Upper-limb (or upper extremity) orthoses are mechanical or electromechanical devices applied externally to the arm, or segments of it, in order to restore or improve function or structural characteristics of the arm segments enclosed in the device. In general, musculoskeletal problems that may be alleviated by the use of upper limb orthoses include those resulting from trauma [ 69 ]  or disease (arthritis for example). They may also benefit individuals who have a neurological impairment from a stroke, spinal cord injury, or peripheral neuropathy. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_902", "text": "Scoliosis , a condition describing an abnormal curvature of the spine, may in certain cases be treated with spinal orthoses, [ 70 ]  such as the  Milwaukee brace ,  Boston brace ,  Charleston bending brace , or  Providence brace . As scoliosis most commonly develops in adolescent females who are undergoing their  adolescent growth spurt , compliance is hampered by patient concerns about appearance and movement restrictions caused by the brace. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_903", "text": "Spinal orthoses may also be used in the treatment of spinal fractures. A Jewett brace, for instance, may be used to aid healing of an anterior  wedge fracture  involving the T10 to L3 vertebrae, and a body jacket may be used to stabilize more involved fractures of the spine. There are several types of orthoses for managing cervical spine pathology. [ 71 ]  The halo brace is the most restrictive cervical thoracic orthosis in use; it is used to immobilize the cervical spine, usually following fracture, and was developed by Vernon L. Nickel at  Rancho Los Amigos National Rehabilitation Center  in 1955. [ 72 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_904", "text": "Helmets  such as a cranial molding orthoses is an example of orthoses for the head. [ 73 ]  These devices are often suggested for infants with  positional plagiocephaly . [ 74 ] [ 75 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_905", "text": "A  pennate  or  pinnate muscle  (also called a  penniform muscle ) is a type of  skeletal muscle  with  fascicles  that attach obliquely (in a slanting position) to its tendon. This type of muscle generally allows higher force production but a smaller range of motion. [ 1 ] [ 2 ] \nWhen a muscle contracts and shortens, the  pennation angle  increases. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_906", "text": "The term \"pennate\" comes from the Latin  pinn\u0101tus  (\"feathered, winged\"), from  pinna  (\"feather, wing\")."}
{"_id": "WikiPedia_Muscular_system$$$corpus_907", "text": "In skeletal muscle tissue, 10-100  endomysium -sheathed  muscle fibers  are organized into  perimysium -wrapped bundles known as  fascicles . Each muscle is composed of a number of fascicles grouped together by a sleeve of connective tissue, known as an  epimysium . In a pennate muscle,  aponeuroses  run along each side of the muscle and attach to the tendon. The fascicles attach to the aponeuroses and form an angle (the pennation angle) to the load axis of the muscle. If all the fascicles are on the same side of the tendon, the pennate muscle is called  unipennate  (Fig. 1A). Examples of this include certain muscles in the  hand . If there are fascicles on both sides of the central tendon, the pennate muscle is called  bipennate  (Fig. 1B). The  rectus femoris , a large muscle in the  quadriceps , is typical. If the central tendon branches within a pennate muscle, the muscle is called multipennate (Fig. 1C), as seen in the  deltoid muscle  in the  shoulder ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_908", "text": "One advantage of pennate muscles is that more muscle fibers can be packed in parallel, thus allowing the muscle to produce more force, although the fiber angle to the direction of action means that the maximum force in that direction is somewhat less than the maximum force in the fiber direction. [ 4 ] [ 5 ] \nThe muscle cross sectional area (blue line in figure 1, also known as anatomical cross section area, or ACSA) does not accurately represent the number of muscle fibers in the muscle. A better estimate is provided by the total area of the cross sections perpendicular to the muscle fibers (green lines in figure 1). This measure is known as the physiological cross sectional area (PCSA), and is commonly calculated and defined by the following formula (an alternative definition is provided in the  main article ): [ 6 ] [ 7 ] [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_909", "text": "where \u03c1 is the density of the muscle:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_910", "text": "PCSA increases with pennation angle, and with muscle length. In a pennate muscle, PCSA is always larger than ACSA. In a non-pennate muscle, it coincides with ACSA."}
{"_id": "WikiPedia_Muscular_system$$$corpus_911", "text": "The total force exerted by the fibers along their oblique direction is proportional to PCSA. If the  specific tension  of the muscle fibers is known (force exerted by the fibers per unit of PCSA), it can be computed as follows: [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_912", "text": "However, only a component of that force can be used to pull the tendon in the desired direction. This component, which is the true  muscle force  (also called  tendon force [ 8 ] ), is exerted along the direction of action of the muscle: [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_913", "text": "The other component, orthogonal to the direction of action of the muscle (Orthogonal force = Total force \u00d7 sin\u03a6) is not exerted on the tendon, but simply squeezes the muscle, by pulling its aponeuroses toward each other."}
{"_id": "WikiPedia_Muscular_system$$$corpus_914", "text": "Notice that, although it is practically convenient to compute PCSA based on volume or mass and fiber length, PCSA (and therefore the total fiber force, which is proportional to PCSA) is not proportional to muscle mass or fiber length alone. Namely, the maximum ( tetanic ) force of a muscle fiber simply depends on its thickness (cross-section area) and  type . By no means it depends on its mass or length alone. For instance, when muscle mass increases due to  physical development  during childhood, this may be only due to an increase in length of the muscle fibers, with no change in fiber thickness (PCSA) or fiber type. In this case, an increase in mass does not produce an increase in force."}
{"_id": "WikiPedia_Muscular_system$$$corpus_915", "text": "In a pennate muscle, as a consequence of their arrangement, fibers are shorter than they would be if they ran from one end of the muscle to the other. This implies that each fiber is composed of a smaller number  N  of  sarcomeres  in series. Moreover, the larger the pennation angle is, the shorter are the fibers."}
{"_id": "WikiPedia_Muscular_system$$$corpus_916", "text": "The speed at which a muscle fiber can shorten is partly determined by the length of the muscle fiber (i.e., by  N ). Thus, a muscle with a large pennation angle will contract more slowly than a similar muscle with a smaller pennation angle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_917", "text": "Architectural gear ratio, also called anatomical gear ratio, (AGR) is a feature of pennate muscle defined by the ratio between the longitudinal strain of the muscle and  muscle fiber  strain. It is sometimes also defined as the ratio between muscle- shortening  velocity and fiber-shortening velocity: [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_918", "text": "where \u03b5 x  = longitudinal strain (or muscle-shortening velocity) and \u03b5 f  is fiber strain (or fiber-shortening velocity). [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_919", "text": "It was originally thought that the distance between aponeuroses did not change during the contraction of a pennate muscle, [ 5 ]  thus requiring the fibers to rotate as they shorten.  However, recent work has shown this is false, and that the degree of fiber angle change varies under different loading conditions. This dynamic gearing automatically shifts in order to produce either maximal velocity under low loads or maximal force under high loads. [ 10 ] [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_920", "text": "Perimysium  is a  sheath  of  dense irregular connective tissue  that groups  muscle  fibers into bundles (anywhere between 10 and 100 or more) or  fascicles ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_921", "text": "Studies of muscle physiology suggest that the perimysium plays a role in  transmitting lateral contractile movements . This hypothesis is strongly supported in one exhibition of the existence of \"perimysial junctional plates\" in  ungulate   flexor carpi radialis  muscles. [ 1 ]  The overall comprehensive organization of the perimysium  collagen  network, as well as its continuity and disparateness, however, have still not been observed and described thoroughly everywhere within the muscle. Found to have type I, III, VI, and XII collagen."}
{"_id": "WikiPedia_Muscular_system$$$corpus_922", "text": "In  muscle   physiology ,  physiological cross-sectional area  (PCSA) is the area of the cross section of a  muscle  perpendicular to its fibers, generally at its largest point. It is typically used to describe the contraction properties of  pennate muscles . [ 1 ]  It is not the same as the anatomical cross-sectional area (ACSA), which is the area of the crossection of a muscle perpendicular to its longitudinal axis. In a non-pennate muscle the fibers are parallel to the longitudinal axis, and therefore PCSA and ACSA coincide."}
{"_id": "WikiPedia_Muscular_system$$$corpus_923", "text": "One advantage of pennate muscles is that more muscle fibers can be packed in parallel, thus allowing the muscle to produce more force, although the fiber angle to the direction of action means that the maximum force in that direction is somewhat less than the maximum force in the fiber direction. [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_924", "text": "The muscle cross-sectional area (blue line in figure 1, also known as anatomical cross-section area, or ACSA) does not accurately represent the number of muscle fibers in the muscle. A better estimate is provided by the total area of the cross-sections perpendicular to the muscle fibers (green lines in figure 1). This measure is known as the physiological cross-sectional area (PCSA), and is commonly calculated and defined by the following formula, developed in 1975 by Alexander and Vernon: [ 4 ] [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_925", "text": "The total force exerted by the fibers in their oblique direction is proportional to PCSA. If the  specific tension  of the muscle fibers is known (force exerted by the fibers per unit of PCSA), it can be computed as follows: [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_926", "text": "However, only a component of that force can be used to pull the tendon in the desired direction. This component, which is the true  muscle force  (also called  tendon force [ 6 ] ), is exerted along the direction of action of the muscle: [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_927", "text": "Sometimes, the increase in mass is associated with an increase in thickness. Only in this case it will have some effect on fiber force, but this effect will be proportional to the increase in thickness, not to the increase in mass. For instance, in some stages of physical development, the increase in mass may be due to both an increase in PCSA and in fiber length. Even in this case, muscle force does not increase as much as muscle mass does, because the mass increase is partly produced by a variation in fiber length, and fiber length has no effect on muscle force."}
{"_id": "WikiPedia_Muscular_system$$$corpus_928", "text": "In 1982 a different definition of PCSA, herein denoted PCSA 2 , to facilitate comparison with the previous definition, was introduced by Sacks & Roy: [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_929", "text": "The comparison shows that"}
{"_id": "WikiPedia_Muscular_system$$$corpus_930", "text": "in a pennate muscle, since  \n \n \n \n cos \n \u2061 \n \u03a6 \n \n \n {\\displaystyle \\cos \\Phi } \n \n  is always smaller than 1, PCSA 2  is always smaller than PCSA. Hence, it cannot be described as the total area of the cross-sections perpendicular to the muscle fibers (green lines in figure 1). It can be interpreted two ways:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_931", "text": "This implies that, in a muscle such as that in figure 1A, PCSA 2  coincides with ACSA. The disadvantage of this definition is its more complex interpretation, its advantage is that muscle force can be computed more directly:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_932", "text": "Currently, some authors keep using the original definition of PCSA, [ 5 ] [ 6 ]  probably because of its intuitively appealing geometrical interpretation (figure 1)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_933", "text": "The  posterior chain  is a group of muscles on the posterior of the body. Examples of these muscles include the  hamstrings , [ 1 ]  the  gluteus maximus , [ 1 ]   erector spinae [ 1 ]  muscle group,  trapezius , and posterior  deltoids ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_934", "text": "The primary exercises for developing the posterior chain are the  Olympic lifts ,  squats , [ 1 ]   good-mornings ,  bent-over rows ,  deadlifts , [ 1 ]   pull-ups  and  hyperextensions . The common denominator among many of these movements is a focus on hip extension, excluding bent-over rows and pull ups. Working on hamstrings is also important."}
{"_id": "WikiPedia_Muscular_system$$$corpus_935", "text": "Preflexes  are the latent capacities in the  musculoskeletal system  that auto-stabilize movements through the use of the  nonlinear   visco-elastic  properties of  muscles  when they  contract . [ 1 ] [ 2 ]  The term \"preflex\" for such a zero-delay, intrinsic feedback loop was coined by Loeb. [ 3 ]  Unlike stabilization methods using  neurons , such as  reflexes  and  higher brain control , a preflex happens with minimal time delay; however, it only stabilizes the main movements of the musculoskeletal system. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_936", "text": "Muscles possess nonlinear visco-elastic properties when they contract. [ 4 ] [ 5 ] [ 6 ]  This property can autocorrect movements when a muscle is forced to change its length, and at a velocity different from that with which it was originally commanded. Such automatic correction is useful when a commanded action is perturbated, for example, if a step goes into a hole as this causes the foot to unexpectedly stretch down. The nonlinear visco-elastic properties of muscles interact with these perturbation induced velocity and length differences such that they  counteract directly, as they happen, the effects upon the body of the perturbation.\nPart of the resistance to perturbation is passive, by means of the nonlinear increase in passive tension and joint torques produced by muscular and other soft tissues. [ 4 ]  Tissue prestress is a preflexive property that constitutes a basal level of passive tension which, due to its presence in antagonistic tissues of a joint, increases joint passive stiffness and stability. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_937", "text": "Muscles contain many different systems on which the  evolutionary selection  of preflex stabilization can operate. The  deltoid muscle , for example, consists of at least seven segments with different bone attachments and neural control. [ 8 ]  Within each muscle segment, there exists a complex internal structure that goes down to one in which each muscle unit consists of a tendon,  aponeurosis , and a  fascicle  of active contractile and passive elements. [ 4 ]  Another source of variation is in the internal architecture of the fiber orientation relative to a muscle's line of action, for example, as found in  pennate muscles . [ 9 ]  The complexities of the different visco-elastic length- and velocity-force relationships of these subparts provides the opportunity for the adaptive selection of structurally complex muscle biocomposites with highly task-tuned nonlinear visco-elastic length- velocity- force relationships. This nature of muscles to be composite structures thus provides the adaptive opportunity for evolution to modify the visco-elastic reactions of the musculoskeletal system so they counteract perturbations without the need for spinal or higher levels of control."}
{"_id": "WikiPedia_Muscular_system$$$corpus_938", "text": "Helmeted guineafowl  like many other  bipedal  birds  walk  upon rough ground. When a guineafowl's leg steps into a hole (a common disruption against which evolution has tuned the nonlinear visco-elastic properties of its musculoskeletal system), a momentarily uncommanded velocity and length change in the muscles that span its leg joints occurs. This length/velocity discrepancy interacts with the nonlinear length and velocity-force relationships that have evolved in response to such a disruption with the result that the leg extends further into the hole, and thus keeps the bird's body stable and upright. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_939", "text": "It is the intrinsic musculoskeletal properties of a  frog 's leg, not neurally mediated spinal reflexes, that stabilize its wiping movements at irritants when the leg movement is instigated. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_940", "text": "A human example of a preflex stabilization occurs when a person explosively  jumps  up from a  squat position , and the leg muscles act to provide a minimal time delay against perturbations from the vertical. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_941", "text": "A  protein supplement  is a  dietary supplement  or a  bodybuilding supplement , and usually comes in the form of a  protein bar , protein powder, and even readily available as a protein shake. Usually made from whey, plant, and/or meat sources."}
{"_id": "WikiPedia_Muscular_system$$$corpus_942", "text": "Protein supplements are extracts or concentrates of high protein foodstuffs, used in bodybuilding and as dietary supplements to fulfill protein intake in a lean and pure source of proteins and  amino acids . They have three main variants: concentrate (food is taken and concentrated into a smaller volume with some fat and carb present), isolate (proteins and amino acids are completely isolated, mostly leaving proteins and amino acids), and hydrolyze (a protein supplement is exposed to enzymes and partially digested). Some protein supplements contain digestive enzymes as an additive for digestion and absorption."}
{"_id": "WikiPedia_Muscular_system$$$corpus_943", "text": "A meta-study found that in the first few weeks of strength training with untrained individuals, changes in  lean body mass  and  muscle strength  during the initial weeks of  strength training  are not influenced by the protein supplementation, but after the first few weeks, protein supplementation \u201cmay promote muscle hypertrophy and enhance gains in muscle strength in both untrained and trained individuals\u201d [ 1 ]  Also,  whey-protein  supplementation in  overweight  individuals may reduce the  body weight , total  fat mass  and risk factors for  cardiovascular diseases . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_944", "text": "When combined with  strength training , protein supplementation promotes greater gains in lean body mass and muscle strength as the intensity, frequency, and duration of strength training increases. [ 1 ]  It increases the  muscles' strength  and  size , during prolonged strength training in healthy adults. [ 3 ]  A meta-study concluded that intake of protein supplements higher than around 1.6 g/kg/day do not further improve the gains in  FFM (fat free mass) [ 3 ]  \u201cat least for younger individuals\u201d, [ 3 ]  with a  confidence interval  from 1.03 to 2.20 [ 3 ]  so \u201cit may be prudent to recommend ~2.2 g protein/kg/d for those seeking to maximize resistance training-induced gains in FFM\u201d. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_945", "text": "As people get older, aging reduces the effect of protein intake, and experts in the field of protein and aging recommend a protein intake between 1.2 and 2.0 g/kg/day or higher for elderly adults. [ 4 ] [ 5 ] [ 6 ] [ 7 ]  Higher-than-ADA protein recommendations are especially important if they have acute or chronic diseases.  [ 8 ]  Increased  resistance training  also helps balance aging's negative effect on muscle mass. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_946", "text": "A study group concluded: \"Older people with severe kidney disease (i.e., estimated  GFR  less than 30 mL/min/1.73m 2 ), but who are not on dialysis, are an exception to this rule; these individuals may need to limit protein intake.\" [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_947", "text": "Past studies propose that spreading protein intake through the day (with a maximum of 30g at a time) achieves maximal total stimulation of muscle protein synthesis. [ 9 ] [ 10 ]  However, recent studies suggest that protein intake for muscle gain can be taken either throughout the day or at one time, if that is more convenient. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_948", "text": "There is no evidence supporting specific pre/post-workout timing for protein-supplement intakes, despite the widely held belief that pre- or post-workout protein supplementation would be more effective. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_949", "text": "Nutritional status can be altered in people living with  chronic kidney disease (CKD).  There is moderate-certainty evidence that regular consumption of oral protein-based nutritional supplements may increase serum  albumin , a protein that can be lower in people with CKD, due to increased loss in urine and malnutrition. Improvements in albumin following protein supplementation may be greater in those who require hemodialysis or who are malnourished. [ 13 ]  Pre-albumin levels and mid-arm circumference measurements may also be increased following supplementation, though the certainty of evidence is low. [ 13 ]  Although these indicate possible improvements in nutritional status, it is unclear whether protein supplements affect quality of life, life expectancy, inflammation or body composition. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_950", "text": "Pyrometallide gels  are types of  gels  based on  pyromellitamide  molecules. [ 1 ] [ 2 ]  Such gels being developed which will enable the repair of severed  muscles  and  spinal cords  in patients."}
{"_id": "WikiPedia_Muscular_system$$$corpus_951", "text": "These types of  artificial muscles  are made possible by creating  synthetic materials  which are very similar to the ones which make up human tissues and cells. These artificial materials are so similar that the body does not reject the material and instead allows normal  cell growth  in the materials which eventually become absorbed into the body."}
{"_id": "WikiPedia_Muscular_system$$$corpus_952", "text": "The gel molecule is composed of a tetra-alkane benzene-1,2,4,5-tetracarboxamide. The gel structure is made up of millions of tiny fibres, which form a 3D mesh by trapping a  liquid  in the same way that a  sponge  absorbs water, to form a solid. The unique feature of self-assembled gels is that  chemical reactions  are not required to form the fibres; it is simply a case of heating them up in a liquid and waiting for them to set."}
{"_id": "WikiPedia_Muscular_system$$$corpus_953", "text": "There is huge range of potential applications for these gels. Aside from the artificial muscles, these gels could also be used for  drug delivery  in  cancer  patients, where they can injected into the patient, and the gel will slowly release a constant stream of anti-cancer drugs in the body. There are also applications for computer and television screens, where gels are used for  LCD  screens. These gels could lower the  manufacturing  costs and be used to construct  flexible display  screens."}
{"_id": "WikiPedia_Muscular_system$$$corpus_954", "text": "This  pharmacology -related article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_955", "text": "Reciprocal inhibition  is a  neuromuscular  process in which  muscles  on one side of a joint relax to allow the contraction of muscles on the opposite side, enabling smooth and coordinated movement. [ 1 ]  This concept, introduced by  Charles Sherrington , a pioneering  neuroscientist , is also referred to as  reflexive antagonism  in some allied health fields. Sherrington, one of the founding figures in neurophysiology, observed that when the central nervous system signals an agonist muscle to contract, inhibitory signals are sent to the antagonist muscle, encouraging it to  relax  and reduce resistance. This mechanism, known as reciprocal inhibition, is essential for efficient movement and helps prevent muscle strain by balancing forces around a joint. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_956", "text": "Joints are controlled by two opposing sets of muscles called  extensors  and  flexors , that work in synchrony for smooth movement. When a muscle spindle is stretched, the  stretch reflex  is activated, and the opposing muscle group must be inhibited to prevent it from working against the contraction of the homonymous muscle. This inhibition is accomplished by the actions of an inhibitor interneuron in the spinal cord. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_957", "text": "The afferent of the muscle spindle bifurcates in the spinal cord. One branch innervates the  alpha motor neuron  that causes the homonymous muscle to contract, producing the reflex. The other branch innervates the inhibitory interneuron, which then innervates the  alpha motor neuron  that synapses onto the opposing muscle. Because the interneuron is inhibitory, it prevents the opposing  alpha motor neuron  from firing, thereby reducing the contraction of the opposing muscle. Without this reciprocal inhibition, both groups of muscles might contract simultaneously and work against each other."}
{"_id": "WikiPedia_Muscular_system$$$corpus_958", "text": "If opposing muscles were to contract at the same time, a muscle tear can occur. This may occur during physical activities such as running, during which opposing muscles engage and disengage sequentially to produce coordinated movement. Reciprocal inhibition facilitates ease of movement and is a safeguard against injury. However, if a \"misfiring\" of motor neurons occurs, causing simultaneous contraction of opposing muscles, a tear can occur. For example, if the  quadriceps femoris  and  hamstring  contract simultaneously at a high intensity, the stronger muscle (traditionally the quadriceps) overpowers the weaker muscle group (hamstrings). This can result in a common muscular injury known as a  pulled hamstring , more accurately called a  muscle strain ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_959", "text": "The phenomenon is fleeting, incomplete, and weak. For example, when the  triceps brachii  is stimulated, the  biceps  is reflexively inhibited. The incompleteness of the effect is related to  postural  and functional tone. Also, some reflexes  in vivo  are  polysynaptic , with entire muscle groups responding to  noxious stimuli ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_960", "text": "As the body ages, the control of voluntary inhibition decreases in conjunction with the torque of the synapse as joints stiffen and their motor output is reduced. However, this reduction in ability tends to be insignificant. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_961", "text": "Reciprocal inhibition is the basic original notion behind indirect  muscle energy techniques . While this notion is now understood to be incomplete, the clinical mechanism of reflexive antagonism continues to be useful in physical therapy."}
{"_id": "WikiPedia_Muscular_system$$$corpus_962", "text": "Muscle energy techniques that use reflexive antagonism, such as rapid deafferentation techniques, are  medical guideline  techniques and protocols that make use of reflexive pathways and reciprocal inhibition as a means of switching off inflammation, pain, and protective spasm for entire synergistic muscle groups or singular muscles and  soft tissue  structures."}
{"_id": "WikiPedia_Muscular_system$$$corpus_963", "text": "Ren\u00e9 Descartes  (1596\u20131650) was one of the first to conceive a model of  reciprocal innervation  (in 1626) as the principle that provides for the control of  agonist  and  antagonist   muscles .  Reciprocal innervation describes skeletal muscles as existing in antagonistic pairs, with contraction of one muscle producing forces opposite to those generated by contraction of the other. For example, in the human  arm , the  triceps  acts to  extend  the lower arm outward while the  biceps  acts to  flex  the lower arm inward. To reach optimum efficiency, contraction of opposing muscles must be inhibited while muscles with the desired action are excited. This reciprocal innervation occurs so that the contraction of a muscle results in the simultaneous relaxation of its corresponding antagonist."}
{"_id": "WikiPedia_Muscular_system$$$corpus_964", "text": "A common example of reciprocal innervation, is the effect of the  nociceptive  (or nocifensive) reflex, or defensive response to pain, otherwise commonly known as the  withdrawal reflex ; a type of involuntary action of the body to remove the body part from the vicinity of an offending object by contracting the appropriate muscles (usually flexor muscles), while relaxing the extensor muscles, allowing smooth movement."}
{"_id": "WikiPedia_Muscular_system$$$corpus_965", "text": "The concept of reciprocal innervation as applicable to the  eye  is also known as  Sherrington's law  (after  Charles Scott Sherrington ), wherein increased innervation to an  extraocular muscle  is accompanied by a simultaneous decrease in innervation to its specific antagonist, such as the medial rectus and the lateral rectus in the case of an eye looking to one side of the midline. When looking outward or laterally, the lateral rectus of one eye must contract via increased innervation, while its antagonist, the medial rectus of the same eye - shall relax. The converse would occur in the other eye, both eyes demonstrating the law of reciprocal innervation. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_966", "text": "The significance of Descartes\u2019 Law of Reciprocal Innervation has been additionally highlighted by recent research and applications of  bioengineering  concepts, such as optimal control and quantitative models of the motor impulses sent by the brain to control eye motion."}
{"_id": "WikiPedia_Muscular_system$$$corpus_967", "text": "In some animals, the male  penis  possesses a  muscle  enabling  retraction  into the  prepuce ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_968", "text": "The retractor penis muscle occurs in  marsupials  and  carnivorans , but it is absent in humans. [ 1 ]  A  stag's penis  forms an S-shaped curve when it is not erect, and is retracted into its  preputial sheath  by the retractor penis muscle. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_969", "text": "In  Tandonia , the retractor penis inserts at the boundary between the penis and epiphallus. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_970", "text": "In stallions , the retractor penis muscle is relatively underdeveloped. [ 4 ]  The retractor muscle contracts to retract the penis into the sheath and relaxes to allow the penis to extend from the sheath. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_971", "text": "In bulls , protrusion is not affected much by erection, but more by relaxation of the retractor penis muscle and straightening of the  sigmoid flexure . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_972", "text": "A  rhabdosphincter  (from  Greek   rhabdos  meaning \"rod\") is a  sphincter  consisting of  striated muscle  fibres. [ 1 ]  The muscle is a part of the  external urethral sphincter  that continues  superiorly  as a trough-like extension running vertically across the  anterior  aspect of the  prostate  to reach the  neck of the bladder . [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_973", "text": "Widely used in the  human factors and ergonomics  field,  Rohmert's law  states that the maximum  force  one's  muscles  can exert  decreases exponentially  from the time one begins continuously exerting the force. It is commonly used to calculate \"maximum holding time\" for any particular task."}
{"_id": "WikiPedia_Muscular_system$$$corpus_974", "text": "Maximum force decays exponentially due to the amount of  energy  (in the form of  oxygen  and  ATP ) the body is able to supply to the muscles. The  circulatory systems  keeps muscles flooded in  nutrients  at all times, so that muscles have a supply of fuel-ready to burn at any given moment. A task requiring maximum force burns a large amount of those nutrients at the onset of the task; the circulatory system is then unable to replenish the nutrients at a rate fast enough to maintain the maximum force for long. As a result, the maximum force the muscle is capable of producing is limited by the bottleneck in  nutrient  availability, and decreases exponentially."}
{"_id": "WikiPedia_Muscular_system$$$corpus_975", "text": "Imagine a theoretical  arm wrestling  match with two perfectly matched opponents, each exactly as strong as the other. They both begin the match by exerting maximum force on each other's hands, but very soon, their arms get fatigued and the actual force being exerted on each other's hands drops off quickly. They are still exerting as much force as they can, but their muscles are burning energy faster than can be replenished, and their maximum force is decreasing exponentially. Eventually, their arms are completely fatigued; they are basically just holding hands and applying what little force their muscles can muster, wondering when the other will give up."}
{"_id": "WikiPedia_Muscular_system$$$corpus_976", "text": "Rohmert's law suggests that, for example, static gripping loads be not more than 15% of the load required for a squeeze-operated tool. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_977", "text": "While Rohmert's law applies to  maximum  force, the inverse is true as well; the less force one is asked to exert, the longer one will be able to exert that force before their muscles become fatigued. If one is asked to exert zero force, they can theoretically hold the position indefinitely."}
{"_id": "WikiPedia_Muscular_system$$$corpus_978", "text": "Rohmert's law is true across all humans. While everyone has a different initial maximum force they can apply, their maximum force will decrease according to the same exponential curve as everyone else."}
{"_id": "WikiPedia_Muscular_system$$$corpus_979", "text": "A  sarcomere  (Greek \u03c3\u03ac\u03c1\u03be  sarx  \"flesh\", \u03bc\u03ad\u03c1\u03bf\u03c2  meros  \"part\") is the smallest functional unit of  striated muscle tissue . [ 1 ]  It is the repeating unit between two Z-lines.  Skeletal muscles  are composed of tubular muscle cells (called muscle fibers or myofibers) which are formed during   embryonic   myogenesis . Muscle fibers contain numerous tubular  myofibrils . Myofibrils are composed of repeating sections of sarcomeres, which appear under the microscope as alternating dark and light bands. Sarcomeres are composed of long, fibrous proteins as filaments that slide past each other when a muscle contracts or relaxes. The  costamere  is a different component that connects the sarcomere to the  sarcolemma ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_980", "text": "Two of the important proteins are  myosin , which forms the thick filament, and  actin , which forms the thin filament. Myosin has a long fibrous tail and a globular head that binds to actin. The  myosin head  also binds to  ATP , which is the source of energy for muscle movement. Myosin can only bind to actin when the binding sites on actin are exposed by calcium ions."}
{"_id": "WikiPedia_Muscular_system$$$corpus_981", "text": "Actin molecules are bound to the Z-line, which forms the borders of the sarcomere. Other bands appear when the sarcomere is relaxed. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_982", "text": "The myofibrils of  smooth muscle  cells are not arranged into sarcomeres."}
{"_id": "WikiPedia_Muscular_system$$$corpus_983", "text": "The sarcomeres give  skeletal  and  cardiac muscle  their  striated appearance , [ 2 ]  which was first described by  Van Leeuwenhoek . [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_984", "text": "The relationship between the proteins and the regions of the sarcomere are as follows:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_985", "text": "The protein  tropomyosin  covers the myosin-binding sites of the actin molecules in the muscle cell.  For a muscle cell to contract, tropomyosin must be moved to uncover the binding sites on the actin.  Calcium ions bind with  troponin C  molecules (which are dispersed throughout the tropomyosin protein) and alter the structure of the tropomyosin, forcing it to reveal the cross-bridge binding site on the actin."}
{"_id": "WikiPedia_Muscular_system$$$corpus_986", "text": "The concentration of calcium within muscle cells is controlled by the  sarcoplasmic reticulum , a unique form of  endoplasmic reticulum  in the  sarcoplasm ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_987", "text": "Muscle cells are stimulated when a  motor neuron  releases the neurotransmitter  acetylcholine , which travels across the  neuromuscular junction  (the synapse between the terminal button of the neuron and the muscle cell).   Acetylcholine  binds to a post-synaptic  nicotinic acetylcholine receptor . A change in the receptor conformation allows an influx of  sodium  ions and initiation of a post-synaptic  action potential . The action potential then travels along  T-tubules  (transverse tubules) until it reaches the sarcoplasmic reticulum. Here, the depolarized membrane activates voltage-gated  L-type calcium channels , present in the plasma membrane. The L-type calcium channels are in close association with  ryanodine receptors  present on the sarcoplasmic reticulum. The inward flow of calcium from the L-type calcium channels activates ryanodine receptors to release calcium ions from the sarcoplasmic reticulum. This mechanism is called  calcium-induced calcium release  (CICR). It is not understood whether the physical opening of the L-type calcium channels or the presence of calcium causes the ryanodine receptors to open. The outflow of calcium allows the myosin heads access to the actin cross-bridge binding sites, permitting muscle contraction. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_988", "text": "Muscle contraction ends when calcium ions are pumped back into the sarcoplasmic reticulum, allowing the contractile apparatus and, thus, muscle cell to relax."}
{"_id": "WikiPedia_Muscular_system$$$corpus_989", "text": "Upon muscle contraction, the A-bands do not change their length (1.85 micrometer in mammalian skeletal muscle), [ 5 ]  whereas the I-bands and the H-zone shorten. This causes the Z-lines to come closer together."}
{"_id": "WikiPedia_Muscular_system$$$corpus_990", "text": "At rest, the  myosin head  is bound to an  ATP  molecule in a low-energy configuration and is unable to access the cross-bridge binding sites on the actin.  However, the myosin head can hydrolyze ATP into  adenosine diphosphate  (ADP) and an inorganic phosphate ion.  A portion of the energy released in this reaction changes the shape of the myosin head and promotes it to a high-energy configuration.  Through the process of binding to the actin, the myosin head releases ADP and an inorganic phosphate ion, changing its configuration back to one of low energy.  The myosin remains attached to actin in a state known as  rigor , until a new ATP binds the myosin head. This binding of ATP to myosin releases the actin by cross-bridge dissociation. The ATP-associated myosin is ready for another cycle, beginning with hydrolysis of the ATP."}
{"_id": "WikiPedia_Muscular_system$$$corpus_991", "text": "The A-band is visible as dark transverse lines across myofibers; the I-band is visible as lightly staining transverse lines, and the Z-line is visible as dark lines separating sarcomeres at the light-microscope level."}
{"_id": "WikiPedia_Muscular_system$$$corpus_992", "text": "Most muscle cells can only store enough ATP for a small number of muscle contractions.  While muscle cells also store  glycogen , most of the energy required for contraction is derived from  phosphagens .  One such phosphagen,  creatine phosphate , is used to provide ADP with a phosphate group for ATP synthesis in  vertebrates . [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_993", "text": "The structure of the sarcomere affects its function in several ways.  The overlap of actin and myosin gives rise to the  length-tension curve , which shows how sarcomere  force  output decreases if the muscle is stretched so that fewer cross-bridges can form or compressed until actin filaments interfere with each other.  Length of the actin and myosin filaments (taken together as sarcomere length) affects force and velocity \u2013 longer sarcomeres have more cross-bridges and thus more force, but have a reduced range of shortening.  Vertebrates display a very limited range of sarcomere lengths, with roughly the same optimal length (length at peak length-tension) in all muscles of an individual as well as between species.   Arthropods , however, show tremendous variation (over seven-fold) in sarcomere length, both between species and between muscles in a single individual.  The reasons for the lack of substantial sarcomere variability in vertebrates is not fully known. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_994", "text": "In anatomy and physiology,  segmental stabilizers  are the muscles which provide support across joints, as in the  multifidus  across  spinal   vertebrae . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_995", "text": "Segmental stabilizers align bones, such as the spine, so as to reduce stress during movement.  They are primarily enlisted during  functional movement  and  balance training ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_996", "text": "Skeletal muscle  (commonly referred to as  muscle ) is one of the three types of  vertebrate   muscle tissue , the others being  cardiac muscle  and  smooth muscle . They are part of the  voluntary  muscular system [ 1 ]  and typically are attached by  tendons  to  bones  of a  skeleton . [ 2 ] [ 3 ]  The skeletal  muscle cells  are much longer than in the other types of muscle tissue, and are also known as  muscle fibers . [ 4 ]  The tissue of a skeletal muscle is  striated  \u2013 having a striped appearance due to the arrangement of the  sarcomeres ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_997", "text": "A skeletal muscle contains multiple  fascicles  \u2013 bundles of muscle fibers. Each individual fiber, and each muscle is surrounded by a type of  connective tissue  layer of  fascia . Muscle fibers are formed from the  fusion  of developmental  myoblasts  in a process known as  myogenesis  resulting in long  multinucleated  cells. In these cells the  nuclei , termed  myonuclei , are located along the inside of the  cell membrane . Muscle fibers also have multiple  mitochondria  to meet energy needs."}
{"_id": "WikiPedia_Muscular_system$$$corpus_998", "text": "Muscle fibers are in turn composed of  myofibrils . The myofibrils are composed of  actin  and  myosin  filaments called  myofilaments , repeated in units called sarcomeres, which are the basic functional, contractile units of the muscle fiber necessary for  muscle contraction . [ 5 ]  Muscles are predominantly powered by the  oxidation  of  fats  and  carbohydrates , but  anaerobic  chemical reactions are also used, particularly by  fast twitch fibers . These chemical reactions produce  adenosine triphosphate  (ATP) molecules that are used to power the movement of the  myosin heads . [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_999", "text": "Skeletal muscle comprises about 35% of the body of humans by weight. [ 7 ]   The functions of skeletal muscle include producing movement, maintaining body posture, controlling body temperature, and stabilizing joints. [ 8 ]  Skeletal muscle is also an  endocrine organ . [ 9 ] [ 10 ] [ 11 ]  Under different physiological conditions, subsets of 654 different proteins as well as lipids, amino acids, metabolites and small RNAs are found in the  secretome  of skeletal muscles. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1000", "text": "Skeletal muscles are substantially composed of  multinucleated  contractile  muscle fibers  (myocytes). However, considerable numbers of resident and infiltrating mononuclear cells are also present in skeletal muscles. [ 13 ]   In terms of volume, myocytes make up the great majority of skeletal muscle. Skeletal muscle myocytes are usually very large, being about 2\u20133\u00a0cm long and 100 \u03bcm in diameter. [ 14 ]   By comparison, the mononuclear cells in muscles are much smaller. Some of the mononuclear cells in muscles [ 15 ]  are endothelial cells (which are about 50\u201370 \u03bcm long, 10\u201330 \u03bcm wide and 0.1\u201310 \u03bcm thick), [ 16 ]   macrophages  (21 \u03bcm in diameter) and  neutrophils  (12-15 \u03bcm in diameter). [ 17 ]   However, in terms of nuclei present in skeletal muscle, myocyte nuclei may be only half of the nuclei present, while nuclei from resident and infiltrating mononuclear cells make up the other half. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1001", "text": "Considerable research on skeletal muscle is focused on the muscle fiber cells, the myocytes, as discussed in detail in the first sections, below. However, recently, interest has also focused on the different types of mononuclear cells of skeletal muscle, as well as on the  endocrine  functions of muscle, described subsequently, below."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1002", "text": "There are more than 600 skeletal muscles in the human body, making up around 40% of body weight in healthy young adults. [ 18 ] [ 19 ] [ 20 ]  In Western populations, men have on average around 61% more skeletal muscle than women. [ 21 ]  Most muscles occur in bilaterally-placed pairs to serve both sides of the body. Muscles are often classed as  groups of muscles  that work together to carry out an action. In the  torso  there are several  major muscle groups  including the  pectoral , and  abdominal muscles ;  intrinsic and extrinsic muscles  are subdivisions of muscle groups in the  hand ,  foot ,  tongue , and  extraocular muscles  of the  eye . Muscles are also grouped into  compartments  including  four groups in the arm ,\nand the  four groups in the leg ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1003", "text": "Apart from the contractile part of a muscle consisting of its fibers, a muscle contains a non-contractile part of dense fibrous connective tissue that makes up the  tendon  at each end. The tendons attach the muscles to bones to give skeletal movement. The length of a muscle includes the tendons.  Connective tissue  is present in all muscles as  deep fascia . Deep fascia specialises within muscles to enclose each muscle fiber as  endomysium ; each muscle fascicle as  perimysium , and each individual muscle as  epimysium . Together these layers are called  mysia . Deep fascia also separates the groups of muscles into muscle compartments."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1004", "text": "Two types of  sensory receptors  found in muscles are  muscle spindles , and  Golgi tendon organs . Muscle spindles are  stretch receptors  located in the muscle belly. Golgi tendon organs are  proprioceptors  located at the  myotendinous junction  that inform of a  muscle's tension ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1005", "text": "Skeletal muscle cells are the individual contractile cells within a muscle, and are often termed as  muscle fibers . [ 3 ]  A single muscle such as the  biceps  in a young adult male contains around 253,000 muscle fibers. [ 22 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1006", "text": "Skeletal muscle fibers are  multinucleated  with the  nuclei  often referred to as  myonuclei . This occurs during  myogenesis  with the  fusion  of myoblasts each contributing a nucleus. [ 23 ]  Fusion depends on muscle-specific proteins known as  fusogens  called  myomaker  and  myomerger . [ 24 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1007", "text": "Many nuclei are needed by the skeletal muscle cell for the large amounts of proteins and enzymes needed to be produced for the cell's normal functioning. A single muscle fiber can contain from hundreds to thousands of nuclei. [ 25 ]  A muscle fiber for example in the human biceps with a length of 10\u00a0cm can have as many as 3,000 nuclei. [ 25 ]  Unlike in a non-muscle  cell  where the nucleus is centrally positioned, the myonucleus is elongated and located close to the  sarcolemma . The myonuclei are quite uniformly arranged along the fiber with each nucleus having its own  myonuclear domain  where it is responsible for supporting the volume of cytoplasm in that particular section of the myofiber. [ 24 ] [ 25 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1008", "text": "A group of muscle  stem cells  known as  myosatellite cells , also  satellite cells  are found between the  basement membrane  and the sarcolemma of muscle fibers. These cells are normally quiescent but can be activated by exercise or pathology to provide additional myonuclei for muscle growth or repair. [ 26 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1009", "text": "Muscles attach to  tendons  in a complex interface region known as the  musculotendinous junction , also known as the  myotendinous junction , an area specialised for the primary transmission of force. [ 27 ]  At the muscle-tendon interface, force is transmitted from the sarcomeres in the muscle cells to the tendon. [ 5 ]  Muscles and tendons develop in close association, and after their joining at the myotendinous junction they constitute a dynamic unit for the transmission of force from muscle contraction to the skeletal system. [ 27 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1010", "text": "Muscle architecture  refers to the arrangement of muscle fibers relative to the axis of  force generation , which runs from a  muscle's origin  to its  insertion . \nThe usual arrangements are types of  parallel , and types of  pennate muscle . In parallel muscles, the fascicles run parallel to the axis of force generation, but the fascicles can vary in their relationship to one another, and to their tendons. [ 28 ]  These variations are seen in  fusiform ,  strap , and  convergent muscles . [ 4 ]  A convergent muscle has a triangular or fan-shape as the fibers converge at its insertion and are fanned out broadly at the origin. [ 28 ]  A less common example of a parallel muscle is a circular muscle such as the  orbicularis oculi , in which the fibers are longitudinally arranged, but create a circle from origin to insertion. [ 29 ]  These different architectures, can cause variations in the tension that a muscle can create between its tendons."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1011", "text": "The fibers in  pennate muscles  run at an angle to the axis of force generation. [ 29 ]  This  pennation angle  reduces the effective force of any individual fiber, as it is effectively pulling off-axis. However, because of this angle, more fibers can be packed into the same muscle volume, increasing the  physiological cross-sectional area  (PCSA). This effect is known as fiber packing, and in terms of force generation, it more than overcomes the efficiency-loss of the off-axis orientation. The trade-off comes in overall speed of muscle shortening and in the total excursion. Overall muscle shortening speed is reduced compared to fiber shortening speed, as is the total distance of shortening. [ 29 ]  All of these effects scale with pennation angle; greater angles lead to greater force due to increased fiber packing and PCSA, but with greater losses in shortening speed and excursion. Types of pennate muscle are  unipennate ,  bipennate , and  multipennate . A unipennate muscle has similarly angled fibers that are on one side of a tendon. A bipennate muscle has fibers on two sides of a tendon. Multipennate muscles have fibers that are oriented at multiple angles along the force-generating axis, and this is the most general and most common architecture. [ 29 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1012", "text": "Muscle fibers grow when exercised and shrink when not in use. This is due to the fact that exercise stimulates the increase in  myofibrils  which increase the overall size of muscle cells. Well exercised muscles can not only add more size but can also develop more  mitochondria ,  myoglobin ,  glycogen  and a higher density of  capillaries . However, muscle cells cannot divide to produce new cells, and as a result there are fewer muscle cells in  an adult than in a newborn. [ 30 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1013", "text": "Broadly there are two types of muscle fiber:  Type I , which is slow, and  Type II  which are fast. Type II has two divisions of type IIA (oxidative), and type IIX (glycolytic), giving three main fiber types. [ 33 ]  These fibers have relatively distinct metabolic, contractile, and  motor unit  properties. The table below differentiates these types of properties. These types of properties\u2014while they are partly dependent on the properties of individual fibers\u2014tend to be relevant and measured at the level of the motor unit, rather than individual fiber. [ 34 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1014", "text": "Slow oxidative (type I) fibers contract relatively slowly and use aerobic respiration to produce ATP. Fast oxidative (type IIA) fibers have fast contractions and primarily use aerobic respiration, but because they may switch to anaerobic respiration (glycolysis), can fatigue more quickly than slow oxidative fibers. Fast glycolytic (type IIX) fibers have fast contractions and primarily use anaerobic glycolysis. The FG fibers fatigue more quickly than the others. Most skeletal muscles in a human contain(s) all three types, although in varying proportions. [ 35 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1015", "text": "Traditionally, fibers were categorized depending on their varying color, which is a reflection of  myoglobin  content. Type\u00a0I fibers appear red due to the high levels of myoglobin. Red muscle fibers tend to have more mitochondria and greater local capillary density. These fibers are more suited for endurance and are slow to fatigue because they use  oxidative metabolism  to generate ATP ( adenosine triphosphate ). Less oxidative Type\u00a0II fibers are white due to relatively low myoglobin and a reliance on glycolytic enzymes."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1016", "text": "Fibers can also be classified on their twitch capabilities, into fast and slow twitch. These traits largely, but not completely, overlap the classifications based on color, ATPase, or MHC ( myosin heavy chain )."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1017", "text": "Some authors define a fast twitch fiber as one in which the myosin can split ATP very quickly. These mainly include the ATPase type\u00a0II and MHC type\u00a0II fibers. However, fast twitch fibers also demonstrate a higher capability for electrochemical transmission of action potentials and a rapid level of calcium release and uptake by the sarcoplasmic reticulum. The fast twitch fibers rely on a well-developed,  anaerobic , short term, glycolytic system for energy transfer and can contract and develop tension at 2\u20133\u00a0times the rate of slow twitch fibers. Fast twitch muscles are much better at generating short bursts of strength or speed than slow muscles, and so fatigue more quickly. [ 36 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1018", "text": "The slow twitch fibers generate energy for ATP re-synthesis by means of a long term system of  aerobic  energy transfer. These mainly include the ATPase type\u00a0I and MHC type\u00a0I fibers. They tend to have a low activity level of ATPase, a slower speed of contraction with a less well developed glycolytic capacity. [ 36 ]  Fibers that become slow-twitch develop greater numbers of  mitochondria and capillaries making them better for prolonged work. [ 37 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1019", "text": "Individual muscles tend to be a mixture of various fiber types, but their proportions vary depending on the actions of that muscle. For instance, in humans, the  quadriceps  muscles contain ~52% type\u00a0I fibers, while the  soleus  is ~80% type\u00a0I. [ 38 ]  The orbicularis oculi muscle of the eye is only ~15% type\u00a0I. [ 38 ]   Motor units  within the muscle, however, have minimal variation between the fibers of that unit. It is this fact that makes the size principal of  motor unit recruitment  viable."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1020", "text": "The total number of skeletal muscle fibers has traditionally been thought not to change.\nIt is believed there are no sex or age differences in fiber distribution; however, proportions of fiber types vary considerably from muscle to muscle and person to person. [ citation needed ]  Among different species there is much variation in the proportions of muscle fiber types. [ 39 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1021", "text": "Sedentary men and women (as well as young children) have 45% type\u00a0II and 55% type\u00a0I fibers. [ citation needed ] \nPeople at the higher end of any sport tend to demonstrate patterns of fiber distribution e.g. endurance athletes show a higher level of type\u00a0I fibers.\nSprint athletes, on the other hand, require large numbers of type\u00a0IIX fibers.\nMiddle-distance event athletes show approximately equal distribution of the two types. This is also often the case for power athletes such as throwers and jumpers.\nIt has been suggested that various types of exercise can induce changes in the fibers of a skeletal muscle. [ 40 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1022", "text": "It is thought that by performing endurance type events for a sustained period of time, some of the type\u00a0IIX fibers transform into type\u00a0IIA fibers. However, there is no consensus on the subject. [ citation needed ] \nIt may well be that the type\u00a0IIX fibers show enhancements of the oxidative capacity after high intensity endurance training which brings them to a level at which they are able to perform oxidative metabolism as effectively as slow twitch fibers of untrained subjects. This would be brought about by an increase in mitochondrial size and number and the associated related changes, not a change in fiber type."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1023", "text": "There are numerous methods employed for fiber-typing, and confusion between the methods is common among non-experts. Two commonly confused methods are  histochemical  staining for  myosin ATPase  activity and  immunohistochemical  staining for myosin heavy chain (MHC) type. Myosin ATPase activity is commonly\u2014and correctly\u2014referred to as simply \"fiber type\", and results from the direct assaying of ATPase activity under various conditions (e.g.  pH ). [ 34 ]   Myosin heavy chain  staining is most accurately referred to as \"MHC fiber type\", e.g. \"MHC IIa fibers\", and results from determination of different MHC  isoforms . [ 34 ]  These methods are closely related physiologically, as the MHC type is the primary determinant of ATPase activity. However, neither of these typing methods is directly metabolic in nature; they do not directly address oxidative or glycolytic capacity of the fiber."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1024", "text": "When \"type\u00a0I\" or \"type\u00a0II\" fibers are referred to generically, this most accurately refers to the sum of numerical fiber types (I vs. II) as assessed by myosin ATPase activity staining (e.g. \"type\u00a0II\" fibers refers to type\u00a0IIA + type\u00a0IIAX + type\u00a0IIXA ... etc.)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1025", "text": "Below is a table showing the relationship between these two methods, limited to fiber types found in humans. Subtype capitalization is used in fiber typing vs. MHC typing, and some ATPase types actually contain multiple MHC types. Also, a  subtype\u00a0B or b is not expressed in humans by either method . [ 41 ]  Early researchers believed humans to express a MHC\u00a0IIb, which led to the ATPase classification of IIB. However, later research showed that the human MHC\u00a0IIb was in fact IIx, [ 41 ]  indicating that the IIB is better named IIX. IIb is expressed in other mammals, so is still accurately seen (along with IIB) in the literature. Non human fiber types include true IIb fibers, IIc, IId, etc."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1026", "text": "Further fiber typing methods are less formally delineated, and exist on more of a spectrum. They tend to be focused more on metabolic and functional capacities (i.e., oxidative vs.  glycolytic , fast vs. slow contraction time). As noted above, fiber typing by ATPase or MHC does not directly measure or dictate these parameters. However, many of the various methods are mechanistically linked, while others are correlated  in vivo . [ 44 ] [ 45 ]  For instance, ATPase fiber type is related to contraction speed, because high ATPase activity allows faster  crossbridge cycling . [ 34 ]  While ATPase activity is only one component of contraction speed, Type\u00a0I fibers are \"slow\", in part, because they have low speeds of ATPase activity in comparison to Type II\u00a0fibers. However, measuring contraction speed is not the same as ATPase fiber typing."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1027", "text": "Almost all multicellular animals depend on muscles to move. [ 46 ]  Generally, muscular systems of most multicellular animals comprise both slow-twitch and fast-twitch muscle fibers, though the proportions of each fiber type can vary across organisms and environments. The ability to shift their phenotypic fiber type proportions through training and responding to the environment has served organisms well when placed in changing environments either requiring short explosive movements (higher fast twitch proportion) or long duration of movement (higher slow twitch proportion) to survive. [ 47 ]  Bodybuilding has shown that changes in muscle mass and force production can change in a matter of months. [ 48 ]  Some examples of this variation are described below. [ 49 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1028", "text": "American lobster ,  Homarus americanus , has three fiber types including fast twitch fibers, slow-twitch and slow-tonic fibers. [ 50 ]  Slow-tonic is a slow twitch-fiber that can sustain longer contractions ( tonic ). [ 51 ] [ 52 ] \u00a0 In lobsters, muscles in different body parts vary in the muscle fiber type proportions based on the purpose of the muscle group. [ 50 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1029", "text": "In the early  development  of vertebrate embryos, growth and formation of muscle happens in successive waves or phases of  myogenesis . The myosin heavy chain  isotype  is a major determinant of the specific fiber type. In  zebrafish  embryos, the first muscle fibers to form are the slow twitch fibers. These cells will undergo migration from their original location to form a monolayer of slow twitch muscle fibers. These muscle fibers undergo further  differentiation  as the embryo matures. [ 53 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1030", "text": "In larger animals, different muscle groups will increasingly require different fiber type proportions within muscle for different purposes.  Turtles , such as  Trachemys scripta elegans , have complementary muscles within the neck that show a potential inverse trend of fiber type percentages (one muscle has high percentage of fast twitch, while the complementary muscle will have a higher percentage of slow twitch fibers). The complementary muscles of turtles had similar percentages of fiber types. [ 51 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1031", "text": "Chimpanzee  muscles are composed of 67% fast-twitch fibers and have a maximum dynamic force and power output 1.35 times higher than human muscles of similar size. Among mammals, there is a predominance of type II fibers utilizing glycolytic metabolism. Because of the discrepancy in fast twitch fibers compared to humans, chimpanzees outperform humans in power related tests. Humans, however, will do better at exercise in aerobic range requiring large metabolic costs such as walking (bipedalism). [ 54 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1032", "text": "Across species, certain gene sequences have been preserved, but do not always have the same functional purpose. Within the zebrafish embryo, the  Prdm1  gene down-regulates the formation of new slow twitch fibers through direct and indirect mechanisms such as  Sox6  (indirect). In mice, the  Prdm1  gene is present but does not control slow muscle genes in mice through  Sox6 . [ 55 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1033", "text": "In addition to having a genetic basis, the composition of muscle fiber types is flexible and can vary with a number of different environmental factors. This plasticity can, arguably, be the strongest evolutionary advantage among organisms with muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1034", "text": "In fish, different fiber types are expressed at different water temperatures. [ 53 ]  Cold temperatures require more efficient metabolism within muscle and fatigue resistance is important. While in more tropical environments, fast powerful movements (from higher fast-twitch proportions) may prove more beneficial in the long run. [ 56 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1035", "text": "In rodents such as rats, the transitory nature of their muscle is highly prevalent. They have high percentage of hybrid muscle fibers and have up to 60% in fast-to-slow transforming muscle. [ 48 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1036", "text": "Environmental influences such as diet, exercise and lifestyle types have a pivotal role in proportions of fiber type in humans. Aerobic exercise will shift the proportions towards slow twitch fibers, while explosive powerlifting and sprinting will transition fibers towards fast twitch. [ 47 ]  In animals, \"exercise training\" will look more like the need for long durations of movement or short explosive movements to escape predators or catch prey. [ 57 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1037", "text": "Skeletal muscle exhibits a distinctive banding pattern when viewed under the microscope due to the arrangement of two contractile proteins  myosin , and  actin  \u2013 that are two of the  myofilaments  in the  myofibrils . The myosin forms the thick filaments, and actin forms the thin filaments, and are arranged in repeating units called  sarcomeres . The interaction of both proteins results in muscle contraction."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1038", "text": "The sarcomere is attached to other organelles such as the mitochondria by  intermediate filaments  in the cytoskeleton. The  costamere  attaches the sarcomere to the sarcolemma. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1039", "text": "Every single organelle and macromolecule of a muscle fiber is arranged to ensure that it meets desired functions. The  cell membrane  is called the sarcolemma with the cytoplasm known as the  sarcoplasm . In the sarcoplasm are the myofibrils. The myofibrils are long protein bundles about one micrometer in diameter. Pressed against the inside of the sarcolemma are the unusual flattened myonuclei. Between the myofibrils are the  mitochondria ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1040", "text": "While the muscle fiber does not have smooth endoplasmic cisternae, it contains  sarcoplasmic reticulum . The sarcoplasmic reticulum surrounds the myofibrils and holds a reserve of the  calcium ions  needed to cause a muscle contraction. Periodically, it has dilated end sacs known as  terminal cisternae . These cross the muscle fiber from one side to the other. In between two terminal cisternae is a tubular infolding called a transverse tubule (T tubule).  T tubules  are the pathways for action potentials to signal the sarcoplasmic reticulum to release calcium, causing a muscle contraction. Together, two terminal cisternae and a transverse tubule form a  triad . [ 58 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1041", "text": "All muscles are derived from  paraxial mesoderm . During  embryonic development  in the process of  somitogenesis  the paraxial mesoderm is divided along the  embryo 's length to form  somites , corresponding to the  segmentation  of the body most obviously seen in the  vertebral column . [ 59 ]  Each somite has three divisions,  sclerotome  (which forms  vertebrae ),  dermatome  (which forms skin), and  myotome  (which forms muscle). The myotome is divided into two sections, the epimere and hypomere, which form  epaxial and hypaxial muscles , respectively. The only epaxial muscles in humans are the  erector spinae  and small vertebral muscles, and are innervated by the dorsal rami of the  spinal nerves . All other muscles, including those of the limbs are hypaxial, and innervated by the  ventral rami  of the spinal nerves. [ 59 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1042", "text": "During development,  myoblasts  (muscle progenitor cells) either remain in the somite to form muscles associated with the vertebral column or migrate out into the body to form all other muscles. Myoblast migration is preceded by the formation of  connective tissue  frameworks, usually formed from the somatic  lateral plate mesoderm . Myoblasts follow chemical signals to the appropriate locations, where they fuse into elongated multinucleated skeletal muscle cells. [ 59 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1043", "text": "Between the tenth and the eighteenth weeks of gestation, all muscle cells have fast myosin heavy chains; two myotube types become distinguished in the developing  fetus  \u2013 both expressing fast chains but one expressing fast and slow chains. Between 10 and 40 per cent of the fibers express the slow myosin chain. [ 60 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1044", "text": "Fiber types are established during embryonic development and are remodelled later in the adult by neural and hormonal influences. [ 39 ]  The population of satellite cells present underneath the basal lamina is necessary for the postnatal development of muscle cells. [ 61 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1045", "text": "The primary function of muscle is  contraction . [ 3 ]  Following contraction, skeletal muscle functions as an  endocrine  organ by secreting  myokines  \u2013 a wide range of  cytokines  and other  peptides  that act as signalling molecules. [ 62 ]  Myokines in turn are believed to mediate the health benefits of  exercise . [ 63 ]  Myokines are secreted into the bloodstream after muscle contraction.  Interleukin 6  (IL-6) is the most studied myokine, other muscle contraction-induced myokines include  BDNF ,  FGF21 , and  SPARC . [ 64 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1046", "text": "Muscle also functions to produce body heat. Muscle contraction is responsible for producing 85% of the body's heat. [ 65 ]  This heat produced is as a by-product of muscular activity, and is mostly wasted. As a  homeostatic  response to extreme cold, muscles are signaled to trigger contractions of  shivering  in order to generate heat. [ 66 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1047", "text": "Contraction is achieved by the muscle's structural unit, the muscle fiber, and by its functional unit, the  motor unit . [ 4 ]  Muscle fibers are  excitable cells  stimulated by  motor neurons . The motor unit consists of a motor neuron and the many fibers that it makes contact with. A single muscle is stimulated by many motor units. Muscle fibers are\nsubject to  depolarization  by the neurotransmitter  acetylcholine , released by the motor neurons at the  neuromuscular junctions . [ 67 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1048", "text": "In addition to the  actin  and  myosin   myofilaments  in the  myofibrils  that make up the contractile  sarcomeres , there are two other important regulatory proteins \u2013  troponin  and  tropomyosin , that make muscle contraction possible. These proteins are associated with actin and cooperate to prevent its interaction with myosin. Once a cell is sufficiently stimulated, the cell's  sarcoplasmic reticulum   releases ionic calcium  (Ca 2+ ), which then interacts with the regulatory protein troponin. Calcium-bound troponin undergoes a conformational change that leads to the movement of tropomyosin, subsequently exposing the myosin-binding sites on actin. This allows for myosin and actin ATP-dependent  cross-bridge cycling  and shortening of the muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1049", "text": "Excitation contraction coupling  is the process by which a  muscular action potential  in the muscle fiber causes the  myofibrils  to contract. This process relies on a direct coupling between the  sarcoplasmic reticulum  calcium release channel  RYR1  (ryanodine receptor 1), and  voltage-gated L-type calcium channels  (identified as dihydropyridine receptors, DHPRs). DHPRs are located on the sarcolemma (which includes the surface sarcolemma and the  transverse tubules ), while the RyRs reside across the SR membrane. The close apposition of a transverse tubule and two SR regions containing RyRs is described as a triad and is predominantly where excitation\u2013contraction coupling takes place. Excitation\u2013contraction coupling occurs when depolarization of skeletal muscle cell results in a muscle action potential, which spreads across the cell surface and into the muscle fiber's network of  T-tubules , thereby depolarizing the inner portion of the muscle fiber. Depolarization of the inner portions activates dihydropyridine receptors in the terminal cisternae, which are close to ryanodine receptors in the adjacent  sarcoplasmic reticulum . The activated dihydropyridine receptors physically interact with ryanodine receptors to activate them via foot processes (involving conformational changes that allosterically activates the ryanodine receptors). As the ryanodine receptors open,  Ca 2+  is released from the sarcoplasmic reticulum into the local junctional space and diffuses into the bulk cytoplasm to cause a  calcium spark . The sarcoplasmic reticulum has a large  calcium buffering  capacity partially due to a  calcium-binding protein  called  calsequestrin . The near synchronous activation of thousands of  calcium sparks  by the action potential causes a cell-wide increase in calcium giving rise to the upstroke of the  calcium transient . The  Ca 2+  released into the cytosol binds to  Troponin C  by the  actin filaments , to allow crossbridge cycling, producing force and, in some situations, motion. The  sarco/endoplasmic reticulum calcium-ATPase  (SERCA) actively pumps  Ca 2+  back into the sarcoplasmic reticulum. As  Ca 2+  declines back to resting levels, the force declines and relaxation occurs. [ 68 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1050", "text": "The  efferent  leg of the  peripheral nervous system  is responsible for conveying commands to the muscles and glands, and is ultimately responsible for voluntary movement.  Nerves  move muscles in response to  voluntary  and  autonomic  (involuntary) signals from the  brain . Deep muscles, superficial muscles,  muscles of the face  and internal muscles all correspond with dedicated regions in the primary motor cortex of the  brain , directly anterior to the central sulcus that divides the frontal and parietal lobes."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1051", "text": "In addition, muscles react to  reflexive  nerve stimuli that do not always send signals all the way to the brain. In this case, the signal from the afferent fiber does not reach the brain, but produces the reflexive movement by direct connections with the efferent nerves in the  spine . However, the majority of muscle activity is volitional, and the result of complex interactions between various areas of the brain."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1052", "text": "Nerves that control skeletal muscles in  mammals  correspond with neuron groups along the  primary motor cortex  of the brain's  cerebral cortex . Commands are routed through the  basal ganglia  and are modified by input from the  cerebellum  before being relayed through the  pyramidal tract  to the  spinal cord  and from there to the  motor end plate  at the muscles. Along the way, feedback, such as that of the  extrapyramidal system  contribute signals to influence  muscle tone  and response."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1053", "text": "Deeper muscles such as those involved in  posture  often are controlled from nuclei in the  brain stem  and basal ganglia."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1054", "text": "In skeletal muscles,  muscle spindles  convey information about the degree of muscle length and stretch to the central nervous system to assist in maintaining posture and joint position. The  sense  of where our bodies are in space is called  proprioception , the perception of body awareness, the \"unconscious\" awareness of where the various regions of the body are located at any one time. Several areas in the brain coordinate movement and position with the feedback information gained from proprioception. The cerebellum and  red nucleus  in particular continuously sample position against movement and make minor corrections to assure smooth motion. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1055", "text": "Muscular activity accounts for much of the body's  energy  consumption. All muscle cells produce  adenosine triphosphate  (ATP) molecules which are used to power the movement of the  myosin heads . Muscles have a short-term store of energy in the form of  creatine phosphate  which is generated from ATP and can regenerate ATP when needed with  creatine kinase . Muscles also keep a storage form of glucose in the form of  glycogen . Glycogen can be rapidly converted to  glucose  when energy is required for sustained, powerful contractions. Within the voluntary skeletal muscles, the glucose molecule can be metabolized anaerobically in a process called glycolysis which produces two ATP and two  lactic acid  molecules in the process (in aerobic conditions, lactate is not formed; instead  pyruvate  is formed and transmitted through the  citric acid cycle ). Muscle cells also contain globules of fat, which are used for energy during  aerobic exercise . The aerobic energy systems take longer to produce the ATP and reach peak efficiency, and requires many more biochemical steps, but produces significantly more ATP than anaerobic glycolysis. Cardiac muscle on the other hand, can readily consume any of the three macronutrients (protein, glucose and fat) aerobically without a 'warm up' period and always extracts the maximum ATP yield from any molecule involved. The heart, liver and red blood cells will also consume lactic acid produced and excreted by skeletal muscles during exercise."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1056", "text": "Skeletal muscle uses more calories than other organs. [ 69 ] \nAt rest it consumes 54.4 kJ/kg\u00a0(13.0\u00a0kcal/kg) per day. This is larger than  adipose tissue  (fat) at 18.8\u00a0kJ/kg (4.5\u00a0kcal/kg), and bone at 9.6\u00a0kJ/kg (2.3\u00a0kcal/kg). [ 70 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1057", "text": "The  efficiency  of human muscle has been measured (in the context of  rowing  and  cycling ) at 18% to 26%. The efficiency is defined as the ratio of  mechanical work  output to the total  metabolic  cost, as can be calculated from oxygen consumption. This low efficiency is the result of about 40% efficiency of generating  ATP  from  food energy , losses in converting energy from ATP into mechanical work inside the muscle, and mechanical losses inside the body. The latter two losses are dependent on the type of exercise and the type of muscle fibers being used (fast-twitch or slow-twitch). For an overall efficiency of 20 percent, one watt of mechanical power is equivalent to 4.3 kcal per hour. For example, one manufacturer of rowing equipment calibrates its  rowing ergometer  to count burned calories as equal to four times the actual mechanical work, plus 300 kcal per hour, this amounts to about 20 percent efficiency at 250 watts of mechanical output. The mechanical energy output of a cyclic contraction can depend upon many factors, including activation timing, muscle strain trajectory, and rates of force rise & decay. These can be synthesized experimentally using  work loop analysis ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1058", "text": "Muscle strength is a result of three overlapping factors:  physiological strength  (muscle size, cross sectional area, available crossbridging, responses to training),  neurological strength  (how strong or weak is the signal that tells the muscle to contract), and  mechanical strength  (muscle's force angle on the lever, moment arm length, joint capabilities). [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1059", "text": "Vertebrate muscle typically produces approximately 25\u201333\u00a0 N  (5.6\u20137.4\u00a0 lb f ) of force per square centimeter of muscle cross-sectional area when isometric and at optimal length. [ 71 ]  Some  invertebrate  muscles, such as in crab claws, have much longer  sarcomeres  than vertebrates, resulting in many more sites for actin and myosin to bind and thus much greater force per square centimeter at the cost of much slower speed. The force generated by a contraction can be measured non-invasively using either  mechanomyography  or  phonomyography , be measured  in vivo  using tendon strain (if a prominent tendon is present), or be measured directly using more invasive methods."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1060", "text": "The strength of any given muscle, in terms of force exerted on the skeleton, depends upon  length, shortening speed , cross sectional area,  pennation ,  sarcomere  length,  myosin  isoforms, and neural activation of  motor units . Significant reductions in muscle strength can indicate underlying pathology, with the chart at right used as a guide."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1061", "text": "The  maximum holding time  for a contracted muscle depends on its supply of energy and is stated by  Rohmert's law  to  exponentially decay  from the beginning of exertion."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1062", "text": "Since three factors affect muscular strength simultaneously and muscles never work individually, it is misleading to compare strength in individual muscles, and state that one is the \"strongest\". But below are several muscles whose strength is noteworthy for different reasons."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1063", "text": "Muscle force  is proportional to  physiological cross-sectional area  (PCSA), and muscle velocity is proportional to muscle fiber length. [ 72 ]  The torque around a joint, however, is determined by a number of biomechanical parameters, including the distance between muscle insertions and pivot points, muscle size and  architectural gear ratio . Muscles are normally arranged in opposition so that when one group of muscles contracts, another group relaxes or lengthens. [ 73 ]  Antagonism in the transmission of nerve impulses to the muscles means that it is impossible to fully stimulate the contraction of two  antagonistic muscles  at any one time. During ballistic motions such as throwing, the antagonist muscles act to 'brake' the  agonist muscles  throughout the contraction, particularly at the end of the motion. In the example of throwing, the chest and front of the shoulder (anterior deltoid) contract to pull the arm forward, while the muscles in the back and rear of the shoulder (posterior deltoid) also contract and undergo eccentric contraction to slow the motion down to avoid injury. Part of the training process is learning to relax the antagonist muscles to increase the force input of the chest and anterior shoulder."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1064", "text": "Contracting muscles produce vibration and sound. [ 74 ]  Slow twitch fibers produce 10 to 30 contractions per second (10 to 30\u00a0Hz). Fast twitch fibers produce 30 to 70 contractions per second (30 to 70\u00a0Hz). [ 75 ]   The vibration can be witnessed and felt by highly tensing one's muscles, as when making a firm fist. The sound can be heard by pressing a highly tensed muscle against the ear, again a firm fist is a good example. The sound is usually described as a rumbling sound. Some individuals can voluntarily produce this rumbling sound by contracting the  tensor tympani muscle  of the middle ear. The rumbling sound can also be heard when the neck or jaw muscles are highly tensed. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1065", "text": "Skeletal muscle fiber-type phenotype in adult animals is regulated by several independent signaling pathways. These include pathways involved with the  Ras /mitogen-activated protein kinase ( MAPK ) pathway, calcineurin, calcium/calmodulin-dependent protein kinase IV, and the peroxisome proliferator \u03b3 coactivator 1 (PGC-1). The  Ras/MAPK signaling pathway  links the motor neurons and signaling systems, coupling excitation and transcription regulation to promote the nerve-dependent induction of the slow program in regenerating muscle.  Calcineurin , a Ca 2+ / calmodulin -activated  phosphatase  implicated in nerve activity-dependent fiber-type specification in skeletal muscle, directly controls the phosphorylation state of the transcription factor  NFAT , allowing for its translocation to the nucleus and leading to the activation of slow-type muscle proteins in cooperation with myocyte enhancer factor 2 ( MEF2 ) proteins and other regulatory proteins.  Ca2+/calmodulin-dependent protein kinase  activity is also upregulated by slow motor neuron activity, possibly because it amplifies the slow-type calcineurin-generated responses by promoting MEF2  transactivator  functions and enhancing oxidative capacity through stimulation of  mitochondrial biogenesis ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1066", "text": "Contraction-induced changes in intracellular calcium or reactive oxygen species provide signals to diverse pathways that include the MAPKs, calcineurin and calcium/calmodulin-dependent protein kinase IV to activate transcription factors that regulate gene expression and enzyme activity in skeletal muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1067", "text": "PGC1-\u03b1 ( PPARGC1A ), a transcriptional coactivator of nuclear receptors important to the regulation of a number of mitochondrial genes involved in oxidative metabolism, directly interacts with MEF2 to synergistically activate selective slow twitch (ST) muscle genes and also serves as a target for calcineurin signaling. A peroxisome proliferator-activated receptor \u03b4 ( PPAR\u03b4 )-mediated transcriptional pathway is involved in the regulation of the skeletal muscle fiber phenotype. Mice that harbor an activated form of PPAR\u03b4 display an \"endurance\" phenotype, with a coordinated increase in oxidative enzymes and  mitochondrial biogenesis  and an increased proportion of ST fibers. Thus\u2014through functional genomics\u2014calcineurin, calmodulin-dependent kinase, PGC-1\u03b1, and activated PPAR\u03b4 form the basis of a signaling network that controls skeletal muscle fiber-type transformation and metabolic profiles that protect against insulin resistance and obesity."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1068", "text": "The transition from aerobic to anaerobic metabolism during intense work requires that several systems are rapidly activated to ensure a constant supply of ATP for the working muscles. These include a switch from fat-based to carbohydrate-based fuels, a redistribution of blood flow from nonworking to exercising muscles, and the removal of several of the by-products of anaerobic metabolism, such as carbon dioxide and lactic acid. Some of these responses are governed by transcriptional control of the fast twitch (FT) glycolytic phenotype. For example, skeletal muscle reprogramming from an ST glycolytic phenotype to an FT glycolytic phenotype involves the Six1/Eya1 complex, composed of members of the Six protein family. Moreover, the hypoxia-inducible factor 1-\u03b1 ( HIF1A ) has been identified as a master regulator for the expression of genes involved in essential hypoxic responses that maintain ATP levels in cells.  Ablation  of HIF-1\u03b1 in skeletal muscle was associated with an increase in the activity of rate-limiting enzymes of the mitochondria, indicating that the citric acid cycle and increased fatty acid oxidation may be compensating for decreased flow through the glycolytic pathway in these animals. However, hypoxia-mediated HIF-1\u03b1 responses are also linked to the regulation of mitochondrial dysfunction through the formation of excessive reactive oxygen species in mitochondria."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1069", "text": "Other pathways also influence adult muscle character. For example, physical force inside a muscle fiber may release the transcription factor  serum response factor  from the structural protein titin, leading to altered muscle growth."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1070", "text": "Physical exercise is often recommended as a means of improving  motor skills ,  fitness , muscle and bone strength, and joint function. Exercise has several effects upon muscles,  connective tissue , bone, and the nerves that stimulate the muscles. One such effect is  muscle hypertrophy , an increase in size of muscle due to an increase in the number of muscle fibers or cross-sectional area of myofibrils. [ 76 ]  Muscle changes depend on the type of exercise used."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1071", "text": "Generally, there are two types of exercise regimes, aerobic and anaerobic.  Aerobic exercise  (e.g. marathons) involves activities of low intensity but long duration, during which the muscles used are below their maximal contraction strength. Aerobic activities rely on aerobic respiration (i.e. citric acid cycle and electron transport chain) for metabolic energy by consuming fat, protein, carbohydrates, and oxygen. Muscles involved in aerobic exercises contain a higher percentage of Type I (or slow-twitch) muscle fibers, which primarily contain mitochondrial and oxidation enzymes associated with aerobic respiration. [ 77 ] [ 78 ]  On the contrary,  anaerobic exercise  is associated with activities of high intensity but short duration, such as sprinting or  weight lifting . The anaerobic activities predominately use Type II, fast-twitch, muscle fibers. [ 79 ]  Type II muscle fibers rely on glucogenesis for energy during anaerobic exercise. [ 80 ]  During anaerobic exercise, type II fibers consume little oxygen, protein and fat, produce large amounts of lactic acid and are fatigable. Many exercises are partially aerobic and anaerobic; for example,  soccer  and  rock climbing ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1072", "text": "The presence of  lactic acid  has an inhibitory effect on ATP generation within the muscle. It can even stop ATP production if the intracellular concentration becomes too high. However, endurance training mitigates the buildup of lactic acid through increased capillarization and myoglobin. [ 81 ]  This increases the ability to remove waste products, like lactic acid, out of the muscles in order to not impair muscle function. Once moved out of muscles, lactic acid can be used by other muscles or body tissues as a source of energy, or transported to the liver where it is converted back to  pyruvate . In addition to increasing the level of lactic acid, strenuous exercise results in the loss of potassium ions in muscle. This may facilitate the recovery of muscle function by protecting against fatigue. [ 82 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1073", "text": "Delayed onset muscle soreness  is pain or discomfort that may be felt one to three days after exercising and generally subsides two to three days later. Once thought to be caused by lactic acid build-up, a more recent theory is that it is caused by tiny tears in the muscle fibers caused by  eccentric contraction , or unaccustomed training levels. Since lactic acid disperses fairly rapidly, it could not explain pain experienced days after exercise. [ 83 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1074", "text": "Diseases of skeletal muscle are termed  myopathies , while diseases of nerves are called  neuropathies . Both can affect muscle function or cause muscle pain, and fall under the umbrella of  neuromuscular disease . The cause of many myopathies is attributed to mutations in the various associated muscle proteins. [ 5 ] [ 84 ]  Some  inflammatory myopathies  include  polymyositis  and  inclusion body myositis"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1075", "text": "Neuromuscular diseases  affect the muscles and their nervous control. In general, problems with nervous control can cause  spasticity  or  paralysis , depending on the location and nature of the problem. A number of  movement disorders  are caused by  neurological disorders  such as  Parkinson's disease  and  Huntington's disease  where there is central nervous system dysfunction. [ 85 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1076", "text": "Symptoms of muscle diseases may include  weakness , spasticity,  myoclonus  and  myalgia . Diagnostic procedures that may reveal muscular disorders include testing  creatine kinase levels in the blood  and  electromyography  (measuring electrical activity in muscles). In some cases,  muscle biopsy  may be done to identify a  myopathy , as well as  genetic testing  to identify  DNA  abnormalities associated with specific myopathies and  dystrophies ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1077", "text": "A non-invasive  elastography  technique that measures muscle noise is undergoing experimentation to provide a way of monitoring neuromuscular disease. The sound produced by a muscle comes from the shortening of  actomyosin   filaments  along the axis of the muscle. During  contraction , the muscle shortens along its length and expands across its width, producing  vibrations  at the surface. [ 86 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1078", "text": "Independent of strength and performance measures, muscles can be induced to grow larger by a number of factors, including hormone signaling, developmental factors,  strength training , and disease. Contrary to popular belief, the number of muscle fibres cannot be increased through  exercise . Instead, muscles grow larger through a combination of muscle cell growth as new protein filaments are added along with additional mass provided by undifferentiated satellite cells alongside the existing muscle cells. [ 87 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1079", "text": "Biological factors such as age and hormone levels can affect muscle hypertrophy. During  puberty  in males, hypertrophy occurs at an accelerated rate as the levels of growth-stimulating  hormones  produced by the body increase. Natural hypertrophy normally stops at full growth in the late teens. As  testosterone  is one of the body's major growth hormones, on average, men find hypertrophy much easier to achieve than women. Taking additional testosterone or other  anabolic steroids  will increase muscular hypertrophy."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1080", "text": "Muscular, spinal and neural factors all affect muscle building. Sometimes a person may notice an increase in strength in a given muscle even though only its opposite has been subject to exercise, such as when a bodybuilder finds her left biceps stronger after completing a regimen focusing only on the right biceps. This phenomenon is called  cross education . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1081", "text": "Every day between one and two percent of muscle is broken down and rebuilt.  Inactivity ,  malnutrition ,  disease , and  aging  can increase the breakdown leading to  muscle atrophy  or  sarcopenia . Sarcopenia is commonly an age-related process that can cause  frailty  and its consequences. [ 88 ]  A decrease in muscle mass may be accompanied by a smaller number and size of the muscle cells as well as lower protein content. [ 89 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1082", "text": "Human spaceflight , involving prolonged periods of immobilization and weightlessness is known to result in muscle weakening and atrophy resulting in a loss of as much as 30% of mass in some muscles. [ 90 ] [ 91 ]  Such consequences are also noted in some mammals following  hibernation . [ 92 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1083", "text": "Many diseases and conditions including  cancer ,  AIDS , and  heart failure  can cause muscle loss known as  cachexia . [ 93 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1084", "text": "Myopathies have been modeled with cell culture systems of muscle from healthy or diseased tissue  biopsies . Another source of skeletal muscle and progenitors is provided by the  directed differentiation  of  pluripotent stem cells . [ 94 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1085", "text": "Research on skeletal muscle properties uses many techniques.  Electrical muscle stimulation  is used to determine force and contraction speed at different frequencies related to fiber-type composition and mix within an individual muscle group.  In vitro muscle testing  is used for more complete characterization of muscle properties."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1086", "text": "The electrical activity associated with muscle contraction is measured via  electromyography  (EMG). Skeletal muscle has two physiological responses: relaxation and contraction. The mechanisms for which these responses occur generate electrical activity measured by EMG. Specifically, EMG can measure the action potential of a skeletal muscle, which occurs from the  hyperpolarization  of the motor  axons  from nerve impulses sent to the muscle. EMG is used in research for determining if the skeletal muscle of interest is being activated, the amount of  force  generated, and an indicator of  muscle fatigue . [ 95 ]  The two types of EMG are intra-muscular EMG and the most common, surface EMG. The EMG signals are much greater when a skeletal muscle is contracting verses relaxing. However, for smaller and deeper skeletal muscles the EMG signals are reduced and therefore are viewed as a less valued technique for measuring the activation. [ 96 ]  In research using EMG, a  maximal voluntary contraction  (MVC) is commonly performed on the skeletal muscle of interest, to have reference data for the rest of the EMG recordings during the main experimental testing for that same skeletal muscle. [ 97 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1087", "text": "Research into the development of  artificial muscles  includes the use of  electroactive polymers ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1088", "text": "Nuclei present in skeletal muscle are about 50% myocyte nuclei and 50% mononuclear cell nuclei. [ 13 ]  Mononuclear cells found in skeletal muscle tissue samples from mice and humans [ 15 ] [ 99 ] [ 98 ]  can be identified by  messenger RNA  transcription of cell type markers. Cameron et al. [ 98 ]  identified nine cell types. They include  endothelial cells  that line capillaries (45% of cells), fibro-adipogenic progenitors (FAPs)(20%), [ 100 ]   pericytes  (14%) and endothelial-like pericytes (4%). Another 9% of mononuclear cells are  muscle stem cells , adjacent to muscle fiber cells. Types of  lymphoid cells  (such as B-cells and T-cells) (3%) and myeloid cells such as  macrophages  (2%) made up most of the remaining mononuclear cells of skeletal muscle. [ 98 ]  In addition,  Cameron et al. [ 98 ]  also identified two types of myocyte cells, Type I and Type II. Each of the different types of cells in skeletal muscle was found to express different sets of genes. The median number of genes expressed in each of the nine different cell types was 1,331 genes. When a biopsy is taken from a thigh muscle, however, the biopsy contains all the different cell types. Mixed together, in a biopsy of human thigh skeletal muscle, there are 13,026 to 13,108 genes with detected expression. [ 101 ] [ 102 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1089", "text": "As pointed out in the Introduction to this article, under different physiological conditions, subsets of 654 different proteins as well as lipids, amino acids, metabolites and small RNAs occur in the  secretome  of skeletal muscles. [ 12 ]  As described in the Wikipedia article \" List of human endocrine organs and actions \", skeletal muscle is identified as an  endocrine organ  due to its secretion of  cytokines  and other peptides produced by skeletal muscle as signaling molecules. Iizuka et al., [ 9 ]  indicated that skeletal muscle is an endocrine organ because it \"synthesizes and secretes multiple factors, and these muscle derived-factors exert beneficial effects on peripheral and remote organs.\" The altered secretomes after  endurance training  or  resistance training  as well as the secretome of sedentary muscle appear to have many effects on distant tissues."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1090", "text": "A study in Canada tested the effect of muscle mass on mental functions during aging. An expectation of the study was that the endocrine components of the secretome specific to skeletal muscle could protect cognitive functions. The skeletal muscle mass of arms and legs of 8,279 Canadians over the age of 65 and in average health was measured at baseline and after three years. [ 103 ]  Of these individuals, 1,605 participants (19.4%) were considered to have a low skeletal muscle mass at baseline, with less than 7.30\u00a0kg/m 2  for males, and less than 5.42\u00a0kg/m 2  for females (levels defined as  sarcopenia  in Canada)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1091", "text": "Executive mental function , memory and psychomotor speed were each measured at baseline and after three years. Executive mental function was measured with standard tests, including the ability to say the sequence 1-A, 2-B, 3-C\u2026, to name a number of animals in one minute, and with the  Stroop test . [ 103 ]  The study found that those individuals with lower skeletal muscle mass at the start of the study declined in their executive mental function considerably more sharply than those with higher muscle mass. Memory, as well as psychomotor speed, on the other hand, did not correlate with skeletal muscle mass. [ 103 ]  Thus, larger muscle mass, with a concomitantly larger secretome, appeared to have the endocrine function of protecting the executive mental function of individuals over the age of 65."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1092", "text": "Paluch et al. [ 104 ]  compared the average number of steps  walked  per day to the risk of  mortality , both for adults over 60 years old and for adults under 60 years old. The study was a meta-analysis of 15 studies, which, combined, evaluated 47,471 adults over a period of 7 years. Individuals were divided into approximately equal quartiles. The lowest quartile averaged 3,553 steps/day, the second quartile 5,801 steps/day, the third quartile 7,842 steps/day and the fourth quartile 10,901 steps/day. The briskness of walking, adjusted for the volume of walking, did not affect mortality. However, the number of steps/day was clearly related to mortality. When risk of mortality for those over 60 years old was set at 1.0 for the lowest quartile of steps/day, the relative risk of mortality for the second, third and fourth quartiles were 0.56, 0.45, and 0.35, respectively. For those under 60 years of age, the results were less pronounced. For those under 60 years of age, with the first quartile risk of mortality set at 1.0, the second, third and fourth quartile relative risks of mortality were 0.57, 0.42 and 0.53, respectively. Thus, use of skeletal muscles in walking has a large effect, especially among older individuals, on mortality."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1093", "text": "Williams et al. [ 102 ]  obtained biopsies of  a thigh skeletal muscle  (vastus lateralis muscle) of eight 23-year old, originally sedentary, Caucasian males. Biopsies were taken both before and after a six-week long endurance exercise training program. The exercise consisted of riding a stationary bicycle for one hour, five days a week for six weeks."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1094", "text": "Of the 13,108 genes with detected expression in the muscle biopsies, 641 genes were upregulated after endurance training and 176 genes were downregulated. Of the 817 total altered genes, 531 were identified as being in the secretome by either or both of  Uniprot  or  Exocarta , or else by studies investigating the secretome of muscle cells. Because many of the exercise-regulated genes are identified as secreted, this indicates that much of the effect of exercise has an endocrine rather than metabolic function. [ 102 ]  The main pathways found to be affected by secreted exercise-regulated proteins were related to  cardiac ,  cognitive ,  kidney  and  platelet  functions."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1095", "text": "Between 2012 and 2019, at least 25 reports indicated a major role of  epigenetic  mechanisms in skeletal muscle responses to exercise. [ 105 ]  Epigenetic alterations often occur by  adding methyl groups to cytosines in the DNA  or  removing methyl groups from the cytosines of DNA , especially at  CpG sites . Methylations of cytosines can cause the DNA to be compacted into  heterochromatin , thus inhibiting access of other molecules to the DNA. [ 106 ]  Epigenetic alterations also often occur through acetylations or deacetylations of the  histone  tails within  chromatin . DNA in the nucleus generally consists of segments of 146  base pairs  of DNA wrapped around eight tightly connected  histones  (and each histone also has a loose tail) in a structure called a  nucleosome  and one segment of DNA is connected to an adjacent DNA segment on a nucleosome by  linker DNA . When histone tails are  acetylated , they usually cause loosening of the DNA around the nucleosome, leading to increased accessibility of the DNA."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1096", "text": "Gene expression  in muscle is largely regulated, as in tissues generally, by  regulatory DNA sequences , especially  enhancers . Enhancers are non-coding sequences in the genome that activate the expression of distant target genes, [ 107 ]  by looping around and interacting with the  promoters  of their target genes [ 108 ]  (see Figure \"Regulation of transcription in mammals\"). As reported by Williams et al., [ 102 ]  the average distance in the loop between the connected enhancers and promoters of genes is 239,000 nucleotide bases."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1097", "text": "Endurance muscle training alters muscle gene expression by epigenetic  DNA methylation  or de-methylation of  CpG sites  within enhancers. [ 109 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1098", "text": "In a study by Lindholm et al., [ 109 ]  twenty-three individuals who were about 27 years old and sedentary volunteered to have  endurance training  on only one leg during 3 months. The other leg was used as an untrained control leg. The training consisted of one-legged knee extension training for 3 month (45 min, 4 sessions per week). Skeletal muscle biopsies from the  vastus lateralis  (a thigh muscle) were taken both before training began and 24 hours after the last training session from each of the legs. The endurance-trained leg, compared to the untrained leg, had significant  DNA methylation  changes at 4,919 sites across the genome. The sites of altered DNA methylation were predominantly in  enhancers . Transcriptional analysis, using  RNA sequencing , identified 4,076 differentially expressed genes."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1099", "text": "The  transcriptionally upregulated genes  were associated with enhancers that had a significant decrease in  DNA methylation , while transcriptionally downregulated genes were associated with enhancers that had increased DNA methylation. Increased methylation was mainly associated with genes involved in structural remodeling of the muscle and glucose metabolism. Enhancers with decreased methylation were associated with genes functioning in inflammatory or immunological processes and in transcriptional regulation."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1100", "text": "As indicated above, after exercise,  epigenetic  alterations to  enhancers  alter long-term  expression  of hundreds of muscle genes. [ 102 ]  This includes genes producing proteins secreted into the systemic circulation, many of which may act as endocrine messengers. [ 102 ]  Six sedentary, about 23 years old, Caucasian males provided  vastus lateralis  (a thigh muscle) biopsies before entering an exercise program (six weeks of 60-minute sessions of riding a stationary cycle, five days per week). Four days after this exercise program was completed, the expression of many genes was persistently  epigentically  altered. The alterations altered acetylations and deacetylations of the histone tails located in the enhancers controlling the genes with altered expression. [ 102 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1101", "text": "Up-regulated genes were associated with epigenetic acetylations added at histone 3 lysine 27 (H3K27ac) of nucleosomes located at their  enhancers . Down-regulated genes were associated with the removal of epigenetic acetylations at H3K27 in nucleosomes located at their enhancers (see Figure \"A  nucleosome  with  histone  tails set for transcriptional activation\"). Biopsies of the vastus lateralis muscle showed expression of 13,108 genes at baseline before the exercise training program. Four days after the exercise program was completed, biopsies of the same muscles showed altered gene expression, with 641 genes up-regulated and 176 genes down-regulated. [ 102 ]  Williams et al. identified 599 enhancer-gene interactions, covering 491 enhancers and 268 genes (multiple enhancers were found connected to some genes), where both the enhancer and the connected target gene were coordinately either upregulated or downregulated after exercise training. [ 102 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1102", "text": "The  skeletal muscle pump  or  musculovenous pump  is a collection of  skeletal muscles  that aid the  heart  in the circulation of  blood . It is especially important in increasing  venous return  to the heart, [ 1 ]  but may also play a role in  arterial blood   flow ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1103", "text": "The skeletal muscle pump is vital in negating  orthostatic intolerance  when  standing . [ 2 ]  When moving upright, the  blood volume  moves to the peripheral parts of the body. To combat this, the  muscles  involved in standing contract and help to bring  venous blood  volume to the heart. [ 1 ] [ 2 ]  The pump is important in affecting the central and local supply of blood output. [ 3 ]   Venous return ,  cardiac output , and  stroke volume  were all increased during  exercise  experiments, as well as affecting the local muscle being used, blood volume."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1104", "text": "Between muscle relaxations, intramuscular pressure transiently returns to a level below the venous blood pressure. This allows blood from the  capillary system  to refill the veins until the next  contraction . It is postulated that this change in  pressure  may be great enough to draw blood from the arterial side to the venous side. It is hypothesized that this pressure drop during rhythmic contraction actually increases blood flow through the muscle, and may be responsible for a portion of the increase in muscle blood flow immediately at the onset of activity. [ 4 ] [ 5 ]  This explanation is attractive, because it would explain the readily observable tight coupling between muscle contraction and a rapid increase in muscle blood flow. However, recent evidence has emerged that cast doubts on this theory. Experiments have shown that a strong muscle contraction can occur without a corresponding increase in skeletal muscle blood flow. [ 6 ]  Given the proposed manner of action of the muscle pump to increase arterial blood flow, it would seem impossible for a muscle contraction and skeletal muscle  hyperemia  to be uncoupled. Another experiment recently was only able to find evidence that  vasodilation , not the skeletal muscle pump, was responsible for maintaining proper pressure and blood return. [ 7 ]  This might have to do with the lack of rigorous  physiological tests  thus far used to be able to prove the pump."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1105", "text": "Experiments have shown the use of passive leg exercises, where only vasodilation was used, was responsible for increased blood return. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1106", "text": "The  sliding filament theory  explains the mechanism of  muscle contraction  based on muscle proteins that slide past each other to generate movement. [ 1 ]  According to the sliding filament theory, the  myosin   ( thick filaments ) of  muscle fibers  slide past the  actin  ( thin filaments ) during muscle contraction, while the two groups of filaments remain at relatively constant length."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1107", "text": "The theory was independently introduced in 1954 by two research teams, one consisting of  Andrew Huxley  and  Rolf Niedergerke  from the  University of Cambridge , and the other consisting of  Hugh Huxley  and  Jean Hanson  from the  Massachusetts Institute of Technology . [ 2 ] [ 3 ]  It was originally conceived by Hugh Huxley in 1953. Andrew Huxley and Niedergerke introduced it as a \"very attractive\" hypothesis. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1108", "text": "Before the 1950s there were several competing theories on muscle contraction, including electrical attraction, protein folding, and protein modification. [ 5 ]  The novel theory directly introduced a new concept called cross-bridge theory (classically swinging cross-bridge, now mostly referred to as  cross-bridge cycle ) which explains the molecular mechanism of sliding filament. Cross-bridge theory states that actin and myosin form a protein complex (classically called  actomyosin ) by attachment of myosin head on the actin filament, thereby forming a sort of cross-bridge between the two filaments. The sliding filament theory is a widely accepted explanation of the mechanism that underlies muscle contraction. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1109", "text": "The first muscle protein discovered was myosin by a German scientist  Willy K\u00fchne ,  who extracted and named it in 1864. [ 7 ]  In 1939 a Russian husband and wife team Vladimir Alexandrovich Engelhardt and Militsa Nikolaevna Lyubimova discovered that myosin had an enzymatic (called  ATPase ) property that can break down  ATP  to release energy. [ 8 ]   Albert Szent-Gy\u00f6rgyi , a Hungarian physiologist, turned his focus on muscle physiology after winning the  Nobel Prize in Physiology or Medicine  in 1937 for his works on  vitamin C  and  fumaric acid . He demonstrated in 1942 that ATP was the source of energy for muscle contraction. He actually observed that muscle fibres containing myosin B shortened in the presence of ATP, but not with myosin A, the experience which he later described as \"perhaps the most thrilling moment of my life.\" [ 9 ]  With  Brun\u00f3 Ferenc   Straub , he soon found that myosin B was associated with another protein, which they called actin, while myosin A was not. Straub purified actin in 1942, and Szent-Gy\u00f6rgyi purified myosin A in 1943. It became apparent that myosin B was a combination of myosin A and actin, so that myosin A retained the original name, whereas they renamed myosin B as actomyosin. By the end of the 1940s Szent-Gy\u00f6rgyi's team had postulated with evidence that contraction of actomyosin was equivalent to muscle contraction as a whole. [ 10 ]  But the notion was generally opposed, even from the likes of Nobel laureates such as  Otto Fritz Meyerhof  and  Archibald Hill , who adhered to the prevailing dogma that myosin was a structural protein and not a functional enzyme. [ 3 ]  However, in one of his last contributions to muscle research, Szent-Gy\u00f6rgyi demonstrated that actomyosin driven by ATP was the basic principle of muscle contraction. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1110", "text": "By the time  Hugh Huxley  earned his PhD from the University of Cambridge in 1952 on his research on the structure of muscle, Szent-Gy\u00f6rgyi had turned his career into cancer research. [ 12 ]  Huxley went to  Francis O. Schmitt 's laboratory at the  Massachusetts Institute of Technology  with a post-doctoral fellowship in September 1952, where he was joined by another English post-doctoral fellow  Jean Hanson  in January 1953. Hanson had a PhD in muscle structure from  King's College, London  in 1951. Huxley had used  X-ray diffraction  to speculate that muscle proteins, particularly myosin, form structured filaments giving rise to  sarcomere  (a segment of muscle fibre). Their main aim was to use  electron microscopy  to study the details of those filaments as never done before. They soon discovered and confirmed the filament nature of muscle proteins. Myosin and actin form overlapping filaments, myosin filaments mainly constituting the A band (the dark region of a sarcomere), while actin filaments traverse both the A and I (light region) bands. [ 13 ]  Huxley was the first to suggest the sliding filament theory in 1953, stating:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1111", "text": "\"\u2026 [I]f it is postulated that stretching of the muscle takes place, not by an extension of the filaments, but by a process in which the two sets of  filaments slide  [emphasis added] past each other; extensibility will then be inhibited if the myosin and actin are linked together.\" [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1112", "text": "Later, in 1996, Huxley regretted that he should have included Hanson in the formulation of his theory because it was based on their collaborative work. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1113", "text": "Andrew Huxley , whom  Alan Hodgkin  described as \"wizard with scientific apparatus\", had just discovered the mechanism of the nerve impulse ( action potential ) transmission (for which he and Hodgkin later won the Nobel Prize in Physiology or Medicine in 1963) in 1949 using his own design of  voltage clamp , and was looking for an associate who could properly dissect out muscle fibres. [ 16 ]  Upon recommendation of a close friend Robert St\u00e4mpfli, a German physician  Rolf Niedergerke  joined him at the University of Cambridge in 1952. By then he realised that the conventionally used  phase-contrast microscope  was not suitable for fine structures of muscle fibres, and thus developed his own  interference microscope . Between March 1953 and January 1954 they executed their research. [ 17 ]  Huxley recollected that at the time the only person who ever thought of sliding filaments before 1953 was  Dorothy Hodgkin  (later winner of the 1964   Nobel Prize in Chemistry ). [ 18 ]  He spent the summer of 1953 at  Marine Biological Laboratory  at Woods Hole, Massachusetts, to use electron microscope there. There he met Hugh Huxley and Hanson with whom he shared data and information on their works. They parted with an agreement that they would keep in touch, and when their aim is achieved, they would publish together, if they ever \"reached similar conclusions\". [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1114", "text": "The sliding filament theory was born from two consecutive papers published on the 22 May 1954 issue of  Nature  under the common theme \"Structural Changes in Muscle During Contraction\". Though their conclusions were fundamentally similar, their underlying experimental data and propositions were different."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1115", "text": "The first paper, written by Andrew Huxley and Rolf Niedergerke, is titled \"Interference microscopy of living muscle fibres\". It was based on their study of frog muscle using interference microscope, which Andrew Huxley developed for the purpose. According to them: [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1116", "text": "The second paper, by Hugh Huxley and Jean Hanson, is titled \"Changes in the cross-striations of muscle during contraction and stretch and their structural interpretation\". It is more elaborate and was based on their study of rabbit muscle using phase contrast and electron microscopes. According to them: [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1117", "text": "In spite of strong evidence, the sliding filament theory did not gain any support for several years to come. [ 20 ]  Szent-Gy\u00f6rgyi himself refused to believe that myosin filaments were confined to the thick filament (A band). [ 15 ]  F.O. Schmitt, whose electron microscope provided the best data, also remained sceptical of the original images. [ 21 ]  There were also immediate arguments as to the organisation of the filaments, whether the two sets (myosin and actin) of filaments were merely overlapping or continuous. It was only with the new electron microscope that Hugh Huxley confirmed the overlapping nature of the filaments in 1957. [ 22 ]  It was also from this publication that the existence of actin-myosin linkage (now called cross-bridge) was clearly shown. But he took another five years to provide evidence that the cross-bridge was a dynamic interaction between actin and myosin filaments. [ 23 ]  He obtained the actual molecular arrangement of the filaments using X-ray crystallography by teaming up with  Kenneth Holmes , who was trained by  Rosalind Franklin , in 1965. [ 24 ]  It was only after a conference in 1972 at  Cold Spring Harbor Laboratory , where the theory and its evidence were deliberated, that it became generally accepted. [ 25 ]  At the conference, as Koscak Maruyama later recalled, Hanson had to answer the criticisms by shouting, \"I know I cannot explain the mechanism yet, but the sliding is a fact.\" [ 26 ]  The factual proofs came in the early 1980s when it could be demonstrated the actual sliding motion using novel sophisticated tools by different researchers. [ 27 ] [ 28 ] [ 29 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1118", "text": "With substantial evidence, Hugh Huxley formally proposed the mechanism for sliding filament which is variously called swinging cross-bridge model, cross-bridge theory or cross-bridge model. [ 3 ] [ 30 ]  (He himself preferred the name \"swinging crossbridge model\", because, as he recalled, \"it [the discovery] was, after all, the 1960s\". [ 2 ] ) He published his theory in the 20 June 1969 issue of  Science  under the title \"The Mechanism of Muscular Contraction\". [ 31 ]   According to his theory, filament sliding occurs by cyclic attachment and detachment of myosin on actin filaments. Contraction occurs when the myosin pulls the actin filament towards the centre of the A band, detaches from actin and creates a force (stroke) to bind to the next actin molecule. [ 32 ]  This idea was subsequently proven in detail, and is more appropriately known as the  cross-bridge cycle . [ 33 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1119", "text": "A  slow-wave potential  is a rhythmic electrophysiological event in the  gastrointestinal tract . The normal conduction of slow waves is one of the key regulators of gastrointestinal motility. [ 1 ]  Slow waves are generated and propagated by a class of pacemaker cells called the  interstitial cells of Cajal , which also act as intermediates between  nerves  and  smooth muscle cells . [ 2 ]  Slow waves generated in interstitial cells of Cajal spread to the surrounding smooth muscle cells and control motility."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1120", "text": "In the human  enteric nervous system , the  slow-wave threshold  is the slow-wave potential which must be reached before a slow wave can be propagated in gut wall  smooth muscle . Slow waves themselves seldom cause any smooth muscle contraction (Except for, probably in the stomach). When the amplitude of slow waves in smooth muscle cells reaches the slow-wave threshold \u2014 the L-type Ca 2+  channels are activated, resulting in calcium influx and initiation of motility. [ 3 ] \nSlow waves are generated at unique intrinsic frequencies by the interstitial cells of Cajal, even within the same organ.  Entrainment  of these different intrinsic frequencies through electrical coupling allows these unique intrinsic frequencies to occur at a single frequency within the stomach and segments of the small intestine. Electron microscopic and dye coupling studies to date have confirmed gap junctions as the major coupling mechanisms between interstitial cells of Cajal. [ 4 ] [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1121", "text": "Coupling between ICC and smooth muscle cells is uncertain. Gap junctions have been demonstrated in rare circumstances as one coupling mechanism between ICC and smooth muscle cells. [ 6 ]  Another potential coupling mechanism is the \"Peg and Socket\" theory which demonstrates that the membranes of smooth muscle cells have the ability either form physical narrow \"sockets\" or \"pegs\" to lock onto other smooth muscle cells and/or interstitial cells of Cajal. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1122", "text": "Gastric slow waves occur at around 3 cycles-per-minute in humans and exhibit significance variances in both amplitudes and propagation velocities in the stomach [ 8 ] [ 9 ] [ 10 ]  due to the existence of a gradient of resting membrane potential gradient, [ 11 ]  interstitial cells of Cajal distributions, and gastric wall thickness. Gastric slow waves frequency, propagation velocity, and amplitude demonstrate significant inter-species differences. Extracellular bioelectrical recording studies have demonstrated that gastric slow waves originate from a pacemaker region located on the greater curvature of the stomach. [ 8 ] [ 9 ] [ 10 ]  Human gastric slow waves propagate slower in the corpus than in the pacemaker region and antrum of the stomach. [ 8 ]  Up to four simultaneous slow wave wavefronts can occur in the human stomach."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1123", "text": "Intestinal slow waves occur at around 12 cycles-per-minute in the duodenum, and decreases in frequency towards the colon. [ 12 ] [ 13 ]  Entrainment of intestinal slow waves forms \"frequency plateaus\" in a piece-wise manner along the intestine. Similar to the stomach, intestinal slow waves frequency, propagation velocity, and amplitude also demonstrate significant inter-species differences."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1124", "text": "In  uterine smooth muscle , slow waves have not been consistently observed. Uterine muscle seems to generate action potentials spontaneously. [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1125", "text": "In gastrointestinal smooth muscle, the slow-wave threshold can be altered by input from endogenous and exogenous innervation, as well as excitatory ( acetylcholine  and  Substance P ) and inhibitory ( vasoactive intestinal peptide  and  nitric oxide ) compounds. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1126", "text": "Textbook of Medical Physiology - Gyton and Hall (12th edition) [ page\u00a0needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1127", "text": "Smooth   muscle  is one of the three major types of  vertebrate   muscle tissue , the others being  skeletal  and  cardiac muscle . It can also be found in invertebrates and is controlled by the  autonomic nervous system . It is non- striated , so-called because it has no  sarcomeres  and therefore no striations ( bands  or  stripes ). [ 1 ] [ 2 ]  It can be divided into two subgroups,  single-unit  and  multi-unit  smooth muscle. Within single-unit muscle, the whole bundle or sheet of  smooth muscle cells   contracts  as a  syncytium ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1128", "text": "Smooth muscle is found in the walls of  hollow organs , including the  stomach ,  intestines ,  bladder  and  uterus . In the walls of  blood vessels , and  lymph vessels , (excluding blood and lymph capillaries) it is known as  vascular smooth muscle . There is smooth muscle in the tracts of the  respiratory ,  urinary , and  reproductive   systems . In the  eyes , the  ciliary muscles ,  iris dilator muscle , and  iris sphincter muscle  are types of smooth muscles. The iris dilator and sphincter muscles are contained in the iris and contract in order to  dilate  or  constrict  the pupils. The ciliary muscles change the shape of the  lens  to focus on objects in  accommodation . In the  skin , smooth muscle cells such as those of the  arrector pili  cause  hair  to stand erect in response to  cold  temperature and  fear . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1129", "text": "Smooth muscle is grouped into two types:  single-unit smooth muscle , also known as visceral smooth muscle, and  multiunit smooth muscle . Most smooth muscle is of the single-unit type, and is found in the walls of most   internal organs  (viscera); and lines blood vessels (except large elastic arteries), the  urinary tract , and the  digestive tract . It is not found in the heart which has cardiac muscle. In single-unit smooth muscle a single  cell  in a bundle is innervated by an autonomic nerve fiber (myogenic). An action potential can be propagated through neighbouring muscle cells due to the presence of many gap junctions between the cells. Due to this property, single-unit bundles form a syncytium that contracts in a coordinated fashion making the whole muscle contract or relax. (such as the uterine muscles during childbirth). [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1130", "text": "Single-unit visceral smooth muscle is myogenic; it can contract regularly without input from a motor neuron (as opposed to multiunit smooth muscle, which is neurogenic - that is, its contraction must be initiated by an autonomic nervous system neuron). A few of the cells in a given single unit may behave as pacemaker cells, generating rhythmic action potentials due to their intrinsic electrical activity. Because of its myogenic nature, single-unit smooth muscle is usually active, even when it is not receiving any neural stimulation. Multiunit smooth muscle is found in the  trachea , in the iris of the eye, and lining the large elastic arteries."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1131", "text": "However, the terms single- and multi-unit smooth muscle represent an  oversimplification . This is due to the fact that smooth muscles for the most part are controlled and influenced by a combination of different neural elements. In addition, it has been observed that most of the time there will be some cell-to-cell communication and activators/inhibitors produced locally. This leads to a somewhat coordinated response even in multiunit smooth muscle. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1132", "text": "Smooth muscle differs from  skeletal muscle  and  cardiac muscle  in terms of structure, function, regulation of contraction, and  excitation-contraction coupling . However, smooth muscle tissue tends to demonstrate greater elasticity and function within a larger length-tension curve than  striated muscle . This ability to stretch and still maintain contractility is important in organs like the intestines and urinary bladder. Smooth muscle in the  gastrointestinal tract  is activated by a composite of  smooth muscle cells  (SMCs),   interstitial cells of Cajal  (ICCs), and  platelet-derived growth factor receptor alpha  (PDGFR\u03b1) that are electrically coupled and work together as an  SIP functional syncytium . [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1133", "text": "A smooth-muscle cell is a spindle-shaped  myocyte  with a wide middle and tapering ends, and a single nucleus. Like striated muscle, smooth muscle can  tense and relax .  In the relaxed state, each cell is 30\u2013200 micrometers in length, some thousands of times shorter than a  skeletal muscle cell . [ 1 ]  There are no  myofibrils  present, but much of the cytoplasm is taken up by the proteins,  myosin  and  actin , which together have the capability to contract. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1134", "text": "Myosin is primarily  class II  in smooth muscle. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1135", "text": "Different combinations of heavy and light chains allow for up to hundreds of different types of myosin structures, but it is unlikely that more than a few such combinations are actually used or permitted within a specific smooth muscle bed. [ 8 ]  In the uterus, a shift in myosin expression has been hypothesized to avail for changes in the directions of  uterine contractions  that are seen during the menstrual cycle. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1136", "text": "The thin filaments that are part of the contractile machinery are predominantly composed of  alpha-actin  and  gamma-actin . [ 8 ]  Smooth muscle alpha-actin is the predominant isoform within smooth muscle. There is also a lot of actin (mainly  beta-actin ) that does not take part in contraction, but that polymerizes just below the plasma membrane in the presence of a contractile stimulant and may thereby assist in mechanical tension. [ 8 ]  Alpha-actin is also expressed as distinct genetic isoforms such as smooth muscle, cardiac muscle and skeletal muscle specific isoforms of alpha-actin. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1137", "text": "The ratio of  actin  to  myosin  is between 2:1 [ 8 ]  and 10:1 [ 8 ]  in smooth muscle. Conversely, from a mass ratio standpoint (as opposed to a molar ratio), myosin is the dominant protein in striated skeletal muscle with the actin to myosin ratio falling in the 1:2 to 1:3 range. A typical value for healthy young adults is 1:2.2. [ 11 ] [ 12 ] [ 13 ] [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1138", "text": "Smooth muscle does not contain the protein  troponin ; instead  calmodulin  (which takes on the regulatory role in smooth muscle),  caldesmon  and  calponin  are significant proteins expressed within smooth muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1139", "text": "Also, all three of these proteins may have a role in inhibiting the  ATPase  activity of the myosin complex that otherwise provides energy to fuel muscle contraction. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1140", "text": "The actin filaments are attached to dense bodies, which are analogous to the Z-discs in striated muscle sarcomeres. Dense bodies are rich in  alpha-actinin  (\u03b1-actinin), [ 8 ]  and also attach  intermediate filaments  (consisting largely of  vimentin  and  desmin ), and thereby appear to serve as anchors from which the thin filaments can exert force. [ 8 ]  Dense bodies also are associated with  beta-actin , which is the type found in the cytoskeleton, suggesting that dense bodies may coordinate tensions from both the contractile machinery and the cytoskeleton. [ 8 ]  Dense bodies appear darker under an electron microscope, and so they are sometimes described as electron dense. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1141", "text": "The intermediate filaments are connected to other intermediate filaments via dense bodies, which eventually are attached to  adherens junctions  (also called focal adhesions) in the  cell membrane  of the smooth muscle cell, called the  sarcolemma . The adherens junctions consist of large number of proteins including alpha-actinin (\u03b1-actinin), vinculin and cytoskeletal actin. [ 8 ]  The adherens junctions are scattered around  dense bands  that are circumfering the smooth muscle cell in a rib-like pattern. [ 7 ]  The dense band (or dense plaques) areas alternate with regions of membrane containing numerous  caveolae . When complexes of actin and myosin contract, force is transduced to the sarcolemma through intermediate filaments attaching to such dense bands."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1142", "text": "During contraction, there is a spatial reorganization of the contractile machinery to optimize force development. [ 8 ]  part of this reorganization consists of vimentin being phosphorylated at  Ser 56  by a  p21 activated kinase , resulting in some disassembly of vimentin polymers. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1143", "text": "Also, the number of myosin filaments is dynamic between the relaxed and contracted state in some tissues as the ratio of actin to myosin changes, and the length and number of myosin filaments change."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1144", "text": "Isolated single smooth muscle cells have been observed contracting in a spiral corkscrew fashion, and isolated permeabilized smooth muscle cells adhered to glass (so contractile proteins allowed to internally contract) demonstrate zones of contractile protein interactions along the long axis as the cell contracts."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1145", "text": "Smooth muscle-containing tissue needs to be stretched often, so elasticity is an important attribute of smooth muscle. Smooth muscle cells may secrete a complex extracellular matrix containing  collagen  (predominantly types I and III),  elastin ,  glycoproteins , and  proteoglycans . Smooth muscle also has specific elastin and collagen receptors to interact with these proteins of the extracellular matrix. These fibers with their extracellular matrices contribute to the  viscoelasticity  of these tissues. For example, the great arteries are viscolelastic vessels that act like a  Windkessel , propagating ventricular contraction and smoothing out the pulsatile flow, and the smooth muscle within the  tunica media  contributes to this property."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1146", "text": "The sarcolemma also contains  caveolae , which are microdomains of  lipid rafts  specialized to  cell signaling  events and  ion channels . These invaginations in the sarcoplasm contain a host of  receptors  ( prostacyclin ,  endothelin ,  serotonin ,  muscarinic receptors ,  adrenergic receptors ),  second messenger  generators ( adenylate cyclase ,  phospholipase C ),  G proteins  (RhoA, G alpha), kinases ( rho kinase -ROCK,  protein kinase C ,  protein Kinase A ), ion channels (L type  calcium channels , ATP sensitive potassium channels, calcium sensitive  potassium channels ) in close proximity. The caveolae are often close to sarcoplasmic reticulum or mitochondria, and have been proposed to organize signaling molecules in the membrane."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1147", "text": "A smooth muscle is excited by external stimuli, which causes contraction. Each step is further detailed below."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1148", "text": "Smooth muscle may contract spontaneously (via  ionic channel  dynamics) or as in the gut special pacemakers cells  interstitial cells of Cajal  produce rhythmic contractions. Also, contraction, as well as relaxation, can be induced by a number of physiochemical agents (e.g., hormones, drugs, neurotransmitters \u2013 particularly from the  autonomic nervous system )."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1149", "text": "Smooth muscle in various regions of the vascular tree, the airway and lungs, kidneys and vagina is different in their expression of ionic channels, hormone receptors, cell-signaling pathways, and other proteins that determine function."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1150", "text": "For instance, blood vessels in skin, gastrointestinal system, kidney and brain respond to  norepinephrine  and  epinephrine  (from  sympathetic  stimulation or the adrenal medulla) by producing vasoconstriction (this response is mediated through  alpha-1 adrenergic receptors ). However, blood vessels within skeletal muscle and cardiac muscle respond to these  catecholamines  producing vasodilation because they possess beta- adrenergic receptors . So there is a difference in the distribution of the various adrenergic receptors that explains the difference in why blood vessels from different areas respond to the same agent norepinephrine/epinephrine differently as well as differences due to varying amounts of these catecholamines that are released and sensitivities of various receptors to concentrations."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1151", "text": "Generally, arterial smooth muscle responds to carbon dioxide by producing vasodilation, and responds to oxygen by producing vasoconstriction. Pulmonary blood vessels within the lung are unique as they vasodilate to high oxygen tension and vasoconstrict when it falls. Bronchiole, smooth muscle that line the airways of the lung, respond to high carbon dioxide producing vasodilation and vasoconstrict when carbon dioxide is low. These responses to carbon dioxide and oxygen by pulmonary blood vessels and bronchiole airway smooth muscle aid in matching perfusion and ventilation within the lungs. Further different smooth muscle tissues display extremes of abundant to little sarcoplasmic reticulum so excitation-contraction coupling varies with its dependence on intracellular or extracellular calcium. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1152", "text": "Recent research indicates that  sphingosine-1-phosphate  (S1P) signaling is an important regulator of  vascular smooth muscle  contraction. When  transmural pressure  increases,  sphingosine kinase 1  phosphorylates sphingosine to S1P, which binds to the S1P2 receptor in plasma membrane of cells. This leads to a transient increase in intracellular calcium, and activates Rac and Rhoa signaling pathways. Collectively, these serve to increase  MLCK  activity and decrease MLCP activity, promoting muscle contraction. This allows arterioles to increase resistance in response to increased blood pressure and thus maintain constant blood flow. The Rhoa and Rac portion of the signaling pathway provides a calcium-independent way to regulate  resistance artery  tone. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1153", "text": "To maintain organ dimensions against force, cells are fastened to one another by  adherens junctions . As a consequence, cells are mechanically coupled to one another such that contraction of one cell invokes some degree of contraction in an adjoining cell.  Gap junctions  couple adjacent cells chemically and electrically, facilitating the spread of chemicals (e.g., calcium) or action potentials between smooth muscle cells. Single unit smooth muscle displays numerous gap junctions and these tissues often organize into sheets or bundles which contract in bulk."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1154", "text": "Smooth muscle contraction is caused by the sliding of  myosin  and  actin  filaments (a  sliding filament mechanism ) over each other. The energy for this to happen is provided by the  hydrolysis  of  ATP . Myosin functions as an ATPase utilizing ATP to produce a molecular conformational change of part of the myosin and produces movement. Movement of the filaments over each other happens when the globular heads protruding from myosin filaments attach and interact with actin filaments to form crossbridges. The myosin heads tilt and drag along the actin filament a small distance (10\u201312\u00a0nm). The heads then release the actin filament and then changes angle to relocate to another site on the actin filament a further distance (10\u201312\u00a0nm) away. They can then re-bind to the actin molecule and drag it along further. This process is called crossbridge cycling and is the same for all muscles (see  muscle contraction ). Unlike cardiac and skeletal muscle, smooth muscle does not contain the calcium-binding protein troponin. Contraction is initiated by a calcium-regulated phosphorylation of myosin, rather than a calcium-activated troponin system."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1155", "text": "Crossbridge cycling causes contraction of myosin and actin complexes, in turn causing increased tension along the entire chains of tensile structures, ultimately resulting in contraction of the entire smooth muscle tissue."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1156", "text": "Smooth muscle may contract phasically with rapid contraction and relaxation, or tonically with slow and sustained contraction. The reproductive, digestive, respiratory, and urinary tracts, skin, eye, and vasculature all contain this tonic muscle type. This type of smooth muscle can maintain force for prolonged time with only little energy utilization. There are differences in the myosin heavy and light chains that also correlate with these differences in contractile patterns and kinetics of contraction between tonic and phasic smooth muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1157", "text": "Crossbridge cycling cannot occur until the  myosin heads  have been activated to allow crossbridges to form. When the light chains are phosphorylated, they become active and will allow contraction to occur. The enzyme that phosphorylates the light chains is called  myosin light-chain kinase  (MLCK), also called MLC 20  kinase. [ 8 ]  In order to control contraction, MLCK will work only when the muscle is stimulated to contract. Stimulation will increase the intracellular concentration of calcium ions. These bind to a molecule called  calmodulin , and form a calcium-calmodulin complex. It is this complex that will bind to MLCK to activate it, allowing the chain of reactions for contraction to occur. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1158", "text": "Activation consists of phosphorylation of a  serine  on position 19 (Ser19) on the MLC 20  light chain, which causes a conformational change that increases the angle in the neck domain of the myosin heavy chain, [ 8 ]  which corresponds to the part of the cross-bridge cycle where the myosin head is unattached to the actin filament and relocates to another site on it. After attachment of the myosin head to the actin filament, this serine phosphorylation also activates the ATPase activity of the myosin head region to provide the energy to fuel the subsequent contraction. [ 8 ]  Phosphorylation of a threonine on position 18 (Thr18) on MLC20 is also possible and may further increase the ATPase activity of the myosin complex. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1159", "text": "Phosphorylation of the MLC 20  myosin light chains correlates well with the shortening velocity of smooth muscle. During this period there is a rapid burst of energy utilization as measured by oxygen consumption. Within a few minutes of initiation the calcium level markedly decrease, MLC 20  myosin light chains phosphorylation decreases, and energy utilization decreases and the muscle can relax. Still, smooth muscle has the ability of sustained maintenance of force in this situation as well. This sustained phase has been attributed to certain myosin crossbridges, termed latch-bridges, that are cycling very slowly, notably slowing the progression to the cycle stage whereby dephosphorylated myosin detaches from the actin, thereby maintaining the force at low energy costs. [ 8 ]  This phenomenon is of great value especially for tonically active smooth muscle. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1160", "text": "Isolated preparations of vascular and visceral smooth muscle contract with depolarizing high potassium balanced saline generating a certain amount of contractile force. The same preparation stimulated in normal balanced saline with an agonist such as endothelin or serotonin will generate more contractile force. This increase in force is termed calcium sensitization. The myosin light chain phosphatase is inhibited to increase the gain or sensitivity of myosin light chain kinase to calcium. There are a number of cell signalling pathways believed to regulate this decrease in myosin light chain phosphatase: a RhoA-Rock kinase pathway, a Protein kinase C-Protein kinase C potentiation  inhibitor protein  17 (CPI-17) pathway, telokin, and a Zip kinase pathway. Further Rock kinase and Zip kinase have been implicated to directly phosphorylate the 20kd myosin light chains."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1161", "text": "Other cell signaling pathways and protein kinases ( Protein kinase C ,  Rho kinase , Zip kinase, Focal adhesion kinases) have been implicated as well and actin polymerization dynamics plays a role in force maintenance. While myosin light chain phosphorylation correlates well with shortening velocity, other cell signaling pathways have been implicated in the development of force and maintenance of force. Notably the phosphorylation of specific tyrosine residues on the focal adhesion adapter protein-paxillin by specific tyrosine kinases has been demonstrated to be essential to force development and maintenance. For example, cyclic nucleotides can relax arterial smooth muscle without reductions in crossbridge phosphorylation, a process termed force suppression. This process is mediated by the phosphorylation of the small heat shock protein,  hsp20 , and may prevent phosphorylated myosin heads from interacting with actin."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1162", "text": "The phosphorylation of the light chains by MLCK is countered by a  myosin light-chain phosphatase , which dephosphorylates the MLC 20  myosin light chains and thereby inhibits contraction. [ 8 ]  Other signaling pathways have also been implicated in the regulation actin and myosin dynamics. In general, the relaxation of smooth muscle is by cell-signaling pathways that increase the myosin phosphatase activity, decrease the intracellular calcium levels, hyperpolarize the smooth muscle, and/or regulate actin and myosin muscle can be mediated by the endothelium-derived relaxing factor-nitric oxide, endothelial derived hyperpolarizing factor (either an endogenous cannabinoid, cytochrome P450 metabolite, or hydrogen peroxide), or  prostacyclin  (PGI2).  Nitric oxide  and PGI2 stimulate soluble  guanylate cyclase  and membrane bound adenylate cyclase, respectively. The cyclic nucleotides (cGMP and cAMP) produced by these cyclases activate Protein Kinase G and Protein Kinase A and phosphorylate a number of proteins. The phosphorylation events lead to a decrease in intracellular calcium (inhibit L type Calcium channels, inhibits  IP3 receptor  channels, stimulates  sarcoplasmic reticulum Calcium pump ATPase ), a decrease in the 20kd myosin light chain phosphorylation by altering calcium sensitization and increasing myosin light chain phosphatase activity, a stimulation of calcium sensitive potassium channels which hyperpolarize the cell, and the phosphorylation of amino acid residue serine 16 on the small heat shock protein (hsp20)by Protein Kinases A and G. The phosphorylation of hsp20 appears to alter actin and focal adhesion dynamics and actin-myosin interaction, and recent evidence indicates that hsp20 binding to 14-3-3 protein is involved in this process. An alternative hypothesis is that phosphorylated  Hsp20  may also alter the affinity of phosphorylated myosin with actin and inhibit contractility by interfering with crossbridge formation. The endothelium derived hyperpolarizing factor stimulates calcium sensitive potassium channels and/or ATP sensitive potassium channels and stimulate potassium efflux which hyperpolarizes the cell and produces relaxation."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1163", "text": "In invertebrate smooth muscle, contraction is initiated with the binding of calcium directly to myosin and then rapidly cycling cross-bridges, generating force. Similar to the mechanism of vertebrate smooth muscle, there is a low calcium and low energy utilization catch phase. This sustained phase or catch phase has been attributed to a catch protein that has similarities to myosin light-chain kinase and the elastic protein-titin called twitchin. Clams and other bivalve mollusks use this catch phase of smooth muscle to keep their shell closed for prolonged periods with little energy usage."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1164", "text": "Although the structure and function is basically the same in smooth muscle cells in different organs, their specific effects or end-functions differ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1165", "text": "The contractile function of vascular smooth muscle regulates the lumenal diameter of the small arteries-arterioles called  resistance arteries , thereby contributing significantly to setting the level of blood pressure and blood flow to vascular beds. Smooth muscle contracts slowly and may maintain the contraction (tonically) for prolonged periods in blood vessels, bronchioles, and some sphincters. Activating arteriole smooth muscle can decrease the lumenal diameter 1/3 of resting so it drastically alters blood flow and resistance. Activation of aortic smooth muscle doesn't significantly alter the lumenal diameter but serves to increase the viscoelasticity of the vascular wall."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1166", "text": "In the digestive tract, smooth muscle contracts in a rhythmic  peristaltic  fashion, rhythmically forcing foodstuffs through the digestive tract as the result of phasic contraction."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1167", "text": "A non-contractile function is seen in specialized smooth muscle within the afferent arteriole of the juxtaglomerular apparatus, which secretes  renin  in response to osmotic and pressure changes, and also it is believed to secrete ATP in tubuloglomerular regulation of glomerular filtration rate. Renin in turn activates the  renin\u2013angiotensin system  to regulate blood pressure."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1168", "text": "The mechanism in which external factors stimulate growth and rearrangement is not yet fully understood. A number of growth factors and neurohumoral agents influence smooth muscle growth and differentiation. The Notch receptor and cell-signaling pathway have been demonstrated to be essential to vasculogenesis and the formation of arteries and veins. The proliferation is implicated in the pathogenesis of atherosclerosis and is inhibited by nitric oxide."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1169", "text": "The embryological origin of smooth muscle is usually of mesodermal origin, after the creation of  muscle cells  in a process known as  myogenesis . However, the smooth muscle within the Aorta and Pulmonary arteries (the Great Arteries of the heart) is derived from  ectomesenchyme  of  neural crest  origin, although coronary artery smooth muscle is of mesodermal origin."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1170", "text": "Multisystemic smooth muscle dysfunction syndrome  is a genetic condition in which the body of a developing embryo does not create enough smooth muscle for the  gastrointestinal system . This condition is fatal."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1171", "text": "Anti-smooth muscle antibodies  (ASMA) can be a symptom of an  auto-immune  disorder, such as  hepatitis ,  cirrhosis , or  lupus ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1172", "text": "Smooth muscle tumors  are most commonly benign, and are then called  leiomyomas . They can occur in any organ, but they usually occur in the  uterus ,  small bowel , and  esophagus . Malignant smooth muscle tumors are called  leiomyosarcomas . Leiomyosarcomas are one of the more common types of  soft-tissue sarcomas . Vascular smooth muscle tumors are very rare. They can be  malignant or benign , and morbidity can be significant with either type.  Intravascular leiomyomatosis  is a  benign neoplasm  that extends through the  veins ;  angioleiomyoma  is a benign neoplasm of the extremities; vascular leiomyosarcomas is a  malignant neoplasm  that can be found in the  inferior vena cava ,  pulmonary arteries  and  veins , and other  peripheral vessels .\nSee  Atherosclerosis ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1173", "text": "A  sphincter  is a circular  muscle  that normally maintains constriction of a natural body passage or orifice and which relaxes as required by normal physiological functioning. Sphincters are found in many animals. There are over 60 types in the  human body , [ citation needed ]  some microscopically small, in particular the millions of  precapillary sphincters . [ 1 ]  Sphincters relax at  death , often releasing  fluids  and  faeces . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1174", "text": "Each sphincter is associated with the lumen (opening) it surrounds. As long as the sphincter muscle is contracted, its length is shortened and the lumen is constricted (closed). Relaxation of the muscle causes it to lengthen, opening the lumen and allowing the passage of liquids, solids, or gases."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1175", "text": "This is evident, for example, in the  blowholes  of numerous  marine mammals ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1176", "text": "Many sphincters are used every day in the normal course of  digestion . For example, the lower  oesophageal  sphincter (or cardiac sphincter), which resides at the top of the  stomach , is closed most of the time, keeping  acids  and other stomach contents from pushing up and into the oesophagus, but opens to let swallowed food pass into the stomach."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1177", "text": "Sphincters can be further classified into functional and anatomical sphincters: [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1178", "text": "Sphincters can also be voluntarily or involuntarily controlled:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1179", "text": "Striated muscle tissue  is a  muscle tissue  that features repeating functional units called  sarcomeres . The presence of sarcomeres manifests as a series of bands visible along the muscle fibers, which is responsible for the striated appearance observed in microscopic images of this tissue. There are two types of striated muscle:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1180", "text": "Striated muscle tissue contains  T-tubules  which enables the release of calcium ions from the  sarcoplasmic reticulum . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1181", "text": "Skeletal muscle includes  skeletal muscle fibers , blood vessels, nerve fibers, and connective tissue. Skeletal muscle is wrapped in  epimysium , allowing structural integrity of the muscle despite contractions. The  perimysium  organizes the muscle fibers, which are encased in collagen and  endomysium , into  fascicles . Each muscle fiber contains  sarcolemma ,  sarcoplasm , and  sarcoplasmic reticulum . The functional unit of a muscle fiber is called a  sarcomere . [ 2 ] \nEach muscle cell contains  myofibrils  composed of actin and myosin  myofilaments  repeated as a sarcomere. [ 3 ]   Many nuclei  are present in each muscle cell placed at regular intervals beneath the sarcolemma."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1182", "text": "Based on their contractile and metabolic phenotypes, skeletal muscle can be classified as slow-oxidative (Type I) or fast-oxidative (Type II). [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1183", "text": "Cardiac muscle lies between the  epicardium  and the  endocardium  in the heart. [ 4 ]   Cardiac muscle cells  generally only contain one nucleus, located in the central region. They contain many mitochondria and myoglobin. [ 5 ]  Unlike skeletal muscle, cardiac muscle cells are unicellular. [ 4 ]  These cells are connected to each other by  intercalated disks , which contain  gap junctions  and  desmosomes . [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1184", "text": "Unlike skeletal and cardiac muscle tissue,  smooth muscle tissue  is not striated since there are no sarcomeres present. Skeletal  muscles are attached to some component of the  skeleton , and smooth muscle is found in hollow structures such as the walls of intestines or blood vessels. The fibres of striated muscle have a cylindrical shape with blunt ends, whereas those in smooth muscle are spindle-like with tapered ends. Striated muscle tissue has more  mitochondria  than smooth muscle. Both smooth muscle cells and cardiac muscle cells have a single  nucleus , and skeletal muscle cells have many nuclei. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1185", "text": "The main function of striated muscle tissue is to create force and contract. These  contractions  in cardiac muscle will pump blood throughout the body. In skeletal muscle the contractions enable  breathing , movement, and  posture maintenance . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1186", "text": "Contractions in cardiac muscle tissue are due to a  myogenic response  of the  heart 's  pacemaker cells . These cells respond to signals from the autonomic nervous system to either increase or decrease the heart rate. Pacemaker cells have  autorhythmicity . The set intervals at which they depolarize to threshold and fire action potentials is what determines the heart rate. Because of the gap junctions, the pacemaker cells transfer the depolarization to other cardiac muscle fibers, in order to contract in unison. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1187", "text": "Signals from  motor neurons  cause skeletal muscle fibers to depolarize and therefore release calcium ions from the sarcoplasmic reticulum. The calcium drives the movement of myosin and actin filaments. The sarcomere then shortens which causes the muscle to contract. [ 3 ]  In the skeletal muscles connected to tendons that pull on bones, the mysia fuses to the  periosteum  that coats the bone. Contraction of the muscle will transfer to the mysia, then the tendon and the periosteum before causing the bone to move. The mysia also may bind to an  aponeurosis  or to  fascia . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1188", "text": "Adult humans cannot regenerate cardiac muscle tissue after an injury, which can lead to scarring and thus heart failure. Mammals have the ability to complete small amounts of cardiac regeneration during development. Other vertebrates can regenerate cardiac muscle tissue throughout their entire life span. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1189", "text": "Skeletal muscle is able to regenerate far better than cardiac muscle due to  satellite cells , which are dormant in all healthy skeletal muscle tissue. [ 8 ]  There are three phases to the regeneration process. These phases include the inflammatory response, the activation, differentiation, and fusion of satellite cells, and the maturation and remodeling of newly formed myofibrils. This process begins with the necrosis of damaged muscle fibers, which in turn induces the inflammatory response. Macrophages induce phagocytosis of the cell debris. They will eventually secrete anti-inflammatory cytokines, which results in the termination of inflammation. These macrophages can also facilitate the proliferation and differentiation of satellite cells. [ 3 ]  The satellite cells re-enter the cell cycle to multiply. They then leave the cell cycle to self-renew or differentiate as  myoblasts . [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1190", "text": "Superhuman strength  is a  superpower  commonly invoked in  fiction  and other literary works, such as  mythology . A fictionalized representation of the phenomenon of  hysterical strength , it is the power to exert  force  and lift weights beyond what is  physically possible  for an ordinary  human being . Alternate terms of superhuman strength have included  enhanced strength ,  super-strength  and  increased strength . Superhuman strength is an amorphous ability, varying in potency depending on the writer or the context of the story in which it is depicted."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1191", "text": "Characters and  deities  with superhuman strength have been found in multiple ancient  mythological accounts  and  religions ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1192", "text": "Superhuman strength is a common trope in  fantasy  and  science fiction . This is generally by means of mechanisms such as  cybernetic  body parts,  genetic modification ,  telekinetic fields  in science fiction, or  magical / supernatural  sources within fantasy. A plethora of comic book  superheroes  and  super-villains  display some degree of super strength. Some films invoke a fictional substance or drug that gives the superpower. The level of superhuman strength portrayed can vary greatly, from just outside the \"normal\" or \"natural\" human range of the strongest  strongmen ,  powerlifters , and  weightlifters  (e.g. unarmored  Master Chief ,  Captain America , or  Deathstroke ), to nearly unlimited strength (e.g.,  Hulk ,  Juggernaut ,  Superman ,  Supergirl ,  Wonder Woman ,  Thor ,  Hercules , or  Goku )."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1193", "text": "Humans are actively trying to achieve superhuman strength via technology and scientific experimentation. Athletes have turned to various methods to improve performance, such as  blood doping  or taking  anabolic steroids . Other technologies being researched are robotic  exoskeletons  to be worn by humans to enhance movement and strength."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1194", "text": "Superhuman strength is a common ability of many  gods  and  demigods  in ancient  mythology , such as  Hercules / Heracles  (Roman/Greek),  Beowulf  (Anglo-Saxon),  Samson  (the Bible),  Bhima  (Hindu),  Kintar\u014d  (Japanese),  M\u0101ui  (Polynesian), and  Achilles  (Greek). Attempts to modify the human body in order to gain extraordinary strength is common throughout history, as seen in fiction through characters such as  Terminator ,  Robocop ,  Iron Man , and  Cyborg ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1195", "text": "Humans have tried to enhance their strength through  the use of substances . Accordingly, \"In Ancient Rome, gladiators would drink herbal infusions to strengthen them before chariot races.\" Currently, drugs including  stimulants ,  anabolic steroids ,  diuretics , and  \u03b2-blockers  are ingested to enhance strength and other attributes. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1196", "text": "Humans have tried to use external devices to enhance their strength. The earliest device that was patented for this specific purpose can be credited to Nicholas Yagn, who filed the patent in 1890. The device was described to be an \"apparatus for facilitating walking, running, and jumping\" through the use of bags of compressed air. [ 2 ]  The  United States Department of Defense  is considering a variety of technologies to create an  exoskeleton  intended for military use to enhance soldier performance. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1197", "text": "In the real world, extraordinary strength can occur via science. A person can become stronger, tougher, and more physically powerful than would seem humanly possible when using enhancements such as  doping ,  substances  and  training ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1198", "text": "Records describe instances of people going beyond \"normal\" strength in specific circumstances without taking any specific measures, as in the case of Tom Boyle, who was able to lift the front of a car in order to rescue a person trapped beneath it. [ 4 ]  Penn State professor of  kinesiology  Vladimir Zatsiorsky stated that extraordinary strength can occur when a person engages their muscles through the conscious \"exertion of will\". [ 5 ]  Zatsiorsky claims that trained athletes can improve their strength under specific conditions of competition. [ 5 ]  Fear can also cause a person to exhibit enhanced human strength. (see  hysterical strength )"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1199", "text": "The term appears in weight-lifting [ 6 ]  and 'protein formula' [ 7 ]  commercials without proof of their efficacy."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1200", "text": "Weight lifters and other athletes routinely perform feats that appear to be superhuman to others. For examples, in 2016 Blaine Sumner achieved the heaviest single  bench press  of 401.05 kilograms (884\u00a0lb). At the same competition, he squat-lifted 500 kilograms (1,102\u00a0lb). [ 8 ]  In 2020,  Haf\u00fe\u00f3r J\u00fal\u00edus Bj\u00f6rnsson  of  Iceland  broke the world record for the heaviest  deadlift  at 501 kilograms (1,105\u00a0lb). [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1201", "text": "Many fictional works involve superhuman strength, rooted in religious texts or in scientific form. [ 10 ]  The depiction of superhuman strength dates as far back as the earliest recorded work of writing, with the Sumarian hero  Gilgamesh . Early legends portray characters gaining their superhuman strength from the gods and exhibiting characteristics of both heroic humans and gods."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1202", "text": "More recently, superhuman strength is employed by characters called superheroes in comic books, which dates back to the 1930s. Characters such as  Mr. Incredible ,  The Incredible Hulk ,  Superman , and  Wonder Woman  possess the strength to perform physical feats impossible for the human body. [ 11 ]  These characters and their powers draw from earlier myths. Wonder Woman ostensibly descended from the  Amazons , a group of women possessing superhuman strength. [ 12 ]  In many of these fictional works, the dilemma and solution lies in the character's superhuman abilities. Having these powers alienates them from society but also aids them in their quest. Recurring adaptations of well-known characters are often employed, which continue to perpetuate the use of superhuman strength in fiction."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1203", "text": "T-tubules  ( transverse tubules ) are extensions of the  cell membrane  that penetrate into the center of  skeletal  and  cardiac muscle cells .   With membranes that contain large concentrations of  ion channels , transporters, and pumps, T-tubules permit rapid transmission of the  action potential  into the cell, and also play an important role in regulating cellular calcium concentration."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1204", "text": "Through these mechanisms, T-tubules allow heart muscle cells to contract more forcefully by synchronising calcium release from the  sarcoplasmic reticulum  throughout the cell. [ 1 ]   T-tubule structure and function are affected beat-by-beat by cardiomyocyte contraction, [ 2 ]  as well as by diseases, potentially contributing to  heart failure  and  arrhythmias . Although these structures were first seen in 1897, research into T-tubule biology is ongoing."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1205", "text": "T-tubules are tubules formed from the same  phospholipid bilayer  as the surface membrane or  sarcolemma  of skeletal or cardiac muscle cells. [ 1 ]   They connect directly with the sarcolemma at one end before travelling deep within the cell, forming a network of tubules with sections running both perpendicular (transverse) to and parallel (axially) to the sarcolemma. [ 1 ]  Due to this complex orientation, some refer to T-tubules as the transverse-axial tubular system. [ 3 ]   The inside or lumen of the T-tubule is open at the cell surface, meaning that the T-tubule is filled with fluid containing the same constituents as the solution that surrounds the cell (the extracellular fluid).  Rather than being just a passive connecting tube, the membrane that forms T-tubules is highly active, being studded with proteins including  L-type calcium channels ,  sodium-calcium exchangers ,  calcium ATPases  and  Beta adrenoceptors . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1206", "text": "T-tubules are found in both  atrial  and  ventricular  cardiac muscle cells ( cardiomyocytes ), in which they develop in the first few weeks of life. [ 4 ]   They are found in ventricular muscle cells in most species, and in atrial muscle cells from large mammals. [ 5 ]   In cardiac muscle cells, across different species, T-tubules are between 20 and 450 nanometers in diameter and are usually located in regions called  Z-discs  where the  actin myofilaments  anchor within the cell. [ 1 ]  T-tubules within the heart are closely associated with the intracellular calcium store known as the  sarcoplasmic reticulum  in specific regions referred to as terminal cisternae.  The association of the T-tubule with a  terminal cisterna  is known as a  diad . [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1207", "text": "In skeletal muscle cells, T-tubules are three to four times narrower than those in cardiac muscle cells, and are between 20 and 40\u00a0nm in diameter. [ 1 ]  They are typically located at either side of the myosin strip, at the junction of overlap (A-I junction) between the A and I bands. [ 7 ]  T-tubules in skeletal muscle are associated with two  terminal cisternae , known as a  triad . [ 1 ] [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1208", "text": "The shape of the T-tubule system is produced and maintained by a variety of proteins. The protein  amphiphysin-2  is encoded by the gene  BIN1  and is responsible for forming the structure of the T-tubule and ensuring that the appropriate proteins (in particular L-type calcium channels) are located within the T-tubule membrane. [ 9 ]  Junctophilin-2 is encoded by the gene  JPH2  and helps to form a junction between the T-tubule membrane and the sarcoplasmic reticulum, vital for  excitation-contraction coupling . [ 6 ]   Titin capping protein known as  telethonin  is encoded by the  TCAP gene  and helps with T-tubule development and is potentially responsible for the increasing number of T-tubules seen as muscles grow. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1209", "text": "T-tubules are an important link in the chain from electrical excitation of a cell to its subsequent contraction (excitation-contraction coupling).  When contraction of a muscle is needed, stimulation from a nerve or an adjacent muscle cell causes a characteristic flow of  charged particles  across the cell membrane known as an  action potential .  At rest, there are fewer positively charged particles on the inner side of the membrane compared to the outer side, and the membrane is described as being polarised. During an action potential, positively charged particles (predominantly sodium and calcium ions) flow across the membrane from the outside to the inside.  This reverses the normal imbalance of charged particles and is referred to as  depolarization .  One region of membrane depolarizes adjacent regions, and the resulting wave of depolarization then spreads along the cell membrane. [ 10 ]   The polarization of the membrane is restored as potassium ions flow back across the membrane from the inside to the outside of the cell."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1210", "text": "In cardiac muscle cells, as the action potential passes down the T-tubules it activates L-type calcium channels in the T-tubular membrane.  Activation of the L-type calcium channel  allows calcium to pass into the cell.  T-tubules contain a higher concentration of L-type calcium channels than the rest of the sarcolemma and therefore the majority of the calcium that enters the cell occurs via T-tubules. [ 11 ]  This calcium binds to and activates a receptor, known as a  ryanodine receptor , located on the cell's own internal calcium store, the sarcoplasmic reticulum. Activation of the ryanodine receptor causes calcium to be released from the sarcoplasmic reticulum, causing the muscle cell to contract. [ 12 ]  In  skeletal muscle  cells, however, the L-type calcium channel is directly attached to the ryanodine receptor on the sarcoplasmic reticulum allowing activation of the ryanodine receptor directly without the need for an influx of calcium. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1211", "text": "The importance of T-tubules is not solely due to their concentration of L-type calcium channels, but lies also within their ability to synchronise calcium release within the cell.  The rapid spread of the action potential along the T-tubule network activates all of the L-type calcium channels near-simultaneously.  As T-tubules bring the sarcolemma very close to the sarcoplasmic reticulum at all regions throughout the cell,  calcium can then be released from the sarcoplasmic reticulum across the whole cell at the same time.  This synchronisation of calcium release allows muscle cells to contract more forcefully. [ 14 ]   In cells lacking T-tubules such as  smooth muscle cells , diseased cardiomyocytes, or muscle cells in which T-tubules have been artificially removed, the calcium that enters at the sarcolemma has to diffuse gradually throughout the cell, activating the ryanodine receptors much more slowly as a wave of calcium leading to less forceful contraction. [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1212", "text": "As the T-tubules are the primary location for excitation-contraction coupling, the ion channels and proteins involved in this process are concentrated here - there are 3 times as many L-type calcium channels located within the T-tubule membrane compared to the rest of the sarcolemma. Furthermore, beta adrenoceptors are also highly concentrated in the T-tubular membrane, [ 15 ]  and their stimulation increases calcium release from the sarcoplasmic reticulum. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1213", "text": "As the space within the lumen of the T-tubule is continuous with the space that surrounds the cell (the extracellular space), ion concentrations between the two are very similar. However, due to the importance of the ions within the T-tubules (particularly calcium in cardiac muscle), it is very important that these concentrations remain relatively constant. As the T-tubules are very thin, they essentially trap the ions. This is important as, regardless of the ion concentrations elsewhere in the cell, T-tubules still have enough calcium ions to permit muscle contraction. Therefore, even if the concentration of calcium outside the cell falls ( hypocalcaemia ), the concentration of calcium within the  T-tubule remains relatively constant, allowing cardiac contraction to continue. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1214", "text": "As well as T-tubules being a site for calcium entry into the cell, they are also a site for calcium removal. This is important as it means that calcium levels within the cell can be tightly controlled in a small area (i.e. between the T-tubule and sarcoplasmic reticulum, known as local control). [ 17 ]  Proteins such as the sodium-calcium exchanger and the sarcolemmal ATPase are located mainly in the T-tubule membrane. [ 6 ]  The sodium-calcium exchanger passively removes one calcium ion from the cell in exchange for three sodium ions.  As a passive process it can therefore allow calcium to flow into or out of the cell depending on the combination of the relative concentrations of these ions and the voltage across the cell membrane (the  electrochemical gradient ). [ 10 ]   The calcium ATPase removes calcium from the cell actively, using energy derived from   adenosine triphosphate  (ATP). [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1215", "text": "In order to study T-tubule function, T-tubules can be artificially uncoupled from the surface membrane using a technique known as  detubulation .  Chemicals such as  glycerol [ 18 ]   or  formamide [ 14 ]  (for skeletal and cardiac muscle respectively) can be added to the extracellular solution that surrounds the cells. These agents increase the osmolarity of the extracellular solution, causing the cells to shrink. When these agents are withdrawn, the cells rapidly expand and return to their normal size.  This shrinkage and re-expansion of the cell causes T-tubules to detach from the surface membrane. [ 19 ]   Alternatively, the osmolarity of the extracellular solution can be decreased, using for example hypotonic saline, causing a transient cell swelling.  Returning the extracellular solution to a normal osmolarity allows the cells to return to their previous size, again leading to detubulation. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1216", "text": "The idea of a cellular structure that later became known as a T-tubule was first proposed in 1881. The very brief time lag between stimulating a striated muscle cell and its subsequent contraction was too short to have been caused by a signalling chemical travelling the distance between the sarcolemma and the sarcoplasmic reticulum. It was therefore suggested that pouches of membrane reaching into the cell might explain the very rapid onset of contraction that had been observed. [ 21 ] [ 22 ] \u00a0It took until 1897 before the first T-tubules were seen, using  light microscopy  to study cardiac muscle injected with  India ink .\u00a0 Imaging technology advanced, and with the advent of  transmission electron microscopy  the structure of T-tubules became more apparent [ 23 ]  leading to the description of the longitudinal component of the T-tubule network in 1971. [ 24 ]  In the\u00a01990s and 2000s  confocal microscopy  enabled three-dimensional reconstruction of the T-tubule network and quantification of T-tubule size and distribution, [ 25 ]  and the important relationships between T-tubules and  calcium release  began to be unravelled with the discovery of  calcium sparks . [ 26 ]  While early work focussed on ventricular cardiac muscle and skeletal muscle, in 2009 an extensive T-tubule network in atrial cardiac muscle cells was observed. [ 27 ]  Ongoing research focusses on the regulation of T-tubule structure and how T-tubules are affected by and contribute to cardiovascular diseases. [ 28 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1217", "text": "The structure of T-tubules can be altered by disease, which in the heart may contribute to weakness of the heart muscle or abnormal heart rhythms.  The alterations seen in disease range from a complete loss of T-tubules to more subtle changes in their orientation or branching patterns. [ 29 ]    T-tubules may be lost or disrupted following a  myocardial infarction , [ 29 ]  and are also disrupted in the ventricles of patients with  heart failure , contributing to reduced force of contraction and potentially decreasing the chances of recovery. [ 30 ]  Heart failure can also cause the near-complete loss of T-tubules from atrial cardiomyocytes, reducing atrial contractility and potentially contributing to  atrial fibrillation . [ 27 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1218", "text": "Structural changes in T-tubules can lead to the L-type calcium channels moving away from the ryanodine receptors. This can increase the time taken for calcium levels within the cell to rise leading to weaker contractions and  arrhythmias . [ 6 ] [ 27 ]  However, disordered T-tubule structure may not be permanent, as some suggest that T-tubule remodelling might be reversed through the use of  interval training . [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1219", "text": "Tachyaerobic  is a term used in  biology  to describe the  muscles  of large animals and birds that are able to maintain high levels or physical activity because their hearts make up at least 0.5-0.6 percent of their body mass and maintain high blood pressures. [ 1 ]   A reptile displaying equal size to a tachyaerobic mammal does not have the same capabilities.  Tachyaerobic animals' hearts beat more quickly, produce more oxygen, and distribute blood at a quicker rate than reptiles."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1220", "text": "The use of tachyaerobic muscles is important to animals such as  giraffes  that need blood circulated through a large body size quickly."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1221", "text": "Tensiomyography   (TMG)  is a measuring method for detection of  skeletal muscles ' contractile properties. [ 1 ]  Tensiomyography assesses  muscle  mechanical response based on radial muscle belly displacement induced by a single  electrical stimulus . [ 2 ]  It is performed using the TMG S2 system. A tensiomyography  measurement instrument  includes an electrical stimulator and  data acquisition  subunit (1), a digital  sensor  (2), a  tripod  with manipulating hand (3), and muscle  electrodes  (4) that work with an essential software interface installed on a PC. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1222", "text": "Tensiomyography is a  non-invasive , evidence-based measurement method that precisely measures the speed of muscle contraction under isometric conditions. It is used in sports performance and rehabilitation, and in sports medicine and research, for instance. Tensiomyography data can be used to determine  muscle fiber  type (e.g., by comparing displacement signal and muscle histochemistry [ 3 ] / heavy chain myosin amount20) and muscle status/condition (e.g.,fatigue, [ 4 ]  potentiation, [ 5 ]  inhibition, stress influence on the body, etc.), to diagnose functional muscular symmetry, either temporal or morphological, to evaluate muscular synchronization, and for fast detection (less than 5 minutes) of infra-clinical lesions in the muscles. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1223", "text": "A tensiomyography measurement consists of four steps:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1224", "text": "Tensiomyography specific software on a 1\u00a0kHz frequency receives tensiomyography signals. Two supra-maximal responses are stored and then the average is calculated. The supra-maximal stimulation is regarded as corresponding to a minimal stimulation and it determines maximum amplitude of muscular deformation, recorded as Dm. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1225", "text": "TMG method output is a displacement-time signal evaluated with standard parameters. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1226", "text": "Some recent studies have also elected to examine  Contraction velocity (Vc)  as a change in Dm over time between 10% and 90% of the contraction. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1227", "text": "Tensiomyography is a simple to use selective and non-invasive method for detecting skeletal muscle contractile parameters using the linear displacement sensor. [ 10 ]  It assesses skeletal muscle thickening [ 11 ]  and low frequency lateral oscillations of active skeletal muscle fibers during twitch contractions. Future directions should be multidimensional: further validation especially with muscle force; increasing the research power of established theories; determining the trends of  physiological  processes and adaptations through longitudinal designs; characterizing muscle fatigue, and developing its application in dynamic muscle contractions. [ 12 ]  \nTensiomyography was originally designed to be used by  medical professionals  but has transitioned from  medicine , [ 13 ]  through  sports medicine [ 14 ]  and is now being utilized in sports  training  programs and post injury rehabilitation quantification. [ 15 ]  Because of its non-invasive nature, tensiomyography provides rapid accurate diagnostic data without discomfort or disruption of the routine of the person whose muscles are being assessed."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1228", "text": "Tensiomyography was originally designed for optimization of rehabilitation processes in medicine. Moving on, tensiomyography is used in military, veterinary and most widely spread in the field of elite sports, especially where explosiveness [ 16 ]  is needed."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1229", "text": "Tensiomyography can be applied in training optimization [ 17 ]  process to prevent negative effects of muscle asymmetry and asynchrony on athletes\u2019 maximal speed, explosiveness, endurance and flexibility. [ 18 ]  Application of tensiomyography method identifies muscle pair asymmetry and asynchronous action in the kinetic chain, which decreases movement economy and increase injury risk. Tensiomyographic assessment identifies muscle dysfunctions to adjust training accordingly (activate, strengthen or release tension in specific muscles). [ 19 ] [ 20 ]  The contractile characteristics of athletes' muscles from specific sports disciplines have been defined using tensiomyography, despite the fact that very few sports have been thoroughly researched. [ 21 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1230", "text": "After an injury, tensiomyography can be used to determine injured muscle\u2019s functional capacity by measuring individual muscle heads in isolation, providing unique and selective information. [ 22 ]  Data comparison with the uninjured contralateral muscle helps monitor early phase recovery. Measurement results help determine recovery of functional capacity so the most effective rehabilitation can be safely administered. [ 15 ]  During rehabilitation athletes can be assessed with tensiomyography for progress and rehabilitation strategy can be adjusted for faster rehabilitation."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1231", "text": "Since its first scientific publication in 1990 more than 300 articles show tensiomyography use and purpose: in the estimation of muscle composition; [ 23 ] [ 24 ]  for evaluating  muscle atrophy ; [ 11 ]  for measuring adaptation to different  pathologies ; [ 10 ] [ 19 ] [ 25 ]  for measuring adaptation to specific training; and for measuring muscle fatigue. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1232", "text": "Tensiomyography has been used in several research areas including acute muscle diagnostics, chronic muscle change diagnostics, local muscle fatigue [ 26 ] [ 27 ]  and non-invasive determination of muscle fiber type composition. [ 1 ] [ 3 ] [ 24 ] [ 28 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1233", "text": "ISOT strives to support further development in the field of tensiomyography and standardize tensiomyographic methods while connecting tensiomyography users worldwide for know-how exchange and networking. ISOT was formed at a congress held in Rome on 24 October 2014. [ 29 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1234", "text": "The tensiomyography method was developed by a group of  experts  from various fields at the Faculty for  Electrical Engineering  at the  University of Ljubljana . The  Rehabilitation  Institute in Ljubljana,  Valdoltra Orthopedic Hospital  and  Slovenian Olympic Committee  were among several other institutions that cooperated and were the method's early users and implementers."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1235", "text": "The inventor of the method, Vojko Valen\u010di\u010d, was a leading researcher and head of Laboratory for Biomedical Imaging and Muscle Biomechanics. He had a close working relationship with the Department of Electronics at the University of Ljubljana, which provided human and technical resources and was aided in his work by three research assistants.\nThe tensiomyography method was invented in the late 1980s and has since been improved through many prototypes and developed to the stage where clinical application of the method was possible. Although tensiomyography was initially intended for medical use, the method was also introduced into sports medicine and athletic training in 1996. In recent years, the development and application of the method has shifted more towards sports in cooperation with Srdjan Djordjevi\u010d, a biologist, applied physiologist and the founder of the company TMG-BMC Ltd."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1236", "text": "Tetanic fade  refers to the diminishing muscle twitch response from an evoked potential stimulation of muscle under the effect of either a non-depolarizing neuromuscular blocking agent, or a muscle that is under a phase 2 depolarizing  neuromuscular blocking agent . [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1237", "text": "In order to  transduce  an excitatory signal to the muscle, an indication must transduce from the presynaptic neuron's axon terminal, travel across the synaptic cleft and be received correctly in the post synaptic muscle tissue's motor end plate to produce the desired effect, at the right intensity. The signal propagates from the presynaptic neuron using  neurotransmitter   Acetylcholine  (ACh), a molecule that is released from stored vesicles at the terminal end of the neuron. ACh travels across the space of the synaptic cleft to ACh receptors on the sarcolemma of the motor end plate. After unbinding from the receptors, ACh is broken down by the enzyme  acetylcholinesterase . [ 3 ] [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1238", "text": "The  ACh receptor  is a  ligand gated channel  that goes through a conformational change when it binds to ACh, allowing the flow of  calcium ,  sodium , and  potassium  down their respective gradients. With enough movement of these ions, an electrochemical potential will form, which is called an  endplate potential  (EPP). The EPP signal will be propagated through the motor end plate and to the T-tubules to affect the muscle filaments via  sodium channels . These sodium channels have a brief activation window, after which they are inactivated until the end plate potential is restored to baseline levels. [ 3 ] [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1239", "text": "Tetany  in evoked stimulus, as defined in Morgan & Mikhail's Clinical Anesthesiology as a ~5 seconds of sustained stimulus of between 50 and a 100\u00a0Hz. The reaction of  muscle tissue  to stimulus under no neuromuscular blockade should be equal in intensity throughout the stimulus: the first muscle twitch and last should be of roughly equal magnitude. Clinically it will present as equal muscle contraction throughout the duration of muscle stimulation. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1240", "text": "Non-depolarizing neuromuscular blocking agents  (ie Rocuronium, Vecuronium) interact with Ach receptor without activating the channel, as well as preventing the binding of acetylcholine to it. This blocks the signal propagation from the presynaptic neuron, and the severs the transduction of the excitatory signal from the synaptic cleft. [ 4 ] [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1241", "text": "Muscle tissue treated with a  non-depolarizing neuromuscular blocking agents  will produce an indicative response in the form of a tetanic fade, a diminishing response to tetanic stimulation where the initial intensity will be the highest, and the following ones will show lower and lower strength of response. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1242", "text": "A some data suggest that this response is due to effect of  non-depolarizing neuromuscular blocking agents  on the presynaptic nerve, leading  to lower acetylcholine secreted to the cleft during the tetanic stimulation. In normal muscle tissue release of Ach works to stimulate more release of Ach from the presynaptic neuron's axon in a  positive feedback  manner. In tissue under a  non-depolarizing neuromuscular blocking agent  greatly diminished the levels of Ach that are released into the synaptic cleft. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1243", "text": "Depolarizing neuromuscular blocking agents  (ie Succinylcholine) employ their effect by binding to the ach receptor and activating it, unlike acetylcholine though, the drug is not rapidly degraded by  acetylcholinesterase . Succinylcholine propagates in high concentration for longer duration until it is degraded in the plasma and liver by a different enzyme ( pseudocholinesterase ). This continues to activate the Ach receptor, and prevents sodium channels from recovering to their active state. This leads to muscle relaxation and termed phase 1 block, clinically it will present as a diminished twitch response during tetanic stimulation. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1244", "text": "Phase 1 block does not show fade under tetanic stimulation. With further administration of  depolarizing neuromuscular blocking agent , an effect that is similar to the response of muscle to  non-depolarizing neuromuscular blocking agents  can be observed. This response, termed phase 2 block, will demonstrate similar fade under tetanic stimulation, a diminishing response to tetanic stimulation where the initial response will be the strongest, and will produce lower and lower response intensity. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1245", "text": "4UOW ,  1BPV ,  1G1C ,  1NCT ,  1NCU ,  1TIT ,  1TIU ,  1TKI ,  1TNM ,  1TNN ,  1WAA ,  1YA5 ,  2A38 ,  2BK8 ,  2F8V ,  2ILL ,  2J8H ,  2J8O ,  2NZI ,  2RQ8 ,  2WP3 ,  2WWK ,  2WWM ,  2Y9R ,  3KNB ,  3LCY ,  3LPW ,  3PUC ,  3Q5O ,  3QP3 ,  4C4K ,  4JNW ,  4O00 ,  4QEG ,  5BS0"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1246", "text": "7273"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1247", "text": "22138"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1248", "text": "ENSG00000155657"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1249", "text": "ENSMUSG00000051747"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1250", "text": "Q8WZ42"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1251", "text": "NM_133432 NM_133437"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1252", "text": "NM_011652 NM_028004"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1253", "text": "NP_597676 NP_597681 NP_035782 NP_082280 NP_001372637"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1254", "text": "Titin [ 5 ]   / \u02c8 t a\u026a t \u026a n /  (contraction for  Tit an prote in ) (also called  connectin ) is a  protein  that in humans is encoded by the  TTN   gene . [ 6 ] [ 7 ]  The protein, which is over 1  \u03bcm  in length, [ 8 ]  functions as a molecular  spring  that is responsible for the passive elasticity of  muscle . It comprises 244 individually folded  protein domains  connected by unstructured  peptide  sequences. [ 9 ]  These domains  unfold  when the protein is stretched and  refold  when the tension is removed. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1255", "text": "Titin is important in the contraction of  striated muscle tissues . It connects the  Z disc  to the  M line  in the  sarcomere . The protein contributes to force transmission at the Z disc and resting tension in the  I band  region. [ 11 ]  It limits the range of motion of the sarcomere in tension, thus contributing to the passive stiffness of muscle. Variations in the sequence of titin between different types of striated muscle ( cardiac  or  skeletal ) have been correlated with differences in the mechanical properties of these muscles. [ 6 ] [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1256", "text": "Titin is the third most abundant protein in muscle (after  myosin  and  actin ), and an adult human contains approximately 0.5\u00a0kg of titin. [ 13 ]   With its length of ~27,000 to ~35,000  amino acids  (depending on the  splice isoform ), titin is the largest known  protein . [ 14 ]   Furthermore, the gene for titin contains the largest number of  exons  (363) discovered in any single gene, [ 15 ]  as well as the longest single exon (17,106  bp )."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1257", "text": "In 1954, Reiji Natori proposed the existence of an elastic structure in muscle fiber to account for the return to the resting state when muscles are stretched and then released. [ 16 ]  In 1977, Koscak Maruyama and coworkers isolated an elastic protein from muscle fiber that they called connectin. [ 17 ]   Two years later,  Kuan Wang  and coworkers identified a doublet band on  electrophoresis gel  corresponding to a high molecular weight, elastic protein that they named titin. [ 5 ] [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1258", "text": "In 1990, Siegfried Labeit isolated a partial  cDNA  clone of titin. [ 7 ]   Five years later, Labeit and Bernhard Kolmerer determined the cDNA sequence of human cardiac titin. [ 9 ]  In 2001, Labeit and colleagues determined the complete sequence of the human titin gene. [ 15 ] [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1259", "text": "The human gene encoding for titin is located on the long arm of chromosome 2 and contains 363 exons, which together code for 38,138  amino acid   residues  (4200 kDa). [ 15 ]  Within the gene are found a large number of PEVK (proline-glutamate-valine-lysine -abundant  structural motifs ) exons 84 to 99 nucleotides in length, which code for conserved 28- to 33-residue motifs that may represent structural units of the titin PEVK spring. The number of PEVK motifs in the titin gene appears to have increased during evolution, apparently modifying the genomic region responsible for titin's spring properties. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1260", "text": "A number of titin  isoforms  are produced in different striated muscle tissues as a result of  alternative splicing . [ 21 ]   All but one of these isoforms are in the range of ~27,000 to ~36,000 amino acid residues in length. The exception is the small cardiac novex-3 isoform, which is only 5,604 amino acid residues in length. The following table lists the known titin isoforms:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1261", "text": "Titin is the largest known protein; its human variant consists of 34,350  amino acids , with the  molecular weight  of the mature \"canonical\" isoform of the protein being approximately 3,816,030.05  Da . [ 22 ]  Its mouse homologue is even larger, comprising 35,213 amino acids with a molecular weight of 3,906,487.6  Da . [ 23 ]  It has a theoretical  isoelectric point  of 6.02. [ 22 ]  The protein's  empirical   chemical formula  is C 169,719 H 270,466 N 45,688 O 52,238 S 911 . [ 22 ]  It has a theoretical  instability index  (II) of 42.38, classifying the protein as unstable. [ 22 ]  The protein's  in vivo   half-life , the time it takes for half of the amount of protein in a cell to break down after its synthesis in the cell, is predicted to be approximately 30 hours (in  mammalian   reticulocytes ). [ 21 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1262", "text": "The Titin protein is located between the  myosin  thick filament and the Z disk. [ 25 ]  Titin consists primarily of a linear array of two types of modules, also referred to as  protein domains  (244 copies in total): type I  fibronectin type III domain  (132 copies) and type II  immunoglobulin domain  (112 copies). [ 13 ] [ 9 ]  However, the exact number of these domains is different in different species. This linear array is further organized into two regions:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1263", "text": "The C-terminal region also contains a serine  kinase  domain [ 27 ] [ 28 ]  that is primarily known for adapting the muscle to mechanical strain. [ 29 ]  It is \u201cstretch-sensitive\u201d and helps repair overstretching of the sarcomere. [ 30 ]  The N-terminal (the Z-disc end) contains a \"Z repeat\" that recognizes  Actinin alpha 2 . [ 31 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1264", "text": "The elasticity of the PEVK region has both  entropic  and  enthalpic  contributions and is characterized by a polymer  persistence length  and a  stretch modulus . [ 32 ]  At low to moderate extensions PEVK elasticity can be modeled with a standard  worm-like chain  (WLC) model of  entropic elasticity . At high extensions PEVK stretching can be modeled with a modified WLC model that incorporates enthalpic elasticity. The difference between low-and high- stretch elasticity is due to electrostatic stiffening and  hydrophobic effects ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1265", "text": "Embedded between the PEVK and Ig residues are N2A domains. [ 33 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1266", "text": "The titin domains have evolved from a common ancestor through many gene duplication events. [ 34 ]  Domain duplication was facilitated by the fact that most domains are encoded by single exons. Other giant sarcomeric proteins made out of Fn3/Ig repeats include  obscurin  and  myomesin . Throughout evolution, titin mechanical strength appears to decrease through the loss of disulfide bonds as the organism becomes heavier. [ 35 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1267", "text": "Titin A-band has homologs in invertebrates, such as twitchin (unc-22) and projectin, which also contain Ig and FNIII repeats and a protein kinase domain. [ 30 ]  The gene duplication events took place independently but were from the same ancestral Ig and FNIII domains. It is said that the protein titin was the first to diverge out of the family. [ 28 ]   Drosophila  projectin, officially known as bent ( bt ), is associated with lethality by failing to escape the egg in some mutations as well as dominant changes in wing angles. [ 36 ] [ 37 ] [ 38 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1268", "text": "Drosophila  Titin, also known as Kettin or  sallimus  ( sls ), is kinase-free. It has roles in the elasticity of both muscle and chromosomes. It is homologous to vertebrate titin I-band and contains Ig PEVK domains, the many repeats being a hot target for splicing. [ 39 ]  There also exists a titin homologue,  ttn-1 , in  C. elegans . [ 40 ]  It has a kinase domain, some Ig/Fn3 repeats, and PEVT repeats that are similarly elastic. [ 41 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1269", "text": "Titin is a large abundant protein of striated muscle. Titin's primary functions are to stabilize the thick filament, center it between the thin filaments, prevent overstretching of the sarcomere, and to recoil the sarcomere like a spring after it is stretched. [ 42 ]  An N-terminal Z-disc region and a C-terminal M-line region bind to the Z-line and M-line of the  sarcomere , respectively, so that a single titin molecule spans half the length of a sarcomere. Titin also contains binding sites for muscle-associated proteins so it serves as an adhesion template for the assembly of contractile machinery in muscle cells. It has also been identified as a structural protein for  chromosomes . [ 43 ] [ 44 ]  Considerable variability exists in the I-band, the M-line and the Z-disc regions of titin. Variability in the I-band region contributes to the differences in elasticity of different titin isoforms and, therefore, to the differences in elasticity of different muscle types. Of the many titin variants identified, five are described with complete transcript information available. [ 6 ] [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1270", "text": "Dominant  mutation in TTN causes predisposition to  hernias . [ 45 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1271", "text": "Titin interacts with many  sarcomeric  proteins including: [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1272", "text": "Mutations  anywhere within the unusually long sequence of this gene can cause  premature stop codons  or other defects.  Titin mutations are associated with hereditary  myopathy  with early respiratory failure, [ 46 ] [ 47 ]  early-onset myopathy with fatal  cardiomyopathy , [ 48 ]  core myopathy with heart disease,  centronuclear myopathy ,  limb-girdle muscular dystrophy  type 2J, [ 49 ]   familial   dilated cardiomyopathy  9, [ 11 ] [ 50 ]   hypertrophic cardiomyopathy  and  tibial muscular dystrophy . [ 51 ]  Further research also suggests that no genetically linked form of any  dystrophy  or myopathy can be safely excluded from being caused by a mutation on the TTN gene. [ 49 ]   Truncating mutations in dilated cardiomyopathy patients are most commonly found in the A region; although truncations in the upstream I region might be expected to prevent translation of the A region entirely,  alternative splicing  creates some transcripts that do not encounter the premature stop codon, ameliorating its effect. [ 52 ]   mRNA splicing factors  such as RBM20 and  SLM2  ( KHDRBS3 ) were shown to mediated alternative mRNA splicing of titin mRNA contributing to the development of  heart failure  due to  cardiomyopathies . [ 53 ] [ 54 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1273", "text": "Autoantibodies to titin are produced in patients with the autoimmune disease  Myasthenia gravis . [ 55 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1274", "text": "Titin has been shown to  interact  with:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1275", "text": "The name titin is derived from the Greek  Titan  (a giant deity, anything of great size). [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1276", "text": "As the largest known protein, titin also has the longest  IUPAC name  of a protein.  The full chemical name  of the human canonical form of titin, which starts  methionyl ...  and ends  ... isoleucine , contains 189,819 letters and is sometimes stated to be the  longest word in the English language , or  of any language . [ 66 ]  However,  lexicographers  regard generic names of  chemical compounds  as  verbal  formulae  rather than English words. [ 67 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1277", "text": "This article incorporates text from the  United States National Library of Medicine , which is in the  public domain ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1278", "text": "In the  histology  of  skeletal muscle , a  triad  is the structure formed by a  T tubule  with a  sarcoplasmic reticulum  (SR) known as the  terminal cisterna  on either side. [ 1 ]  Each  skeletal muscle fiber  has many thousands of triads, visible in muscle fibers that have been sectioned longitudinally. (This property holds because T tubules run perpendicular to the longitudinal axis of the muscle fiber.) In mammals, triads are typically located at the  A-I junction ; [ 1 ]  that is, the junction between the  A  and  I bands  of the  sarcomere , which is the smallest unit of a muscle fiber."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1279", "text": "Triads form the anatomical basis of  excitation-contraction coupling , whereby a stimulus excites the muscle and causes it to contract. A stimulus, in the form of positively charged current, is transmitted from the  neuromuscular junction  down the length of the  T tubules , activating  dihydropyridine receptors  (DHPRs). Their activation causes 1) a negligible influx of  calcium  and 2) a mechanical interaction with calcium-conducting  ryanodine receptors  (RyRs) on the adjacent SR membrane. Activation of RyRs causes the release of calcium from the SR, which subsequently initiates a cascade of events leading to  muscle contraction . These muscle contractions are caused by calcium's bonding to troponin and unmasking the binding sites covered by the troponin-tropomyosin complex on the actin myofilament and allowing the myosin cross-bridges to connect with the actin."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1280", "text": "Tropomyosin  is a two-stranded  alpha-helical ,  coiled coil   protein  found in many  animal  and  fungal  cells. In animals, it is an important component of the muscular system which works in conjunction with  troponin  to regulate muscle contraction. It is present in smooth and striated muscle tissues, which can be found in various organs and body systems, including the heart, blood vessels, respiratory system, and digestive system. In fungi, tropomyosin is found in cell walls and helps maintain the structural integrity of cells."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1281", "text": "Tropomyosin is found in other  eukaryotes  too, but not in plants. Overall, tropomyosin is an important protein that plays a vital role in the proper functioning of many different organisms."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1282", "text": "All organisms contain organelles that provide physical integrity to their cells. These type of organelles are collectively known as the cytoskeleton, and one of the most ancient systems is based on filamentous polymers of the protein  actin . A polymer of a second protein, tropomyosin, is an integral part of most actin filaments in animals."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1283", "text": "Tropomyosins are a large family of integral components of actin filaments that play a critical role in regulating the function of actin filaments in both muscle and nonmuscle cells. These proteins consist of rod-shaped coiled-coil hetero- or homo- dimers  that lie along the  \u03b1-helical groove  of most actin filaments. Interaction occurs along the length of the actin filament, with dimers aligning in a head-to-tail fashion."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1284", "text": "Tropomyosins are often categorised into two groups: muscle tropomyosin  isoforms  and nonmuscle tropomyosin isoforms. Muscle tropomyosin isoforms are involved in regulating interactions between actin and  myosin  in the muscle  sarcomere  and play a pivotal role in regulated  muscle contraction . Nonmuscle tropomyosin isoforms function in both muscle and nonmuscle cells, and are involved in a range of cellular pathways that control and regulate the cell's  cytoskeleton  and other key cellular functions."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1285", "text": "The actin filament system that is involved in regulating these cellular pathways is more complex than the actin filament systems that regulates muscle contraction. The contractile system relies upon 4 actin filament isoforms and 5 tropomyosin isoforms, [ 1 ]  whereas the actin filament system of the cytoskeleton uses two actin filament isoforms and over 40 tropomyosin isoforms. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1286", "text": "In direct contrast with the 'one  gene , one  polypeptide ' rule, it is now known from a combination of  genomic sequencing , such as the  Human Genome Project  and  EST  data of expressed proteins, that many  eukaryotes  produce a range of proteins from a single gene. This plays a crucial role in the functionality of higher eukaryotes, with humans expressing more than 5 times as many different proteins (isoforms) as genes through  alternative splicing . From a mechanistic point of view, it is much easier for an organism to expand on a current gene/protein family (creating protein isoforms) than it is to create an entirely new gene.\nFrom an evolutionary point of view, tropomyosins in higher eukaryotes are notable in retaining all 4 of the potential genes produced by the dual genomic duplication event that took place in early eukaryotic evolution.\n [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1287", "text": "Within mammals, four genes are responsible for generating more than 40 different tropomyosin isoforms. In terms of structure, the genes are very similar, suggesting that they arose through  gene duplication  of an ancestral gene. In humans, these genes are no longer linked and are widely dispersed. In humans, the \u03b11-, \u03b2-, \u03b13-, and \u03b14-genes are formally known as  TPM1 ,  TPM2 ,  TPM3 , and  TPM4  and are located at 15q22, [ 4 ]  9p13, [ 5 ]  1q22 [ 6 ]  and 19p13, [ 7 ]  respectively. An alternative nomenclature names the four genes (\u03b1,\u03b2,\u03b3,\u03b4). [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1288", "text": "Isoforms are defined as highly related gene products that perform, in essence, similar biological functions, with variations existing between the isoforms in terms of biological activity, regulatory properties, temporal and spatial expression, and/or the intercellular location. Isoforms are produced by two distinct mechanisms, gene duplication and alternative splicing. The former mechanism is a process by which multiple copies of a gene are generated through unequal crossing over, through tandem duplication, or by translocation. Alternative splicing is a mechanism wherein exons are either retained in the mRNA or targeted for removal in different combinations to create a diverse array of mRNAs from a single pre-mRNA."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1289", "text": "A vast array of tropomyosin isoforms are generated by using a combination of different genes and alternative splicing. [ 8 ]  In mammals, regardless of the gene, transcription is initiated at the start of either exon 1a or exon 1b. Depending on the  promoter  and initial exon used, tropomyosin isoforms can be categorized as either high- molecular-weight  (HMW, 284 amino acids) or low-molecular-weight (LMW, 248). [ 1 ] [ 9 ]  HMW isoforms express exon 1a and either 2a or 2b, while LMW isoforms express exon 1b. [ 9 ]  To date, all known tropomyosins contain exons 3-9. Alternative splicing can occur at exon 6, with the mutually exclusive choice of exon 6a or 6b. [ 10 ]  At the c-terminus, the transcript is spliced again at exon 9, with the choice of exon 9a, 9b, 9c, or 9d. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1290", "text": "In terms of structure, the genes are very similar, suggesting that they arose through gene duplication of an ancestral gene. The most highly related genes are the \u03b1- and \u03b3-genes, utilizing two promoters and differing only with the presence of the unique 2a exon in the \u03b1-gene. [ 11 ] [ 12 ]  Although substantial differences between alternative exons from the same gene have been revealed by sequence comparison (1a and 1b, 6a and 6b, and the exon 9s), most exons are, however, highly conserved between the different genes. [ 1 ] [ 8 ] [ 13 ] [ 14 ]  For example, exon 1a and 1b from the \u03b1-gene vary considerably in sequence; however, the sequence from exon 1a from the \u03b1-, \u03b2-, \u03b3-, and \u03b4-genes is highly conserved."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1291", "text": "Due to the conservative nature of the genes, it is believed that the genes evolved from a common ancestral gene, giving rise to over 40 functionally distinct isoforms. The expression of these isoforms is highly regulated and variable throughout development. The diversity of tropomyosin expression, both in space and in time, provides the potential not only to regulate actin filament function but to create specialised actin filament populations. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1292", "text": "Numerous reports detail that tropomyosin isoforms are sorted to different intracellular locations, often associating with actin filament populations that are involved in specific processes. [ 15 ] [ 16 ] [ 17 ] [ 18 ]  Direct visualization of spatial segregation of isoforms was initially observed by Burgoyne and Norman and soon after by Lin and co-workers. [ 18 ] [ 19 ] [ 20 ]  They observed that specific isoforms were associated with distinct cellular structures. [ 18 ]  Using specific antibodies, they were able to identify the presence of both HMW and the LMW isoforms of the \u03b3-gene in stress fibers; however, only LMW isoforms were detected in  ruffling membranes . [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1293", "text": "These studies have been extended to a number of cell types with similar results. Extensive studies in neuronal cells, [ 21 ]   fibroblasts , [ 16 ] [ 17 ] [ 22 ]  skeletal muscle [ 23 ] [ 24 ]  and  osteoclast  cells has further highlighted the complex association tropomyosin isoforms have with cellular structures. These studies have led to the realization that the regulation of isoform sorting is extremely complex and highly regulated."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1294", "text": "Sorting of tropomyosin isoforms in discrete intracellular locations is developmentally regulated. Initial studies reported that the sorting of isoforms changed through development, where Tropomyosin 4 was initially localized to the  growth cone  of growing neurons, but in mature neurons it was relocated to the somatodendritic compartment. [ 25 ]  These observations have been supported by studies on different tropomyosin isoforms, showing how tropomyosin populations were relocated during neuron maturation. This evidence is supportive of the notion that tropomyosin isoforms are subject to temporal regulation."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1295", "text": "Additional studies have identified the role the cell cycle plays in isoform sorting. A study that screened a range HMW products from the \u03b1- and \u03b2-genes and  compared localisation with LMW products from the \u03b3-gene found that the HMW and LMW products are mutually exclusively segregated during the early  G1 phase  of the cell cycle. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1296", "text": "While studies suggest that tropomyosin sorting may be influenced by the sorting of mRNAs, [ 21 ]  there is no absolute correlation between mRNA and protein location. In neurons, Tropomyosin 5NM1 mRNA was found to sort to the pole of the neuron elaborating an axon prior to morphological differentiation. [ 26 ]  The sorting of Tropomyosin 5NM1/2 mRNA to this location correlated with the expression of the Tropomyosin 5NM1/2 protein. In contrast, the mRNA encoding the Tropomyosin Br2 protein was excluded from the pole of the neuron. [ 26 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1297", "text": "The link between mRNA sorting and protein location has been tested in transgenic mice models. The models were created so that the coding regions of Tropomyosin 5NM1/2 and Tropomyosin 3 were expressed under the control of the \u03b2-actin promoter with the a \u03b2-actin 3'-untranslated region lacking targeting information. [ 27 ]  The study found that Tropomyosin 3, an isoform that is not normally expressed in neuronal cells, was broadly distributed throughout the neuron, while exogenous expression of the neuronal isoform Tropomyosin 5NM1/2 was found to sort to the growth cone of neurons as does the endogenous Tropomyosin 5NM1/2. As these two transgenes differ only in the tropomyosin coding region yet are localized in two distinct areas, the findings suggest that, in addition to mRNA sorting, the proteins themselves contain sorting information."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1298", "text": "Studies suggest that tropomyosin isoform sorting may also be influenced by the actin isoform composition of microfilaments. [ 27 ]  In myoblasts, overexpression of \u03b3-actin resulted in the down-regulation of \u03b2\u2013actin and the removal of Tropomyosin 2 but not Tropomyosin 5 from stress fibers. [ 28 ]  It was later found that, when cells were exposed to cytochalasin D, a chemical that results in the disorganization of actin filaments, tropomyosin isoform sorting was disrupted. Upon the washing out of cytochalasin D, tropomyosin isoform sorting was re-established. [ 29 ]  This is suggestive of a strong relationship between the process of tropomyosin isoform sorting and the incorporation of tropomyosin isoforms into organized arrays of actin filaments. There is no evidence for active transport of tropomyosin isoforms to specific locations. Rather, it appears that sorting is the result of local assembly of preferred isoforms at specific intracellular site. The mechanisms that underlie tropomyosin isoform sorting appear to be inherently flexible and dynamic in nature."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1299", "text": "Many studies have led to the understanding that tropomyosins perform essential functions and are required in a diverse range of species from yeast, worms, and flies to complex mammals."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1300", "text": "The essential role of tropomyosins was discovered in the Bretscher laboratory, where researchers found that, by eliminating the TPM1 gene of budding yeasts, growth rates were reduced, the presence of actin cables disappeared, defects in vesicular transport were observed, and mating of the yeast was poor. [ 30 ]  When a second yeast gene, TPM2, was deleted, no observable changes in the phenotype were recorded; however, when deleted in combination with TPM1, it resulted in lethality. This suggests that TPM1 and -2 genes have overlapping function; however, TPM2 cannot fully compensate of the loss of TPM1, indicating that some functions of TPM1  are unique. Similar results have been observed in flies, worms, amphibians, and mammals, confirming previous results and suggestive of tropomyosin's being involved in a wide range of cellular functions. However, the three co-expressed TMP1, 2, and 4 genes cannot compensate for deletion of the TPM3 gene in embryonic stem cells and preimplantation mouse embryos."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1301", "text": "Results from gene knockout experiments can be ambiguous and must be carefully examined. In studies in which the deletion of a gene leads to lethality, it can at first appear that the gene product had a truly unique role. However, lethality can also be the result of the inability of the compromised cell to express other isoforms to rescue the phenotype because the required isoform is not naturally expressed in the cell."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1302", "text": "The  actin microfilament  system is the fundamental cytoskeletal system involved in the development and maintenance of cell morphology. The ability of this system to readily respond to cellular cues and undergo structural re-organisation has led to the belief that this system regulates specific structural changes within different cellular regions."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1303", "text": "Within humans, there are only six actin isoforms, and these isoforms are responsible for an array of unique and complex cellular structures and key cellular interactions. It is thought that the function and form of the actin cytoskeleton is controlled largely by  actin-binding proteins  (ABP) that are associated with the actin polymer. ABP are a group of proteins that bind to actin. Although tropomyosin is sometimes included as an ABP, it is not a true ABP. The tropomyosin dimer has very low affinity for an actin filament and forms no van der waals contacts with actin. It is only the formation of a tropomyosin polymer's winding around the actin filament that provides stability to the tropomyosin-actin filament interaction."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1304", "text": "Many studies suggest that the binding of tropomyosin isoforms to an actin filament may influence the binding of other ABPs, which together alter the structure and convey specific properties and ultimately specific functions to an actin filament. This is demonstrated in neuroepithelial cells, where increased expression of Tropomyosin 5NM1 increases the recruitment of myosin IIB, a myosin motor protein to the growth cone area. [ 31 ]  However, the over-expression of Tropomyosin Br3 had the opposite effect, decreasing myosin activity in the same region."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1305", "text": "In a pioneering study by Bernstein and Bamburg, it was observed that the actin-binding protein  actin depolymerisation factor (ADF)/ cofilin , a factor that promotes actin filament depolymerisation, competed with tropomyosin for binding to the actin filament. [ 32 ]  The expression of Tropomyosin 5NM1 in neuronal cells eliminated ADF/cofilin from the growth cone region, leading to more stable actin filaments. [ 31 ]  However, the increased expression of Tropomyosin Br3 was observed to recruit ADF/cofilin to actin filaments bound to the Tropomyosin Br3 isoform within the lamellipodium, which led to the disassembly of actin filaments. [ 31 ]  This phenomenon, whereby a specific tropomyosin isoform directs specific interactions between actin-binding proteins, and the actin filament has been observed in a variety of model systems with a range of different binding proteins (reviewed in Gunning et al., 2008 [ 10 ] ). These interactions, under the influence of tropomyosin isoforms, allow actin filaments to be involved in a diverse range of cellular functions."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1306", "text": "Skeletal muscle  is composed of large, multi-nucleated cells ( muscle fibers ). Each muscle fiber is packed with longitudinal arrays of  myofibrils . Myofibrils are composed of repeating protein structures or  sarcomeres , the basic functional unit of skeletal muscle. The sarcomere is a highly structured protein array, consisting of interdigitating thick and thin filaments, where the thin filaments are tethered to a protein structure, the  Z-line . The dynamic interaction between the thick and thin filaments results in muscle contraction."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1307", "text": "Myosin belongs to a family of motor proteins, and the muscle isoforms of this family comprise the thick filament. The thin filament is made of the skeletal muscle isoforms of actin. Each myosin protein 'paddles' along the thin actin filament, repeatedly binding to myosin-binding sites along the actin filament, ratcheting and letting go. In effect, the thick filament moves or slides along the thin filament, resulting in  muscle contraction . This process is known as the  sliding filament model ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1308", "text": "The binding of the myosin heads to the muscle actin is a highly regulated process. The thin filament is made of actin, tropomyosin, and troponin. The contraction of skeletal muscle is triggered by nerve impulses that in turn stimulate the release of Ca 2+ . The release of Ca 2+  from the  sarcoplasmic reticulum  causes an increase in the concentration of Ca 2+  in the cytosol. Calcium ions then bind to troponin, which is associated with tropomyosin. Binding causes changes in the shape of troponin and subsequently causes the tropomyosin isoform to shift its position on the actin filament. This shifting in position exposes the myosin-binding sites on the actin filament, allowing the myosin heads of the thick filament to bind to the thin filament."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1309", "text": "Structural and biochemical studies suggest that the position of tropomyosin and troponin on the thin filament regulates the interactions between the myosin heads of the thick filament and the binding sites on the actin of the thin filament.  X-ray diffraction  and  cryoelectron microscopy  suggest that tropomyosin  sterically  blocks the access of myosin to the actin filament."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1310", "text": "Although this model is well-established, it is unclear as to whether the movement of tropomyosin directly causes the myosin head to engage the actin filament. As such, an alternative model has emerged, whereby the movement of the tropomyosin in the filament functions as an  allosteric  switch that is modulated by activating myosin binding but does not function solely by regulating myosin binding."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1311", "text": "Smooth muscle  is a type of non-striated muscle, and, unlike striated muscle, contraction of smooth muscle is not under conscious control. Smooth muscle may contract spontaneously or rhythmically and be induced by a number of physiochemical agents (hormones, drugs, neurotransmitters). Smooth muscle is found within the walls of various organs and tubes in the body such as the esophagus, stomach, intestines, bronchi, urethra, bladder, and blood vessels."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1312", "text": "Although smooth muscles do not form regular arrays of thick and thin filaments like the sarcomeres of striated muscles, contraction is still due to the same sliding filament mechanism controlled by myosin crossbridges interacting with actin filaments. The thin filament of smooth muscle is made of actin, tropomyosin,  caldesmon , and  calmodulin . Within this type of muscle, caldesmon and calmodulin control the tropomyosin-mediated transition between on and off activity states. Caldesmon binds to actin, tropomyosin, calmodulin, and myosin, of which its interactions with actin are most important. The binding of caldesmon is strongly influenced by tropomyosin. Caldesmon is an inhibitor of actinomyosin ATPase and motility, and both actin binding and caldesmon inhibition are greatly enhanced in the presence of tropomyosin."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1313", "text": "Smooth muscle contraction is initiated by the release of Ca 2+ . Ca 2+  binds to and activates calmodulin, which then binds to caldesmon. This binding causes the caldesmon protein to disengage from the actin filament, exposing the myosin-binding sites on the actin filament. Myosin motor heads are phosphorylated by  myosin light-chain kinase , allowing the myosin head to interact with the actin filament and cause contraction."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1314", "text": "The cytoskeleton is an elaborate network of filaments required for the proper functioning of a range of cellular processes including cell motility, cell division, intracellular trafficking, and the maintenance of cell shape.  The cytoskeleton is composed of three distinct filament systems: microtubules, intermediate filaments, and microfilaments (also known as the actin cytoskeleton). It is the dynamic interactions between these filaments that provide cells with unique structures and functions."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1315", "text": "A number of regulatory mechanisms, employing many actin-binding proteins, have evolved to control the dynamics of the actin filament system. It is believed that tropomyosins play a pivotal role in this regulatory system, influencing the associations the actin filament has with other ABPs. Together, these associations confer specific properties on the filament, allowing these structures to be involved in a wide range of cellular processes, but also to rapidly respond to cellular stimuli."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1316", "text": "Many studies have shown that there are specific changes to the repertoire of tropomyosins expressed in cells that are undergoing cellular transformation. These highly reproducible results suggest that, during the process of cellular transformation, a process whereby a normal cell becomes malignant, there is a decreased synthesis of HMW tropomyosin isoforms. In the initial studies, transformation of rat embryo fibroblast cell line REF-52 and of normal rat kidney cells led to decreased synthesis of HMW tropomyosins. [ 33 ] [ 34 ] [ 35 ]  In both of these systems, the down regulation was contributed to a decrease in the mRNA levels. These early results suggested that tropomyosins played a critical role in facilitating certain processes that occurred during cell transformation, such as actin filament re-organisation and changes in cell shape. These studies have been reproduced in other laboratories and in other cell lines, with similar results (reviewed in Gunning et al., 2008 [ 10 ] )."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1317", "text": "Furthermore, studies have highlighted a link between tropomyosin isoform expression and the acquisition of metastatic properties. A study compared isoform expression between a low- and highly-metastatic Lewis lung carcinoma cell line. [ 36 ] [ 37 ]  The study found that as cells become more metastatic, there is a marked decrease in the expression of HMW tropomyosin 2 protein and mRNA levels."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1318", "text": "These results have been confirmed in primary tumors and human models. Studies in colon and bladder cancer found increased expression of the LMW tropomyosin  Tropomyosin 5NM1 . [ 38 ] [ 39 ]  The elevated expression of this isoform has also been seen in transformed rat fibroblasts, and it is thought that this isoform is required for the motility of highly metastatic melanoma. [ 40 ]  In addition, elevated expression of Tropomyosin 4 has been linked with lymph node metastasis in breast cancer."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1319", "text": "All of these studies suggest that changes in the expression and complement of tropomyosin isoforms are integral to cancer and cancer progression. The consensus is that, in general, cancer cells become more reliant on LMW tropomyosins as HMW tropomyosins disappear with increasing malignancy. [ 10 ]  This discovery has led to the development of novel anti-tropomyosin compounds as potential anti-cancer agents."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1320", "text": "Tropomyosins have been implicated in the autoimmune disease  ulcerative colitis , a disease of the colon that is characterised by ulcers or open sores. The link between this disease and tropomyosin was first acknowledged in a study that found blood serum taken from 95% of patients with ulcerative colitis contained antibodies that reacted positively to tropomyosin. [ 41 ]  Additional studies have confirmed these results, but also identify Tropomyosin 5 and Tropomyosin 1 as the primary tropomyosins involved in the pathogenesis of ulcerative colitis. [ 42 ] [ 43 ]  Tropomyosin 5 has been related to the development of pouchitis in the ileal pouch following surgery for ulcerative colitis. The elevated number of IgG-producing cells in the colonic mucosa of ulcerative colitis patients is largely committed to producing IgG against Tropomyosin  5-related epitopes. Tropomyosin 5 is, therefore, capable of inducing a significant T-cell response. [ 44 ]   A physicochemical analysis of common structural motifs present in 109 human autoantigens revealed that tropomyosins have the highest number of such motifs, and thus a very high propensity to act as autoantigens. [ 45 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1321", "text": "In addition to the role tropomyosins play in ulcerative colitis, tropomyosin antibodies have also been reported in acute  rheumatic fever [ 46 ]  \nand the inflammatory disorder  Behcet's syndrome . [ 47 ]  In both instances, it is unclear as to whether these antibodies play a direct role in the pathogenesis of these human conditions or reflect the high antigenicity of tropomyosins released from compromised cells."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1322", "text": "Nemaline myopathy is a muscle disease that is characterised by the presence of electron-dense rod bodies in skeletal muscle fibers. These electron-dense rod bodies are composed mainly of \u03b1-actinin and actin. The disorder is often clinically categorized into several groups, including mild (typical), intermediate, severe, and adult-onset; however, these distinctions are somewhat ambiguous, as the categories frequently overlap. Causative mutations have been detected in skeletal \u03b1-actinin, tropomyosin,  nebulin , and troponin. Within humans, mutations in both the \u03b3-Tropomyosin and \u03b2-Tropomyosin genes have been identified. No mutations in the \u03b1-Tropomyosin gene have been identified in this condition for humans."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1323", "text": "Tropomyosin is the primary protein responsible for  shellfish allergies , including those to  crustaceans  and  molluscs . [ 48 ] [ 49 ] [ 50 ] [ 51 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1324", "text": "Tropomyosin also causes some cases of  cockroach  allergy. [ 52 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1325", "text": "Given the vast array of processes that this protein has been reported to be involved with, there is great interest in tropomyosin isoforms within the scientific community."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1326", "text": "One way in which specific isoforms of this protein can be studied in detail is through the use of antibodies. These specific antibodies can be used in protein-blotting experiments and applied to cells or tissue sections and observed under a microscope. This allows researchers not only to determine the level or concentration of an isoform or a group of isoforms, but to also identify the cellular location of a particular isoform and associations with other cellular structures or proteins."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1327", "text": "At the present time, there are many commercially available antibodies; however, many of these antibodies are sold with minimal information regarding the antigen used to raise the antibody and therefore, the isoform specificity; as such, some research groups develop their own antibodies. Before these antibodies can be used, they must be extensively characterised, a process whereby the specificity of the antibody is examined to ensure that the antibody does not cross-react with other tropomyosins or other proteins."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1328", "text": "Troponin , or the  troponin complex , is a complex of three  regulatory proteins  ( troponin C ,  troponin I , and  troponin T ) that are integral to  muscle contraction [ 2 ]  in  skeletal muscle  and  cardiac muscle , but not  smooth muscle . Measurements of cardiac-specific troponins I and T are extensively used as diagnostic and prognostic indicators in the management of  myocarditis ,  myocardial infarction  and  acute coronary syndrome . [ 3 ]  Blood troponin levels may be used as a  diagnostic marker  for  stroke  or other myocardial injury that is ongoing, although the sensitivity of this measurement is low. [ 4 ] [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1329", "text": "Troponin is attached to the protein  tropomyosin  and lies within the groove between  actin  filaments in muscle tissue. In a relaxed muscle, tropomyosin blocks the attachment site for the  myosin   crossbridge , thus preventing contraction. When the muscle cell is stimulated to contract by an  action potential ,  calcium channels  open in the sarcoplasmic membrane and release calcium into the sarcoplasm. Some of this calcium attaches to troponin, which causes it to change shape, exposing binding sites for myosin (active sites) on the  actin   filaments .  Myosin 's binding to actin causes  crossbridge  formation, and contraction of the muscle begins. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1330", "text": "Troponin is found in both  skeletal muscle  and  cardiac muscle , but the specific versions of troponin differ between types of muscle. The main difference is that the TnC subunit of troponin in skeletal muscle has four calcium ion-binding sites, whereas in cardiac muscle there are only three. The actual amount of calcium that binds to troponin has not been definitively established. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1331", "text": "In both cardiac and skeletal muscles, muscular force production is controlled primarily by changes in intracellular  calcium  concentration. In general, when calcium rises, the muscles contract and, when calcium falls, the muscles relax. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1332", "text": "Troponin is a component of thin filaments (along with  actin  and  tropomyosin ), and is the protein complex to which calcium binds to trigger the production of muscular force. Troponin has three subunits, TnC, TnI, and TnT, each playing a role in force regulation. [ citation needed ] . Under resting intracellular levels of calcium, tropomyosin covers the active actin sites to which  myosin  (a molecular motor organized in muscle thick filaments) binds in order to generate force. When calcium becomes bound to specific sites in the N-domain of TnC, a series of protein structural changes occurs, [ citation needed ]  such that  tropomyosin  is rolled away from myosin-binding sites on actin, allowing myosin to attach to the thin filament and produce force and shorten the  sarcomere . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1333", "text": "Individual subunits serve different functions: [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1334", "text": "Smooth muscle does not have troponin. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1335", "text": "TnT is a tropomyosin-binding subunit which regulates the interaction of troponin complex with thin filaments; TnI inhibits ATP-ase activity of acto-myosin; TnC is a Ca 2+ -binding subunit, playing the main role in Ca 2+  dependent regulation of muscle contraction. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1336", "text": "TnT and TnI in cardiac muscle are presented by forms different from those in skeletal muscles. Two isoforms of TnI and two isoforms of TnT are expressed in human skeletal muscle tissue (skTnI and skTnT). Only one tissue-specific isoform of TnI is described for cardiac muscle tissue (cTnI), whereas the existence of several cardiac specific isoforms of TnT (cTnT) are described in the literature. No cardiac specific isoforms are known for human TnC. TnC in human cardiac muscle tissue is presented by an isoform typical for slow skeletal muscle. Another form of TnC, the fast skeletal TnC isoform, is more typical for fast skeletal muscles. [ 11 ]  cTnI is expressed only in myocardium. No examples of cTnI expression in healthy or injured skeletal muscle or in other tissue types are known. cTnT is probably less cardiac specific. The expression of cTnT in skeletal tissue of patients with chronic skeletal muscle injuries has been described. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1337", "text": "Inside the cardiac troponin complex the strongest interaction between molecules has been demonstrated for cTnI \u2013 TnC binary complex especially in the presence of Ca 2+  ( KA = 1.5 \u2009\u00d7\u2009 10 \u22128  M \u22121 ). [ 13 ]  TnC, forming a complex with cTnI, changes the conformation of cTnI molecule and shields part of its surface. According to the latest data cTnI is released in the blood stream of the patient in the form of binary complex with TnC or ternary complex with cTnT and TnC. [ 14 ]  cTnI-TnC complex formation plays an important positive role in improving the stability of cTnI molecule. cTnI, which is extremely unstable in its free form, demonstrates significantly better stability in complex with TnC or in ternary cTnI-cTnT-TnC complex. It has been demonstrated that stability of cTnI in native complex is significantly better than stability of the purified form of the protein or the stability of cTnI in artificial troponin complexes combined from purified proteins. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1338", "text": "Subtypes of troponin (cardiac  I  and  T ) are  sensitive and specific   indicators  of  heart  muscle damage ( myocardium ). They are measured in the  blood  to differentiate between unstable  angina  and  myocardial infarction  (heart attack) in people with  chest pain  or  acute coronary syndrome . A person who recently had a myocardial infarction has areas of damaged heart muscle and elevated cardiac troponin levels in the blood. [ 15 ]  This can also occur in people with  coronary vasospasm , a type of myocardial infarction involving severe constriction of the cardiac blood vessels. After a myocardial infarction troponins may remain high for up to 2 weeks. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1339", "text": "Cardiac troponins are a marker of all heart muscle damage, not just myocardial infarction, which is the most severe form of heart disorder. However, diagnostic criteria for raised troponin indicating myocardial infarction is currently set by the WHO at a threshold of 2\u00a0\u03bcg/L or higher. Critical levels of other cardiac biomarkers are also relevant, such as  creatine kinase . [ 17 ]  Other conditions that directly or indirectly lead to heart muscle damage and death can also increase troponin levels, such as  kidney failure . [ 18 ] [ 19 ]  Severe  tachycardia  (for example due to  supraventricular tachycardia ) in an individual with normal coronary arteries can also lead to increased troponins for example, it is presumed due to increased oxygen demand and inadequate supply to the heart muscle. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1340", "text": "Coronary artery  stent  placement can also cause immediate post-procedure elevated serum troponin levels. This can be problematic in a clinical setting as troponin values and guidance protocols become subject to more thoughtful interpretation. Essentially, making it difficult for a clinician to use troponin elevation diagnostically in this patient group. After stenting and related PCI procedures, troponin levels do return to standard levels once the stent has 'settled' and is no longer causing localized cardiac muscle inflammation. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1341", "text": "In patients with non-severe asymptomatic  aortic valve stenosis  and no overt  coronary artery disease , the increased  troponin T  (above 14 pg/mL) was found associated with an increased 5-year event rate of ischemic cardiac events ( myocardial infarction ,  percutaneous coronary intervention , or  coronary artery bypass surgery ). [ 21 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1342", "text": "Troponins are also increased in patients with  heart failure , where they also predict mortality and ventricular rhythm abnormalities. They can rise in inflammatory conditions such as  myocarditis  and  pericarditis  with heart muscle involvement (which is then termed myopericarditis). Troponins can also indicate several forms of  cardiomyopathy , such as  dilated cardiomyopathy ,  hypertrophic cardiomyopathy  or (left)  ventricular hypertrophy ,  peripartum cardiomyopathy ,  Takotsubo cardiomyopathy , or infiltrative disorders such as cardiac  amyloidosis . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1343", "text": "Heart injury with increased troponins also occurs in  cardiac contusion ,  defibrillation  and internal or external  cardioversion . Troponins are commonly increased in several procedures such as  cardiac surgery  and  heart transplantation , closure of  atrial septal defects ,  percutaneous coronary intervention , or  radiofrequency ablation . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1344", "text": "The distinction between cardiac and non-cardiac conditions is somewhat artificial; the conditions listed below are not primary heart diseases, but they exert indirect effects on the heart muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1345", "text": "Troponins are increased in around 40% of patients with  critical illnesses  such as  sepsis . There is an increased risk of mortality and length of stay in the intensive-care unit in these patients. [ 22 ]  In severe  gastrointestinal bleeding , there can also be a mismatch between oxygen demand and supply of the myocardium."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1346", "text": "Chemotherapy agents can exert toxic effects on the heart (examples include  anthracycline ,  cyclophosphamide ,  5-fluorouracil , and  cisplatin ). Several toxins and venoms can also lead to heart muscle injury ( scorpion venom ,  snake venom , and venom from jellyfish and  centipedes ).  Carbon monoxide poisoning  or  cyanide poisoning  can also be accompanied by the release of troponins due to hypoxic cardiotoxic effects. Cardiac injury occurs in about one-third of severe CO poisoning cases, and troponin screening is appropriate in these patients. [ 23 ] [ 24 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1347", "text": "In both primary  pulmonary hypertension ,  pulmonary embolism , and acute exacerbations of  chronic obstructive pulmonary disease  (COPD),  right ventricular  strain results in increased wall tension and may cause  ischemia . Of course, patients with COPD exacerbations might also have concurrent myocardial infarction or pulmonary embolism, so care has to be taken to attribute increased troponin levels to COPD."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1348", "text": "People with  end-stage kidney disease  can have chronically elevated troponin T levels, which are linked to a poorer prognosis. [ 25 ] [ 26 ]  Troponin I is less likely to be falsely elevated. [ 25 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1349", "text": "Strenuous endurance  exercise  such as  marathons  or  triathlons  can lead to increased troponin levels in up to one-third of subjects, but it is not linked to adverse health effects in these competitors. [ 27 ] [ 28 ] [ 29 ] \nHigh troponin T levels have also been reported in patients with inflammatory muscle diseases such as  polymyositis  or  dermatomyositis . [ 30 ] [ 31 ]  Troponins are also increased in  rhabdomyolysis ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1350", "text": "In hypertensive disorders of pregnancy such as  preeclampsia , elevated troponin levels indicate some degree of myofibrillary damage. [ 32 ] [ 33 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1351", "text": "Cardiac troponin T and I can be used to monitor drug and toxin-induced cardiomyocyte toxicity. . [ 34 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1352", "text": "In 2020, it was found that patients with severe COVID-19 had higher troponin I levels compared to those with milder disease. [ 35 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1353", "text": "Elevated troponin levels are prognostically important in many of the conditions in which they are used for diagnosis. [ 36 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1354", "text": "In a community-based cohort study indicating the importance of silent cardiac damage, troponin I has been shown to predict mortality and first coronary heart disease event in men free from cardiovascular disease at baseline. [ 37 ]  In people with stroke, elevated blood troponin levels are not a useful marker to detect the condition. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1355", "text": "First cTnI [ 38 ]  and later cTnT [ 39 ]  were originally used as markers for cardiac cell death. Both proteins are now widely used to diagnose acute myocardial infarction (AMI), unstable angina, post-surgery myocardium trauma and some other related diseases with cardiac muscle injury. Both markers can be detected in patient's blood 3\u20136 hours after onset of the chest pain, reaching peak level within 16\u201330 hours. Elevated concentration of cTnI and cTnT in blood samples can be detected even 5\u20138 days after onset of the symptoms, making both proteins useful also for the late diagnosis of AMI. [ 40 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1356", "text": "Cardiac troponin T and I are measured by  immunoassay  methods. [ 41 ] [ 42 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1357", "text": "Troponin elevation following cardiac cell necrosis starts within 2\u20133 hours, peaks in approx. 24 hours, and persists for 1\u20132 weeks. [ 44 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1358", "text": "The  vascular lacuna  (Latin:  lacuna vasorum (retroinguinalis) ) is the medial compartment beneath the  inguinal ligament . [ 1 ]  It is separated from the lateral  muscular lacuna  by the  iliopectineal arch . [ 1 ] [ 2 ]  It gives passage to the  femoral vessels , [ 1 ]  lymph vessels and  lymph nodes ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1359", "text": "The lacunar ligament can be a site of entrapment for femoral hernias. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1360", "text": "Its boundaries are the iliopectineal arch, the inguinal ligament, the  lacunar ligament , and the superior border of the pubis."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1361", "text": "The structures found in the vascular lacuna, from medial to lateral, are:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1362", "text": "Vulpian\u2013Heidenhain\u2013Sherrington phenomenon  is a term given for slow  contraction  of denervated  skeletal muscle  by stimulating the  autonomic   cholinergic  fibers  innervating  its  blood vessels . It is named after French  neurologist   Alfred Vulpian  (1826\u201387), German  physiologist   Rudolf Heidenhain  (1834\u20131897) and English  neurophysiologist   Charles Scott Sherrington  (1857\u20131952). [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1363", "text": "This template is used to identify a  muscle  stub. It uses {{ asbox }}, which is a meta-template designed to ease the process of creating and maintaining stub templates."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1364", "text": "Typing  {{Muscle-stub}}  produces the message shown at the beginning, and adds the article to the following category:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1365", "text": "This is a  stub template . A brief explanation of these templates follows; for full details please consult  Wikipedia:Stub ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1366", "text": "A stub is an article containing only a few sentences of text which is too short to provide encyclopedic coverage of a subject."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1367", "text": "Further information can be found at:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1368", "text": "New stub templates and categories (collectively \"stub types\") should not be created without prior proposal at  Wikipedia:WikiProject Stub sorting/Proposals . This allows for the proper coordination of all stub types across Wikipedia, and for the checking of any new stub type for possible problems prior to its creation."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1369", "text": "The  accessory soleus muscle  is an  accessory muscle  of the calf which is rarely present in humans; [ 1 ]  it is, however, the most common accessory muscle of the  ankle . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1370", "text": "The muscle inserts on the anterior aspect of the  soleus muscle  or on the posterior aspect of the  tibia  or the muscles of the deep posterior compartment. It lies anterior to the  calcaneal tendon  and terminates on the calcaneal tendon or the superior or medial aspect of the calcaneus via fleshy fibers or a distinct  tendon . [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1371", "text": "Present in approximately 3% (or 10%) [ 4 ]  of people, this muscle usually appears as a distant belly, medial to the  Achilles tendon . Clinically, the accessory soleus may be associated with pain and edema during periods of prolonged exercise. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1372", "text": "The  anal fascia  is the inferior layer of the diaphragmatic part of the  pelvic fascia , which covers both surfaces of the  levatores ani . It is attached above to the  obturator fascia  along the line of origin of the  levator ani , while below it is continuous with the superior fascia of the  urogenital diaphragm , and with the fascia on the  sphincter ani internus ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1373", "text": "The layer covering the upper surface of the pelvic diaphragm follows, above, the line of origin of the levator ani and is therefore somewhat variable."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1374", "text": "In front it is attached to the back of the  pubic symphysis  about 2\u00a0cm. above its lower border."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1375", "text": "It can then be traced laterally across the back of the  superior ramus of the   pubic bone  for a distance of about 1.25\u00a0cm, when it reaches the obturator fascia."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1376", "text": "It is attached to this fascia along a line which pursues a somewhat irregular course to the  spine of the   ischium ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1377", "text": "The irregularity of this line is because the origin of the levator ani, which in lower forms is from the pelvic brim, is in man lower down, on the obturator fascia."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1378", "text": "Tendinous fibers of origin of the muscle are therefore often found extending up toward, and in some cases reaching, the pelvic brim, and on these the fascia is carried."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1379", "text": "This article incorporates text in the  public domain  from  page 421  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1380", "text": "The  antebrachial fascia  ( antibrachial fascia  or  deep fascia of forearm ) continuous above with the  brachial fascia , is a dense, membranous investment, which forms a general sheath for the muscles in this region; it is attached, behind, to the  olecranon  and dorsal border of the  ulna , and gives off from its deep surface numerous  intermuscular septa , which enclose each muscle separately."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1381", "text": "Over the  flexor muscles   tendons  as they approach the wrist it is especially thickened, and forms the  volar carpal ligament ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1382", "text": "This is continuous with the  transverse carpal ligament , and forms a sheath for the tendon of the  palmaris longus  which passes over the  transverse carpal ligament  to be inserted into the  palmar aponeurosis ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1383", "text": "Behind, near the wrist-joint, it is thickened by the addition of many transverse fibers, and forms the  dorsal carpal ligament ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1384", "text": "It is much thicker on the dorsal than on the volar surface, and at the lower than at the upper part of the forearm, and is strengthened above by tendinous fibers derived from the  biceps brachii  in front, and from the  triceps brachii  behind."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1385", "text": "It gives origin to muscular fibers, especially at the upper part of the medial and lateral sides of the forearm, and forms the boundaries of a series of cone-shaped cavities, in which the muscles are contained."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1386", "text": "Besides the vertical septa separating the individual muscles, transverse septa are given off both on the volar and dorsal surfaces of the forearm, separating the deep from the superficial layers of muscles."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1387", "text": "Apertures exist in the fascia for the passage of vessels and nerves; one of these apertures of large size, situated at the front of the  elbow , serves for the passage of a communicating branch between the superficial and deep veins."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1388", "text": "This article incorporates text in the  public domain  from  page 445  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1389", "text": "The  antitragicus  is an  intrinsic muscle  of the  outer ear ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1390", "text": "In  human anatomy , the antitragicus arises from the outer part of the  antitragus , and is inserted into the  cauda helicis  (or tail of the  helix ) and  antihelix . [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1391", "text": "The function of the muscle is to adjusts the shape of the  ear  by pulling the antitragus and cauda helicis towards each other. While the muscle modifies the auricular shape only minimally in the majority of individuals, this action could increase the opening into the  external acoustic meatus  in some. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1392", "text": "The helicis minor is developmentally derived from the  second   pharyngeal arch . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1393", "text": "This article incorporates text in the  public domain  from  page 1035  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1394", "text": "The  aponeurosis of the  abdominal external oblique muscle  is a thin but strong membranous structure, the fibers of which are directed downward and medially."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1395", "text": "It is joined with that of the opposite muscle along the middle line, and covers the whole of the front of the abdomen; above, it is covered by and gives origin to the lower fibers of the  pectoralis major ; below, its fibers are closely aggregated together, and extend obliquely across from the  anterior superior iliac spine  to the  pubic tubercle  and the  pectineal line  to form the inguinal ligament."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1396", "text": "In the middle line, it interlaces with the  aponeurosis  of the opposite muscle, forming the  linea alba , which extends from the  xiphoid process  to the  pubic symphysis ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1397", "text": "That portion of the aponeurosis which extends between the anterior superior iliac spine and the pubic tubercle is a thick band, folded inward, and continuous below with the fascia lata; it is called the  inguinal ligament ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1398", "text": "The portion which is reflected from the inguinal ligament at the pubic tubercle is attached to the pectineal line and is called the  lacunar ligament ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1399", "text": "From the point of attachment of the latter to the pectineal line, a few fibers pass upward and medialward, behind the medial crus of the  superficial inguinal ring , to the linea alba; they diverge as they ascend, and form a thin triangular fibrous band which is called the  reflected inguinal ligament ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1400", "text": "In the aponeurosis of the external oblique, immediately above the  pubic crest , is a triangular opening, the superficial inguinal ring, formed by a separation of the fibers of the aponeurosis in this situation."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1401", "text": "This article incorporates text in the  public domain  from  page 410  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1402", "text": "Arcade of Frohse , sometimes called the  supinator arch , [ 1 ]  is the most superior part of the superficial layer of the  supinator muscle , and is a fibrous arch over the  posterior interosseous nerve ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1403", "text": "The arcade of Frohse is a site of interosseous posterior nerve entrapment, [ 2 ]  and is believed to play a role in causing progressive  paralysis  of the posterior interosseous nerve, both with and without injury."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1404", "text": "The arcade of Frohse was named after German  anatomist , Fritz Frohse (1871\u20131916). [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1405", "text": "The  aryepiglottic muscle  or  aryepiglotticus muscle , often considered the  aryepiglottic part of oblique arytenoid muscle , is an  intrinsic muscle of the larynx . [ 1 ]  It is a direct continuation of a portion of the fibers of the  oblique arytenoid  muscle, sharing its  innervation  and blood supply, after these select fibers travel laterally around the arytenoid apex to the  aryepiglottic fold . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1406", "text": "The aryepiglottic muscle is innervated by the inferior laryngeal nerve, a branch of the  recurrent laryngeal nerve  (itself a branch of the  vagus nerve ). [ 2 ]  Together with the oblique arytenoid muscle, it helps to act as a  sphincter  and weak  adductor  of the  laryngeal inlet . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1407", "text": "In  electrocardiography , the  atrial action potential  are  action potentials  that occur in the  heart atrium . They are similar to  ventricular action potential  with the exception of having a more narrow phase 2 (plateau phase) due to a smaller calcium influx. Also, in comparison to the ventricular action potential, atrial action potentials have a more gradual  repolarization  period. This indicates that the atria's repolarization currents are not very large and they do not undergo a large repolarization peak. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1408", "text": "Cardiac action potential"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1409", "text": "The  brachial fascia  ( deep fascia  of the arm ) is continuous with that covering the  deltoideus  and the  pectoralis major muscle , by means of which it is attached, above, to the  clavicle ,  acromion , and  spine of the scapula ; it forms a thin, loose, membranous sheath for the muscles of the  arm , and sends septa between them; it is composed of fibers disposed in a circular or spiral direction, and connected together by vertical and oblique fibers."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1410", "text": "It differs in thickness at different parts, being thin over the  biceps brachii , but thicker where it covers the  triceps brachii , and over the  epicondyles  of the  humerus : it is strengthened by fibrous aponeuroses, derived from the pectoralis major and  latissimus dorsi  medially, and from the deltoideus laterally."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1411", "text": "On either side it gives off a strong  intermuscular septum , which is attached to the corresponding  supracondylar ridge  and  epicondyle  of the humerus."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1412", "text": "This article incorporates text in the  public domain  from  page 442  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1413", "text": "The  caudofemoralis  (from the Latin  cauda , tail and  femur , thighbone) is a  muscle  found in the pelvic limb of mostly all animals possessing a tail. It is thus found in nearly all  tetrapods . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1414", "text": "The caudofemoralis spans  plesiomorphically  between femur (thigh) and tail; in mammals it is reduced and found directly  posterior / caudal  to the  gluteus maximus  and directly  anterior / cranial  to the  biceps femoris ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1415", "text": "The caudofemoralis originates from the transverse processes of the second, third and fourth caudal  vertebrae .\nThe caudodistal portion of the muscle in mammals lies deep to the proximocranial portion of the Biceps femoris; near the middle of the  thigh , the caudofemoralis gives rise to a long, thin, and narrow  tendon  that passes distally to the knee joint and inserts into the  fascia lata  that is anchored to the lateral border of the  patella . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1416", "text": "Among  archosaurians , the caudofemoralis is divided in a  pars pelvica/brevis  (characterized by a pelvic origin) and a  pars caudalis/longa  (caudal origin), and the insertion on the femur is marked by the  fourth trochanter  (but this becomes reduced in  maniraptorans  and absent in  birds )."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1417", "text": "In  mammals the caudofemoralis acts to flex the tail laterally to its corresponding side when the pelvic limb is bearing weight. When the pelvic limb is lifted off the ground, contraction of the caudofemoralis causes the limb to abduct and the shank to extend by extending the  hip  joint (acetabulofemoral or coxofemoral joint). In other tetrapods contraction of the caudofemoralis retracts the hindlimb."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1418", "text": "The  corrugator cutis ani  is a  muscle  of the  human body , also known as the  Ellis' muscle , after the anatomist  George Viner Ellis . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1419", "text": "Around the  anus  is a thin stratum of involuntary muscle fiber, which radiates from the orifice. Medially the fibers fade off into the submucous tissue, while laterally they blend with the true  skin . By its contraction it raises the skin into ridges around the margin of the anus. The name of this muscle is primarily limited to older texts."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1420", "text": "The  cremasteric fascia  is a  fascia  in the  scrotum . As the  cremaster  descends, it forms a series of loops which differ in thickness and length in different subjects. At the upper part of the cord the loops are short, but they become in succession longer and longer, the longest reaching down as low as the  testis , where a few are inserted into the  tunica vaginalis . These loops are united together by  areolar tissue , and form a thin covering over the cord and testis, the cremasteric fascia."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1421", "text": "The cremasteric fascia lies between the more superficial  external spermatic fascia  and the deeper  internal spermatic fascia . [ 1 ]  It is a continuation of the  aponeurosis  of the  abdominal internal oblique muscle . [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1422", "text": "This article incorporates text in the  public domain  from  page 414  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1423", "text": "This article related to the  genitourinary system  is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1424", "text": "Cricoarytenoid muscles  are muscles that connect the  cricoid cartilage  and  arytenoid cartilage ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1425", "text": "More specifically, it can refer to:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1426", "text": "The  depressor supercilii  is an  eye   muscle  of the  human body . The nature of this muscle is in some dispute. Few printed anatomies include it (Netter, et al.) and many authorities consider it to be part of the  orbicularis oculi  muscle. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1427", "text": "On the other hand, many  dermatologists ,  ophthalmologists , and  plastic surgeons [ 2 ]  hold that the depressor supercilii is a distinct muscle and has a definite, individual effect on the movement of the eyebrow and skin of the  glabella . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1428", "text": "The depressor supercilii originates on the medial orbital rim, near the  lacrimal bone , and inserts on the medial aspect of the bony orbit, inferior to the  corrugator supercilii . In some specimens it exhibits two heads and in others, only one. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1429", "text": "The  external intercostal muscles   or  external intercostals  ( intercostales externi ) are eleven in number on both sides."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1430", "text": "The muscles extend from the tubercles of the  ribs  behind, to the cartilages of the ribs in front, where they end in thin membranes, the  external intercostal membranes , which are continued forward to the  sternum .\nThese muscles work in unison when  inhalation  occurs. The  internal intercostal muscles  relax while the external muscles contract causing the expansion of the chest cavity and an influx of air into the lungs."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1431", "text": "Each arises from the lower border of a rib, and is inserted into the upper border of the rib below. In the two lower spaces they extend to the ends of the cartilages, and in the upper two or three spaces they do not quite reach the ends of the ribs."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1432", "text": "They are thicker than the internal intercostals, and their fibers are directed  obliquely  downward and laterally on the back of the  thorax , and downward, forward, and medially on the front."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1433", "text": "Continuation with the  external oblique  or  serratus anterior : A  supracostalis  muscle, from the anterior end of the first rib down to the second, third or fourth ribs occasionally occurs."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1434", "text": "This article incorporates text in the  public domain  from  page 403  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1435", "text": "The  external sphincter muscle of the female urethra  is a muscle which controls  urination  in females. The muscle fibers arise on either side from the margin of the inferior ramus of the pubis. They are directed across the pubic arch in front of the urethra, and pass around it to blend with the muscular fibers of the opposite side, between the urethra and vagina."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1436", "text": "The term \"urethrovaginal sphincter\" (\"sphincter urethrovaginalis\") is sometimes used to describe the component adjacent to the  vagina . [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1437", "text": "The \"compressor urethrae\" is also considered a distinct, adjacent muscle by some sources, [ 6 ] [ 7 ] [ 8 ] [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1438", "text": "The muscle helps maintain  continence  of  urine  along with the  internal urethral sphincter  which is under control of the  autonomic nervous system . The external sphincter muscle prevents urine leakage as the muscle is tonically contracted via  somatic  fibers that originate in  Onuf's nucleus  and pass through  sacral spinal nerves  S2-S4 then the  pudendal nerve  to  synapse  on the muscle. [ 7 ] [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1439", "text": "Voiding urine begins with voluntary relaxation of the external urethral sphincter. This is facilitated by inhibition of the somatic neurons in Onuf's nucleus via signals arising in the  pontine micturition center  and traveling through the  descending reticulospinal tracts ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1440", "text": "This article incorporates text in the  public domain  from  page 431  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1441", "text": "The  external sphincter muscle of the male urethra , also  sphincter urethrae membranaceae ,  sphincter urethrae externus , surrounds the whole length of the  membranous urethra , and is enclosed in the  fascia  of the  urogenital diaphragm ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1442", "text": "Its external fibers arise from the junction of the  inferior pubic ramus  and  ischium  to the extent of 1.25 to 2\u00a0cm., and from the neighboring fascia."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1443", "text": "They arch across the front of the urethra and  bulbourethral  glands, pass around the urethra, and behind it unite with the muscle of the opposite side, by means of a tendinous  raphe ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1444", "text": "Its innermost fibers form a continuous circular investment for the membranous urethra."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1445", "text": "The muscle helps maintain  continence  of  urine  along with the  internal urethral sphincter  which is under control of the  autonomic nervous system . The external sphincter muscle prevents urine leakage as the muscle is tonically contracted via  somatic  fibers that originate in  Onuf's nucleus  and pass through  sacral spinal nerves  S2-S4 then the  pudendal nerve  to  synapse  on the muscle. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1446", "text": "Voiding urine begins with voluntary relaxation of the external urethral sphincter. This is facilitated by inhibition of the somatic neurons in Onuf's nucleus via signals arising in the  pontine micturition center  and traveling through the  descending reticulospinal tracts . During ejaculation, the external sphincter opens and the internal sphincter closes. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1447", "text": "This article incorporates text in the  public domain  from  page 429  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1448", "text": "In  anatomy  for  cardiac muscle ,  fascia adherens  are ribbon-like structures that stabilize non-epithelial tissue. They are similar in function and structure to the zonula adherens or  adherens junction  of  epithelial cells . It is a broad intercellular junction in the transversal sections of an  intercalated disc  of cardiac muscle anchoring  actin  filaments. It helps to transmit contractile forces. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1449", "text": "This  cardiovascular system  article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1450", "text": "The  membranous layer of the superficial fascia of the perineum  ( Colles' fascia ) is the deeper layer ( membranous layer ) of the  superficial perineal fascia . It is thin,  aponeurotic  in structure, and of considerable strength, serving to bind down the muscles of the  root of the penis . Colles' fascia emerges from the  perineal membrane , which divides the base of the penis from the prostate.  Colles' fascia emerges from the inferior side of the perineal membrane and continues along the ventral (inferior) penis without covering the  scrotum . It separates the  skin  and subcutaneous fat from the  superficial perineal pouch ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1451", "text": "In front , it is continuous with the  dartos fascia  of the penis and  Scarpa's fascia  upon the  anterior wall of the abdomen ;"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1452", "text": "On either side  it is firmly attached to the margins of the  rami of the pubis and ischium , lateral to the  crus penis  and as far back as the  tuberosity of the   ischium ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1453", "text": "Posteriorly , it curves around the  superficial transverse perineal muscle  to join the lower margin of the  inferior fascia of the urogenital diaphragm ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1454", "text": "In the middle line , it is connected with the  superficial fascia  and with the median septum of the  bulbospongiosus muscle ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1455", "text": "This fascia not only covers the muscles in this region, but at its back part sends upward a vertical septum from its deep surface, which separates the posterior portion of the subjacent space into two."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1456", "text": "This article incorporates text in the  public domain  from  page 426  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1457", "text": "The  fascial compartments of the forearm  are the  posterior compartment of the forearm  and the  anterior compartment of the forearm . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1458", "text": "The  flexor digiti minimi brevis  ( flexor brevis minimi digiti ,  flexor digiti quinti brevis ) lies under the  metatarsal  bone on the little toe, and resembles one of the  interossei ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1459", "text": "It arises from the base of the  fifth metatarsal bone , and from the sheath of the  fibularis longus ; its tendon is inserted into the lateral side of the base of the first  phalanx  of the fifth toe."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1460", "text": "Occasionally a few of the deeper fibers are inserted into the lateral part of the distal half of the fifth metatarsal bone; these are described by some as a distinct muscle, the opponens digiti quinti."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1461", "text": "This article incorporates text in the  public domain  from  page 494  of\u00a0the 20th edition of   Gray's Anatomy   (1918) ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1462", "text": "The  gluteal aponeurosis  is a fibrous  membrane , from the fascia lata, that lies between the  iliac crest  and the superior border of the  gluteus maximus . A part of the  gluteus medius  arises from this membrane."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1463", "text": "The  helicis major  (or  large muscle of helix [ 1 ] ) is an  intrinsic muscle  of the  outer ear ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1464", "text": "In  human anatomy , it is the form of a narrow vertical band situated upon the anterior margin of the  helix , at the point where the helix becomes transverse. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1465", "text": "It arises below, from the  spina helicis , and is inserted into the anterior border of the helix, just where it is about to curve backward. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1466", "text": "The function of the muscle is to adjust the shape of the  ear  by depressing the anterior margin of the ear cartilage. While the muscle modifies the auricular shape only minimally in the majority of individuals, this action could increase the opening into the  external acoustic meatus  in some. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1467", "text": "The helicis major is developmentally derived from the  second   pharyngeal arch . [ 2 ]  It seem that only in  primates  is the  helicis minor  and major two distinctive muscles. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1468", "text": "The  Helicis minor  ( musculus helicis minor  or  smaller muscle of helix ) is a small  skeletal   muscle . The helicis minor is an  intrinsic muscle  of the  outer ear . The muscle runs obliques and covers the  helical crus , part of the  helix  located just above the  tragus ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1469", "text": "The helicis minor originates from the base of the helical crus, runs obliques and inserts at the anterior aspect of the helical crus where it curves upward above the tragus. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1470", "text": "The function of the muscle is to assist in adjusting the shape of the anterior margin of the ear cartilage. While this is a potential action in some individuals, in the majority of individuals the muscle modifies auricular shape to a minimal degree. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1471", "text": "The helicis minor is developmentally derived from the  second   pharyngeal arch [ 1 ]  It seem that only in  primates  is the  helicis major  and minor two distinctive muscles. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1472", "text": "Iliocostalis muscle  is the muscle immediately lateral to the  longissimus  that is the nearest to the furrow that separates the  epaxial  muscles from the  hypaxial . It lies very deep to the fleshy portion of the  serratus posterior muscle . It laterally  flexes  the  vertebral column  to the same side."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1473", "text": "Iliocostalis muscle has a common origin from the  iliac crest , the  sacrum , the  thoracolumbar fascia , and the  spinous processes  of the  vertebrae  from  T11  to  L5 . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1474", "text": "Iliocostalis cervicis  (cervicalis ascendens) arises from the angles of the third, fourth, fifth, and sixth ribs, and is inserted into the  posterior tubercles  of the transverse processes of the fourth, fifth, and sixth cervical vertebrae."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1475", "text": "Iliocostalis thoracis  (musculus accessorius; iliocostalis thoracis) arises by flattened tendons from the upper borders of the angles of the lower six ribs medial to the tendons of insertion of the iliocostalis lumborum; these become muscular, and are inserted into the upper borders of the angles of the upper six ribs and into the back of the  transverse process  of the seventh  cervical vertebra ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1476", "text": "Iliocostalis lumborum  (iliocostalis muscle; sacrolumbalis muscle) is inserted, by flattened  tendons , into the inferior borders of the angles of the lower six to nine  ribs . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1477", "text": "Iliocostalis muscle is supplied by the  dorsal rami  of  spinal nerves . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1478", "text": "Iliocostalis muscle laterally  flexes  the  vertebral column  to the same side. [ 1 ]  It bilaterally extends the vertebral column. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1479", "text": "This article incorporates text in the  public domain  from  page 399  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1480", "text": "The  iliopubic tract  is a thickened band of fibers curving over the  external iliac vessels , at the spot where they become femoral, on the abdominal side of the  inguinal ligaments  and loosely connected with it. It is apparently a thickening of the  transversalis fascia  joined laterally to the iliac crest, and arching across the front of the  femoral sheath  to be inserted by a broad attachment into the  pubic tubercle  and  pectineal line , behind the  conjoint tendon . In some subjects this structure is not very prominently marked, and not infrequently it is altogether wanting. It can be of clinical significance in  hernia repair . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1481", "text": "This article incorporates text in the  public domain  from  page 419  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1482", "text": "The  inferior longitudinal muscle of tongue  is an intrinsic muscle of the  tongue . [ 1 ]  It is situated on the under surface of the  tongue  between the  genioglossus  and  hyoglossus . [ citation needed ]  It is innervated by the  hypoglossal nerve (cranial nerve XII) . Its contraction shortens and thickens the tongue."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1483", "text": "The inferior longitudinal muscle of the tongue is an  intrinsic muscle  of the  tongue . [ 1 ]  It is thin and oval in cross-section. It is situated between the paramedian septum, and the lateral septum. [ 2 ]  It extends from the root to the apex of the tongue. Posteriorly, some of its fibers attach onto the body of the  hyoid bone . [ citation needed ]  Anteriorly, its fibres blend with those of the  styloglossus ,  hyoglossus , and  genioglossus  to form the ventral area of the tip of the tongue. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1484", "text": "The inferior longitudinal muscle of the tongue is supplied by the  hypoglossal nerve (CN XII) . [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1485", "text": "Contraciton of the inferior longitudinal muscle of the tongue shortens and thickens the tongue. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1486", "text": "This article incorporates text in the  public domain  from  page 1130  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1487", "text": "The  innermost intercostal muscle  is a layer of  intercostal muscles . [ 1 ]  It may also be called the  intima of the internal intercostal muscles . [ 2 ]  It is the deepest muscular layer of the  thorax , [ 3 ]  with  muscle fibres  running vertically (in parallel with the  internal intercostal muscles ). [ 2 ]  It is present only in the middle of each  intercostal space , and often not present higher up the  rib cage . [ 3 ]  It lies deep to the plane that contains the  intercostal nerves  and  intercostal vessels , and the  internal intercostal muscles . [ 3 ] [ 4 ]  The  diaphragm  is continuous with the innermost intercostal muscle. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1488", "text": "The  interosseous muscles of the foot  are muscles found near the  metatarsal  bones that help to control the toes. They are considered voluntary muscles."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1489", "text": "They are generally divided into two sets:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1490", "text": "The axial line goes down the middle of the 2nd digit, towards the sole of the foot (it's an imaginary line)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1491", "text": "Both sets of muscles are innervated by the Lateral plantar nerve. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1492", "text": "The  interosseous muscles of the hand  are muscles found near the  metacarpal  bones that help to control the fingers. They are considered voluntary muscles."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1493", "text": "This is often remembered by the mnemonic  PAD-DAB , as the  P almar interosseous muscles  AD duct, and the  D orsal interosseous muscles  AB duct. The axial line goes down the middle of the 3rd digit, towards the palm of the hand (it's an imaginary line)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1494", "text": "Both sets of muscles are innervated by the deep branch of the ulnar nerve. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1495", "text": "The  interspinales  are short  muscle fascicles , found in pairs between the spinous processes of the contiguous  vertebrae , one on either side of the  interspinal ligament ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1496", "text": "This article incorporates text in the  public domain  from  page 400  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1497", "text": "The  lateral cricoarytenoid  (also  anterior cricoarytenoid ) is an intrinsic muscle of the  larynx . It attaches at the  cricoid cartilage  anteriorly, and at the  arytenoid cartilage  of the same side posteriorly. It is innervated by the  recurrent laryngeal nerve . It acts to close the  rima glottidis , thus closing the  airway ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1498", "text": "The muscle is directed obliquely superoposteriorly from its anterior attachment to its posterior attachment. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1499", "text": "The muscle's anterior attachment is onto the superior border of the arch of the  cricoid cartilage . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1500", "text": "Its posterior attachment is onto the anterior aspect of the  muscular process  of the ipsilateral  arytenoid cartilage . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1501", "text": "The muscle receives motor innervation from (branches of the anterior terminal division of) the  recurrent laryngeal nerve [ 3 ]  (which is in turn a branch of a  vagus nerve (CN X) )."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1502", "text": "The muscle rotates the arytenoid cartilage medially (it thus acts as antagonist to the  posterior cricoarytenoid muscle  which rotates the cartilage laterally). [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1503", "text": "The muscle closes the  rima glottidis , adducting (approximating) the apices of the  vocal process  to close the ligamentous part of rima glottidis (in which it is synergystic with the  oblique arytenoid muscles  and  transverse arytenoid muscle ). [ 1 ]  It thus functions to close the  airway . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1504", "text": "It also shortens and slackens the vocal cords. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1505", "text": "The  levator anguli oris  ( caninus ) is a  facial muscle  of the  mouth  arising from the  canine fossa , immediately below the  infraorbital foramen . It  elevates  angle of mouth medially. Its fibers are inserted into the angle of the mouth, intermingling with those of the  zygomaticus ,  triangularis , and  orbicularis oris . Specifically, the levator anguli oris is innervated by the  buccal branches of the facial nerve ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1506", "text": "This article incorporates text in the  public domain  from  page 383  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1507", "text": "A fibrous or muscular band is sometimes found attached, above, to the body of the  hyoid bone , and below to the  thyroid isthmus , or its pyramidal lobe. When muscular, it is termed the  Levator muscle of thyroid gland ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1508", "text": "This article incorporates text in the  public domain  from  page 1270  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1509", "text": "The  levatores costarum  ( / \u02cc l \u025b v \u0259 \u02c8 t \u0254\u02d0r i\u02d0 z   k \u0259 \u02c8 s t \u025b\u0259r \u0259 m / ), twelve in number on either side, are small tendinous and fleshy bundles, which arise from the ends of the transverse processes of the seventh  cervical  and upper eleven  thoracic vertebrae"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1510", "text": "They pass obliquely downward and laterally, like the fibers of the  Intercostales externi , and each is inserted into the outer surface of the  rib  immediately below the  vertebra  from which it takes origin, between the tubercle and the  angle  ( Levatores costarum breves )."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1511", "text": "Each of the four lower muscles divides into two fasciculi, one of which is inserted as above described; the other passes down to the second rib below its origin ( Levatores costarum longi )."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1512", "text": "They have a role in  forceful inspiration . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1513", "text": "The  longus capitis muscle  (Latin for  long muscle of the head , alternatively  rectus capitis anticus major ) is broad and thick above, narrow below, and arises by four tendinous slips, from the anterior tubercles of the  transverse processes  of the third, fourth, fifth, and sixth  cervical vertebr\u00e6 , and ascends, converging toward its fellow of the opposite side, to be inserted into the inferior surface of the  basilar  part of the  occipital bone ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1514", "text": "It is innervated by a branch of cervical plexus."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1515", "text": "Longus capitis has several actions:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1516", "text": "acting unilaterally, to:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1517", "text": "acting bilaterally:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1518", "text": "This article incorporates text in the  public domain  from  page 395  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1519", "text": "The  lumbricals  are four small  skeletal muscles , accessory to the tendons of the  flexor digitorum longus muscle . They are numbered from the medial side of the foot. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1520", "text": "The lumbricals arise from the tendons of the  flexor digitorum longus muscle , [ 1 ]  as far back as their angles of division, each springing from two tendons, except the first. The first lumbrical is unipennate, while the second, third and fourth are bipennate."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1521", "text": "The muscles end in  tendons , which pass forward on the medial sides of the four lesser toes, and are inserted into the expansions of the tendons of the extensor digitorum longus muscle on the dorsal surfaces of the proximal  phalanges . [ 1 ]  All four lumbricals insert into extensor hoods of the phalanges, thus creating extension at the inter-phalangeal (PIP and DIP) joints. However, as the tendons also pass inferior to the metatarsal phalangeal (MTP) joints it creates flexion at this joint."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1522", "text": "The most medial lumbrical is innervated by the  medial plantar nerve  while the remaining three lumbricals are supplied by the  lateral plantar nerve ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1523", "text": "Absence of one or more; doubling of the third or fourth even the fifth. Insertion partly or wholly into the first phalanges."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1524", "text": "The term \"lumbrical\" comes from the  Latin , meaning \" worm \". [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1525", "text": "This article incorporates text in the  public domain  from  page 493  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1526", "text": "Muscular defense  is a  reflex  of the  abdominal muscles  to contract upon mechanical force to the  abdomen , and serves as protection."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1527", "text": "It is a  visceromotor reflex , since the  parietal peritoneum  and  viscera  are involved in generating the reflex. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1528", "text": "Myology  is the study of the  muscular system , including the study of the structure, function and  diseases  of  muscle . [ 1 ]  The muscular system consists of  skeletal muscle , which contracts to move or position parts of the body (e.g., the bones that articulate at joints),  smooth  and  cardiac muscle  that propels, expels or controls the flow of fluids and contained substance."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1529", "text": "The  oblique arytenoid  is bilaterally paired intrinsic muscle of the  larynx . It is superficial to the  transverse arytenoid ; the oblique and transverse arytenoids are often considered two parts of a single muscle - the  interarytenoid muscle  (which is then said to have an oblique part and a transverse part). [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1530", "text": "Each oblique arytenoid muscle attaches to both  arytenoid cartilages ; the two oblique arytenoids thus cross each other. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1531", "text": "Some muscle fibres of the oblique arytenoid muscle proceed to extend laterally around the apex of arythenoid cartilage into the  aryepiglottic fold , thus forming the  aryepiglottic muscle . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1532", "text": "Each oblique arytenoid muscle attaches to the posterior aspect of the  muscular process of arytenoid cartilage  of one side, and to the apex of the  arytenoid cartilage  of the opposite side; the two oblique arytenoid muscles thus cross each other obliquely. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1533", "text": "Arterial supply is provided by laryngeal branches of  superior thyroid arteries  and  inferior thyroid arteries . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1534", "text": "The muscle receives motor innervation from the  recurrent laryngeal nerve  (a branch of the  vagus nerve (CN X) ) [ 1 ]  (as is the case with all intrinsic muscles of the larynx except the cricothyroid muscle). [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1535", "text": "Together with the  aryepiglottic muscles , the two oblique arytenoid muscles function as a sphincter of the  laryngeal inlet  by adducting aryepiglottic folds, and approximating the arytenoid cartilages and the tubercle of epiglottis. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1536", "text": "The muscles act during swallowing or coughing. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1537", "text": "The  oblique muscle of auricle  ( oblique auricular muscle  or  Tod muscle [ 1 ] ) is an  intrinsic muscle  of the  outer ear ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1538", "text": "The oblique muscle of auricle is placed on the cranial surface of the  pinna . It consists of a few fibers extending from the upper and back part of the  concha  to the convexity immediately above it."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1539", "text": "The  opponens digiti minimi  ( opponens digiti quinti  in older texts) is a  muscle  in the  hand . It is of a triangular form, and placed immediately beneath the  palmaris brevis ,  abductor digiti minimi  and  flexor digiti minimi brevis . It is one of the three  hypothenar muscles  that control the  little finger . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1540", "text": "It arises from the convexity of the  hamulus  of the  hamate bone  and the contiguous portion of the  transverse carpal ligament ; it is inserted into the whole length of the  metacarpal bone  of the little finger, along its ulnar margin."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1541", "text": "The opponens digiti minimi muscle serves to flex and laterally rotate the 5th  metacarpal  about the 5th  carpometacarpal joint , as when bringing the little finger and thumb into opposition. It is innervated by the  deep branch of the ulnar nerve ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1542", "text": "This article incorporates text in the  public domain  from  page 464  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1543", "text": "The  pharyngeal muscles  are a group of muscles that form the  pharynx , which is posterior to the oral cavity, determining the shape of its  lumen , and affecting its sound properties as the primary resonating cavity."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1544", "text": "The pharyngeal muscles (involuntary skeletal) push food into the  esophagus . There are two muscular layers of the  pharynx : the outer circular layer and the inner longitudinal layer."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1545", "text": "The outer circular layer includes:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1546", "text": "During  swallowing , these muscles constrict to propel a  bolus  downwards (an involuntary process)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1547", "text": "The inner longitudinal layer includes:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1548", "text": "During swallowing, these muscles act to shorten and widen the pharynx."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1549", "text": "They are innervated by the  pharyngeal branch  of the  vagus nerve  (CN X) with the exception of the stylopharyngeus muscle which is innervated by the  glossopharyngeal nerve  (CN IX). [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1550", "text": "They are primarily supplied by branches of the  facial artery . Other blood supply includes the  ascending pharyngeal artery ,  lingual artery , and ascending and descending palatine arteries."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1551", "text": "The  pubovaginal muscle  is a  pelvic floor   muscle  that attaches to the muscles of lateral walls of the midsection of the vagina and the  pubis . [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ] [ 6 ]  It is relatively short compared to the other  levator ani muscles  and extends between the  pubic bones  and the  vagina . [ 7 ] [ 8 ] [ 9 ]   Other muscles that are part of the levator ani are: the  pubococcygeus muscle  which is made up of the  puboperineal , pubovaginal, and  puboanal  muscles; the  puborectal muscle ; and the  iliococcygeal muscle . [ 9 ] [ 10 ]  The pubovaginal muscle was identified by  anatomists  as early as 1912. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1552", "text": "The  quadratus plantae  ( flexor accessorius ) is separated from the muscles of the first layer by the lateral plantar vessels and nerve. It acts to aid in flexing the 2nd to 5th toes (offsetting the oblique pull of the  flexor digitorum longus ) and is one of the few muscles in the foot with no homolog in the hand."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1553", "text": "It arises by two heads, which are separated from each other by the  long plantar ligament : the medial or larger head is muscular, and is attached to the medial concave surface of the  calcaneus , below the groove which lodges the tendon of the  flexor hallucis longus ; the lateral head, flat and tendinous, arises from the lateral border of the inferior surface of the calcaneus, in front of the lateral process of its tuberosity, and from the  long plantar ligament ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1554", "text": "The two portions join at an acute angle, and end in a flattened band which is inserted into the lateral margin and upper and under surfaces of the tendon of the  flexor digitorum longus , forming a kind of groove, in which the tendon is lodged. It usually sends slips to those tendons of the flexor digitorum longus which pass to the second, third, and fourth toes."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1555", "text": "Lateral head often wanting; entire muscle absent. Variation in the number of digital tendons to which fibers can be traced. Most frequent offsets are sent to the second, third and fourth toes; in many cases to the fifth as well; occasionally to two toes only."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1556", "text": "The  rectus capitis anterior  ( rectus capitis anticus minor ) is a short, flat muscle, situated immediately behind the upper part of the  Longus capitis ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1557", "text": "It arises from the anterior surface of the  lateral mass  of the  atlas , and from the root of its  transverse process , and passing obliquely upward and medialward, is inserted into the inferior surface of the  basilar part  of the  occipital bone  immediately in front of the  foramen magnum ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1558", "text": "action:  aids in flexion of the head and the neck;\n nerve supply:  C1, C2. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1559", "text": "The  rectus capitis lateralis , a short, flat muscle, arises from the upper surface of the  transverse process  of the  atlas , and is inserted into the under surface of the  jugular process  of the  occipital bone ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1560", "text": "The  rectus capitis posterior major  (or  rectus capitis posticus major [ citation needed ] ) is a muscle in the upper back part of the neck. It is one of the  suboccipital muscles . Its inferior attachment is at the  spinous process  of the  axis (Second cervical vertebra) ; its superior attachment is onto the outer surface of the  occipital bone  on and around the side part of the  inferior nuchal line . The muscle is innervated by the  suboccipital nerve  (the  posterior ramus  of  cervical spinal nerve C1 ). The muscle acts to extend the head and rotate the head to its side."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1561", "text": "The rectus capitis posterior major muscle is one of the  suboccipital muscles . It forms the superomedial boundary of the  suboccipital triangle . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1562", "text": "The muscle extends obliquely [ 2 ]  superiolaterally from its inferior attachment to its superior attachment. [ 1 ] [ 2 ]  It becomes broader superiorly. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1563", "text": "Its inferior attachment is (via a pointed tendon [ 1 ] ) at (the external aspect of) the (bifid) [ 2 ]   spinous process  of the  axis (cervical vertebra C2) . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1564", "text": "Its superior attachment is at (the lateral portion of [ 1 ] [ 2 ] ) the  inferior nuchal line [ 1 ]  and the surface of the occipital bone just inferior to this line. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1565", "text": "The muscle receives motor innervation from the  suboccipital nerve  (the  posterior ramus  of  cervical spinal nerve C1 ). [ 2 ] [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1566", "text": "Superiorly, as the two muscles diverge laterally, they create between them a triangular space in which parts of the two  recti capitis posteriores minores muscles  are exposed. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1567", "text": "The muscle extends the head and (acting together with the  obliquus capitis inferior muscle [ 1 ] ) ipsilaterally rotates the head. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1568", "text": "Its main actions are to extend and rotate the  atlanto-occipital joint ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1569", "text": "A soft tissue connection bridging from the rectus capitis posterior major to the cervical  dura mater  was described in 2011. Various clinical manifestations may be linked to this anatomical relationship. [ 3 ]  It has also been postulated that this connection serves as a monitor of dural tension along with the  rectus capitis posterior minor  and the  obliquus capitis inferior . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1570", "text": "This article incorporates text in the  public domain  from  page 401  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1571", "text": "The  scapulohumeral muscles  are a group of seven muscles that connect the  humerus  to the  scapula . They are amongst the muscles that act on and stabilise the  glenohumeral joint  in the  human body ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1572", "text": "They include\u00a0:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1573", "text": "Other muscles that attach to the humerus and affect its rotation and stability\u00a0:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1574", "text": "Sebileau's muscle  is the deep muscle fibres of the  dartos tunic  which pass into the  scrotal septum . [ 1 ]  It is named after French anatomist  Pierre Sebileau  (1860\u20131953)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1575", "text": "The  splenius cervicis  ( / \u02c8 s p l i\u02d0 n i \u0259 s   s \u0259r \u02c8 v a\u026a s \u026a s / ) (also known as the  splenius colli ,  /-   \u02c8 k \u0252 l a\u026a / ) is a muscle in the back of the neck. It arises by a narrow tendinous band from the  spinous processes  of the third to the sixth  thoracic vertebrae ; it is inserted, by tendinous  fasciculi , into the  posterior tubercles  of the  transverse processes  of the upper two or three  cervical vertebrae ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1576", "text": "Its name is based on the Greek word \u03c3\u03c0\u03bb\u03b7\u03bd\u03af\u03bf\u03bd,  splenion  (meaning a bandage) and the Latin word  cervix  (meaning a neck). [ 1 ]  The word  collum  also refers to the neck in Latin. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1577", "text": "The function of the splenius cervicis muscle is extension of the cervical spine, rotation to the ipsilateral side and lateral flexion to the ipsilateral side. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1578", "text": "This article incorporates text in the  public domain  from  page 397  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1579", "text": "The  splenius muscles  are:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1580", "text": "Their origins are in the upper thoracic and lower cervical  spinous processes . Their actions are to extend and ipsilaterally rotate the head and neck."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1581", "text": "The  subcostales  (singular: subcostalis) (Infracostales) consist of muscular and  aponeurotic   fasciculi , which are usually well-developed only in the lower part of the  thorax ; each originates from the inner surface of one  rib , and is inserted into the inner surface of the second or third rib below, near its angle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1582", "text": "Their fibers run in the same direction as those of the  intercostales interni ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1583", "text": "Depresses the ribs to assist in expiration."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1584", "text": "The  suboccipital muscles  are a group of muscles defined by their location to the  occiput . Suboccipital muscles are located below the  occipital bone . These are four paired muscles on the underside of the occipital bone; the two straight muscles ( rectus ) and the two oblique muscles ( obliquus )."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1585", "text": "The muscles are named"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1586", "text": "They are innervated by the  suboccipital nerve ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1587", "text": "The  superficial cervical fascia  is a thin layer of subcutaneous  connective tissue  that lies between the  dermis  of the skin and the  deep cervical fascia . [ 1 ]  It contains the  platysma , cutaneous nerves [ 1 ] [ 2 ]  from the  cervical plexus , [ 2 ]  blood vessels, and lymphatic vessels. [ 1 ] [ 2 ]  It also contains a varying amount of fat, which is its distinguishing characteristic. It is considered by some to be a part of the  panniculus adiposus , and not true  fascia . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1588", "text": "Superficial muscular aponeurotic system  (or  superficial musculoaponeurotic system [ 1 ] ) ( SMAS ) is a thin yet tough [ 2 ] :\u200a438\u200a  unitary tissue plane of the face [ 3 ]  formed by facial fasciae, subcutis connective tissue, and facial muscles. [ 2 ] :\u200a438\u200a  Its composition varies, containing muscle fibres in some areas, and fibrous or fibroaponeurotic tissue in others. [ 3 ]  It connects to the dermis via vertical septa. [ citation needed ]  It does not attach to bone. In most areas, a distinct plane can be defined deep to the SMAS (continuous with that formed between the platysma and underlying  investing layer of deep cervical fascia ). [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1589", "text": "Superiorly, the SMAS extends to the  galea aponeurotica  of [ citation needed ]  the scalp, [ 2 ] :\u200a438\u200a  becoming continuous with  temporoparietal fascia [ 1 ] [ 1 ]  (at the  zygomatic arch [ 1 ] ) and galea. [ citation needed ]  It becomes continuous with the  platysma muscle  inferiorly (inferior to the inferior border of the mandible), and indistinct laterally (inferior to the  zygomatic arch ). Anteromedially, it blends with the  epimysium  of some facial muscles; [ 3 ]  a link between facial muscles and the skin of the face is thereby established, enabling  facial expression . [ 2 ] :\u200a429\u200a  Over the parotid gland, the SMAS is firmly united with the superficial layer of  parotid fascia . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1590", "text": "The SMAS is clinically important in  facial   plastic surgery  for  rhytidectomy (facelift procedure) . During this procedure, the SMAS is accessed through an arch-shaped incision anterior to the ear; a portion of the SMAS is then excised and the remaining SMAS is stretched by drawing it posterior-ward and suturing it, thus making the skin of the face which overlies the SMAS taut. [ 2 ] :\u200a438"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1591", "text": "The  superior longitudinal muscle of tongue  or  superior lingualis  is a thin layer of oblique and longitudinal fibers immediately underlying the mucous membrane on the dorsum of the  tongue ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1592", "text": "The superior longitudinal muscle of the tongue is one of the  intrinsic muscles  of the  tongue . [ 1 ]  It arises from the submucous fibrous layer close to the  epiglottis  and from the  median fibrous septum , and runs forward to the edges of the tongue."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1593", "text": "The superior longitudinal muscle of the tongue is supplied by the  hypoglossal nerve  (CN XII). [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1594", "text": "The superior longitudinal muscle of the tongue works with the other intrinsic muscles to move the  tongue . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1595", "text": "A considerable number of the fibers of the  thyroarytenoid muscle  are prolonged into the  aryepiglottic fold , where some of them become lost, while others continue to the margin of the epiglottis. They have received a distinctive name,  thyroepiglotticus  or  thyroepiglottic muscle , and are sometimes described as a separate muscle. This muscle's function is to widen the  laryngeal inlet ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1596", "text": "This article incorporates text in the  public domain  from  page 1083  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1597", "text": "The  tragicus , also called the  tragus muscle  or  Valsalva muscle , [ 1 ]  is an  intrinsic muscle  of the  outer ear ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1598", "text": "It is a short, flattened vertical band on the lateral surface of the  tragus . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1599", "text": "While the muscle modifies the auricular shape only minimally in the majority of individuals, this action could increase the opening of the  external acoustic meatus  in some. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1600", "text": "The  transverse muscle of auricle  ( transverse auricular muscle , [ 1 ]   transversus auriculae ,  transversus auricularis  or  transverse muscle of pinna [ 2 ] ) is an  intrinsic muscle  of the  outer ear ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1601", "text": "The muscle is located on the cranial surface of the  pinna . It consists of scattered fibers, partly tendinous and partly muscular, extending from the  eminentia conchae  to the prominence corresponding with the  scapha . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1602", "text": "While the muscle modifies the auricular shape only minimally in the majority of individuals, it could help flatten the cranial profile of the auricular cartilage. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1603", "text": "The transverse muscle is developmentally derived from the  second   pharyngeal arch . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1604", "text": "The  transversus menti , or  transverse muscle of the chin , is a  facial muscle  that is often considered to be the superficial fibers of the  depressor anguli oris  muscle which cross to the other side of the face. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1605", "text": "The  transverse muscle of tongue  ( transversus linguae ) is an  intrinsic muscle  of the  tongue . [ 1 ]  It consists of fibers which arise from the  median fibrous septum . It passes laterally to insert into the submucous fibrous tissue at the sides of the  tongue . [ citation needed ]  It is innervated by the  hypoglossal nerve (cranial nerve XII) . Its contraction elongates and narrows the tongue."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1606", "text": "The transverse muscle of the tongue is an  intrinsic muscle  of the  tongue . [ 1 ]  It consists of fibers which arise from the  median fibrous septum . It passes laterally to insert into the submucous fibrous tissue at the sides of the  tongue . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1607", "text": "The transverse lingual muscle is innervated by the  hypoglossal nerve (CN XII) . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1608", "text": "Contraction of the transverse muscle of the tongue elongates and narrows the tongue. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1609", "text": "The  transversus thoracis muscle  ( / t r \u00e6 n z \u02c8 v \u025c\u02d0r s \u0259 s   \u03b8 \u0259 \u02c8 r e\u026a s \u026a s / ), also known as  triangularis sterni ,  lies internal to the  thoracic cage , anteriorly.  It is usually a thin plane of muscular and tendinous fibers, however on athletic individuals it can be a thick 'slab of meat', situated upon the inner surface of the front wall of the chest. It is in the same layer as the  subcostal muscles  and the  innermost intercostal  muscles."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1610", "text": "It arises on either side from the lower third of the posterior surface of the body of the  sternum , from the posterior surface of the  xiphoid process , and from the sternal ends of the  costal cartilages  of the lower three or four true ribs."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1611", "text": "Its fibers diverge upward and lateralward, to be inserted by slips into the lower borders and inner surfaces of the costal cartilages of the  second , third, fourth, fifth, and sixth ribs."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1612", "text": "The lowest fibers of this muscle are horizontal in their direction, and are continuous with those of the  transversus abdominis ; the  intermediate fibers  are oblique, while the highest are almost vertical."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1613", "text": "This muscle varies in its attachments, not only in different subjects, but on opposite sides of the same subject."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1614", "text": "The muscle is supplied by the anterior rami of the  thoracic spinal nerves  (intercostal nerves)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1615", "text": "It is almost completely without function, but it separates the thoracic cage from the  parietal pleura .  It depresses the ribs."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1616", "text": "Contraction of this muscle aids in exertional expiration by decreasing the transverse diameter of the thoracic cage."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1617", "text": "The  vertical muscle of the tongue  is an  intrinsic muscle  of the  tongue . Its fibers extend from the upper to the under surface of the tongue. It is innervated by the  hypoglossal nerve (cranial nerve XII) . Its contraction flattens, widens and elongates the tongue. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1618", "text": "The vertical muscle of the tongue is an intrinsic muscle of the tongue. [ 1 ]  It is found only at the borders of the forepart of the  tongue . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1619", "text": "Fibres of the vertical muscle of the tongue are arranged in an almost vertical direction, and intersect the transversely oriented fibres of the  transverse muscle of tongue . [ 2 ]  Fibers of the vertical muscle of the tongue extend from the upper to the under surface of the tongue. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1620", "text": "The vertical of the tongue is innervated by the  hypoglossal nerve (CN XII) . [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1621", "text": "Contraction of the vertical muscle of the tongue flattens, widens and elongates the tongue. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1622", "text": "This article incorporates text in the  public domain  from  page 1131  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1623", "text": "Zenker's degeneration  is a severe glassy or waxy  hyaline   degeneration  or  necrosis  of  skeletal  muscles in acute infectious diseases; a prototype of coagulative necrosis."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1624", "text": "The condition was named by  Friedrich Albert von Zenker . It is a hyaline degeneration of skeletal muscles such as  rectus abdominis  and  diaphragm , and occurs in severe  toxaemia  as typhoid fever. It is also seen in electrical burns. [ 1 ]  Grossly the muscles appear pale and friable; microscopically, the muscle fibres are swollen, have a loss of cross striations, and show a hyaline appearance. Rupture and small hemorrhage may complicate the lesion. Coagulative necrosis occurs here."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1625", "text": "This article about a disease of musculoskeletal and connective tissue is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1626", "text": "A  tendon  or  sinew  is a tough band of  dense fibrous connective tissue  that connects  muscle  to  bone . It sends the mechanical forces of muscle contraction to the skeletal system, while withstanding  tension ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1627", "text": "Tendons, like  ligaments , are made of  collagen . The difference is that ligaments connect bone to bone, while tendons connect muscle to bone. There are about 4,000 tendons in the adult human body. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1628", "text": "A tendon is made of  dense regular connective tissue , whose main cellular components are special  fibroblasts  called  tendon cells  (tenocytes). [ 3 ]  Tendon cells synthesize the tendon's  extracellular matrix , which abounds with densely-packed  collagen fibers . The collagen fibers run parallel to each other and are grouped into fascicles. Each fascicle is bound by an  endotendineum , which is a delicate loose connective tissue containing thin collagen fibrils [ 4 ] [ 5 ]  and elastic fibers. [ 6 ]  A set of fascicles is bound by an  epitenon , which is a sheath of  dense irregular connective tissue . The whole tendon is enclosed by a  fascia . The space between the fascia and the tendon tissue is filled with the  paratenon , a fatty  areolar tissue . [ 7 ]  Normal healthy tendons are anchored to bone by  Sharpey's fibres ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1629", "text": "The dry mass of normal tendons, which is 30\u201345% of their total mass, is made of:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1630", "text": "Although most of a tendon's collagen is  type I collagen , many minor collagens are present that play vital roles in tendon development and function. These include type II collagen in the  cartilaginous  zones, type III collagen in the  reticulin  fibres of the vascular walls, type IX collagen, type IV collagen in the basement membranes of the  capillaries , type V collagen in the vascular walls, and type X collagen in the mineralized fibrocartilage near the interface with the bone. [ 8 ] [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1631", "text": "Collagen fibres coalesce into  macroaggregates . After secretion from the cell, cleaved by  procollagen  N- and C- proteases , the tropocollagen molecules spontaneously assemble into insoluble fibrils. A collagen molecule is about 300\u00a0nm long and 1\u20132\u00a0nm wide, and the diameter of the fibrils that are formed can range from 50\u2013500\u00a0nm. In tendons, the fibrils then assemble further to form fascicles, which are about 10\u00a0mm in length with a diameter of 50\u2013300 \u03bcm, and finally into a tendon fibre with a diameter of 100\u2013500 \u03bcm. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1632", "text": "The collagen in tendons are held together with  proteoglycan  (a compound consisting of a protein bonded to glycosaminoglycan groups, present especially in connective tissue) components including  decorin  and, in compressed regions of tendon,  aggrecan , which are capable of binding to the collagen fibrils at specific locations. [ 14 ]  The proteoglycans are interwoven with the collagen fibrils\u00a0\u2013  their  glycosaminoglycan  (GAG) side chains have multiple interactions with the surface of the fibrils\u00a0\u2013  showing that the proteoglycans are important structurally in the interconnection of the fibrils. [ 15 ]  The major GAG components of the tendon are  dermatan sulfate  and  chondroitin sulfate , which associate with collagen and are involved in the fibril assembly process during tendon development. Dermatan sulfate is thought to be responsible for forming associations between fibrils, while chondroitin sulfate is thought to be more involved with occupying volume between the fibrils to keep them separated and help withstand deformation. [ 16 ]  The dermatan sulfate side chains of decorin aggregate in solution, and this behavior can assist with the assembly of the collagen fibrils. When decorin molecules are bound to a collagen fibril, their dermatan sulfate chains may extend and associate with other dermatan sulfate chains on decorin that is bound to separate fibrils, therefore creating interfibrillar bridges and eventually causing parallel alignment of the fibrils. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1633", "text": "The  tenocytes  produce the collagen molecules, which aggregate end-to-end and side-to-side to produce collagen fibrils. Fibril bundles are organized to form fibres with the elongated tenocytes closely packed between them. There is a three-dimensional network of cell processes associated with collagen in the tendon. The cells communicate with each other through  gap junctions , and this signalling gives them the ability to detect and respond to mechanical loading. [ 18 ]  These communications happen by two proteins essentially:  connexin 43 , present where the cells processes meet and in cell bodies  connexin 32 , present only where the processes meet. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1634", "text": "Blood vessels may be visualized within the endotendon running parallel to collagen fibres, with occasional branching transverse  anastomoses ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1635", "text": "The internal tendon bulk is thought to contain no nerve fibres, but the epitenon and paratenon contain nerve endings, while  Golgi tendon organs  are present at the  myotendinous junction  between tendon and muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1636", "text": "Tendon length varies in all major groups and from person to person. Tendon length is, in practice, the deciding factor regarding actual and potential muscle size. For example, all other relevant biological factors being equal, a man with a shorter tendons and a longer biceps muscle will have greater potential for muscle mass than a man with a longer tendon and a shorter muscle. Successful  bodybuilders  will generally have shorter tendons. Conversely, in sports requiring athletes to excel in actions such as running or jumping, it is beneficial to have longer than average  Achilles tendon  and a shorter  calf muscle . [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1637", "text": "Tendon length is determined by genetic predisposition, and has not been shown to either increase or decrease in response to environment, unlike muscles, which can be shortened by trauma, use imbalances and a lack of recovery and stretching. [ 21 ]  In addition tendons allow muscles to be at an optimal distance from the site where they actively engage in movement, passing through regions where space is premium, like the  carpal tunnel . [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1638", "text": "There are about 4,000 tendons in the human body, of which 55 are listed here:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1639", "text": "Naming convention for the table:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1640", "text": "Traditionally, tendons have been considered to be a mechanism by which muscles connect to bone as well as muscles itself, functioning to transmit forces. This connection allows tendons to passively modulate forces during locomotion, providing additional stability with no active work. However, over the past two decades, much research has focused on the elastic properties of some tendons and their ability to function as springs. Not all tendons are required to perform the same functional role, with some predominantly positioning limbs, such as the fingers when writing (positional tendons) and others acting as springs to make locomotion more efficient (energy storing tendons). [ 22 ]  Energy storing tendons can store and recover energy at high efficiency. For example, during a human stride, the Achilles tendon stretches as the ankle joint dorsiflexes. During the last portion of the stride, as the foot plantar-flexes (pointing the toes down), the stored elastic energy is released. Furthermore, because the tendon stretches, the muscle is able to function with less or even  no change in length , allowing the muscle to generate more force."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1641", "text": "The mechanical properties of the tendon are dependent on the collagen fiber diameter and orientation. The collagen fibrils are parallel to each other and closely packed, but show a wave-like appearance due to planar undulations, or crimps, on a scale of several micrometers. [ 23 ]  In tendons, the collagen fibres have some flexibility due to the absence of hydroxyproline and proline residues at specific locations in the amino acid sequence, which allows the formation of other conformations such as bends or internal loops in the triple helix and results in the development of crimps. [ 24 ]  The crimps in the collagen fibrils allow the tendons to have some flexibility as well as a low compressive stiffness. In addition, because the tendon is a multi-stranded structure made up of many partially independent fibrils and fascicles, it does not behave as a single rod, and this property also contributes to its flexibility. [ 25 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1642", "text": "The  proteoglycan  components of tendons also are important to the mechanical properties. While the collagen fibrils allow tendons to resist tensile stress, the proteoglycans allow them to resist compressive stress. These molecules are very hydrophilic, meaning that they can absorb a large amount of water and therefore have a high swelling ratio. Since they are noncovalently bound to the fibrils, they may reversibly associate and disassociate so that the bridges between fibrils can be broken and reformed. This process may be involved in allowing the fibril to elongate and decrease in diameter under tension. [ 26 ]  However, the proteoglycans may also have a role in the tensile properties of tendon. The structure of tendon is effectively a fibre composite material, built as a series of hierarchical levels. At each level of the hierarchy, the collagen units are bound together by either collagen crosslinks, or the proteoglycans, to create a structure highly resistant to tensile load. [ 27 ]  The elongation and the strain of the collagen fibrils alone have been shown to be much lower than the total elongation and strain of the entire tendon under the same amount of stress, demonstrating that the proteoglycan-rich matrix must also undergo deformation, and stiffening of the matrix occurs at high strain rates. [ 28 ]  This deformation of the non-collagenous matrix occurs at all levels of the tendon hierarchy, and by modulating the organisation and structure of this matrix, the different mechanical properties required by different tendons can be achieved. [ 29 ]  Energy storing tendons have been shown to utilise significant amounts of sliding between fascicles to enable the high strain characteristics they require, whilst positional tendons rely more heavily on sliding between collagen fibres and fibrils. [ 30 ]  However, recent data suggests that energy storing tendons may also contain fascicles which are twisted, or helical, in nature - an arrangement that would be highly beneficial for providing the spring-like behaviour required in these tendons. [ 31 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1643", "text": "Tendons are  viscoelastic  structures, which means they exhibit both elastic and viscous behaviour. When stretched, tendons exhibit typical \"soft tissue\" behavior. The force-extension, or stress-strain curve starts with a very low stiffness region, as the crimp structure straightens and the collagen fibres align suggesting negative Poisson's ratio in the fibres of the tendon. More recently, tests carried out in vivo (through  MRI ) and ex vivo (through mechanical testing of various cadaveric tendon tissue) have shown that healthy tendons are highly anisotropic and exhibit a negative Poisson's ratio ( auxetic ) in some planes when stretched up to 2% along their length, i.e. within their normal range of motion. [ 32 ]  After this 'toe' region, the structure becomes significantly stiffer, and has a linear stress-strain curve until it begins to fail. The mechanical properties of tendons vary widely, as they are matched to the functional requirements of the tendon. The energy storing tendons tend to be more elastic, or less stiff, so they can more easily store energy, whilst the stiffer positional tendons tend to be a little more viscoelastic, and less elastic, so they can provide finer control of movement. A typical energy storing tendon will fail at around 12\u201315% strain, and a stress in the region of 100\u2013150 MPa, although some tendons are notably more extensible than this, for example the superficial digital flexor in the  horse , which stretches in excess of 20% when galloping. [ 33 ]  Positional tendons can fail at strains as low as 6\u20138%, but can have moduli in the region of 700\u20131000 MPa. [ 34 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1644", "text": "Several studies have demonstrated that tendons respond to changes in mechanical loading with growth and remodeling processes, much like  bones . In particular, a study showed that disuse of the  Achilles tendon  in rats resulted in a decrease in the average thickness of the collagen fiber bundles comprising the tendon. [ 35 ]  In humans, an experiment in which people were subjected to a simulated micro-gravity environment found that tendon stiffness decreased significantly, even when subjects were required to perform restiveness exercises. [ 36 ]  These effects have implications in areas ranging from treatment of bedridden patients to the design of more effective exercises for  astronauts ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1645", "text": "Tendons are subject to many types of injuries. There are various forms of  tendinopathies  or tendon injuries due to overuse. These types of injuries generally result in inflammation and degeneration or weakening of the tendons, which may eventually lead to  tendon rupture . [ 37 ]  Tendinopathies can be caused by a number of factors relating to the tendon extracellular matrix (ECM), and their classification has been difficult because their symptoms and histopathology often are similar."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1646", "text": "Types of tendinopathy include: [ 38 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1647", "text": "Tendinopathies may be caused by several intrinsic factors including age, body weight, and nutrition. The extrinsic factors are often related to sports and include excessive forces or loading, poor training techniques, and environmental conditions. [ 41 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1648", "text": "It was believed that tendons could not undergo matrix turnover and that tenocytes were not capable of repair. However, it has since been shown that, throughout the lifetime of a person, tenocytes in the tendon actively synthesize matrix components as well as enzymes such as  matrix metalloproteinases  (MMPs) can degrade the matrix. [ 41 ]  Tendons are capable of healing and recovering from injuries in a process that is controlled by the tenocytes and their surrounding extracellular matrix."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1649", "text": "The three main stages of tendon healing are inflammation, repair or proliferation, and remodeling, which can be further divided into consolidation and maturation. These stages can overlap with each other. In the first stage, inflammatory cells such as  neutrophils  are recruited to the injury site, along with  erythrocytes .  Monocytes  and  macrophages  are recruited within the first 24 hours, and  phagocytosis  of  necrotic  materials at the injury site occurs. After the release of  vasoactive  and  chemotactic  factors,  angiogenesis  and the  proliferation  of tenocytes are initiated. Tenocytes then move into the site and start to synthesize collagen III. [ 37 ] [ 40 ]  After a few days, the repair or proliferation stage begins. In this stage, the tenocytes are involved in the synthesis of large amounts of collagen and proteoglycans at the site of injury, and the levels of GAG and water are high. [ 42 ]  After about six weeks, the remodeling stage begins. The first part of this stage is consolidation, which lasts from about six to ten weeks after the injury. During this time, the synthesis of collagen and GAGs is decreased, and the cellularity is also decreased as the tissue becomes more fibrous as a result of increased production of collagen I and the fibrils become aligned in the direction of mechanical stress. [ 40 ]  The final maturation stage occurs after ten weeks, and during this time there is an increase in crosslinking of the collagen fibrils, which causes the tissue to become stiffer. Gradually, over about one year, the tissue will turn from fibrous to scar-like. [ 42 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1650", "text": "Matrix metalloproteinases (MMPs) have a very important role in the degradation and remodeling of the ECM during the healing process after a tendon injury. Certain MMPs including MMP-1, MMP-2, MMP-8, MMP-13, and MMP-14 have collagenase activity, meaning that, unlike many other enzymes, they are capable of degrading collagen I fibrils. The degradation of the collagen fibrils by MMP-1 along with the presence of denatured collagen are factors that are believed to cause weakening of the tendon ECM and an increase in the potential for another rupture to occur. [ 43 ]  In response to repeated mechanical loading or injury,  cytokines  may be released by tenocytes and can induce the release of MMPs, causing degradation of the ECM and leading to recurring injury and chronic tendinopathies. [ 40 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1651", "text": "A variety of other molecules are involved in tendon repair and regeneration. There are five growth factors that have been shown to be significantly upregulated and active during tendon healing:  insulin-like growth factor 1  (IGF-I),  platelet-derived growth factor  (PDGF),  vascular endothelial growth factor  (VEGF),  basic fibroblast growth factor  (bFGF), and  transforming growth factor beta  (TGF-\u03b2). [ 42 ]  These growth factors all have different roles during the healing process. IGF-1 increases collagen and proteoglycan production during the first stage of inflammation, and PDGF is also present during the early stages after injury and promotes the synthesis of other growth factors along with the synthesis of DNA and the proliferation of tendon cells. [ 42 ]  The three isoforms of TGF-\u03b2 (TGF-\u03b21, TGF-\u03b22, TGF-\u03b23) are known to play a role in wound healing and scar formation. [ 44 ]  VEGF is well known to promote angiogenesis and to induce endothelial cell proliferation and migration, and VEGF mRNA has been shown to be expressed at the site of tendon injuries along with collagen I mRNA. [ 45 ]  Bone morphogenetic proteins (BMPs) are a subgroup of TGF-\u03b2 superfamily that can induce bone and cartilage formation as well as tissue differentiation, and BMP-12 specifically has been shown to influence formation and differentiation of tendon tissue and to promote fibrogenesis."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1652", "text": "In animal models, extensive studies have been conducted to investigate the effects of mechanical strain in the form of activity level on tendon injury and healing. While stretching can disrupt healing during the initial inflammatory phase, it has been shown that controlled movement of the tendons after about one week following an acute injury can help to promote the synthesis of collagen by the tenocytes, leading to increased tensile strength and diameter of the healed tendons and fewer adhesions than tendons that are immobilized. In chronic tendon injuries, mechanical loading has also been shown to stimulate fibroblast proliferation and collagen synthesis along with collagen realignment, all of which promote repair and remodeling. [ 42 ]  To further support the theory that movement and activity assist in tendon healing, it has been shown that immobilization of the tendons after injury often has a negative effect on healing. In rabbits, collagen fascicles that are immobilized have shown decreased tensile strength, and immobilization also results in lower amounts of water, proteoglycans, and collagen crosslinks in the tendons. [ 37 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1653", "text": "Several  mechanotransduction  mechanisms have been proposed as reasons for the response of tenocytes to mechanical force that enable them to alter their gene expression, protein synthesis, and cell phenotype, and eventually cause changes in tendon structure. A major factor is mechanical deformation of the  extracellular matrix , which can affect the  actin cytoskeleton  and therefore affect cell shape, motility, and function. Mechanical forces can be transmitted by focal adhesion sites,  integrins , and cell-cell junctions. Changes in the actin cytoskeleton can activate integrins, which mediate \"outside-in\" and \"inside-out\" signaling between the cell and the matrix.  G-proteins , which induce intracellular signaling cascades, may also be important, and ion channels are activated by stretching to allow ions such as calcium, sodium, or potassium to enter the cell. [ 42 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1654", "text": "Sinew was widely used throughout  pre-industrial  eras as a tough, durable  fiber . Some specific uses include using sinew as  thread  for sewing, attaching feathers to arrows (see  fletch ), lashing tool blades to shafts, etc. It is also recommended in survival guides as a material from which strong cordage can be made for items like traps or living structures. Tendon must be treated in specific ways to function usefully for these purposes.  Inuit  and other  circumpolar people  utilized sinew as the only cordage for all domestic purposes due to the lack of other suitable fiber sources in their ecological habitats. The elastic properties of particular sinews were also used in  composite recurved bows  favoured by the steppe nomads of Eurasia, and Native Americans. The first stone throwing artillery also used the elastic properties of sinew."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1655", "text": "Sinew makes for an excellent cordage material for three reasons: It is extremely strong, it contains natural glues, and it shrinks as it dries, doing away with the need for knots [ clarification needed ] ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1656", "text": "Tendon (in particular,  beef  tendon) is used as a food in some Asian cuisines (often served at  yum cha  or  dim sum  restaurants). One popular dish is  suan bao niu jin , in which the tendon is marinated in garlic. It is also sometimes found in the Vietnamese noodle dish  ph\u1edf ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1657", "text": "In some organisms, notably  birds , [ 46 ]  and  ornithischian   dinosaurs , [ 47 ]  portions of the tendon can become ossified. In this process, osteocytes infiltrate the tendon and lay down bone as they would in sesamoid bone such as the patella. In birds, tendon ossification primarily occurs in the hindlimb, while in ornithischian dinosaurs, ossified axial muscle tendons form a latticework along the neural and haemal spines on the tail, presumably for support."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1658", "text": "The  Achilles tendon  or  heel cord , also known as the  calcaneal tendon , is a  tendon  at the back of the lower  leg , and is the thickest in the human body. [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ] [ 6 ] [ excessive citations ]  It serves to attach the  plantaris ,  gastrocnemius  (calf) and  soleus muscles  to the  calcaneus  (heel) bone. These muscles, acting via the tendon, cause  plantar flexion  of the foot at the  ankle joint , and (except the soleus)  flexion  at the  knee ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1659", "text": "Abnormalities of the Achilles tendon include inflammation ( Achilles tendinitis ), degeneration,  rupture , and becoming embedded with cholesterol deposits ( xanthomas )."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1660", "text": "The Achilles tendon was named in 1693 after the Greek hero  Achilles . [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1661", "text": "The oldest-known written record of the tendon being named after  Achilles  is in 1693 by the Flemish/Dutch anatomist  Philip Verheyen . In his widely used text  Corporis Humani Anatomia  he described the tendon's location and said that it was commonly called \"the cord of Achilles.\" [ 8 ] [ 9 ]  The tendon has been described as early as the time of  Hippocrates , who described it as the \" tendo magnus \" (Latin for \"great tendon\") [ dubious  \u2013  discuss ]  and by subsequent anatomists prior to Verheyen as \" chorda Hippocratis \" (Latin for \"Hippocrates' string\"). [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1662", "text": "Verheyen referred to the mythological account of Achilles being held by the heel by his mother  Thetis  when she dipped him in the  River Styx  as a baby to render his body invulnerable. As the heel by which she held him was not touched by the water, it was his one vulnerable spot (hence the expression \" Achilles' heel \") and he was eventually killed by a poison dart to the heel. The name thus also refers to the particularly disabling and painful effect of an injury to this tendon. [ 9 ]  The first closed rupture was described by  Ambroise Pare  in the sixteenth century. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1663", "text": "The Achilles tendon is also known as the \" tendo calcaneus \" (Latin for \"calcaneal tendon\"). [ 9 ]  Because  eponyms  (names relating to people) have no relationship to the subject matter, most anatomical eponyms also have scientifically descriptive terms. The term calcaneal comes from the Latin  calcaneum , meaning heel."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1664", "text": "The Achilles tendon connects muscle to bone, like other  tendons , and is located at the back of the lower leg. The Achilles tendon connects the  gastrocnemius  and  soleus  muscles to the  calcaneal tuberosity  on the  calcaneus  (heel bone). [ 10 ]  The tendon begins near the middle of the calf, and receives muscle fibers on its inner surface, particularly from the soleus muscle, almost to its lower end. Gradually thinning below, it inserts into the middle part of the back of the calcaneus bone. The tendon spreads out somewhat at its lower end so that its narrowest part is about 4\u00a0cm (1.6\u00a0in) above its insertion. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1665", "text": "The tendon is covered by the  fascia  and skin, and stands out prominently behind the bone; the gap is filled up with  areolar  and  adipose tissue . A  bursa  lies between the tendon and the upper part of the calcaneus. It is about 15 centimetres (6\u00a0in) long."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1666", "text": "Along the side of the muscle, and superficial to it, is the  small saphenous vein . The  sural nerve  accompanies the small saphenous vein as it descends in the posterior leg, traveling inferolateral to it as it crosses the lateral border of the Achilles tendon. [ 12 ]  The tendon is the thickest tendon in the human body. [ 11 ]  It can receive a load stress 3.9 times body weight during walking and 7.7 times body weight when running. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1667", "text": "The blood supply to the Achilles tendon is poor, and mostly via a recurrent branch of the  posterior tibial artery , and some through arterial branches passing through surrounding muscles. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1668", "text": "Acting via the Achilles tendon, the gastrocnemius and soleus muscles cause  plantar flexion  of the foot at the  ankle . This action brings the sole of the foot closer to the back of the leg. The gastrocnemius also  flexes  the leg at the knee. Both muscles are innervated by the  tibial nerve . [ 14 ]  Because the fibres of the tendon spiral about 90 degrees, fibres from the gastrocnemius tend to attach to the outer part of the bone, whereas fibres from the soleus tend to attach closer to the midline. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1669", "text": "Vibration of the tendon without vision has a major impact on  postural  orientation. [ 15 ]  Vibration of the tendon causes movement backwards and the illusion of a forward body tilt in standing subjects. [ 16 ]  This is because vibrations stimulate  muscle spindles  in the calf muscles. The muscle spindles alert the brain that the body is moving forward, so the  central nervous system  compensates by moving the body backwards."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1670", "text": "Inflammation  of the Achilles tendon is called  Achilles tendinitis . Achilles  tendinosis  is the soreness or stiffness of the tendon, particularly worse when exercising, and generally due to overuse. [ 17 ]  The most common symptoms are sharp achy pain and swelling around the affected tendon. [ 18 ] [ 19 ] [ 20 ]  The pain is typically worse at the start of exercise and decreases thereafter. [ 21 ]  Stiffness of the ankle may also be present. [ 17 ]  Onset is generally gradual. [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1671", "text": "It commonly occurs as a result of overuse such as  running . [ 17 ] [ 21 ]  Other risk factors include trauma, a lifestyle that includes little exercise,  high-heel shoes ,  rheumatoid arthritis , and medications of the  fluoroquinolone  or  steroid  class. [ 18 ]  Diagnosis is generally based on symptoms and  examination . [ 21 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1672", "text": "While  stretching  and exercises to strengthen the back are often recommended for prevention, evidence to support these measures is poor. [ 22 ] [ 23 ] [ 24 ]  Treatment typically involves rest, ice,  non-steroidal antiinflammatory agents  (NSAIDs), and  physical therapy . [ 17 ] [ 18 ]  A  heel lift  or  orthotics  may also be helpful. [ 17 ] [ 21 ]  In those in whose symptoms last more than six months despite other treatments, surgery may be considered. [ 17 ]  Achilles tendinitis is relatively common. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1673", "text": "Achilles tendon degeneration (tendinosis) is typically investigated with either  MRI  or  ultrasound .  In both cases, the tendon is thickened, may demonstrate surrounding inflammation by virtue of the presence of paratenonitis, retrocalcaneal or retro-achilles  bursitis . Within the tendon, increased blood flow, tendon fibril disorganisation, and partial thickness tears may be identified. Achilles tendinosis frequently involves the mid portion of the tendon but may involve the insertion, which is then known as enthesopathy. Though  enthesopathy  may be seen in the context of advancing age, it is also associated with  arthritis  such as  gout  and the  seronegative spondyloarthritides .  Achilles tendinosis is a known risk factor for calf muscle tears. [ 25 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1674", "text": "Achilles tendon rupture  is when the Achilles tendon breaks. [ 26 ]  Symptoms include the sudden onset of sharp pain in the  heel . [ 18 ]  A snapping sound may be heard as the tendon breaks and walking becomes difficult. [ 27 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1675", "text": "Rupture typically occurs as a result of a sudden bending up of the foot when the calf muscle is engaged, direct  trauma , or long-standing tendonitis. [ 27 ] [ 26 ]  Other risk factors include the use of  fluoroquinolones , a significant change in exercise,  rheumatoid arthritis ,  gout , or  corticosteroid  use. [ 28 ] [ 26 ]  Diagnosis is typically based on symptoms and  examination  and supported by  medical imaging . [ 26 ]  Achilles tendon rupture occurs in about 1 per 10,000 people per year. [ 26 ]  Males are more commonly affected than females. [ 28 ]  People in their 30s to 50s are most commonly affected. [ 26 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1676", "text": "Prevention may include stretching before activity. [ 27 ]  Treatment may be by surgery or  casting  with the toes somewhat  pointed down . [ 29 ] [ 26 ]  Relatively rapid return to weight bearing (within 4 weeks) appears acceptable. [ 29 ] [ 30 ]  The risk of re-rupture is about 25% with casting. [ 26 ]  If appropriate treatment does not occur within 4 weeks of the injury outcomes suffer. [ 31 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1677", "text": "Tendon xanthomas  are cholesterol deposits that commonly develop in the Achilles tendon of people with lipid metabolism disorders such as  familial hypercholesterolemia . [ 32 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1678", "text": "The Achilles tendon is often tested as part of a  neurological examination . In this examination, the tendon is hit with a  tendon hammer . This tests the S1 and S2  spinal nerves : a normal response is  plantar flexion  (downward movement) of the foot. [ 33 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1679", "text": "Level or portion of tendon affected: [ 34 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1680", "text": "The Achilles tendon is short or absent in  great apes , but long in arboreal  gibbons  and humans. [ 38 ]  It provides elastic energy storage in hopping, [ 39 ]  walking, and running. [ 38 ]  Computer models suggest this energy storage Achilles tendon increases top running speed by >80% and reduces running costs by more than three-quarters. [ 38 ]  It has been suggested that the \"absence of a well-developed Achilles tendon in the nonhuman African apes would preclude them from effective running, both at high speeds and over extended distances.\" [ 38 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1681", "text": "The  central tendon  of the  diaphragm  is a thin but strong  aponeurosis  situated slightly anterior to  the vault formed by the muscle , resulting in longer posterior muscle fibers."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1682", "text": "It is inferior to the  fibrous pericardium , which fuses with the central tendon of the diaphragm via the pericardiacophrenic  ligament ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1683", "text": "The  caval opening  (at the level of the  T8 vertebra ) passes through the central tendon. This transmits the  inferior vena cava [ 1 ]  and  right phrenic nerve ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1684", "text": "The central tendon is shaped somewhat like a  trefoil   leaf , consisting of three divisions or  leaflets  separated from one another by slight indentations. The right leaflet is the largest, the middle (directed toward the  xiphoid process ) the next in size, and the left the smallest."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1685", "text": "The central tendon is composed of several planes of  fibers , which intersect one another at various angles and unite into straight or curved bundles\u2014an arrangement which gives it additional  strength ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1686", "text": "During  inspiration , the diaphragm contracts, causing the central tendon to be drawn inferiorly which partially flattens the domes bilaterally. The result is an increase in the  thoracic  volume and a reduction in intra-thoracic  pressure . This reduction allows air to enter the lungs, enhancing venous return. During inspiration, the central tendon retains its shape due to its tendinous nature, and prevents constriction of the inferior vena cava."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1687", "text": "Rarely, a central tendon defect may be involved in a central  congenital diaphragmatic hernia . [ 2 ]  This may be repaired with thoracoscopic surgery. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1688", "text": "This article incorporates text in the  public domain  from  page 406  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1689", "text": "The  common extensor tendon  is a  tendon  that attaches to the  lateral epicondyle  of the  humerus ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1690", "text": "The common extensor tendon serves as the upper attachment (in part) for the superficial muscles that are located on the posterior aspect of the  forearm :"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1691", "text": "The tendon of extensor carpi radialis brevis is usually the most major tendon to which the other tendons merge. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1692", "text": "The common extensor tendon is the major attachment point for extensor muscles of the forearm. This enables finger extension and aids in forearm supination."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1693", "text": "Lateral elbow pain can be caused by various  pathologies  of the common extensor tendon. [ 3 ]   Overuse injuries  can lead to  inflammation . [ 4 ] [ 5 ]   Tennis elbow  is a common issue with the common extensor tendon. [ 6 ] [ 4 ] [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1694", "text": "The  common flexor tendon  is a  tendon  that attaches to the  medial epicondyle  of the  humerus  (lower part of the bone of the upper arm that is near the elbow joint)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1695", "text": "It serves as the upper attachment point for the superficial muscles of the front of the  forearm :"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1696", "text": "Linburg\u2013Comstock variation  is an occasional  tendinous  connection between the  flexor pollicis longus  and the  flexor digitorum profundus  of the  index , the  middle finger  or both. It is found in around 21% of the population. [ 1 ]  It is an  anatomical variation  in humans, which may be viewed as a  pathology  if it causes symptoms. It was recognised as early as the 1800s, but was first described by Linburg and Comstock in 1979. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1697", "text": "Although Linburg\u2013Comstock variation remains  asymptomatic , a number of case reports suggested that symptoms could develop after a forceful  extension  of the  index finger  with the thumb in a  flexed  position. [ 3 ] [ 4 ]  Symptoms also develop from heavy and repetitive use of the wrist and  forearm  and can also develop in those who require fine and independent functionality of the fingers, such as musicians. [ 3 ] [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1698", "text": "This abnormality is clinically evident when the patient is unable to flex the thumb without flexing the distal  interphalangeal joint  of the index or middle finger or vice versa."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1699", "text": "Flexor tenosynovitis is a common finding in the patients with Linburg\u2013Comstock syndrome. Another  hypothesis  is that anatomical variations, which in this case is an additional tendon slip, may act as  space-occupying lesions  and potentially contribute to  carpal tunnel syndrome . [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1700", "text": "Linburg\u2013Comstock variation and syndrome may result from  phylogenetic  differences between human and  non-human primates . Phylogenetically, the flexor pollicis longus and the flexor digitorum profundus both originate from a common  mesodermal  mass. [ 6 ]  In non-human primates, there is only one flexor muscle for all the fingers, whereas in humans, the flexor pollicis longus becomes distinct. [ 7 ]  Linburg\u2013Comstock syndrome may be viewed as an  evolutionary  persistent structure. It is still inconclusive whether or not the connection is congenital or acquired at a later time point in life. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1701", "text": "Multiple types of the connection between the flexor pollicis longus and the flexor digitorum profundus were described: [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1702", "text": "The examiner passively restricts the flexion of the fingers while the examinee attempts to actively flex the thumb. [ 10 ]  A positive test is marked by restricted active thumb flexion with pain or cramping discomfort in the palmar and radial sides of the distal (lower) forearm or wrist. [ 10 ]  The  magnetic resonance imaging  (MRI) can confirm and localise Linburg and Comstock syndrome. [ 10 ]  As reported by Karalezli, magnetic resonance imaging was performed on all patients diagnosed with positive test, and there were tendinous connection in all cases. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1703", "text": "Surgery may be performed by excising or splitting the tendinous connection to form two separate tendons, depending on the nature of the connection. [ 12 ]   Muscle  belly associated with the symptoms may also be removed. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1704", "text": "This variant occurred bilaterally (in both hands) in 14% and unilaterally in 31% (either in left or right hand) out of 194 patients as reported by the original study. [ 2 ]  Four cases were responsible for  chronic tenosynovitis . [ 2 ]  A recent meta analysis reported that the connection is present in 21% of the population. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1705", "text": "In  human anatomy , the  quadriceps tendon  works with the  quadriceps muscle  to extend the leg. All four parts of the quadriceps muscle attach to the  shin  via the  patella  (knee cap), where the quadriceps tendon becomes the  patellar ligament . It attaches the quadriceps to the top of the patella, which in turn is connected to the shin from its bottom by the patellar ligament. A tendon connects muscle to bone, while a ligament connects bone to bone. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1706", "text": "Injuries are common to this tendon, with tears, either partial or complete, being the most common.  If the quadriceps tendon is completely torn, surgery will be required to regain function of the knee. [ 2 ]   Without the quadriceps tendon, the knee cannot extend.  Often, when the tendon is completely torn, part of the kneecap bone will break off with the tendon as well. [ 2 ]   It can rupture resulting in  quadriceps tendon rupture . [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1707", "text": "It has been studied in the analysis of  patellofemoral pain syndrome . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1708", "text": "A  retinaculum  ( pl. :  retinacula ) is a band of thickened  deep fascia  around  tendons  that holds them in place. [ 1 ]  It is not part of any  muscle .  Its function is mostly to stabilize a tendon. The term retinaculum is  Neo-Latin , [ 2 ]  derived from the  Latin  verb  retinere  (to retain). Specific retinacula include:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1709", "text": "Paratenonitis  occurs where a tendon rubs over a bony surface. It is presented with acute  edema  and  hyperaemia  of the paratenon with infiltration of inflammatory cells. After few hours or few days,  tendon sheath  is filled by fibrinous exudate and leads to  crepitus . In chronic paratenonitis fibroblasts appear along with perivascular lymphocytic infiltrate. Peritendinous tissues become macroscopically thickened and new connective tissue adhesions occur. In paratenonitis, inflammatory cells are found in the cellular elements of the paratenon and in the vascular ingrowth. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1710", "text": "A  fascia  ( / \u02c8 f \u00e6 \u0283 ( i ) \u0259 / ;  pl. :  fasciae   / \u02c8 f \u00e6 \u0283 i i /  or  fascias ; [ 1 ]  adjective  fascial ; from  Latin    band ) is a generic term for  macroscopic   membranous  bodily structures. [ 2 ] :\u200a42\u200a  Fasciae are classified as  superficial ,  visceral  or  deep , and further designated according to their anatomical location. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1711", "text": "The knowledge of fascial structures is essential in  surgery , as they create borders for infectious processes (for example  Psoas abscess ) and haematoma. An increase in pressure may result in a  compartment syndrome , where a prompt  fasciotomy  may be necessary. For this reason, profound descriptions of fascial structures are available in anatomical literature from the 19th century."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1712", "text": "Fasciae were traditionally thought of as passive structures that transmit mechanical tension generated by muscular activities or external forces throughout the body. An important function of muscle fasciae is to reduce friction of muscular force. In doing so, fasciae provide a supportive and movable wrapping for nerves and blood vessels as they pass through and between muscles. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1713", "text": "In the tradition of medical dissections it has been common practice to carefully clean muscles and other organs from their surrounding fasciae in order to study their detailed topography and function. However, this practice tends to ignore that many muscle fibers insert into their fascial envelopes and that the function of many organs is significantly altered  when their related fasciae are removed. [ 5 ]  This insight contributed to several modern biomechanical concepts of the human body, in which fascial tissues take over important stabilizing and connecting functions, by distributing tensional forces across several joints in a network-like manner similar to the architectural concept of tensegrity. [ 6 ] \nStarting in 2018 this concept of the fascial tissue serving as a body-wide tensional support system has been successfully expressed as an educational model with the  Fascial Net Plastination Project ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1714", "text": "Fascial tissues \u2013 particularly those with tendinous or aponeurotic properties \u2013 are also able to store and release elastic potential energy."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1715", "text": "A  fascial compartment  is a section within the body that contains  muscles  and  nerves  and is surrounded by fascia. In the  human body , the  limbs  can each be divided into two segments: The  upper limb  can be divided into the  arm  and the  forearm  and the sectional compartments of both of these \u2013 the  fascial compartments of the arm  and the  fascial compartments of the forearm  contain an anterior and a posterior compartment. The lower limbs can be divided into two segments \u2013 the  leg  and the  thigh  \u2013 and these contain the  fascial compartments of the leg  and the  fascial compartments of the thigh ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1716", "text": "Fascia itself becomes clinically important when it loses stiffness, becomes too stiff, or has decreased shearing ability. [ 7 ]  When inflammatory  fasciitis  or trauma causes  fibrosis  and adhesions, fascial tissue fails to differentiate the adjacent structures effectively. This can happen after surgery, where the fascia has been incised and healing includes a  scar  that traverses the surrounding structures."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1717", "text": "The  Fascial Net Plastination Project  (FNPP) is an anatomical research initiative spearheaded by fascia researcher  Robert Schleip . The project aims to enhance the study of fascia through the technique of  plastination . Led by an international team of fascia experts and anatomists, the FNPP resulted in the creation of a full-body fascia plastinate known as  FR:EIA  (Fascia Revealed: Educating Interconnected Anatomy). [ 8 ]  This plastinate provides a detailed view of the human fascial network, allowing for a better understanding of its structure and function as an interconnected tissue throughout the body."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1718", "text": "FR:EIA was unveiled at the 2021  Fascia Research Congress  and is currently exhibited at the  Body Worlds  exhibition in Berlin. This project represents a significant contribution to the visualization of fascia and has the potential to influence future research in fields such as medicine, physical therapy, and movement science. [ 8 ] [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1719", "text": "There exists some controversy about what structures are considered \"fascia\" and how they should be classified. [ 10 ] [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1720", "text": "The current version of the International Federation of Associations of Anatomists divides into: [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1721", "text": "Two former, rather commonly used systems are:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1722", "text": "Superficial fascia is the lowermost layer of the  skin  in nearly all of the regions of the  body , that blends with the  reticular dermis  layer. [ 13 ]  It is present on the  face , over the upper portion of the  sternocleidomastoid , at the  nape  of the  neck  and overlying the  breastbone . [ 14 ]  It consists mainly of loose  areolar  and fatty  adipose   connective tissue  and is the layer that primarily determines the shape of a body. [ medical citation needed ]  In addition to its  subcutaneous  presence, superficial fascia surrounds  organs ,  glands  and  neurovascular bundles , and fills otherwise empty space at many other locations. It serves as a storage medium of  fat  and  water ; as a passageway for  lymph ,  nerve  and  blood vessels ; and as a protective padding to cushion and insulate. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1723", "text": "Superficial fascia is present, but does not contain fat, in the  eyelid ,  ear ,  scrotum ,  penis  and  clitoris . [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1724", "text": "Due to its  viscoelastic  properties, superficial fascia can stretch to accommodate the deposition of adipose that accompanies both ordinary and  prenatal  weight gain. After  pregnancy  and weight loss, the superficial fascia slowly reverts to its original level of tension."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1725", "text": "Visceral fascia (also called  subserous fascia ) suspends the organs within their cavities and wraps them in layers of connective tissue  membranes .  Each of the organs is covered in a double layer of fascia; these layers are separated by a thin  serous membrane ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1726", "text": "Visceral fascia is less extensible than superficial fascia.  Due to its suspensory role for the organs, it needs to maintain its tone rather consistently. If it is too lax, it contributes to organ  prolapse , yet if it is  hypertonic , it restricts proper organ  motility . [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1727", "text": "Deep fascia is a layer of  dense fibrous connective tissue  which surrounds individual  muscles  and divides groups of muscles into  fascial compartments .\nThis fascia has a high density of  elastin  fibre that determines its  extensibility  or resilience. [ 19 ]  Deep fascia was originally considered to be essentially avascular but later investigations have confirmed a rich presence of thin blood vessels. [ 20 ]  Deep fascia is also richly supplied with  sensory receptors . [ 21 ]  Examples of deep fascia are  fascia lata ,  fascia cruris ,  brachial fascia ,  plantar fascia ,  thoracolumbar fascia  and  Buck's fascia ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1728", "text": "Abdominal fascia  refers to the various types of  fascia  found in the  abdominal  region. Fascia is a sheet of  connective tissue  that is found beneath the skin that attaches, stabilizes, encloses, and separates muscles and other internal organs. Everyone has fascia, as it is part of how the human body is composed. Fascia is organized by layer, and can also be classified by location or function in the body. While abdominal fascia is quite a simple part of how the human body is made up, there are other implications and involvements that abdominal fascia is a part of."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1729", "text": "In a 2016 study, abdominal superficial fascia was collected from both male and female  cadavers . [ 1 ]  The elastic, collagen, and hydroxyproline components were sampled and then studied. It was found that the elastic, collagen, and hydroxyproline components were higher in upper abdomen regions compared to lower abdomen regions. [ 1 ]  This could be a reason as to why bulging of the abdomen and skin sagging occurs more in the lower regions of people, compared to the upper regions. This study that was conducted could lead to further discussions and studies in finding ways to manage obesity."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1730", "text": "In a study from January 2011, Mechanical properties of abdominal human fascia were studied according to the direction of loading and localization. [ 2 ]  Human umbilical (UF) and  transversalis fascia (FT) have been studied to understand the differences in mechanical properties of the human body. [ 2 ]  The differences between the mechanical properties of both UF and FT were not significant according to localization; therefore, the mechanical properties of human abdominal fascia are not controlled by the localization. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1731", "text": "Another study from 2018, showed differences in mechanical and structural properties of human fascia and their gender differences. [ 3 ]  While the study was done on fascia from the thighs, the results which were comparing the differences between males and females, can also be applied to understanding the abdominal area of males and females. [ 3 ]  Ultimately, it was found that the fascia lata at the lateral site was thicker and longitudinally directed fibers had higher rates of distribution compared to other sites.  [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1732", "text": "It can be involved in certain forms of  breast reconstruction . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1733", "text": "The  pectoral fascia  is very thin over the upper part of the  pectoralis major , but thicker in the interval between it and the  latissimus dorsi , where it closes in the axillary space and forms the  axillary fascia . Axillary fascia, together with the skin, forms the base of the axilla."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1734", "text": "This article incorporates text in the  public domain  from  page 436  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1735", "text": "The  axillary sheath  is a fibrous sheath that encloses the  axillary artery  and the three cords of the  brachial plexus  to form the  neurovascular bundle . [ 1 ] [ 2 ] [ 3 ]  It is surrounded by the  axillary fat . [ 1 ] [ 2 ]  It is an extension of the prevertebral fascia of the  deep cervical fascia [ citation needed ]  and is continuous with the  carotid sheath  at the  venous angle . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1736", "text": "A  brachial plexus nerve block  can be achieved by injecting anaesthetic into this area. [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1737", "text": "This article incorporates text in the  public domain  from  page 586  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1738", "text": "Buck's fascia  ( deep fascia of the penis , [ 1 ] [ 2 ]   Gallaudet's fascia [ 3 ]  or  fascia of the penis ) is a layer of  deep fascia  covering the three erectile bodies of the  penis . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1739", "text": "Buck's fascia is continuous with the  external spermatic fascia  in the  scrotum  and the  suspensory ligament of the penis ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1740", "text": "On its ventral aspect, it splits to envelop corpus spongiosum in a separate compartment from the tunica albuginea and corporal bodies. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1741", "text": "Sources differ on its proximal extent. Some state that it is a  continuation  of the  deep perineal fascia , [ 6 ]  whereas others state that it fuses with the  tunica albuginea . [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1742", "text": "The  deep dorsal vein of the penis , the cavernosal veins of the penis, and the para-arterial veins of the penis are inside Buck's fascia, but the  superficial dorsal veins of the penis  are in the superficial ( dartos ) fascia immediately under the skin."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1743", "text": "The name Buck's fascia is named after  Gurdon Buck , an American  plastic surgeon ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1744", "text": "The  cervical fascia  is fascia found in the region of the neck."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1745", "text": "It usually refers to the  deep cervical fascia . However, there is also a  superficial cervical fascia . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1746", "text": "The  clavipectoral fascia  (costocoracoid membrane; coracoclavicular fascia) is a strong  fascia  situated under cover of the  clavicular  portion of the  pectoralis major ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1747", "text": "It occupies the interval between the  pectoralis minor  and  subclavius , and protects the  axillary vein  and  artery , and  axillary nerve . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1748", "text": "Traced upward, it splits to enclose the subclavius, and its two layers are attached to the  clavicle , one in front of and the other behind the muscle; the deep layer fuses with the deep cervical fascia and with the sheath of the axillary vessels."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1749", "text": "Medially, it blends with the fascia covering the first two  intercostal spaces , and is attached also to the first rib medial to the origin of the subclavius."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1750", "text": "Laterally, it is very thick and dense, and is attached to the  coracoid process ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1751", "text": "The portion extending from the first rib to the coracoid process is often whiter and denser than the rest, and is sometimes called the costocoracoid membrane."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1752", "text": "Below this. it is thin, and at the upper border of the  pectoralis minor , it splits into two layers to invest the muscle; from the lower border of the pectoralis minor, it is continued downward to join the axillary fascia, and lateralward to join the fascia over the short head of the  biceps brachii ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1753", "text": "The clavipectoral fascia is pierced by the  cephalic vein ,  thoracoacromial artery  and vein, lymphatics and  lateral pectoral nerve ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1754", "text": "This article incorporates text in the  public domain  from  page 437  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1755", "text": "The  cribriform fascia  (also known as the  fascia cribrosa , or  Hesselbach's fascia ) is the portion of the superficial layer of the  deep fascia of leg  which extends between the  sartorius muscle ,  adductor longus muscle , and  inguinal ligament  to form the anterior portion of the  femoral canal . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1756", "text": "The cribriform fascia forms numerous openings to allow the passage of vessels and nerves, the most prominent of these being the  saphenous opening (saphenous hiatus)  (which gives passage to the  great saphenous vein ). [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1757", "text": "An inferior aponeurotic thickening of the cribriform fascia - the  falciform margin of sphenous opening  - forms the inferior margin of the sapnenous opening, embracing the arch of the great saphenous vein. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1758", "text": "The cribriform fascia has been proposed for use in preventing  new vascularization  when surgery is performed at the join between the  great saphenous vein  and the  femoral vein . [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1759", "text": "When the eponym is used, it is named for  Franz Kaspar Hesselbach . [ 4 ] [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1760", "text": "This article incorporates text in the  public domain  from  page 468  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1761", "text": "The  dartos fascia ,  dartos tunic  or simply  dartos  is a layer of  connective tissue  found in the  penile shaft ,  foreskin  and  scrotum . [ 1 ]  The penile portion is referred to as the  superficial fascia of penis  or the  subcutaneous tissue of penis , [ 2 ]  while the scrotal part is the dartos proper. In addition to being continuous with itself between the scrotum and the penis, it is also continuous with  Colles' fascia  of the perineum and  Scarpa's fascia  of the abdomen. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1762", "text": "The dartos lies just below the skin, which places it just superficial to the external spermatic fascia in the scrotum and to  Buck's fascia  in the penile shaft. In the scrotum, it consists mostly of  smooth muscle . [ 3 ]  The tone of this smooth muscle is responsible for the wrinkled (rugose) appearance of the scrotum. [ 1 ]  In females, the same muscle fibers are less well developed and termed  dartos muliebris , lying beneath the skin of the  labia majora . The dartos fascia receives innervation from  postganglionic sympathetic nerve fibers  arriving via the  ilioinguinal nerve  and the  posterior scrotal nerve ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1763", "text": "In the penis, the loose attachment of the dartos fascia to Buck's fascia is responsible for the high degree of mobility of the penile skin over the underlying tissue. [ 1 ]  It is also responsible for carrying the blood supply of the penile skin, a longitudinally-coursing anastomotic network of vessels that arise from the external pudendal vessels. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1764", "text": "In the scrotum, the dartos fascia acts to regulate the  temperature  of the  testicles , which promotes  spermatogenesis . It does this by expanding or contracting to wrinkle the scrotal skin."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1765", "text": "The dartos muscle works in conjunction with the  cremaster muscle  to elevate the  testis  but should not be confused with the  cremasteric reflex ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1766", "text": "The dartos fascia keeps the foreskin close to the glans penis throughout life. In infancy, the dartos fascia operates as a one-way check valve at the tip of the foreskin, allowing urine to pass out, but prohibiting the entry of foreign matter and pathogens."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1767", "text": "There is an increase in elastic fibers with increasing maturity that allows the foreskin to become retractable by adulthood and glide freely back and forth."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1768", "text": "Etymology:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1769", "text": "Some dartos-related terms:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1770", "text": "Deep fascia  (or  investing fascia ) is a  fascia , a layer of  dense connective tissue  that can surround individual  muscles  and groups of muscles to separate into  fascial compartments ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1771", "text": "This fibrous connective tissue interpenetrates and surrounds the muscles, bones, nerves, and blood vessels of the body. It provides connection and communication in the form of  aponeuroses ,  ligaments ,  tendons ,  retinacula ,  joint capsules , and  septa . The deep fasciae envelop all bone ( periosteum  and  endosteum );  cartilage  ( perichondrium ), and blood vessels ( tunica externa ) and become specialized in muscles ( epimysium ,  perimysium , and  endomysium ) and nerves ( epineurium ,  perineurium , and  endoneurium ). The high density of  collagen  fibers gives the deep fascia its strength and integrity.  The amount of  elastin  fiber determines how much  extensibility  and resilience it will have. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1772", "text": "Examples include:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1773", "text": "Deep fascia is less extensible than  superficial fascia .  It is essentially  avascular , [ 2 ]  but is richly  innervated  with  sensory receptors  that report the presence of pain ( nociceptors ); change in movement ( proprioceptors ); change in pressure and vibration ( mechanoreceptors ); change in the chemical milieu ( chemoreceptors ); and fluctuation in temperature ( thermoreceptors ). [ 3 ] [ 4 ]  Deep fascia is able to respond to sensory input by contracting; by relaxing; or by adding, reducing, or changing its composition through the process of fascial remodeling. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1774", "text": "Fascia may be able to contract due to the activity of  myofibroblasts  which may play a role in wound healing. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1775", "text": "The deep fascia can also relax. By monitoring changes in muscular tension, joint position, rate of movement, pressure, and vibration, mechanoreceptors in the deep fascia are capable of initiating relaxation.  Deep fascia can relax rapidly in response to sudden muscular overload or rapid movements.  Golgi tendon organs  operate as a feedback mechanism by causing myofascial relaxation before muscle force becomes so great that tendons might be torn.   Pacinian corpuscles  sense changes in pressure and vibration to monitor the rate of  acceleration  of movement. They will initiate a sudden relaxatory response if movement happens too fast. [ 7 ]   Deep fascia can also relax slowly as some mechanoreceptors respond to changes over longer timescales.  Unlike the Golgi tendon organs, Golgi receptors report joint position independent of muscle contraction. This helps the body to know where the bones are at any given moment.   Ruffini endings  respond to regular stretching and to slow sustained pressure.  In addition to initiating fascial relaxation, they contribute to full-body relaxation by inhibiting sympathetic activity which slows down heart rate and respiration. [ 3 ] [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1776", "text": "When contraction persists, fascia will respond with the addition of new material. Fibroblasts secrete collagen and other proteins into the  extracellular matrix  where they bind to existing proteins, making the composition thicker and less extensible. Although this potentiates the  tensile strength  of the fascia, it can unfortunately restrict the very structures it aims to protect.  The pathologies resulting from fascial restrictions range from a mild decrease in joint  range of motion  to severe fascial binding of muscles, nerves and blood vessels, as in  compartment syndrome  of the leg.  However, if fascial contraction can be interrupted long enough, a reverse form of fascial remodeling occurs. The fascia will normalize its composition and tone and the extra material that was generated by prolonged contraction will be ingested by macrophages within the extracellular matrix. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1777", "text": "Like mechanoreceptors, chemoreceptors in deep fascia also have the ability to promote fascial relaxation.  We tend to think of relaxation as a good thing, however fascia needs to maintain some degree of tension.  This is especially true of ligaments.  To maintain joint integrity, they need to provide adequate tension between bony surfaces.  If a ligament is too lax, injury becomes more likely.  Certain chemicals, including  hormones , can influence the composition of the ligaments.  An example of this is seen in the  menstrual cycle , where hormones are secreted to create changes in the  uterine  and  pelvic floor  fascia.  The hormones are not site-specific, however, and chemoreceptors in other ligaments of the body can be receptive to them as well.  The ligaments of the knee may be one of the areas where this happens, as a significant association between the  ovulatory  phase of the menstrual cycle and an increased likelihood for an  anterior cruciate ligament  injury has been demonstrated. [ 10 ] [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1778", "text": "The continuity of the deep fasciae within the human body inspired the artistic expression seen in the  Fascial Net Plastination Project , which is prominently displayed at the  Body Worlds  exhibition in Berlin. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1779", "text": "The  deep fascia of leg  or  crural fascia  forms a complete investment to the  muscles , and is fused with the  periosteum  over the subcutaneous surfaces of the  bones ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1780", "text": "The  deep fascia  of the leg is continuous above with the  fascia lata  (deep fascia of the thigh), and is attached around the knee to the  patella , the  patellar ligament , the tuberosity and condyles of the  tibia , and the head of the fibula."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1781", "text": "Behind, it forms the popliteal fascia, covering in the  popliteal fossa ; here it is strengthened by transverse fibers, and perforated by the  small saphenous vein ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1782", "text": "It receives an expansion from the tendon of the  biceps femoris  laterally, and from the tendons of the  sartorius ,  gracilis ,  semitendinosus , and  semimembranosus  medially; in front, it blends with the periosteum covering the subcutaneous surface of the tibia, and with that covering the head and malleolus of the fibula; below, it is continuous with the transverse crural and laciniate ligaments."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1783", "text": "It is thick and dense in the upper and anterior part of the leg, and gives attachment, by its deep surface, to the  tibialis anterior  and  extensor digitorum longus ; but thinner behind, where it covers the  gastrocnemius  and  soleus ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1784", "text": "It gives off from its deep surface, on the lateral side of the leg, two strong intermuscular septa, the anterior and posterior peroneal septa, which enclose the  fibularis (peroneus) longus  and  brevis  muscles and separate them from the muscles of the anterior and posterior crural regions, and several more slender processes which enclose the individual muscles in each region."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1785", "text": "A broad transverse intermuscular septum, called the deep transverse fascia of the leg, intervenes between the superficial and deep posterior crural muscles."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1786", "text": "This article incorporates text in the  public domain  from  page 480  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1787", "text": "The  deep transverse fascia  or  transverse intermuscular septum of leg [ 1 ]  is a transversely placed, intermuscular septum, from the  deep fascia ,  between the superficial and deep muscles of the back of the leg."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1788", "text": "At the sides it is connected to the margins of the  tibia  and  fibula ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1789", "text": "Above, where it covers the  popliteus , it is thick and dense, and receives an expansion from the tendon of the  semimembranosus . It is thinner in the middle of the leg; but below, where it covers the tendons passing behind the  malleoli , it is thickened and continuous with the  laciniate ligament ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1790", "text": "This article incorporates text in the  public domain  from  page 483  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1791", "text": "The  endothoracic fascia  is the layer of loose  connective tissue  deep to the  intercostal spaces  and  ribs , separating these structures from the underlying  pleura . This fascial layer is the outermost membrane of the  thoracic cavity .  The endothoracic fascia contains variable amounts of  fat .\nIt becomes more fibrous over the  apices  of the  lungs  as the  suprapleural membrane . It separates the  internal thoracic artery  from the parietal pleura."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1792", "text": "The  external spermatic fascia  ( intercrural  or  intercolumnar fascia ) is a thin membrane, prolonged downward around the surface of the  spermatic cord  and  testis . It is separated from the  dartos tunic  by  loose areolar tissue . It is occasionally referred to as 'Le Fascia de Webster' after an anatomist who once described it."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1793", "text": "The external spermatic fascia is derived from the  aponeurosis  of the  abdominal external oblique muscle . [ 1 ] [ 2 ]  It is acquired by the  spermatic cord  at the  superficial inguinal ring . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1794", "text": "This article incorporates text in the  public domain  from  page 1238  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1795", "text": "The  fascia lata  is the  deep fascia  of the  thigh . It encloses the thigh muscles and forms the outer limit of the  fascial compartments of thigh , which are internally separated by the  medial intermuscular septum  and the  lateral intermuscular septum . The fascia lata is thickened at its  lateral  side where it forms the  iliotibial tract , a structure that runs to the  tibia  and serves as a site of muscle attachment. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1796", "text": "The fascia lata is an investment for the whole of the thigh, but varies in thickness in different parts. It is thicker in the upper and lateral part of the thigh, where it receives a fibrous expansion from the  gluteus maximus , and where the  tensor fasciae latae  is inserted between its layers; it is very thin behind and at the upper and medial part, where it covers the  adductor muscles , and again becomes stronger around the knee, receiving fibrous expansions from the tendon of the  biceps femoris  laterally, from the  sartorius  medially, and from the  quadriceps femoris  in front."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1797", "text": "The fascia lata surrounds the tensor fasciae latae muscle. It is a fibrous sheath that encircles the thigh subcutaneously. This encircling of the muscle allows the muscles to be bound together tightly. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1798", "text": "The fascia lata is attached, above and behind (i.e. proximal and posterior), to the back of the  sacrum  and  coccyx ; laterally, to the  iliac crest ; in front, to the  inguinal ligament , and to the  superior ramus  of the  pubis ; and medially, to the  inferior ramus  of the pubis, to the inferior ramus and tuberosity of the  ischium , and to the lower border of the  sacrotuberous ligament ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1799", "text": "From its attachment to the iliac crest it passes down over the  gluteus medius  to the upper border of the  gluteus maximus , where it splits into two layers, one passing superficial to and the other beneath this muscle; at the lower border of the muscle the two layers reunite."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1800", "text": "Laterally, the fascia lata receives the greater part of the tendon of insertion of the gluteus maximus, and becomes proportionately thickened."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1801", "text": "The portion of the fascia lata attached to the front part of the iliac crest, and corresponding to the origin of the tensor fasciae latae, extends down the lateral side of the thigh as two layers, one superficial to and the other beneath this muscle; at the lower end of the muscle these two layers unite and form a strong band, having first received the insertion of the muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1802", "text": "This band is continued downward under the name of the  iliotibial band  and is attached to the lateral condyle of the  tibia ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1803", "text": "The part of the iliotibial band which lies beneath the  tensor fasciae latae  is prolonged upward to join the lateral part of the capsule of the  hip joint ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1804", "text": "Below, the fascia lata is attached to all the prominent points around the  knee joint , viz., the  condyles  of the femur and tibia, and the  head of the fibula ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1805", "text": "On either side of the  kneecap  it is strengthened by transverse fibers from the lower parts of the vasti muscles (three of the four  quadriceps ) which are attached to and support this bone."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1806", "text": "Of these the lateral are the stronger, and are continuous with the iliotibial band."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1807", "text": "The deep surface of the fascia lata gives off two strong intermuscular septa, which are attached to the whole length of the  linea aspera  and its prolongations above and below; the  lateral intermuscular septum , the stronger of the two, extends from the insertion of the  gluteus maximus  to the  lateral condyle , separates the  vastus lateralis  in front from the short head of the  biceps femoris  behind, and gives partial origin to these muscles; the  medial intermuscular septum  is the thinner one and separates the  vastus medialis  from the  adductor muscles ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1808", "text": "Besides these there are numerous smaller septa, separating the individual muscles, and enclosing each in a distinct sheath."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1809", "text": "The  deep fascia of the lower leg  is a continuation of the fascia lata. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1810", "text": "Since the 1920s fasciae latae from deceased donors have been used in reconstructive surgery. In 1999 preserved mashed fasciae latae became FDA-approved as  a tissue product designed to replace areas of lost fascia or collagen. [ 3 ] \nThe fascia lata normally performs the function of encircling and tightening the muscles in the thigh. Because of this function, it has been used as grafts for patients with facial paralysis. The fascia lata offers supports to the muscles that make up the face and this support increases the recovery of the facial muscles. The surgeons use the fascia lata as a sort of facial sling to support up the paralyzed face and loops the fascia lata around the center of the lower lip, the corner of the mouth and the center of the upper lip.\n [ 4 ] \nA small portion of fascia lata harvested through a sub centimeter skin incision on the lower lateral side of the thigh is used for reconstructing the ear drum in tympanoplasty surgery.\nA larger portion is used in nasal endoscopic skull base surgery."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1811", "text": "It is named from its great extent. \"Latus\" give the superlative \"Latissimus\" meaning broadest or widest. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1812", "text": "The  fascia of Camper  is a thick superficial  layer of the anterior abdominal wall . [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1813", "text": "It is  areolar  in texture, and contains in its meshes a varying quantity of  adipose tissue . It is found  superficial  to the  fascia of Scarpa ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1814", "text": "Superficial fascia is composed of two layers: the fatty outer layer, known as Camper's fascia, and the more membranous inner layer, called Scarpa's fascia. These parts of the superficial fascia are most prominent in the lower aspect of the abdominal wall below the level of the umbilicus. Camper's fascia is continuous inferiorly with the superficial fascia of the thigh. Medial and inferior to the pubic tubercle, in the male, Scarpa's fascia changes as it continues over the scrotum and forms  dartos tunic . This layer is highly infiltrated by elastic and smooth muscle fibers and contains a minimal amount of fat. Scarpa's fascia ends inferior to the inguinal ligament fusing with the fascia lata of the thigh. In the midline, just superior to the penis, Scarpa's fascia contributes to formation of the  fundiform ligament  of the penis. As Scarpa's fascia continues posteriorly onto the perineum, it is called  Colles' fascia . [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1815", "text": "The structure was named after Dutch physician and anatomist Petrus Camper. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1816", "text": "This article incorporates text in the  public domain  from  page 408  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1817", "text": "The  fascia of perineum  ( deep perineal fascia ,  superficial investing fascia of perineum  or  Gallaudet fascia ) is the  fascia  which covers the muscles of the  superficial perineal pouch .  The muscles surrounded by the deep perineal fascia are the  bulbospongiosus ,  ischiocavernosus , and  superficial transverse perineal .\nThe fascia is attached laterally to the  ischiopubic rami  and fused anteriorly with the  suspensory ligament of the penis  or  clitoris .  It is continuous anteriorly with the  deep investing fascia  of the abdominal wall muscles, and in males, it is continuous with  Buck's fascia ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1818", "text": "The  fascia of Scarpa  is the deep  membranous layer   (stratum membranosum)  of the  superficial fascia  of the abdomen. It is a  layer of the anterior abdominal wall . It is found  deep  to the  fascia of Camper  and  superficial  to the  external oblique muscle ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1819", "text": "It is thinner and more membranous in character than the superficial  fascia of Camper , and contains a considerable quantity of orange elastic fibers."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1820", "text": "It is loosely connected by areolar tissue to the aponeurosis of the  external oblique muscle , but in the midline it is more intimately adherent to the  linea alba  and the  pubic symphysis , and in the male, it is prolonged on to the dorsum of the  penis , forming the  fundiform ligament ; above, it is continuous with the  superficial fascia  over the rest of the  trunk ; inferiorly, it is continuous with the  fascia of Colles  of the  perineum ; however, it does not extend into the thigh as it just attaches to its fascia, which is known as  fascia lata ; medially and below, it is continued over the penis and  spermatic cord  to the  scrotum , where it helps to form the  dartos ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1821", "text": "From the scrotum, it may be traced backward into continuity with the deep layer of the superficial  fascia of the perineum  (superficial perineal fascia or fascia of Colles)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1822", "text": "In the female, it is continued into the  labia majora  and from there to the fascia of Colles. The Scarpa's fascia also thickens into a collagenous structure called the fundiform ligament of the  clitoris . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1823", "text": "It is named for Italian anatomist  Antonio Scarpa . [ 2 ]  His description of the membranous superficial fascia is vague in his 1809 hernia monograph. [ 3 ]  Life-size illustrations included by Scarpa do not identify the layer even though some show all the other anatomical layers of the abdominal wall in the inguinal region. A probable description of the fascia is in the text which discusses femoral (called crural) hernia in the male. Scarpa describes that \"below the skin\" we find \"a layer of condensed substance forming the second covering of the hernia\" which adheres to \"the aponeurosis of the fascia lata\". A little later he describes this layer as being membranous and he believes it has a role in containing this particular herniation. In 1810,  Abraham Colles  described detailed methods of dissection to expose membranous superficial fascia in the lower abdomen and the inguino-perineal region including the penis and scrotum.  Colles clearly associated the subcutaneous limitation of urine extravasation from a ruptured urethra with the attachments of the membranous superficial fascia to deeper structures. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1824", "text": "Scarpa's belief that the fascia stops hernias from forming is not thought to be true today. Some anatomists suggest the membranous superficial fascia is the scaffold which attaches the skin to the deeper structures so that the skin does not sag with gravity but still stretches as the body flexes or changes shape with exercise. [ 4 ]  The attachment of the fascia to deeper layers confines fluid which may have come from inside the body in certain diseases giving rise to  clinical signs  such as urethral disruption noticed by  Colles  and bruising in  Cullen's sign  or  Grey Turner's sign . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1825", "text": "Fascia training  describes sports activities and movement exercises that attempt to improve the functional properties of the muscular  connective tissues  in the human body, such as  tendons ,  ligaments ,  joint capsules  and muscular envelopes. Also called  fascia , these tissues take part in a body-wide tensional force transmission network and are responsive to training stimulation. [ 1 ]  As of 2018 the body-wide continuity of this tensional system has been expressed in an educational manner within the  Fascial Net Plastination Project . The FNPP brought together experts in  anatomy ,  dissection , and  plastination , and it was the first project of its kind to plastinate a complete human fascia specimen. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1826", "text": "Whenever  muscles  and joints are moved this also exerts mechanical strain on related  fascia . The general assumption in sports science had therefore been that muscle strength exercises as well as cardiovascular training would be sufficient for an optimal training of the associate  fibrous connective tissues . However, recent [ when? ]   ultrasound -based research revealed that the mechanical threshold for a training effect on tendinous  tissues  tends to be significantly higher than for muscle fibers. This insight happened roughly during the same time in which the field of fascia research attracted major attention by showing that fascial tissues are much more than passive transmitters of muscular tension (years 2007 \u2013 2010). Both influences together triggered an increasing attention in sports science towards the question whether and how fascial tissues can be specifically stimulated with active exercises. Researchers who contributed to the initial scientific investigation of this direction include  Robert Schleip ,  Jan Wilke ,  Michael Kjaer  and  Adamantios Arampatzis . [ 3 ] [ 4 ] [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1827", "text": "Fascia training follows the following principles: [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1828", "text": "While good to moderate scientific evidence exists for several of the included training principles \u2013 e.g. the inclusion of  elastic recoil  as well as a training of proprioceptive refinement \u2013 there is currently insufficient evidence for the claimed beneficial effects of a fascia oriented exercises program as such, consisting of a combination of the above described four training elements. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1829", "text": "Self- myofascial release  using a foam roller or roller massager pre- and post-exercise has been observed to decrease soreness due to  DOMS . Self-myofascial release appears to have no negative effect on performance.  [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1830", "text": "A  fascial compartment [ 1 ]  is a section within the body that contains  muscles  and  nerves  and is surrounded by  deep fascia . In the  human body , the  limbs  can each be divided into two segments \u2013 the  upper limb  can be divided into the  arm  and the  forearm  and the sectional compartments of both of these \u2013 the  fascial compartments of the arm  and the  fascial compartments of the forearm  contain an anterior and a posterior compartment. Likewise, the lower limbs can be divided into two segments \u2013 the  leg  and the  thigh  \u2013 and these contain the  fascial compartments of the leg  and the  fascial compartments of the thigh . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1831", "text": "If these segments are cut transversely, it is apparent that they are divided into multiple sections. These are called fascial compartments, and are formed by tough connective tissue  septa ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1832", "text": "These compartments usually have a  nerve  and  blood  supply separate from their neighbours. The muscles in each compartment will often all be supplied by the same nerve."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1833", "text": "Sometimes the segment is also covered by bone profoundly (as e.g. the  brachial fascia ). It is distinguished from  pharmacokinetic compartment , which is a defined volume of  body fluids ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1834", "text": "Compartment syndrome is an acute medical problem following injury or surgery in which increased pressure (usually caused by inflammation) occurs within a compartment."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1835", "text": "The  iliac fascia  (or  Abernethy's fascia [ citation needed ] ) is the  fascia  overlying the  iliacus muscle . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1836", "text": "Superiorly and laterally, the iliac fascia is attached to the inner aspect of the  iliac crest ; inferiorly and laterally, it extends into the thigh to unite with the  femoral sheath ; medially, it attaches to the periosteum of the ilium and  iliopubic eminence  near the  linea terminalis , and blends with the  psoas fascia  and - over the  quadratus lumborum muscle  - with the anterior layer of  thoracolumbar fascia . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1837", "text": "The iliac fascia overlies the femoral nerve, and  lateral femoral cutaneous nerve . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1838", "text": "It has the following connections:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1839", "text": "At the  iliopectineal eminence  it receives the tendon of insertion of the  psoas minor , when that muscle exists."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1840", "text": "Lateral to the  femoral vessels  it is intimately connected to the posterior margin of the  inguinal ligament , and is continuous with the  transversalis fascia ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1841", "text": "Immediately lateral to the femoral vessels the iliac fascia is prolonged backward and medialward from the inguinal ligament as a band, the  iliopectineal fascia , which is attached to the iliopectineal eminence."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1842", "text": "This fascia divides the space between the inguinal ligament and the hip bone into two lacun\u00e6 or compartments:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1843", "text": "Medial to the vessels the iliac fascia is attached to the  pectineal line  behind the  conjoint tendon , where it is again continuous with the transversalis fascia."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1844", "text": "This article incorporates text in the  public domain  from  page 466  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1845", "text": "The  iliopectineal arch  is a thickened band of fused  iliac fascia  and  psoas fascia [ 1 ]  passing from the posterior aspect of the  inguinal ligament  anteriorly across the front of the  femoral nerve  to attach to the  iliopubic eminence  of the hip bone posteriorly. The iliopectineal arch thus forms a septum which subdivides the space deep to the inguinal ligament into a lateral  muscular lacuna  and a medial  vascular lacuna . When a  psoas minor muscle  is present, its tendon of insertion blends with the iliopectineal arch"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1846", "text": "It is sometimes transected in treatment of  femoral nerve  entrapment. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1847", "text": "The  infraspinatous fascia  is a dense fibrous membrane, covering the  infraspinatous muscle  and fixed to the circumference of the  infraspinatous fossa ; it affords attachment, by its deep surface, to some fibers of that muscle. It is intimately attached to the  deltoid fascia  along the over-lapping border of the  deltoideus ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1848", "text": "This article incorporates text in the  public domain  from  page 441  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1849", "text": "The  lumbar fascia  is the lumbar portion of the  thoracolumbar fascia . It consists of three fascial layers - posterior, middle, and anterior - that enclose two (anterior and posterior) muscular compartments. The anterior and middle layers occur only in the lumbar region, whereas the posterior layer (as part of the thoracolumbar fascia) extends superiorly to the inferior part of the neck, and the inferiorly to the dorsal surface of the sacrum. The  quadratus lumborum  is contained in the anterior muscular compartment (between anterior and middle layers), and the  erector spinae  in the posterior compartment (between middle and posterior layers). [ 1 ] :\u200a274\u200a   Psoas major  lies anterior to the anterior layer. Various superficial muscles of the posterior thorax and abdomen arise from the posterior layer - namely the  latissimus dorsi , and  serratus posterior inferior . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1850", "text": "The posterior layer and middle layer unite at the lateral margin of erector spinae, forming a though raphe; all three layers then unite at the lateral margin of quadratus lumborum, thus forming the aponeurotic origin of the transversus abdominis muscle. [ 2 ] :\u200a814\u2013815"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1851", "text": "The posterior layer is thick, being reinforced by the aponeurosis (origin) of the  latissimus dorsi muscle . [ 1 ] :\u200a274\u200a  It consists of a superficial lamina derived primarily from the latissimus dorsi and serratus posterior inferior, and a deeper lamina which forms a retinacular sheet encapsulating the paraspinal muscles. [ 3 ]  The posterior layer is attached to the spinous processes of lumbar and sacral vertebrae, and to the  supraspinous ligament . [ 2 ] :\u200a814\u2013815"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1852", "text": "At sacral levels, the posterior layer attaches to the posterior superior iliac spines, and posterior iliac crest, fuses with the underlying erector spinae muscle aponeurosis, [ 2 ] :\u200a814\u2013815\u200a  and extends along the transverse tubercles of the sacrum. [ 1 ] :\u200a274"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1853", "text": "In the thoracic region, the posterior layer (i.e. thoracic part of thoracolumbar fascia) attaches to the supraspinous ligament and spinous processes of all thoracic vertebrae, and to the costal angles of all ribs. It extends as far superiorly as the inferior part of the neck. [ 1 ] :\u200a274"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1854", "text": "The middle layer is attached superiorly to the inferior margin of the 12th rib, and the  lumbocostal ligament , medially to the tips of transverse processes of lumbar vertebrae, and inferiorly to [ 2 ] :\u200a814\u2013815\u200a  the posterior part of the intermediate area of [ 4 ]  the iliac crest. [ 2 ] :\u200a814\u2013815"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1855", "text": "The anterior layer is the thinnest of the three layers. [ citation needed ]  The anterior layer forms the  lateral arcuate ligament  superiorly, is attached medially to anterior surfaces of transverse processes of lumbar vertebra, and is attached inferiorly to the  iliolumbar ligament  and adjoining  iliac crest . [ 2 ] :\u200a814\u2013815"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1856", "text": "The  ascending colon [ 1 ] :\u200a257\u200a  and  descending colon [ 1 ] :\u200a258\u200a  lie upon the lumbar fascia."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1857", "text": "The lumbar fascia gives origin to the  latissimus dorsi muscle  (which arises from posterior layer of lumbar fascia), [ 1 ] :\u200a40\u200a   abdominal internal oblique muscle  (which arises along the entire length of the lumbar fascia),  transversus abdominis muscle , [ 1 ] :\u200a222\u200a  and  gluteus maximus muscle . [ 1 ] :\u200a125"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1858", "text": "The psoas fascia (a part of the  iliac fascia ) laterally blends with the lumbar fascia. [ 1 ] :\u200a272\u200a  The  lateral arcuate ligament  arises as a thickening of the lumbar fascia. [ 1 ] :\u200a185\u200a  The superior band of the  iliolumbar ligament  is continuous with the anterior layer of lumbar fascia. [ 1 ] :\u200a325\u200a  The inferior portion of the  supraspinous ligament  becomes indistinct amid the lumbar fascia. [ 1 ] :\u200a424"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1859", "text": "Each  subcostal artery  passes across the anterior surface of the lumbar fascia before reaching the anterior abdominal wall. [ 1 ] :\u200a276\u200a  Each  subcostal nerve  passes across the anterior aspect of the anterior layer of lumbar fascia. [ 1 ] :\u200a278\u200a  The  ilioinguinal nerve  pierces the anterior layer of lumbar fascia posterior to the kidney to come to pass inferoanteriorly anterior to the anterior layer of lumbar fascia. [ 1 ] :\u200a279"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1860", "text": "The lumbar fascia binds the deep muscles of the back to the spine and to the transverse processes of the vertebrae. Additionally the lumbar fascia is an attachment for the  gluteus maximus muscle  and the  latissimus dorsi muscle . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1861", "text": "The  nuchal fascia  is a  fascia  covering the autochthonous musculature of the neck as a part of the  cervical fascia . It proceeds the  thoracolumbar fascia  to the top (cranial). The fascia itself is made of two parts: A superficial layer ( lat. :  Fascia nuchae superficialis)  and a deeper layer that is located among the  Trapezius muscle  and that sheaths the deeper cervical musculature from dorsal side. Expanding laterally, the fascia also covers the dorsal musculature. [ 1 ]   In the middle of the deeper layer a bulge is resided \u2013 the  nuchal ligament ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1862", "text": "The  obturator fascia , or  fascia of the  internal obturator muscle ,  covers the pelvic surface of that muscle and is attached around the margin of its origin."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1863", "text": "Above, it is loosely connected to the back part of the  arcuate line , and here it is continuous with the  iliac fascia ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1864", "text": "In front of this, as it follows the line of origin of the  internal obturator , it gradually separates from the iliac fascia and the continuity between the two is retained only through the  periosteum ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1865", "text": "It arches beneath the obturator vessels and nerve, completing the  obturator canal , and at the front of the pelvis is attached to the back of the  superior ramus  of the  pubis ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1866", "text": "Below, the obturator fascia is attached to the  falciform process  of the  sacrotuberous ligament  and to the  pubic arch , where it becomes continuous with the superior fascia of the  urogenital diaphragm ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1867", "text": "Behind, it is prolonged into the  gluteal  region."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1868", "text": "The internal pudendal vessels and  pudendal nerve  cross the pelvic surface of the  internal obturator and are enclosed in a special canal\u2014 Alcock's canal \u2014formed by the obturator fascia."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1869", "text": "The  iliococcygeus  portion of the  levator ani  attaches to the lateral walls of the pelvis via the obturator fascia through the tendinous arch of the obturator fascia."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1870", "text": "This article incorporates text in the  public domain  from  page 420  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1871", "text": "In  anatomy , the  orbital septum  ( palpebral fascia ) is a  membranous  sheet that acts as the anterior (frontal) boundary of the  orbit . It extends from the orbital rims to the  eyelids . It forms the fibrous portion of the eyelids. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1872", "text": "In the upper eyelid, the orbital septum blends with the tendon of the  levator palpebrae superioris , and in the lower eyelid with the  tarsal plate . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1873", "text": "When the eyes are closed, the whole orbital opening is covered by the septum and tarsi.  Medially it is thin, and, becoming separated from the  medial palpebral ligament , attaches to the lacrimal bone at its  posterior crest .  The medial ligament and its much weaker lateral counterpart, attached to the septum and orbit, keep the lids stable as the eye moves. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1874", "text": "The septum is perforated by the vessels and nerves which pass from the orbital cavity to the  face  and  scalp ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1875", "text": "Orbital septum supports the orbital contents located posterior to it, especially orbital fat. The septum can be weakened by trauma or due to hereditary diseases. Anatomical structures important in the  blepharoplasty  operation (operation to strengthen the orbital septum) are located posterior to the orbital septum. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1876", "text": "The orbital septum is an important structure that separates anterior and posterior extent of the orbit. Orbital septum acts as a physical barrier that prevents the infection of the anterior part of the eye spreading posteriorly. For example,  preseptal cellulitis  mainly infects the eyelids, anterior to the orbital septum. Meanwhile,  orbital cellulitis  is located posterior the orbital septum, due to infections spreading from the  ethmoidal sinuses . The porous  lamina papyracea  separating the orbit from the ethmoidal sinus causes infection to spread between the orbit and ethmoidal sinuses. Infection of the ethmoidal sinuses can spread to the brain, causing  meningitis  and  cerebral abscess . Orbital cellulitis can also spread to the anterior orbit, by lifting the loosely attached  periosteum , causing subperiosteal abscess. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1877", "text": "Orbital septum appears as hypointense on both MRI T1 and T2 weighted images, in contrast with surrounding hyperintense fat. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1878", "text": "This article incorporates text in the  public domain  from  page 1026  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1879", "text": "The  pectoral fascia  is a thin lamina, covering the surface of the  pectoralis major , and sending numerous prolongations between its  fasciculi : it is attached, in the middle line, to the front of the  sternum ; above, to the  clavicle ; laterally and below it is continuous with the fascia of the  shoulder ,  axilla , and  thorax ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1880", "text": "It is very thin over the upper part of the pectoralis major, but thicker in the interval between it and the  latissimus dorsi , where it closes in the  axillary space  and forms the  axillary fascia ; it divides at the lateral margin of the latissimus dorsi into two layers, one of which passes in front of, and the other behind it; these proceed as far as the spinous processes of the thoracic vertebrae, to which they are attached."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1881", "text": "As the fascia leaves the lower edge of the pectoralis major to cross the floor of the axilla it sends a layer upward under cover of the muscle; this lamina splits to envelop the  pectoralis minor , at the upper edge of which it is continuous with the coracoclavicular fascia. The hollow of the armpit, seen when the arm is abducted, is produced mainly by the traction of this fascia on the axillary floor, and hence the lamina is sometimes named the  suspensory ligament of the axilla ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1882", "text": "At the lower part of the thoracic region the deep fascia is well-developed, and is continuous with the fibrous sheaths of the  rectus abdominis ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1883", "text": "This article incorporates text in the  public domain  from  page 435  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1884", "text": "The  pelvic fasciae  are the  fascia  of the  pelvis  and can be divided into:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1885", "text": "Pelvic fascia extends to cover the organs within the pelvis."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1886", "text": "It is attached to the fascia that runs along the pelvic floor along the  tendinous arch . The fascia which covers pelvic organs  can be divided according to the organs that are covered:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1887", "text": "The part of the pelvic fascia on the pelvic floor covers both surfaces of the  levatores ani  muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1888", "text": "The layer covering the upper surface of the  pelvic diaphragm  follows, above, the line of origin of the Levator ani and is therefore somewhat variable. In front it is attached to the back of the  pubic symphysis  about 2\u00a0cm above its lower border."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1889", "text": "It can then be traced laterally across the back of the  superior ramus of the pubis  for a distance of about 1.25\u00a0cm, when it reaches the  obturator fascia ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1890", "text": "It is attached to this fascia along a line which pursues a somewhat irregular course to the  spine of the ischium ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1891", "text": "The irregularity of this line is because the origin of the Levator ani, which in lower forms is from the  pelvic brim , is in man lower down, on the obturator fascia."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1892", "text": "The diaphragmatic part of the pelvic fascia covers both surfaces of the  levatores ani . The inferior layer is known as the  anal fascia . It is attached above to the  obturator fascia  along the line of origin of the Levator ani, while below it is continuous with the superior fascia of the  urogenital diaphragm , and with the fascia on the  sphincter ani internus ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1893", "text": "The  fascia of the piriformis  is very thin and is attached to the front of the  sacrum  and the sides of the  greater sciatic foramen ; it is prolonged on the muscle into the gluteal region."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1894", "text": "At its sacral attachment around the margins of the  anterior sacral foramina  it comes into contact with and ensheathes the nerves emerging from these foramina."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1895", "text": "Hence, the  sacral nerves  are frequently described as lying behind the fascia."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1896", "text": "The  internal iliac artery ,  internal iliac vein , and their branches, on the other hand, lie in the subperitoneal tissue in front of the fascia, and the branches to the gluteal region emerge in special sheaths of this tissue, above and below the  piriformis muscle ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1897", "text": "The  plantar fascia  or  plantar aponeurosis [ 1 ]  is the thick  connective tissue   aponeurosis  which supports the  arch  on the bottom ( plantar  side) of the  foot . Recent studies suggest that the plantar fascia is actually an  aponeurosis  rather than true fascia. [ citation needed ]  It runs from the  tuberosity  of the  calcaneus  (heel bone) forward to the heads of the  metatarsal bones  (the bone between each  toe  and the bones of the mid-foot)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1898", "text": "The plantar fascia is the thick central portion of the fascia investing the plantar muscles. It extends between the medial process of the tuber calcanei [ 1 ]  and the proximal  phalanges  of [ citation needed ]  the toes. It provides some attachment to the flexor muscles of the toes. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1899", "text": "Distally, the plantar fascia becomes continuous with the fibrous sheaths enveloping the flexor tendons passing to the toes. At the anterior extremity of the sole - inferior to the heads of the metatarsal bones - the plantar aponeurosis forms the  superficial transverse metatarsal ligament . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1900", "text": "The plantar fascia is made up of predominantly longitudinally oriented  collagen  fibers. There are three distinct structural components: the  medial component , the  central component  ( plantar aponeurosis ), and the  lateral component  (see diagram at right). The central component is the largest and most prominent."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1901", "text": "In younger people the plantar fascia is also intimately related to the  Achilles tendon , with a continuous fascial connection between the two from the distal aspect of the Achilles to the origin of the plantar fascia at the calcaneal tubercle. However, the continuity of this connection decreases with age to a point that in the elderly there are few, if any, connecting fibers. There are also distinct attachments of the plantar fascia and the Achilles tendon to the calcaneus so the two do not directly contact each other. Nevertheless, there is an indirect relationship whereby if the toes are  dorsiflexed , the plantar fascia tightens via the  windlass  mechanism. If a tensile force is then generated in the Achilles tendon it will increase tensile strain in the plantar fascia. Clinically, this relationship has been used as a basis for treatment for plantar fasciitis, with stretches and night stretch splinting being applied to the  gastrocnemius / soleus muscle  unit."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1902", "text": "The plantar fascia contributes to support of  arch of the foot by acting as a tie-rod, where it undergoes tension when the foot bears weight. One  biomechanical  model estimated it carries as much as 14% of the total load of the foot. In an experiment using  cadavers , it was found that failure of the plantar fascia averaged at loads of 1189\u00a0\u00b1\u00a0244  newtons [ 3 ]  (121\u00a0\u00b1\u00a024  kgf  or 267\u00a0\u00b1\u00a055  lbf ). Failure most often occurred at the proximal attachment to the calcaneus, which is consistent with the usual location of  symptoms  (i.e. in plantar fasciitis). Complete  rupture  or surgical release of the plantar fascia leads to a decrease in arch stiffness and a significant collapse of the  longitudinal arch of the foot . By modeling it was predicted such conditions would result in a 17% increase in vertical displacement and a 15% increase in horizontal elongation of the foot when it was loaded at 683 newtons (154\u00a0lbf). [ 4 ]  Surgical release also significantly increases both stress in the plantar  ligaments  and plantar pressures under the metatarsal heads. Although most of the figures mentioned above are from either  cadaver  studies or investigations using models, they highlight the relatively large load the plantar fascia is subjected to while contributing to the structural integrity of the foot."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1903", "text": "The plantar fascia also has an important role in dynamic function during  gait . It was found the plantar fascia continuously elongated during the contact phase of gait. It went through rapid elongation before and immediately after mid-stance, reaching a maximum of 9% to 12% elongation between mid-stance and toe-off. [ 5 ]  During this phase the plantar fascia behaves like a spring, which may assist in conserving energy. In addition, the plantar fascia has a critical role in normal mechanical function of the foot, contributing to the \"windlass mechanism\". When the toes are dorsiflexed in the propulsive phase of gait, the plantar fascia becomes tense, resulting in elevation of the longitudinal arch and shortening of the foot (see 3A). One can liken this mechanism to a cable being wound around the drum of a windlass (see 3B); the plantar fascia being the cable, the metatarsal head the drum, and the handle, the  proximal phalanx ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1904", "text": "The  presacral fascia  lines the anterior aspect of the  sacrum , enclosing the sacral vessels and  nerves .  It continues anteriorly as the pelvic  parietal fascia , covering the entire  pelvic cavity . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1905", "text": "The presacral fascia is limited postero-inferiorly, as it fuses with the mesorectal fascia,  lying above the  levator ani  muscle, at the level of the anorectal junction. [ 2 ]  These two fascias have been erroneously confused, [ 3 ]  though they are in fact, separate anatomical entities. The colloquial term, among colo-rectal surgeons, for this inter-fascial plane, is known as the  holy plane  of dissection first coined by Bill Heald. [ 4 ]  During rectal  surgery  and  mesorectum excision , dissection along the avascular alveolar plane between these two fascias, facilitates a straightforward dissection and preserves the sacral vessels and  hypogastric nerves ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1906", "text": "Waldeyer's fascia  (a.k.a. rectosacral fascia) originates from the presacral parietal fascia at the S2 to S4 level fusing with the rectal visceral fascia at the posterior aspect of the rectum. Waldeyer's fascia divides the retrorectal space into a superior and inferior compartments. [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1907", "text": "Identification and preservation of the presacral fascia is of fundamental importance in preventing complications and reducing local recurrences of  rectal cancer . [ 7 ]   Hence attention to this anatomy is essential in contemporary rectal surgery."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1908", "text": "The mesorectal fascia, also known as the fascia propria or the pelvic visceral fascia, has been originally described as the fascia recti in Waldeyer's publication, Das Becken.  Fascia recti is also a term commonly used among French surgeons to describe the mesorectal fascia. [ 8 ]   Confusingly, fascia recti is described in some anatomy books, referring to the fascia of the  rectus abdominis muscle ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1909", "text": "The  rectoprostatic fascia  ( Denonvilliers' fascia ) is a membranous partition at the lowest part of the  rectovesical pouch . It separates the  prostate  and  urinary bladder  from the  rectum . [ 1 ]  It consists of a single fibromuscular structure with several layers that are fused together and covering the  seminal vesicles . It is also called  Denonvilliers' fascia  after French anatomist and surgeon  Charles-Pierre Denonvilliers . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1910", "text": "The structure corresponds to the  rectovaginal fascia  in the female. The rectoprostatic fascia also inhibits the posterior spread of prostatic adenocarcinoma; therefore invasion of the rectum is less common than is invasion of other contiguous structures."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1911", "text": "The  rectovaginal fascia  (often called  rectovaginal septum  or sometimes  fascia of Otto ) is a thin structure separating the  vagina  and the  rectum .    This corresponds to the  rectoprostatic fascia  in the male. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1912", "text": "Perforations in it can lead to  rectocele . [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1913", "text": "The  renal fascia  is a dense,  elastic   connective tissue  envelope enclosing the  kidney  and  adrenal gland , together with the layer of  perirenal fat  surrounding these two. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1914", "text": "The renal fascia separates the  adipose capsule of kidney  from the overlying  pararenal fat . The deeper layers deep to the renal fascia are, in order, the adipose capsule (or perirenal fat), the  renal capsule  and finally the  parenchyma  of the  renal cortex . [ 2 ]  At the  renal hilum , the renal capsule extends into the  renal sinus . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1915", "text": "The renal fascia was originally described as consisting of two distinct structures: the anterior renal fascia (Gerota's fascia), and posterior renal fascia (Zuckerkandl's fascia); these two fasciae were said to fuse laterally to form the lateroconal fascia. Understanding of the structure of the renal fascia has subsequently evolved. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1916", "text": "This article incorporates text in the  public domain  from  page 1220  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1917", "text": "The  subcutaneous tissue of penis  (or  superficial penile fascia ) is continuous above with the  fascia of Scarpa , and below with the  dartos tunic  of the  scrotum  and the  fascia of Colles ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1918", "text": "It is sometimes just called the \"dartos layer\". [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1919", "text": "It attaches at the intersection of the body and glans. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1920", "text": "The term \"superficial penile fascia\" is more common, but \"subcutaneous tissue of penis\" is the term used by  Terminologia Anatomica ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1921", "text": "This article incorporates text in the  public domain  from  page 1249  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1922", "text": "The  subcutaneous tissue of perineum  (or  superficial perineal fascia ) is a layer of  subcutaneous tissue  surrounding the region of the  perineal body ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1923", "text": "The superficial fascia of this region consists of two layers, superficial and deep."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1924", "text": "The  superior fascia of the urogenital diaphragm  is continuous with the  obturator fascia  and stretches across the  pubic arch ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1925", "text": "If the obturator fascia be traced medially after leaving the  obturator internus muscle , it will be found attached by some of its deeper or anterior fibers to the inner margin of the  pubic arch , while its superficial or posterior fibers pass over this attachment to become continuous with the superior fascia of the  urogenital diaphragm ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1926", "text": "Behind, this layer of the fascia is continuous with the inferior fascia and with the  fascia of Colles ; in front it is continuous with the fascial sheath of the  prostate , and is fused with the inferior fascia to form the  transverse ligament of the pelvis ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1927", "text": "Some sources dispute that this structure exists. [ 1 ]  However, whether this layer is real or imagined, it still serves to describe a division of the contents of the perineum in many modern anatomy resources."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1928", "text": "The  supraspinous fascia  completes the  osseofibrous  case in which the  supraspinatus muscle  is contained; it affords attachment, by its deep surface, to some of the fibers of the muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1929", "text": "It is thick medially, but thinner laterally under the  coracoacromial ligament ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1930", "text": "This article incorporates text in the  public domain  from  page 440  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1931", "text": "The  temporoparietal fascia  (or  superficial temporal fascia ) [ 1 ] :\u200a357\u200a [ 2 ]  is a  superficial fascia  of the side of the head over the area of the  temporal fossa [ 2 ]  situated superficial to the  (deep) temporal fascia , [ 1 ] :\u200a357\u200a [ 2 ]  and deep to the skin and subcutaneous tissue of the region. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1932", "text": "The temporoparietal fascia consists of a thin layer of connective tissue. [ 3 ]  It measures some 2-3mm in thickness. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1933", "text": "The fascia unites anteriorly with the  orbicularis oris muscle , and the  frontalis muscle ; it unites posteriorly with the  occipitalis muscle . Inferior to the  zygomatic arch , the fascia is continuous with the  superficial muscular aponeurotic system ; both structures are continuous with the  platysma muscle  of the neck, creating a single continuous fascial layer between the scalp superiorly and the clavicle inferiorly. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1934", "text": "The fascia is situated superficial to the  (deep) temporal fascia , [ 1 ] :\u200a357\u200a [ 2 ]  with an intervening layer of (sources differ)  avascular   loose connective tissue  (the  innominate fascia ) situated in the interval between the two fasciae; this structural arrangement of loose superficial layers and deep rigit layers confers a combination of mobility coupled with structural integrity to the region. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1935", "text": "The  superficial temporal artery  and  vein , and the  auriculotemporal nerve  course within or just deep to the temporoparietal fascia, [ 1 ] :\u200a357\u200a  and the frontal branch of the  frontal nerve (CN VII)  courses within the fascia. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1936", "text": "The temporoparietal fascia can serve as a donor tissue for  reconstructive surgery . It affords reliable flaps with good blood supply when the tissues of the region are intact (however, prior lesions to the region may compromise the blood supply of the tissues; creating flaps from such compromised tissue is contraindicated due to a risk of subsequent ischaemic necrosis of the flap). [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1937", "text": "At the level of a line extending from the lower part of the  pubic symphysis  to the  spine of the ischium  is a thickened whitish band in this upper layer of the diaphragmatic part of the  pelvic fascia . It is termed the  tendinous arch  or  white line of the pelvic fascia , and marks the line of attachment of the special fascia (pars endopelvina fasciae pelvis) which is associated with the pelvic  viscera .\nIt joins the fascia of the pubocervical fascia that covers the anterior wall of the vagina. If this fascia falls, the ipsilateral side of the vagina falls, carrying with it the bladder and the urethra, and thus contributing to urinary incontinence. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1938", "text": "This article incorporates text in the  public domain  from  page 422  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1939", "text": "Tenon's capsule  ( / t \u0259 \u02c8 n o\u028a n / ), also known as the  Tenon capsule ,  fascial sheath of the eyeball  ( Latin :  vagina bulbi ) or the  fascia bulbi , is a thin membrane which envelops the eyeball from the  optic nerve  to the  corneal limbus , separating it from the orbital fat and forming a socket in which it moves."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1940", "text": "The inner surface of Tenon's capsule is smooth and is separated from the outer surface of the  sclera  by the  periscleral lymph space . This lymph space is continuous with the  subdural  and  subarachnoid  cavities and is traversed by delicate bands of connective tissue which extend between the capsule and the sclera."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1941", "text": "The capsule is perforated behind by the ciliary vessels and nerves and fuses with the sheath of the optic nerve and with the sclera around the entrance of the  optic nerve . In front it adheres to the  conjunctiva , and both structures are attached to the ciliary region of the eyeball."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1942", "text": "The structure was named after  Jacques-Ren\u00e9 Tenon  (1724\u20131816), [ 1 ]  a French surgeon and pathologist."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1943", "text": "Tenon's capsule is perforated by the tendons of the  ocular muscles  and is reflected backward on each as a tubular sheath. The sheath of the  obliquus superior  is carried as far as the fibrous pulley of that muscle, and that on the  obliquus inferior  reaches as far as the floor of the  orbit , to which it gives off a slip. The sheaths on the recti muscles are gradually lost in the  perimysium , but they give off important expansions. The expansion from the  rectus superior  blends with the tendon of the  levator palpebrae , and that of the  rectus inferior  is attached to the  inferior tarsus ; it is the space which lies between the sclera and the capsule. The expansions from the sheaths of the  recti lateralis  and  medialis  are strong, especially that from the latter muscle, and are attached to the  zygomatic bone  and  lacrimal bone  respectively; as they probably check the actions of these two recti, they have been named the medial and lateral  check ligaments ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1944", "text": "Charles Barrett Lockwood  described a thickening of the lower part of Tenon's capsule, which he named the  suspensory ligament of the eye . It is slung like a hammock below the eyeball, being expanded in the center, and narrow at its extremities which are attached to the  zygomatic  and  lacrimal bones  respectively."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1945", "text": "Tenon's capsule may be affected by a disease called idiopathic orbital inflammation, a condition of unknown etiology that is characterized by inflammation of one or more layers of the eye. The disease is also known as orbital inflammatory pseudotumor, and sometimes may only affect the  lacrimal gland  or the  extraocular muscles . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1946", "text": "Local anaesthetic may be instilled into the space between Tenon's capsule and the sclera to provide anaesthesia for eye surgery, principally cataract surgery. After applying local anaesthetic drops to anaesthetise the  conjunctiva , a small fold of conjunctiva is lifted off the eyeball and an incision made. A blunt, curved cannula is passed through the incision into the  periscleral lymph space  and a volume of  local anaesthetic  solution is instilled. The advantages are a reduced risk of bleeding and of penetration of the globe, compared to  peribulbar  and  retrobulbar  approaches. Akinesia (paralysis of the external eye muscles) may be less complete, however."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1947", "text": "Toldt's fascia , is a discrete layer of  connective tissue  containing  lymphatic  channels. [ 1 ]  It is found between the two  mesothelial  layers that separate the  mesocolon  from the underlying  retroperitoneum . It was first described by the Austrian anatomist  Carl Toldt  (1840\u20131920) as a fascial plane formed by the fusion of the  visceral peritoneum  with the  parietal peritoneum . This was later called Toldt's fascia. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1948", "text": "The  transversalis fascia  (or  transverse fascia ) is the  fascial  lining of the anterolateral  abdominal wall [ 1 ] [ 2 ]  situated between the inner surface of the  transverse abdominal muscle , and the  preperitoneal fascia . [ 3 ] [ 2 ]  It is directly continuous with the  iliac fascia , [ 2 ]  the  internal spermatic fascia , [ citation needed ]  and  pelvic fascia . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1949", "text": "In the  inguinal region , the transversalis fascia is thick and dense; here, it is joined by fibers of the aponeurosis of the  transverse abdominal muscle . It becomes thin towards to the  diaphragm , blending with the fascia covering the inferior surface of the diaphragm. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1950", "text": "Posteriorly, it is lost in  the fat which covers the posterior surfaces of the kidneys [ clarification needed ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1951", "text": "Below, it has the following attachments: posteriorly, to the whole length of the  iliac crest , between the attachments of the transverse abdominal and  Iliacus ; between the  anterior superior iliac spine  and the  femoral vessels  it is connected to the posterior margin of the  inguinal ligament , and is there continuous with the  iliac fascia . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1952", "text": "Medial to the femoral vessels it is thin and attached to the  pubis  and  pectineal line , behind the  inguinal falx , with which it is united; it descends in front of the femoral vessels to form the anterior wall of the  femoral sheath . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1953", "text": "Beneath the inguinal ligament it is strengthened by a band of fibrous tissue, which is only loosely connected to the ligament, and is specialized as the  iliopubic tract . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1954", "text": "The  spermatic cord  in the male and the  round ligament of the uterus  in the female pass through the transversalis fascia at the  deep inguinal ring , the entrance to the  inguinal canal . This opening is not visible externally. In the male, the transverse fascia extends downwards as the  internal spermatic fascia . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1955", "text": "The  umbilical fascia  (or  umbilicovesical fascia [ 1 ] ) is a thin fascial layer that extends between the  medial umbilical ligaments [ 2 ]  from the  umbilicus , [ 1 ]  and extends inferiorly, becoming continuous with the visceral fascia enclosing the  urinary bladder . [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1956", "text": "Rhabdomyoma  is a benign mesenchymal tumor of skeletal muscle, separated into two major categories based on site: Cardiac and extracardiac. They are further separated by histology: fetal (myxoid and cellular), juvenile (intermediate), and adult types. Genital types are recognized, but are often part of either the fetal or juvenile types. The fetal type is thought to recapitulate  immature skeletal muscle  at about week six to ten of gestational development."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1957", "text": "Most fetal rhabdomyomas are tumors that develop in the head and neck or in the genital region. [ 1 ]  There are a number of cases which have been seen in association with  Gorlin syndrome . [ 2 ] [ 3 ]  However, cardiac myxomas are known to be associated with  tuberous sclerosis ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1958", "text": "The tumor may be seen within the subcutaneous tissues (below the skin), [ 4 ]  mucosal surfaces or in soft tissue. Within the head and neck, the posterior ear region, skin of the face, and the tongue are the most commonly affected sites (about a 2:1 ratio of soft tissue to mucosa). [ 5 ] [ 6 ]  The tumors are well defined, non-specific usually solitary masses, but when seen in the head and neck (or genital region), they may be polypoid. Tumors range in dimension from a few millimeters up to 12.5\u00a0cm, with a mean of about 3.0\u00a0cm. Although there are isolated case reports, multifocality is very rare."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1959", "text": "Fetal rhabdomyoma are separated into two histologic types: Myxoid and cellular. [ 7 ] [ 8 ]  However, irrespective of histologic type, these tumors almost never show necrosis or increased mitoses. However, a  cambium  layer, abnormal mitoses and nuclear pleomorphism is not seen."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1960", "text": "Cellular fetal rhabdomyomas are composed of bland, primitive spindled cells. The spindle cells are haphazardly arranged primitive, elongated skeletal muscle cells. The cells are set within a well-developed fibromyxoid stroma. A different pattern (intermediate type) is predominantly composed of cells with better differentiation towards skeletal muscle. There are often large ganglion cell-like rhabdomyoblasts showing prominent nucleoli within nuclei that show vesicular chromatin distribution. Another population includes strap-like rhabdomyoblasts with darkly staining pink cytoplasm. Nearly all tumors show short to more sweeping fascicles of spindled rhabdomyoblasts. The tumor cells may infiltrate into adjacent skeletal muscle or fat. It is not uncommon to see peri-neural association, although not perineural infiltration. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1961", "text": "These tumors may be detected prenatally by ultrasound and MRI. [ 10 ]  Additionally, preoperative fine needle aspiration can be used to diagnose the tumor. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1962", "text": "A phosphotungstic acid hematoxylin stain may be used to highlight cross striations in the cytoplasm of the tumor cells. PAS with diastase will highlight the presence of glycogen in the tumor cells' cytoplasm. Immunohistochemistry will yield a positive reaction with a variety of myoid markers, including desmin, myoglobin, myogenin, MYOD1 and muscle specific actin. They may also be positive with vimentin, smooth muscle actin, and Leu-7.  However, the tumor cells are almost always negative with glial fibrillary acidic protein, S100 protein, cytokeratin, epithelial membrane antigen, CD68, FLI1, CD99 and CD56. Although not used as frequently now, electron microscopy will show thick and thin myofilaments, Z-bands: these are features of sarcometric differentiation. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1963", "text": "The differential diagnosis histologically includes  rhabdomyosarcoma ,  granular cell tumor ,  alveolar soft part sarcoma ,  hibernoma ,  oncocytoma , and  crystal storing histiocytosis , among others. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1964", "text": "Surgical excision is the treatment of choice. [ 14 ]  Recurrences are reported, but this is usually due to incomplete removal initially. [ 15 ] [ 16 ]  There is no role for chemotherapy or radiation therapy."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1965", "text": "They present over a wide age range (birth to about 65 years), but within the head and neck region, about 50% of cases develop in patients younger than 15 years of age. Within the head and neck, males are affected about 2\u20133 times more often than females. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1966", "text": "Intramyocellular lipids  (or IMCL) are  fats  stored in droplets in  muscle cells . They provide an important energy source for working muscle. During exercise, a large amount of circulating  free fatty acids  are directed into muscle cells for energy; during rest, incoming fatty acids are instead stored in the muscle cell as  triglycerides  for later burning. [ 1 ]  However, an increase in muscle insulin resistance, caused by  obesity ,  diabetes mellitus type 2 , and  metabolic syndrome , will result in an excess accumulation of intramyocellular lipids. [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1967", "text": "Insulin glargine"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1968", "text": "Myosins  ( / \u02c8 m a\u026a \u0259 s \u026a n ,   - o\u028a -/ [ 1 ] [ 2 ] ) are a  family  of  motor proteins  (though most often protein complexes) best known for their roles in  muscle contraction  and in a wide range of other  motility  processes in  eukaryotes . They are  ATP -dependent and responsible for  actin -based motility."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1969", "text": "The first myosin (M2) to be discovered was in 1864 by  Wilhelm K\u00fchne . K\u00fchne had extracted a viscous protein from  skeletal muscle  that he held responsible for keeping the tension state in muscle. He called this protein  myosin . [ 3 ] [ 4 ]  The term has been extended to include a group of similar  ATPases  found in the  cells  of both  striated muscle tissue  and  smooth muscle tissue ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1970", "text": "Following the discovery in 1973 of enzymes with myosin-like function in  Acanthamoeba castellanii , a global range of divergent myosin  genes  have been discovered throughout the realm of eukaryotes. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1971", "text": "Although myosin was originally thought to be restricted to  muscle cells  (hence  myo- (s) +  -in ), there is no single \"myosin\"; rather it is a very large superfamily of genes whose protein products share the basic properties of actin binding, ATP  hydrolysis  (ATPase enzyme activity), and force transduction. Virtually all eukaryotic cells contain myosin  isoforms .  Some isoforms have specialized functions in certain cell types (such as muscle), while other isoforms are ubiquitous.  The structure and function of myosin is globally conserved across species, to the extent that rabbit muscle myosin II will bind to actin from an  amoeba . [ 6 ] [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1972", "text": "Most myosin molecules are composed of a  head , neck, and tail domain."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1973", "text": "Multiple  myosin II  molecules generate force in  skeletal muscle  through a power stroke mechanism fuelled by the energy released from ATP hydrolysis. [ 8 ]  The power stroke occurs at the release of phosphate from the myosin molecule after the ATP hydrolysis while myosin is tightly bound to actin. The effect of this release is a conformational change in the molecule that pulls against the actin. The release of the ADP molecule leads to the so-called rigor state of myosin. [ 9 ]  The binding of a new ATP molecule will release myosin from actin. ATP hydrolysis within the myosin will cause it to bind to actin again to repeat the cycle. The combined effect of the myriad power strokes causes the muscle to contract."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1974", "text": "The wide variety of myosin genes found throughout the eukaryotic phyla were named according to different schemes as they were discovered.  The nomenclature can therefore be somewhat confusing when attempting to compare the functions of myosin proteins within and between organisms."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1975", "text": "Skeletal muscle myosin, the most conspicuous of the myosin superfamily due to its abundance in  muscle fibers , was the first to be discovered. This protein makes up part of the  sarcomere  and forms macromolecular filaments composed of multiple myosin subunits. Similar filament-forming myosin proteins were found in  cardiac muscle , smooth muscle, and nonmuscle cells. However, beginning in the 1970s, researchers began to discover new myosin genes in simple eukaryotes [ 5 ]  encoding proteins that acted as monomers and were therefore entitled Class I myosins. These new myosins were collectively termed \"unconventional myosins\" [ 10 ]  and have been found in many tissues other than muscle. These new superfamily members have been grouped according to phylogenetic relationships derived from a comparison of the amino acid sequences of their head domains, with each class being assigned a  Roman numeral [ 11 ] [ 12 ] [ 13 ] [ 14 ]  (see phylogenetic tree). The unconventional myosins also have divergent tail domains, suggesting unique functions. [ 15 ]  The now diverse array of myosins likely evolved from an ancestral  precursor  (see picture)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1976", "text": "Analysis of the amino acid sequences of different myosins shows great variability among the tail domains, but strong conservation of head domain sequences. Presumably this is so the myosins may interact, via their tails, with a large number of different cargoes, while the goal in each case \u2013 to move along actin filaments \u2013 remains the same and therefore requires the same machinery in the motor. For example, the  human genome  contains over 40 different myosin  genes ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1977", "text": "These differences in shape also determine the speed at which myosins can move along actin filaments. The hydrolysis of ATP and the subsequent release of the  phosphate  group causes the \"power stroke\", in which the \"lever arm\" or \"neck\" region of the heavy chain is dragged forward. Since the power stroke always moves the lever arm by the same angle, the length of the lever arm determines the displacement of the cargo relative to the actin filament.   A longer lever arm will cause the cargo to traverse a greater distance even though the lever arm undergoes the same angular displacement \u2013 just as a person with longer legs can move farther with each individual step.  The velocity of a myosin motor depends upon the rate at which it passes through a complete kinetic cycle of ATP binding to the release of ADP."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1978", "text": "Myosin I, a ubiquitous cellular protein, functions  as monomer and functions in  vesicle  transport. [ 16 ]  It has a step size of 10\u00a0nm and has been implicated as being responsible for the adaptation response of the stereocilia in the inner ear. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1979", "text": "Myosin II  (also known as conventional myosin) is the myosin type responsible for producing  muscle contraction  in  muscle cells  in most animal cell types. It is also found in non-muscle cells in contractile bundles called  stress fibers . [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1980", "text": "In muscle cells, the long  coiled-coil  tails of the individual myosin molecules can auto-inhibit active function in the 10S conformation or upon phosphorylation, change to the 6S conformation and join, forming the thick filaments of the  sarcomere . [ 29 ] [ 30 ]  The force-producing head domains stick out from the side of the thick filament, ready to walk along the adjacent actin-based thin filaments in response to the proper chemical signals and may be in either auto-inhibited or active conformation. The balance/transition between active and inactive states is subject to extensive chemical regulation."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1981", "text": "Myosin III is a poorly understood member of the myosin family. It has been studied  in vivo  in the eyes of  Drosophila , where it is thought to play a role in  phototransduction . [ 31 ]  A human  homologue  gene for myosin III,  MYO3A , has been uncovered through the  Human Genome Project  and is expressed in the  retina  and  cochlea . [ 32 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1982", "text": "Myosin IV has a single  IQ motif  and a tail that lacks any coiled-coil forming sequence. It has homology similar to the tail domains of Myosin VII and XV. [ 33 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1983", "text": "Myosin V is an unconventional myosin motor, which is processive as a  dimer  and has a step size of 36\u00a0nm. [ 34 ]  It translocates (walks) along actin filaments traveling towards the barbed end (+ end) of the filaments. Myosin V is involved in the transport of cargo (e.g. RNA, vesicles, organelles, mitochondria) from the center of the cell to the periphery, but has been furthermore shown to act like a dynamic tether, retaining vesicles and organelles in the actin-rich periphery of cells. [ 35 ] [ 36 ]  A recent single molecule in vitro reconstitution study on assembling actin filaments suggests that Myosin V travels farther on newly assembling (ADP-Pi rich) F-actin, while processive runlengths are shorter on older (ADP-rich) F-actin. [ 37 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1984", "text": "The Myosin V motor head can be subdivided into the following functional regions: [ 38 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1985", "text": "Myosin VI is an unconventional myosin motor, which is primarily processive as a dimer, but also acts as a nonprocessive monomer. It walks along actin filaments, travelling towards the pointed end (- end) of the filaments. [ 44 ]  Myosin VI is thought to transport  endocytic  vesicles into the cell. [ 45 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1986", "text": "Myosin VII is an unconventional myosin with two  FERM domains  in the tail region. It has an extended lever arm consisting of five calmodulin binding IQ motifs followed by a single alpha helix (SAH) [ 46 ]  Myosin VII is required for  phagocytosis  in  Dictyostelium discoideum ,  spermatogenesis  in  C. elegans  and  stereocilia  formation in mice and zebrafish. [ 47 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1987", "text": "Myosin VIII is a plant-specific myosin linked to cell division; [ 48 ]  specifically, it is involved in regulating the flow of cytoplasm between cells [ 49 ]  and in the localization of vesicles to the  phragmoplast . [ 50 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1988", "text": "Myosin IX is a group of single-headed motor proteins. It was first shown to be minus-end directed, [ 51 ]  but a later study showed that it is plus-end directed. [ 52 ]  The movement mechanism for this myosin is poorly understood."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1989", "text": "Myosin X is an unconventional myosin motor, which is functional as a  dimer . The dimerization of myosin X is thought to be antiparallel. [ 53 ]  This behavior has not been observed in other myosins. In mammalian cells, the motor is found to localize to  filopodia . Myosin X walks towards the barbed ends of filaments.  Some research suggests it preferentially walks on bundles of actin, rather than single filaments. [ 54 ]  It is the first myosin motor found to exhibit this behavior."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1990", "text": "Myosin XI directs the movement of organelles such as  plastids  and  mitochondria  in plant cells. [ 55 ]  It is responsible for the light-directed movement of  chloroplasts  according to light intensity and the formation of  stromules  interconnecting different plastids. Myosin XI also plays a key role in polar root tip growth and is necessary for proper  root hair  elongation. [ 56 ]  A specific Myosin XI found in  Nicotiana tabacum  was discovered to be the fastest known processive  molecular motor , moving at 7\u03bcm/s in 35\u00a0nm steps along the  actin  filament. [ 57 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1991", "text": "This myosin group has been found in the  Apicomplexa  phylum. [ 58 ]  The myosins localize to plasma membranes of the intracellular  parasites  and may then be involved in the cell invasion process. [ 59 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1992", "text": "This myosin is also found in the ciliated protozoan  Tetrahymena thermophila .  Known functions include: transporting phagosomes to the nucleus and perturbing the developmentally regulated elimination of the  macronucleus  during conjugation."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1993", "text": "Myosin XV is necessary for the development of the actin core structure of the non-motile  stereocilia  located in the inner ear. It is thought to be functional as a monomer."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1994", "text": "MYO18A A gene on chromosome 17q11.2 that encodes actin-based motor molecules with ATPase activity, which may be involved in maintaining stromal cell scaffolding required for maintaining intercellular contact."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1995", "text": "Unconventional myosin XIX (Myo19) is a mitochondrial associated myosin motor. [ 60 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_1996", "text": "Note that not all of these genes are active."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1997", "text": "Myosin light chains are distinct and have their own properties.  They are not considered \"myosins\" but are components of the macromolecular complexes that make up the functional myosin enzymes."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1998", "text": "Paramyosin is a large, 93-115kDa  muscle   protein  that has been described in a number of diverse  invertebrate  phyla. [ 61 ]  Invertebrate thick filaments are thought to be composed of an inner paramyosin core surrounded by myosin.  The myosin interacts with  actin , resulting in fibre contraction. [ 62 ]  Paramyosin is found in many different invertebrate species, for example,  Brachiopoda ,  Sipunculidea ,  Nematoda ,  Annelida ,  Mollusca ,  Arachnida , and  Insecta . [ 61 ]   Paramyosin is responsible for the \"catch\" mechanism that enables sustained contraction of muscles with very little energy expenditure, such that a  clam  can remain closed for extended periods."}
{"_id": "WikiPedia_Muscular_system$$$corpus_1999", "text": "Paramyosins can be found in seafood. A recent computational study showed that following human intestinal digestion, paramyosins of  common octopus ,  Humboldt squid , Japanese abalone, Japanese scallop,  Mediterranean mussel ,  Pacific oyster ,  sea cucumber , and  Whiteleg shrimp  could release short  peptides  that inhibit the enzymatic activities of  angiotensin converting enzyme  and  dipeptidyl peptidase . [ 63 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2000", "text": "A  neuromuscular junction  (or  myoneural junction ) is a  chemical synapse  between a  motor neuron  and a  muscle fiber . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2001", "text": "It allows the motor neuron to transmit a signal to the muscle fiber, causing  muscle contraction . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2002", "text": "Muscles require innervation to function\u2014and even just to maintain  muscle tone , avoiding  atrophy . In the  neuromuscular system , nerves from the  central nervous system  and the  peripheral nervous system  are linked and work together with muscles. [ 3 ]  Synaptic transmission at the neuromuscular junction begins when an  action potential  reaches the presynaptic terminal of a  motor neuron , which activates  voltage-gated calcium channels  to allow calcium ions to enter the neuron. Calcium ions bind to sensor proteins ( synaptotagmins ) on synaptic vesicles, triggering vesicle fusion with the cell membrane and subsequent  neurotransmitter  release from the motor neuron into the  synaptic cleft . In  vertebrates , motor neurons release  acetylcholine  (ACh), a small molecule neurotransmitter, which diffuses across the synaptic cleft and binds to  nicotinic acetylcholine receptors  (nAChRs) on the cell membrane of the muscle fiber, also known as the  sarcolemma . nAChRs are  ionotropic  receptors, meaning they serve as  ligand -gated  ion channels . The binding of ACh to the receptor can depolarize the muscle fiber, causing a cascade that eventually results in muscle contraction."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2003", "text": "Neuromuscular junction diseases  can be of  genetic  and  autoimmune  origin.  Genetic disorders, such as  Congenital myasthenic syndrome , can arise from mutated structural proteins that comprise the neuromuscular junction, whereas autoimmune diseases, such as  myasthenia gravis , occur when antibodies are produced against nicotinic acetylcholine receptors on the sarcolemma."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2004", "text": "At the  neuromuscular junction , presynaptic motor axons terminate  30 nanometers from the cell membrane  or  sarcolemma  of a muscle fiber.  The sarcolemma at the junction has  invaginations  called postjunctional folds, which increase its surface area  facing the synaptic cleft. [ 4 ]   These postjunctional folds form the motor endplate, which is studded with  nicotinic acetylcholine receptors  (nAChRs) at a density of 10,000 receptors/\u03bcm 2 . [ 5 ]   The presynaptic axons terminate in bulges called terminal boutons (or presynaptic terminals) that project toward the postjunctional folds of the sarcolemma. In the frog each motor nerve terminal contains about 300,000  vesicles , with an average  diameter of 0.05 micrometers.  The vesicles contain acetylcholine.  Some of these vesicles  are gathered  into groups of fifty, positioned at active zones close to the nerve membrane.  Active zones are about 1 micrometer apart.\nThe 30 nanometer cleft between nerve ending and endplate contains a meshwork of  acetylcholinesterase  (AChE) at a density of 2,600 enzyme molecules/\u03bcm 2 , held in place by the structural proteins  dystrophin  and  rapsyn .  Also present is the  receptor tyrosine kinase  protein  MuSK , a signaling protein involved in the development of the neuromuscular junction, which is also held in place by rapsyn. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2005", "text": "About once every second in a resting junction randomly one of the synaptic vesicles fuses with the presynaptic neuron's  cell membrane  in a process mediated by  SNARE  proteins. Fusion results in the emptying of the vesicle's contents of 7000\u201310,000 acetylcholine molecules  into the  synaptic cleft , a process known as  exocytosis . [ 6 ]  Consequently, exocytosis releases  acetylcholine in packets that are called quanta. The acetylcholine quantum diffuses through the acetylcholinesterase meshwork, where the high local transmitter concentration occupies all of the binding sites on the enzyme in its path.  The acetylcholine that reaches the endplate activates ~2,000 acetylcholine receptors, opening their ion channels which permits sodium ions to move into the endplate producing a depolarization of ~0.5 mV known as a miniature endplate potential (MEPP). By the time the acetylcholine is released from the receptors the acetylcholinesterase has destroyed its bound ACh, which takes about ~0.16 ms,  and hence is available to destroy the  ACh released from the receptors. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2006", "text": "When the motor nerve is stimulated there is a delay of only 0.5 to 0.8 msec between the arrival of the nerve impulse in the motor nerve terminals and the first response of the endplate  [ 7 ]   The arrival of the motor nerve  action potential  at the presynaptic neuron terminal opens  voltage-dependent calcium channels , and Ca 2+   ions  flow from the extracellular fluid into the presynaptic neuron's  cytosol . This influx of Ca 2+  causes several hundred  neurotransmitter -containing  vesicles  to fuse with the presynaptic neuron's cell membrane through  SNARE  proteins to release their acetylcholine quanta by exocytosis. The endplate depolarization by the released acetylcholine is called an endplate potential (EPP). The EPP is accomplished when ACh binds the nicotinic acetylcholine receptors (nAChR) at the motor end plate, and causes an influx of sodium ions. This influx of sodium ions generates the EPP (depolarization), and triggers an action potential that travels along the sarcolemma and into the muscle fiber via the  T-tubules  (transverse tubules) by means of voltage-gated sodium channels. [ 8 ]  The conduction of action potentials along the T-tubules stimulates the opening of voltage-gated Ca 2+  channels which are mechanically coupled to Ca 2+  release channels in the sarcoplasmic reticulum. [ 9 ]  The Ca 2+  then diffuses out of the sarcoplasmic reticulum to the myofibrils so it can stimulate contraction. The endplate potential is thus responsible for setting up an action potential in the muscle fiber which triggers muscle contraction.  The transmission from nerve to muscle is so rapid because each quantum of acetylcholine reaches the endplate in millimolar concentrations, high enough to combine with a receptor with a low affinity, which then swiftly releases the bound transmitter. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2007", "text": "Acetylcholine  is a  neurotransmitter  synthesized from dietary  choline  and  acetyl-CoA  (ACoA), and is involved in the stimulation of  muscle tissue  in  vertebrates  as well as in some  invertebrate  animals. In vertebrates, the acetylcholine receptor subtype that is found at the neuromuscular junction of  skeletal muscles  is the  nicotinic acetylcholine receptor  (nAChR), which is a  ligand-gated ion channel .  Each subunit of this receptor has a characteristic \"cys-loop\", which is composed of a  cysteine  residue followed by 13  amino acid  residues and another cysteine residue. The two cysteine residues form a  disulfide linkage  which results in the \"cys-loop\" receptor that is capable of binding acetylcholine and other ligands.  These cys-loop receptors are found only in  eukaryotes , but  prokaryotes  possess ACh receptors with similar properties. [ 5 ]   Not all species use a  cholinergic  neuromuscular junction; e.g.  crayfish  and fruit flies have a  glutamatergic  neuromuscular junction. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2008", "text": "AChRs at the skeletal neuromuscular junction form heteropentamers composed of two \u03b1, one \u03b2, one \u025b, and one \u03b4 subunits. [ 10 ]   When a single ACh ligand binds to one of the \u03b1 subunits of the ACh receptor it induces a  conformational change  at the interface with the second AChR \u03b1 subunit.  This conformational change results in the increased  affinity  of the second \u03b1 subunit for a second ACh ligand.  AChRs, therefore, exhibit a sigmoidal dissociation curve due to this  cooperative binding . [ 5 ]   The presence of the inactive, intermediate receptor structure with a single-bound ligand keeps ACh in the  synapse  that might otherwise be lost by  cholinesterase  hydrolysis or diffusion.  The persistence of these ACh ligands in the synapse can cause a prolonged post-synaptic response. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2009", "text": "The development of the neuromuscular junction requires signaling from both the motor neuron's terminal and the muscle cell's central region. During development, muscle cells produce acetylcholine receptors (AChRs) and express them in the central regions in a process called prepatterning.  Agrin , a heparin  proteoglycan , and MuSK kinase are thought to help stabilize the accumulation of AChR in the central regions of the myocyte. MuSK is a receptor  tyrosine kinase \u2014meaning that it induces cellular signaling by binding  phosphate  molecules to self regions like  tyrosines , and to other targets in the  cytoplasm . [ 12 ]  Upon activation by its ligand agrin, MuSK signals via two proteins called \" Dok-7 \" and \" rapsyn \", to induce \"clustering\" of acetylcholine receptors. [ 13 ]  ACh release by developing motor neurons produces postsynaptic potentials in the muscle cell that positively reinforces the localization and stabilization of the developing neuromuscular junction. [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2010", "text": "These findings were demonstrated in part by mouse \" knockout \" studies.  In mice which are deficient for either agrin or MuSK, the neuromuscular junction does not form. Further, mice deficient in  Dok-7  did not form either acetylcholine receptor clusters or neuromuscular synapses. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2011", "text": "The development of neuromuscular junctions is mostly studied in model organisms, such as rodents. In addition, in 2015 an all-human neuromuscular junction has been created in vitro using human  embryonic stem cells  and somatic muscle stem cells. [ 16 ]   In this model presynaptic  motor neurons  are activated by  optogenetics  and in response synaptically connected muscle fibers twitch upon light stimulation."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2012", "text": "Jos\u00e9 del Castillo and  Bernard Katz  used ionophoresis to determine the location and density of  nicotinic acetylcholine receptors  (nAChRs) at the neuromuscular junction.  With this technique, a microelectrode was placed inside the motor endplate of the muscle fiber, and a micropipette filled with acetylcholine (ACh) was placed directly in front of the endplate in the synaptic cleft.  A positive voltage was applied to the tip of the micropipette, which caused a burst of positively charged ACh molecules to be released from the pipette. These ligands flowed into the space representing the synaptic cleft and bound to AChRs.  The intracellular microelectrode monitored the  amplitude  of the  depolarization  of the motor endplate in response to ACh binding to nicotinic (ionotropic) receptors.  Katz and del Castillo showed that the amplitude of the depolarization ( excitatory postsynaptic potential ) depended on the proximity of the micropipette releasing the ACh ions to the endplate.  The farther the micropipette was from the motor endplate, the smaller the depolarization was in the muscle fiber.  This allowed the researchers to determine that the nicotinic receptors were localized to the motor endplate in high density. [ 4 ] [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2013", "text": "Toxins are also used to determine the location of acetylcholine receptors at the neuromuscular junction.  \u03b1-Bungarotoxin  is a toxin found in the snake species  Bungarus multicinctus  that acts as an ACh antagonist and binds to AChRs irreversibly.  By coupling assayable enzymes such as  horseradish peroxidase  (HRP) or fluorescent proteins such as  green fluorescent protein  (GFP) to the \u03b1-bungarotoxin, AChRs can be visualized and quantified. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2014", "text": "Nerve gases bind to and phosphorylate AChE, effectively deactivating them. The accumulation of ACh within the synaptic cleft causes muscle cells to be perpetually contracted, leading to severe complications such as paralysis and death within minutes of exposure."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2015", "text": "Botulinum toxin  (also known as botulinum  neurotoxin , and commercially sold under the trade name Botox) inhibits the release of acetylcholine at the neuromuscular junction by interfering with SNARE proteins. [ 4 ]  This toxin crosses into the nerve terminal through the process of  endocytosis  and subsequently cleaves SNARE proteins, preventing the ACh vesicles from fusing with the intracellular membrane. This induces a transient  flaccid paralysis  and chemical denervation localized to the striated muscle that it has affected. The inhibition of ACh release does not set in until approximately two weeks after the injection is made. Three months after the inhibition occurs, neuronal activity begins to regain partial function, and six months after, complete neuronal function is regained. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2016", "text": "Tetanus toxin, also known as  tetanospasmin  is a potent neurotoxin produced by  Clostridium tetani  and causes the disease state, tetanus. The LD 50  of this toxin has been measured to be approximately 1\u00a0ng/kg, making it second only to botulinum toxin D as the deadliest toxin in the world. It functions very similarly to botulinum neurotoxin by attaching and endocytosing into the presynaptic nerve terminal and interfering with SNARE proteins. It differs from botulinum neurotoxin in a few ways, most apparently in its end state, wherein tetanospasmin causes  spastic paralysis  as opposed to the flaccid paralysis demonstrated with botulinum neurotoxin."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2017", "text": "Latrotoxin  (\u03b1-Latrotoxin) found in venom of widow spiders also affects the neuromuscular junction by causing the release of acetylcholine from the presynaptic cell. Mechanisms of action include binding to receptors on the presynaptic cell activating the  IP3/DAG pathway  and release of calcium from intracellular stores and pore formation resulting in influx of calcium ions directly. Either mechanism causes increased calcium in presynaptic cell, which then leads to release of synaptic vesicles of acetylcholine. Latrotoxin causes pain, muscle contraction and if untreated potentially paralysis and death."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2018", "text": "Snake venoms act as toxins at the neuromuscular junction and can induce weakness and  paralysis . Venoms can act as both presynaptic and postsynaptic neurotoxins. [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2019", "text": "Presynaptic neurotoxins, commonly known as \u03b2-neurotoxins, affect the presynaptic regions of the neuromuscular junction. The majority of these neurotoxins act by inhibiting the release of neurotransmitters, such as acetylcholine, into the synapse between neurons. However, some of these toxins have also been known to enhance neurotransmitter release. Those that inhibit neurotransmitter release create a  neuromuscular blockade  that prevents signaling molecules from reaching their postsynaptic target receptors. In doing so, the victim of these snake bite suffer from profound weakness. Such neurotoxins do not respond well to anti-venoms. After one hour of inoculation of these toxins, including  notexin  and  taipoxin , many of the affected nerve terminals show signs of irreversible physical damage, leaving them devoid of any  synaptic vesicles . [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2020", "text": "Postsynaptic neurotoxins, otherwise known as \u03b1-neurotoxins, act oppositely to the presynaptic neurotoxins by binding to the postsynaptic acetylcholine receptors. This prevents interaction between the acetylcholine released by the presynaptic terminal and the receptors on the postsynaptic cell. In effect, the opening of sodium channels associated with these acetylcholine receptors is prohibited, resulting in a neuromuscular blockade, similar to the effects seen due to presynaptic neurotoxins. This causes paralysis in the muscles involved in the affected junctions. Unlike presynaptic neurotoxins, postsynaptic toxins are more easily affected by anti-venoms, which accelerate the dissociation of the toxin from the receptors, ultimately causing a reversal of paralysis. These neurotoxins experimentally and qualitatively aid in the study of acetylcholine receptor  density  and  turnover , as well as in studies observing the direction of  antibodies  toward the affected acetylcholine receptors in patients diagnosed with  myasthenia gravis . [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2021", "text": "Any  disorder  that compromises the synaptic transmission between a motor neuron and a muscle cell is categorized under the umbrella term of  neuromuscular diseases . These disorders can be  inherited  or acquired and can vary in their severity and mortality. In general, most of these disorders tend to be caused by mutations or autoimmune disorders. Autoimmune disorders, in the case of neuromuscular diseases, tend to be  humoral  mediated,  B cell  mediated, and result in an  antibody  improperly created against a motor neuron or muscle fiber protein that interferes with synaptic transmission or signaling."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2022", "text": "Myasthenia gravis  is an autoimmune disorder where the body makes antibodies against either the acetylcholine receptor (AchR) (in 80% of cases), or against postsynaptic muscle-specific kinase (MuSK) (0\u201310% of cases). In seronegative myasthenia gravis  low density lipoprotein  receptor-related protein 4 is targeted by  IgG1 , which acts as a competitive inhibitor of its ligand, preventing the ligand from binding its receptor. It is not known if seronegative myasthenia gravis will respond to standard therapies. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2023", "text": "Neonatal MG is an autoimmune disorder that affects 1 in 8 children born to mothers who have been diagnosed with myasthenia gravis (MG). MG can be transferred from the mother to the fetus by the movement of AChR antibodies through the  placenta . Signs of this disease at birth include weakness, which responds to anticholinesterase medications, as well as fetal akinesia, or the lack of fetal movement. This form of the disease is transient, lasting for about three months. However, in some cases, neonatal MG can lead to other health effects, such as arthrogryposis and even fetal death. These conditions are thought to be initiated when maternal AChR antibodies are directed to the  fetal  AChR and can last until the 33rd week of  gestation , when the \u03b3 subunit of AChR is replaced by the \u03b5 subunit. [ 20 ]   [ 21 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2024", "text": "Lambert\u2013Eaton myasthenic syndrome  (LEMS) is an autoimmune disorder that affects the presynaptic portion of the neuromuscular junction. This rare disease can be marked by a unique triad of symptoms: proximal muscle weakness,  autonomic dysfunction , and areflexia. [ 22 ]  Proximal muscle weakness is a product of  pathogenic  autoantibodies directed against P/Q-type voltage-gated calcium channels, which in turn leads to a reduction of acetylcholine release from motor nerve terminals on the presynaptic cell. Examples of autonomic dysfunction caused by LEMS include  erectile dysfunction  in men,  constipation , and, most commonly,  dry mouth . Less common dysfunctions include  dry eyes  and altered  perspiration .  Areflexia  is a condition in which tendon reflexes are reduced and it may subside temporarily after a period of exercise. [ 23 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2025", "text": "50\u201360% of the patients that are diagnosed with LEMS also have present an associated  tumor , which is typically  small-cell lung carcinoma  (SCLC). This type of tumor also expresses  voltage-gated calcium channels . [ 23 ]  Oftentimes, LEMS also occurs alongside myasthenia gravis. [ 22 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2026", "text": "Treatment for LEMS consists of using 3,4-diaminopyridine as a first measure, which serves to increase the compound muscle action potential as well as muscle strength by lengthening the time that voltage-gated calcium channels remain open after blocking voltage-gated potassium channels. In the US, treatment with 3,4-diaminopyridine for eligible LEMS patients is available at no cost under an expanded access program. [ 24 ] [ 25 ]  Further treatment includes the use of  prednisone  and  azathioprine  in the event that 3,4-diaminopyridine does not aid in treatment. [ 23 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2027", "text": "Neuromyotonia  (NMT), otherwise known as Isaac's syndrome, is unlike many other diseases present at the neuromuscular junction. Rather than causing muscle weakness, NMT leads to the hyperexcitation of motor nerves. NMT causes this hyperexcitation by producing longer depolarizations by down-regulating  voltage-gated potassium channels , which causes greater neurotransmitter release and repetitive firing. This increase in rate of firing leads to more active transmission and as a result, greater muscular activity in the affected individual. NMT is also believed to be of  autoimmune  origin due to its associations with autoimmune symptoms in the individual affected. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2028", "text": "Congenital myasthenic syndromes  (CMS) are very similar to both MG and LEMS in their functions, but the primary difference between CMS and those diseases is that CMS is of genetic origins. Specifically, these syndromes are diseases incurred due to mutations, typically  recessive , in 1 of at least 10 genes that affect presynaptic, synaptic, and postsynaptic proteins in the neuromuscular junction. Such mutations usually arise in the \u03b5-subunit of AChR, [ 20 ]  thereby affecting the kinetics and expression of the receptor itself.  Single nucleotide substitutions or deletions may cause loss of function in the subunit. Other  mutations , such as those affecting  acetylcholinesterase  and  acetyltransferase , can also cause the expression of CMS, with the latter being associated specifically with episodic  apnea . [ 26 ]  These syndromes can present themselves at different times within the life of an individual. They may arise during the fetal phase, causing fetal  akinesia , or the perinatal period, during which certain conditions, such as  arthrogryposis ,  ptosis ,  hypotonia ,  ophthalmoplegia , and feeding or breathing difficulties, may be observed. They could also activate during adolescence or adult years, causing the individual to develop slow-channel syndrome. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2029", "text": "Treatment for particular subtypes of CMS (postsynaptic fast-channel CMS) [ 27 ] [ 28 ]  is similar to treatment for other neuromuscular disorders.  3,4-Diaminopyridine , the first-line treatment for LEMS, is under development as an orphan drug for CMS [ 29 ]  in the US, and available to eligible patients under an expanded access program at no cost. [ 24 ] [ 25 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2030", "text": "The  thoracic diaphragm , or simply the  diaphragm  ( / \u02c8 d a\u026a \u0259 f r \u00e6 m / ; [ 1 ]   Ancient Greek :  \u03b4\u03b9\u03ac\u03c6\u03c1\u03b1\u03b3\u03bc\u03b1 ,  romanized :\u00a0 di\u00e1phragma ,  lit. \u2009 'partition'), is a sheet of internal  skeletal muscle [ 2 ]  in  humans  and other  mammals  that extends across the bottom of the  thoracic cavity . The diaphragm is the most important  muscle of respiration , [ 3 ]  and separates the  thoracic cavity , containing the  heart  and  lungs , from the  abdominal cavity : as the diaphragm contracts, the volume of the thoracic cavity increases, creating a negative pressure there, which draws air into the lungs. [ 4 ]  Its high oxygen consumption is noted by the many  mitochondria  and  capillaries  present; more than in any other skeletal muscle. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2031", "text": "The term  diaphragm  in anatomy, created by  Gerard of Cremona , [ 5 ]  can refer to other flat structures such as the  urogenital diaphragm  or  pelvic diaphragm , but \"the diaphragm\" generally refers to the thoracic diaphragm. In humans, the diaphragm is slightly asymmetric\u2014its right half is higher up (superior) to the left half, since the large liver rests beneath the right half of the diaphragm. There is also speculation that the diaphragm is lower on the other side due to heart's presence."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2032", "text": "Other  mammals  have diaphragms, and other  vertebrates  such as  amphibians  and  reptiles  have diaphragm-like structures, but important details of the anatomy may vary, such as the position of the lungs in the thoracic cavity."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2033", "text": "The diaphragm is an upward curved, c-shaped structure of  muscle  and  fibrous tissue  that separates the  thoracic cavity  from the abdomen. [ 6 ]  The superior surface of the dome forms the floor of the thoracic cavity, and the inferior surface the roof of the abdominal cavity. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2034", "text": "As a dome, the diaphragm has peripheral attachments to structures that make up the abdominal and chest walls. The muscle fibres from these attachments converge in a  central tendon , which forms the crest of the dome. [ 7 ]  Its peripheral part consists of muscular fibers that take origin from the circumference of the  inferior thoracic aperture  and converge to be inserted into a central tendon."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2035", "text": "The muscle fibres of the diaphragm radiate outward from the central tendon. While the diaphragm is one muscle, it is composed of two distinct muscle regions: the costal, which serves as the driver in the work of breathing, and crural diaphragm, which serves as an \"anchor;\" attaching the muscle to the lower ribs and lumbar vertebrae. The costal diaphragm is further divided into ventral, medial, and dorsal costal portions.  [ 8 ] [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2036", "text": "The vertebral part of the diaphragm arises from the crura and arcuate ligaments. Right crus arises from L1-L3 vertebral bodies and their intervertebral discs. Smaller left crus arises from L1, L2 vertebral bodies and their intervertebral discs. [ 8 ] [ 7 ] [ 10 ]  Medial arcuate ligament arises from the fascia thickening from body of L2 vertebrae to transverse process of L1 vertebrae, crossing over the body of the  psoas major  muscle. The  lateral arcuate ligament  arises from the transverse process of L1 vertebrae and is attached laterally to the 12th rib. The lateral arcuate ligament also arises from fascia thickening that covers the  quadratus lumborum  muscle. The  median arcuate ligament  arises from the fibrous parts of right and left crura where descending  thoracic aorta  passes behind it. No diaphragmatic muscle arises from the median arcuate ligament. [ 8 ]  Both adrenal glands lie near the diaphragmatic crus and arcuate ligament. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2037", "text": "The costal part of diaphragm arises from the lower four ribs (7 to 10) costal cartilages. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2038", "text": "The  central tendon  of the diaphragm is a thin but strong  aponeurosis  near the center of the vault formed by the muscle, closer to the front than to the back of the  thorax . The central part of the tendon is attached above to  pericardium . The both sides of the posterior fibres are attached to paracolic gutters (the curving of ribs before attaching to both sides of the vertebral bodies). [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2039", "text": "There are a number of openings in the diaphragm through which structures pass between the thorax and abdomen. There are three large openings \u2014 one for the  aorta  ( aortic hiatus ), [ 2 ]  one for the  esophagus  ( esophageal hiatus ), and one for the  inferior vena cava  (the  caval opening ), [ 8 ]  as well as a series of smaller openings. [ 12 ] [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2040", "text": "The inferior vena cava passes through the caval opening, a quadrilateral opening at the junction of the right and middle leaflets of the  central tendon , so that its margins are tendinous. Surrounded by tendons, the opening is stretched open every time inspiration occurs. However, there has been argument that the caval opening actually constricts during inspiration. Since thoracic pressure decreases upon inspiration and draws the caval blood upwards toward the right atrium, increasing the size of the opening allows more blood to return to the heart, maximizing the efficacy of lowered thoracic pressure returning blood to the heart. The  aorta  does not pierce the diaphragm but rather passes behind it in between the left and right crus. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2041", "text": "There are several structures that pierce through the diaphragm, including:  left phrenic nerve  pierces through the central tendon, greater, lesser, and least  thoracic splanchnic nerves  pierces through bilateral crura, and lymphatic vessels that pierce throughout the diaphragm, especially behind the diaphragm. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2042", "text": "The diaphragm is primarily innervated by the  phrenic nerve  which is formed from the  cervical nerves  C3, C4 and C5. [ 7 ]   While the central portion of the diaphragm sends sensory afferents via the phrenic nerve, the peripheral portions of the diaphragm send sensory afferents via the  intercostal  (T5\u2013T11) [ 8 ]  and  subcostal nerves  (T12). [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2043", "text": "Arteries and veins above and below the diaphragm supply and drain blood."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2044", "text": "From above, the diaphragm receives blood from branches of the  internal thoracic arteries , namely the  pericardiacophrenic artery  and  musculophrenic artery ; from the  superior phrenic arteries , which arise directly from the  thoracic aorta ; and from the lower  internal intercostal arteries . From below, the  inferior phrenic arteries  supply the diaphragm. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2045", "text": "The diaphragm drains blood into the  brachiocephalic veins ,  azygos veins , and veins that drain into the  inferior vena cava  and  left suprarenal vein . [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2046", "text": "The sternal portion of the muscle is sometimes wanting and more rarely defects occur in the lateral part of the  central tendon  or adjoining muscle fibers."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2047", "text": "The thoracic diaphragm develops during  embryogenesis , beginning in the third week after fertilization with two processes known as transverse folding and longitudinal folding. The  septum transversum , the primitive central tendon of the diaphragm, originates at the rostral pole of the  embryo  and is relocated during longitudinal folding to the ventral thoracic region.  Transverse folding brings the body wall anteriorly to enclose the gut and body cavities.  The pleuroperitoneal membrane and body wall myoblasts, from somatic lateral plate  mesoderm , meet the septum transversum to close off the pericardio-peritoneal canals on either side of the presumptive esophagus, forming a barrier that separates the peritoneal and pleuropericardial cavities.  Furthermore, dorsal  mesenchyme  surrounding the presumptive esophagus form the muscular crura of the diaphragm."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2048", "text": "Because the earliest element of the embryological diaphragm, the septum transversum, forms in the cervical region, the  phrenic nerve  that innervates the diaphragm originates from the cervical spinal cord (C3,4, and 5).  As the septum transversum descends inferiorly, the phrenic nerve follows, accounting for its circuitous route from the upper cervical vertebrae, around the  pericardium , finally to innervate the diaphragm."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2049", "text": "The diaphragm is the main  muscle of respiration  and functions in  breathing . During inhalation, the diaphragm contracts and moves in the inferior direction, enlarging the volume of the thoracic cavity and reducing intra-thoracic pressure (the  external intercostal muscles  also participate in this enlargement), forcing the lungs to expand. In other words, the diaphragm's movement downwards creates a partial  vacuum  in the thoracic cavity, which forces the lungs to expand to fill the void, drawing air in the process."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2050", "text": "Cavity expansion happens in two extremes, along with intermediary forms. When the lower ribs are stabilized and the central tendon of the diaphragm is mobile, a contraction brings the insertion (central tendon) towards the origins and pushes the lower cavity towards the pelvis, allowing the thoracic cavity to expand downward. This is often called  belly breathing . When the central tendon is stabilized and the lower ribs are mobile, a contraction lifts the origins (ribs) up towards the insertion (central tendon) which works in conjunction with other muscles to allow the ribs to slide and the thoracic cavity to expand laterally and upwards."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2051", "text": "When the diaphragm relaxes (moves in the superior direction), air is exhaled by elastic recoil process  of the lung and the tissues lining the thoracic cavity. Assisting this function with muscular effort (called forced  exhalation ) involves the  internal intercostal muscles  used in conjunction with the  abdominal muscles , which act as an  antagonist  paired with the diaphragm's contraction. Diaphragm dysfunction is a well-known factor associated with various complications in patients, such as prolonged respiratory failure, difficulties in weaning from mechanical ventilation, extended hospitalization, increased morbidity, and mortality. [ 15 ]  Studies have reported that a thin diaphragm leads to greater lung compliance, which can contribute to respiratory failure. Furthermore, reduction in diaphragm thickness during the early stages of disease can serve as a prognostic marker in sepsis patients, and COVID-19 patients. [ 16 ] [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2052", "text": "The diaphragm is also involved in non-respiratory functions. It helps to expel  vomit ,  feces , and  urine  from the body by increasing intra-abdominal pressure, aids in childbirth, [ 18 ]  and prevents  acid reflux  by exerting pressure on the  esophagus  as it passes through the  esophageal hiatus ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2053", "text": "In some non-human animals, the diaphragm is not crucial for breathing; a cow, for instance, can survive fairly asymptomatically with diaphragmatic paralysis as long as no massive aerobic metabolic demands are made of it.  [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2054", "text": "If either the  phrenic nerve ,  cervical spine  or  brainstem  is damaged, this will sever the nervous supply to the diaphragm. The most common damage to the phrenic nerve is by  bronchial cancer , which usually only affects one side of the diaphragm. Other causes include  Guillain\u2013Barr\u00e9 syndrome  and  systemic lupus erythematosus . [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2055", "text": "A  hiatus hernia  is a  hernia  common in adults in which parts of the lower esophagus or stomach that are normally in the abdomen pass/bulge abnormally through the diaphragm and are present in the thorax.  Hernias are described as  rolling , in which the hernia is beside the oesophagus, or  sliding , in which the hernia directly involves the esophagus.  These hernias are implicated in the development of reflux, as the different pressures between the thorax and abdomen normally act to keep pressure on the  esophageal hiatus .  With herniation, this pressure is no longer present, and the angle between the  cardia  of the  stomach  and the oesophagus disappear. Not all hiatus hernias cause symptoms however, although almost all people with  Barrett's oesophagus  or  oesophagitis  have a hiatus hernia. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2056", "text": "Hernias may also occur as a result of congenital malformation, a  congenital diaphragmatic hernia . When the  pleuroperitoneal  membranes fail to fuse, the diaphragm does not act as an effective barrier between the abdomen and thorax. Herniation is usually of the left, and commonly through the posterior  lumbocostal triangle , although rarely through the anterior  foramen of Morgagni . The contents of the abdomen, including the  intestines , may be present in the thorax, which may impact development of the growing lungs and lead to  hypoplasia . [ 20 ]  This condition is present in 0.8 - 5/10,000 births. [ 21 ]   A large herniation has high mortality rate, and requires immediate surgical repair. [ 22 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2057", "text": "Due to its position separating the  thorax  and  abdomen , fluid abnormally present in the thorax, or air abnormally present in the abdomen, may collect on one side of the diaphragm. An  X-ray  may reveal this.  Pleural effusion , in which there is fluid abnormally present between the two  pleurae  of the  lungs , is detected by an  X-ray  of the chest, showing fluid collecting in the  angle between the ribs and diaphragm . [ 19 ]  An X-ray may also be used to reveal a  pneumoperitoneum , in which there is gas in the abdomen."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2058", "text": "An X-ray may also be used to check for herniation. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2059", "text": "The adoption of a deeper breathing pattern typically occurs during physical exercise in order to facilitate greater oxygen absorption. During this process the diaphragm more consistently adopts a lower position within the body's core. In addition to its primary role in breathing, the diaphragm also plays a secondary role in strengthening the posture of the core. This is especially evident during deep breathing where its generally lower position increases intra-abdominal pressure, which serves to strengthen the lumbar spine. [ 23 ] [ better\u00a0source\u00a0needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2060", "text": "The key to real core stabilization is to maintain the increased IAP while going through normal breathing cycles. [...] The diaphragm then performs its breathing function at a lower position to facilitate a higher IAP. [ 23 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2061", "text": "[ better\u00a0source\u00a0needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2062", "text": "Therefore, if a person's diaphragm position is lower in general, through deep breathing, then this assists the strengthening of their core during that period. This can be an aid in strength training and other forms of athletic endeavour. For this reason, taking a deep breath or adopting a deeper breathing pattern is typically recommended when lifting heavy weights."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2063", "text": "The existence of a membrane separating the pharynx from the stomach can be traced widely among the  chordates .  Thus the  model organism , the marine chordate  lancelet , possesses an atriopore by which water exits the pharynx, which has been claimed (and disputed) to be homologous to structures in  ascidians  and  hagfishes . [ 25 ]   The  tunicate  epicardium separates digestive organs from the pharynx and heart, but the anus returns to the upper compartment to discharge wastes through an outgoing siphon."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2064", "text": "Thus the diaphragm emerges in the context of a body plan that separated an upper feeding compartment from a lower digestive tract, but the point at which it originates is a matter of definition.  Structures in fish, amphibians, reptiles, and birds have been called diaphragms, but it has been argued that these structures are not  homologous .  For instance, the alligator diaphragmaticus muscle does not insert on the  esophagus  and does not affect pressure of the lower esophageal sphincter. [ 26 ]   The lungs are located in the abdominal compartment of amphibians and reptiles, so that contraction of the diaphragm expels air from the lungs rather than drawing it into them.  In birds and mammals, lungs are located above the diaphragm.  The presence of an exceptionally well-preserved fossil of  Sinosauropteryx , with lungs located beneath the diaphragm as in crocodiles, has been used to argue that dinosaurs could not have sustained an active warm-blooded physiology, or that birds could not have evolved from dinosaurs. [ citation needed ]   An explanation for this (put forward in 1905), is that lungs originated beneath the diaphragm, but as the demands for respiration increased in warm-blooded birds and mammals, natural selection came to favor the  parallel evolution  of the herniation of the lungs from the abdominal cavity in both lineages. [ 24 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2065", "text": "However, birds lack diaphragms.  They do not breathe in the same way as mammals and do not rely on creating a negative pressure in the thoracic cavity, at least not to the same extent.  They rely on a rocking motion of the keel of the sternum to create local areas of reduced pressure to supply thin, membranous airsacs cranially and caudally to the fixed-volume, non-expansive lungs.  A complicated system of valves and air sacs cycles air constantly over the absorption surfaces of the lungs so allowing maximal efficiency of gaseous exchange.  Thus, birds do not have the reciprocal tidal breathing flow of mammals.  On careful dissection, around eight air sacs can be clearly seen.  They extend quite far caudally into the abdomen. [ 27 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2066", "text": "This article incorporates text in the  public domain  from  page 404  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2067", "text": "This article incorporates text from a publication now in the  public domain :\u00a0 Chambers, Ephraim , ed. (1728).  Cyclop\u00e6dia, or an Universal Dictionary of Arts and Sciences  (1st\u00a0ed.). James and John Knapton, et al.   {{ cite encyclopedia }} :  Missing or empty  |title=  ( help )"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2068", "text": "The  aortic hiatus  is a midline [ 1 ] :\u200a185\u200a  opening in the posterior part of the  diaphragm  giving passage to the  descending aorta  as well as the  thoracic duct , and variably the  azygos  and  hemiazygos  veins. [ 2 ]  It is the lowest and most posterior of the large apertures. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2069", "text": "It is located at the level of the inferior border of the  twelfth thoracic vertebra (T12) , [ 2 ]  posterior to the  median arcuate ligament [ 2 ] [ 1 ] :\u200a185\u200a  between the two  crura of the diaphragm . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2070", "text": "Strictly speaking, it is not an aperture in the diaphragm but an  osseoaponeurotic  opening between it and the  vertebral column , and therefore behind the diaphragm (meaning that diaphragmatic contractions during respiration do not directly affect aortic blood flow [ 3 ] ). [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2071", "text": "The hiatus is situated slightly to the left of the midline, and is bound anteriorly by the crura, and posteriorly by the body of the first  lumbar vertebra . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2072", "text": "Occasionally some tendinous fibers prolonged across the bodies of the vertebr\u00e6 from the medial parts of the inferior ends of the  crura  pass posterior to the aorta, and thus convert the hiatus into a fibrous ring. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2073", "text": "The aorta is situated on the left, the thoracic duct in the middle, and the azygos vein on the right. [ 1 ] :\u200a185\u200a  The hemiazygos vein may pass through the aortic hiatus [ 2 ]  or may pass through the diaphragm independently through its own foramen in the left crus. [ 1 ] :\u200a186"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2074", "text": "The  crus of diaphragm  ( pl. : crura), refers to one of two  tendinous  structures that extends below the  diaphragm  to the  vertebral column . There is a right crus and a left crus, which together form a tether for muscular contraction. They take their name from their leg-shaped appearance \u2013  crus  meaning  leg  in Latin."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2075", "text": "The crura originate from the front of the bodies and  intervertebral fibrocartilage  of the  lumbar vertebrae . They are tendinous and blend with the  anterior longitudinal ligament  of the  vertebral column ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2076", "text": "The medial tendinous margins of the crura pass anteriorly and medialward, and meet in the middle line to form an arch across the front of the  aorta  known as the  median arcuate ligament ; this arch is often poorly defined.  The area behind this arch is known as the  aortic hiatus ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2077", "text": "From this series of origins the fibers of the diaphragm converge to be inserted into the  central tendon ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2078", "text": "The fibers arising from the  xiphoid process  are very short, and occasionally  aponeurotic ; those from the medial and  lateral lumbocostal arches , and more especially those from the ribs and their cartilages, are longer, and describe marked curves as they ascend and converge to their insertion. The fibers of the crura diverge as they ascend, the most lateral being directed upward and lateralward to the central tendon."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2079", "text": "The medial fibers of the right crus ascend on the left side of the  esophageal hiatus , and occasionally a fasciculus of the left crus crosses the aorta and runs obliquely through the fibers of the right crus toward the  vena caval foramen ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2080", "text": "This article incorporates text in the  public domain  from  page 405  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2081", "text": "In human anatomy, the  esophageal hiatus  is an opening in the  diaphragm  through which the  esophagus  and the  vagus nerve  pass."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2082", "text": "The esophageal hiatus is an oval opening [ 1 ]  in (sources differ) the right  crus of the diaphragm [ 1 ] /left crus of the diaphragm, with fibres of the right crus looping around the hiatus to form a sling (upon  inspiration , this sling would constrict the esophagus, forming a functional (not anatomical) sphincter that prevents gastric contents from refluxing up the esophagus when intra-abdominal pressure rises during inspiration [ citation needed ] ). [ 2 ]  Fibers of the right crus  decussate  inferior to the hiatus. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2083", "text": "The esophageal hiatus gives passage to the oesophagus as well as the  anterior  and the  posterior vagal trunk , esophageal branches of the  left gastric artery  and  vein , and some lymphatic vessels. [ 1 ] [ 2 ]  The  transversalis fascia  lining the inferior surface of the diaphragm extends superiorly through the hiatus to blend with the  endothoracic fascia  and attach to the oesophagus 2-3 cm superior to the  phrenoesophageal ligament . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2084", "text": "The esophageal hiatus is located at level of the  tenth thoracic vertebra (T10) , 2.5 cm to the left of the midline, [ 2 ]  and (sources differ) posterior to the 7th left  costal cartilage [ 2 ] /at the level of the 8th or 9th  intercostal spaces . [ 3 ]  It is placed superior, anterior, and slightly left of the  aortic hiatus . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2085", "text": "Hiatal hernia  occurs when part of the stomach passes through the esophageal hiatus. [ 4 ] [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2086", "text": "The  lateral arcuate ligament  (also  lateral lumbocostal arch  and  external arcuate ligament ) is a  ligament  under the  diaphragm  that arches across the upper part of the  quadratus lumborum muscle . It is traversed by the  subcostal nerve ,  artery  and  vein ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2087", "text": "The lateral arcuate ligament runs from the front of the transverse process of the first  lumbar vertebra , and, laterally, to the tip and lower margin of the twelfth  rib . [ 1 ]  It forms an arch over the  quadratus lumborum muscle . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2088", "text": "The lateral arcuate ligament is commonly described in anatomy textbooks as attaching at the first lumbar vertebra (L1). [ 2 ]  However, other instances have been found in  cadaver  studies with attachments at either the second (L2) or third (L3) lumbar vertebra. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2089", "text": "In around 5% of people, inferolateral extensions of the lateral arcuate ligaments, such as thickened nodular areas, are found adjacent to the lateral diaphragmatic surface which can be visualized with  computed tomography  (CT) scans. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2090", "text": "The lateral arcuate ligaments were described by  Galen , as early as AD 177. [ 4 ] [ 5 ]  This was found in his animal dissections performed as part of his  Rome  lectures, collected in  De Anatomicus Administrationibus . [ 4 ] [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2091", "text": "The  lumbocostal triangle  (also  Bochdalek's foramen ,   Bochdalek's triangle ) is a space between the costal and lumbar parts of the diaphragm. The base of this triangular space is formed by muscle attachments originating from the XII rib and muscle fibers attaching to the  lateral arcuate ligament . The apex of the triangle is oriented towards the tendinous centre of the diaphragm.  Parietal pleura  and  renal capsule  are in contact in this space, so possible infection can be transmitted through this space."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2092", "text": "The existence of this foramen might cause a  congenital diaphragmatic hernia ,  Bochdalek hernia ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2093", "text": "This condition has also been associated with thoracic kidney, the presence of the kidney in the thorax instead of the usual abdominal position. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2094", "text": "The  medial arcuate ligament  (also  medial lumbocostal arch  and  internal arcuate ligament ) is a tendinous fascia that arches over the  psoas major  muscle as it passes posterior the  diaphragm .  \nThe purpose of the medial arcuate ligament is to attach the diaphragm to the spine (lumbar vertebra L1 - L2)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2095", "text": "The medial arcuate ligament is an arch in the fascia covering the upper part of the  psoas major .  It is attached to the side of the body of the first or second  lumbar vertebra , laterally, it is fixed to the front of the transverse process of the first and, sometimes also, to that of the second lumbar vertebra."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2096", "text": "It lies between the  lateral arcuate ligament  and the midline  median arcuate ligament ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2097", "text": "The sympathetic chain enters the abdomen by passing deep into this ligament of the diaphragm. This is in contrast to the parasympathetic  vagus nerve  which passes through the  esophageal hiatus ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2098", "text": "The  median arcuate ligament  is a  ligament  under the  diaphragm  that connects the right and left  crura  of  diaphragm ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2099", "text": "The median arcuate ligament is formed by the right and left crura of the  diaphragm . [ 1 ]  The crura connect to form an arch, behind which is the  aortic hiatus , through which pass the  aorta , the  azygos vein , and the  thoracic duct ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2100", "text": "In between 10% and 24% of people, the median arcuate ligament occurs very low. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2101", "text": "Compression of  celiac artery  and  celiac ganglia  by the median arcuate ligament being too low in some individuals; [ 3 ]  can lead to the  median arcuate ligament syndrome , which is characterized by abdominal pain, weight loss, and an epigastric  bruit . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2102", "text": "The  sternocostal triangle  (foramina of Morgagni, Larrey's space, sternocostal hiatus, etc. [ 1 ] ) are small zones lying between the  costal  and  sternal  attachments of the  thoracic diaphragm . No vascular elements are present within this space. [ 2 ]  The borders of this space are:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2103", "text": "Medial: the lateral border of the sternal part of the  diaphragm"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2104", "text": "Lateral: the medial border of the costal part of the  diaphragm"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2105", "text": "Anterior: the musculoaponeurotic plane formed by a confluence of the  transversus thoracis  superiorly and the  transversus abdominis  inferiorly"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2106", "text": "The  superficial epigastric artery  passes in front of the aponeurotic plane that forms the anterior border and enters the abdomen anterior to the  diaphragm . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2107", "text": "It is named for  Giovanni Battista Morgagni . [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2108", "text": "It can be a site of  Morgagni's hernia ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2109", "text": "The  caval opening of diaphragm [ 2 ]  (also  foramen of vena cava , [ 1 ]   vena caval foramen [ 3 ] [ 1 ] ) is an opening in the  central tendon of diaphragm  giving passage to the  inferior vena cava [ 2 ] [ 3 ]  as well as to some terminal [ 2 ]  branches of [ 2 ] [ 1 ]  the  right phrenic nerve , [ 2 ] [ 3 ]  and some lymphatic vessels en route to middle phrenic and  mediastinal lymph nodes . [ 2 ]  The foramen occurs between the middle leaf and the right leaf of the  central tendon of diaphragm , [ 2 ] [ 3 ]  with the fibres of the central tendon uniting vigorously with the  adventitia  of the inferior vena cava (resulting in dilation of the IVC with contraction of the diaphragm during inspiration so as to facilitate venous return to the heart [ 2 ] ). [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2110", "text": "It is the superior-most of the three large diaphragmatic openings [ 2 ]  and is situated at the level of (sources differ) the 8th  thoracic vertebra  (T8) [ 3 ] /the intervertebral disc between T8 and T9 vertebrae. [ 2 ]  It is situated slightly to the right of the midline. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2111", "text": "The  heart  is a muscular  organ  found in  humans  and other  animals . This organ pumps  blood  through the  blood vessels . [ 1 ]  Heart and blood vessels together make the  circulatory system . [ 2 ]  The pumped blood carries  oxygen  and  nutrients  to the tissue, while carrying  metabolic waste  such as  carbon dioxide  to the  lungs . [ 3 ]  In  humans , the heart is approximately the size of a closed  fist  and is located between the lungs, in the middle compartment of the  chest , called the  mediastinum . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2112", "text": "In humans, the heart is divided into four chambers: upper left and right  atria  and lower left and right  ventricles . [ 5 ] [ 6 ]  Commonly, the right atrium and ventricle are referred together as the  right heart  and their left counterparts as the  left heart . [ 7 ]  In a healthy heart, blood flows one way through the heart due to  heart valves , which prevent  backflow . [ 4 ]  The heart is enclosed in a protective sac, the  pericardium , which also contains a small amount of  fluid . The wall of the heart is made up of three layers:  epicardium ,  myocardium , and  endocardium . [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2113", "text": "The heart pumps blood with a  rhythm  determined by a group of  pacemaker cells  in the  sinoatrial node . These generate an electric current that causes the heart to contract, traveling through the  atrioventricular node  and along the  conduction system of the heart . In humans, deoxygenated blood enters the heart through the right atrium from the  superior  and  inferior venae cavae  and passes to the right ventricle. From here, it is pumped into  pulmonary circulation  to the  lungs , where it receives oxygen and gives off carbon dioxide. Oxygenated blood then returns to the left atrium, passes through the left ventricle and is pumped out through the  aorta  into  systemic circulation , traveling through  arteries ,  arterioles , and  capillaries \u2014where  nutrients  and other substances are exchanged between blood vessels and cells, losing oxygen and gaining carbon dioxide\u2014before being returned to the heart through  venules  and  veins . [ 9 ]  The heart beats at a  resting rate  close to 72 beats per minute. [ 10 ]   Exercise  temporarily increases the rate, but lowers it in the long term, and is good for heart health. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2114", "text": "Cardiovascular diseases  are the most common cause of death globally as of 2008, accounting for 30% of all human deaths. [ 12 ] [ 13 ]  Of these more than three-quarters are a result of  coronary artery disease  and  stroke . [ 12 ]  Risk factors include:  smoking , being  overweight , little exercise,  high cholesterol ,  high blood pressure , and poorly controlled  diabetes , among others. [ 14 ]  Cardiovascular diseases do not frequently have symptoms but may cause  chest pain  or  shortness of breath . Diagnosis of heart disease is often done by the taking of a  medical history ,  listening  to the  heart-sounds  with a  stethoscope , as well as with  ECG , and  echocardiogram  which uses  ultrasound . [ 4 ]  Specialists who focus on diseases of the heart are called  cardiologists , although many specialties of medicine may be involved in treatment. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2115", "text": "The human heart is situated in the  mediastinum , at the level of  thoracic vertebrae   T5 \u2013 T8 . A double-membraned sac called the  pericardium  surrounds the heart and attaches to the mediastinum. [ 16 ]  The back surface of the heart lies near the  vertebral column , and the front surface, known as the sternocostal surface, sits behind the  sternum  and  rib cartilages . [ 8 ]  The upper part of the heart is the attachment point for several large blood vessels\u2014the  venae cavae ,  aorta  and  pulmonary trunk . The upper part of the heart is located at the level of the third costal cartilage. [ 8 ]  The lower tip of the heart, the  apex , lies to the left of the sternum (8 to 9\u00a0cm from the  midsternal line ) between the junction of the fourth and fifth ribs near their  articulation  with the costal cartilages. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2116", "text": "The largest part of the heart is usually slightly offset to the left side of the chest ( levocardia ). In a rare congenital disorder ( dextrocardia ) the heart is offset to the right side and is felt to be on the left because the  left heart  is stronger and larger, since it pumps to all body parts. Because the heart is between the  lungs , the left lung is smaller than the right lung and has a cardiac notch in its border to accommodate the heart. [ 8 ] \nThe heart is cone-shaped, with its  base  positioned upwards and tapering down to the apex. [ 8 ]  An adult heart has a mass of 250\u2013350 grams (9\u201312\u00a0oz). [ 17 ]  The heart is often described as the size of a fist: 12\u00a0cm (5\u00a0in) in length, 8\u00a0cm (3.5\u00a0in) wide, and 6\u00a0cm (2.5\u00a0in) in thickness, [ 8 ]  although this description is disputed, as the heart is likely to be slightly larger. [ 18 ]  Well-trained  athletes  can have much larger hearts due to the effects of exercise on the heart muscle, similar to the response of skeletal muscle. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2117", "text": "The heart has four chambers, two upper  atria , the receiving chambers, and two lower  ventricles , the discharging chambers. The atria open into the ventricles via the  atrioventricular valves , present in the  atrioventricular septum . This distinction is visible also on the surface of the heart as the  coronary sulcus . [ 19 ]  There is an ear-shaped structure in the upper right atrium called the  right atrial appendage , or auricle, and another in the upper left atrium, the  left atrial appendage . [ 20 ]  The right atrium and the right ventricle together are sometimes referred to as the  right heart . Similarly, the left atrium and the left ventricle together are sometimes referred to as the  left heart . [ 7 ]  The ventricles are separated from each other by the  interventricular septum , visible on the surface of the heart as the  anterior longitudinal sulcus  and the  posterior interventricular sulcus . [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2118", "text": "The  fibrous   cardiac skeleton  gives structure to the heart. It forms the atrioventricular septum, which separates the atria from the ventricles, and the fibrous rings, which serve as bases for the four  heart valves . [ 21 ]  The cardiac skeleton also provides an important boundary in the heart's electrical conduction system since collagen cannot conduct  electricity . The interatrial septum separates the atria, and the interventricular septum separates the ventricles. [ 8 ]  The interventricular septum is much thicker than the interatrial septum since the ventricles need to generate greater pressure when they contract. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2119", "text": "The heart has four valves, which separate its chambers. One valve lies between each atrium and ventricle, and one valve rests at the exit of each ventricle. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2120", "text": "The valves between the atria and ventricles are called the atrioventricular valves. Between the right atrium and the right ventricle is the  tricuspid valve . The tricuspid valve has three cusps, [ 22 ]  which connect to  chordae tendinae  and three  papillary muscles  named the anterior, posterior, and septal muscles, after their relative positions. [ 22 ]  The  mitral valve  lies between the left atrium and left ventricle. It is also known as the bicuspid valve due to its having two cusps, an anterior and a posterior cusp. These cusps are also attached via chordae tendinae to two papillary muscles projecting from the ventricular wall. [ 23 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2121", "text": "The papillary muscles extend from the walls of the heart to valves by cartilaginous connections called chordae tendinae. These muscles prevent the valves from falling too far back when they close. [ 24 ]  During the relaxation phase of the cardiac cycle, the papillary muscles are also relaxed and the tension on the chordae tendineae is slight. As the heart chambers contract, so do the papillary muscles. This creates tension on the chordae tendineae, helping to hold the cusps of the atrioventricular valves in place and preventing them from being blown back into the atria. [ 8 ]   [ g ] [ 22 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2122", "text": "Two additional semilunar valves sit at the exit of each of the ventricles. The  pulmonary valve  is located at the base of the  pulmonary artery . This has three cusps which are not attached to any papillary muscles. When the ventricle relaxes blood flows back into the ventricle from the artery and this flow of blood fills the pocket-like valve, pressing against the cusps which close to seal the valve. The semilunar  aortic valve  is at the base of the  aorta  and also is not attached to papillary muscles. This too has three cusps which close with the pressure of the blood flowing back from the aorta. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2123", "text": "The right heart consists of two chambers, the right atrium and the right ventricle, separated by a valve, the  tricuspid valve . [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2124", "text": "The right atrium receives blood almost continuously from the body's two major  veins , the  superior  and  inferior   venae cavae . A small amount of blood from the coronary circulation also drains into the right atrium via the  coronary sinus , which is immediately above and to the middle of the opening of the inferior vena cava. [ 8 ]  In the wall of the right atrium is an oval-shaped depression known as the  fossa ovalis , which is a remnant of an opening in the fetal heart known as the  foramen ovale . [ 8 ]  Most of the internal surface of the right atrium is smooth, the depression of the fossa ovalis is medial, and the anterior surface has prominent ridges of  pectinate muscles , which are also present in the  right atrial appendage . [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2125", "text": "The right atrium is connected to the right ventricle by the tricuspid valve. [ 8 ]  The walls of the right ventricle are lined with  trabeculae carneae , ridges of cardiac muscle covered by endocardium. In addition to these muscular ridges, a band of cardiac muscle, also covered by endocardium, known as the  moderator band  reinforces the thin walls of the right ventricle and plays a crucial role in cardiac conduction. It arises from the lower part of the interventricular septum and crosses the interior space of the right ventricle to connect with the inferior papillary muscle. [ 8 ]  The right ventricle tapers into the  pulmonary trunk , into which it ejects blood when contracting. The pulmonary trunk branches into the left and right pulmonary arteries that carry the blood to each lung. The pulmonary valve lies between the right heart and the pulmonary trunk. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2126", "text": "The left heart has two chambers: the left atrium and the left ventricle, separated by the  mitral valve . [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2127", "text": "The left atrium receives oxygenated blood back from the lungs via one of the four  pulmonary veins . The left atrium has an outpouching called the  left atrial appendage . Like the right atrium, the left atrium is lined by  pectinate muscles . [ 25 ]  The left atrium is connected to the left ventricle by the mitral valve. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2128", "text": "The left ventricle is much thicker as compared with the right, due to the greater force needed to pump blood to the entire body. Like the right ventricle, the left also has  trabeculae carneae , but there is no  moderator band . The left ventricle pumps blood to the body through the aortic valve and into the aorta. Two small openings above the aortic valve carry blood to the  heart muscle ; the  left coronary artery  is above the left cusp of the valve, and the  right coronary artery  is above the right cusp. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2129", "text": "The heart wall is made up of three layers: the inner  endocardium , middle  myocardium  and outer  epicardium . These are surrounded by a double-membraned sac called the pericardium."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2130", "text": "The innermost layer of the heart is called the endocardium. It is made up of a lining of  simple squamous epithelium  and covers heart chambers and valves. It is continuous with the  endothelium  of the veins and arteries of the heart, and is joined to the myocardium with a thin layer of connective tissue. [ 8 ]  The endocardium, by secreting  endothelins , may also play a role in regulating the contraction of the myocardium. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2131", "text": "The middle layer of the heart wall is the myocardium, which is the  cardiac muscle \u2014a layer of involuntary  striated muscle tissue  surrounded by a framework of  collagen . The cardiac muscle pattern is elegant and complex, as the muscle cells swirl and spiral around the chambers of the heart, with the outer muscles forming a figure 8 pattern around the atria and around the bases of the great vessels and the inner muscles, forming a figure 8 around the two ventricles and proceeding toward the apex. This complex swirling pattern allows the heart to pump blood more effectively. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2132", "text": "There are two types of cells in cardiac muscle:  muscle cells  which have the ability to contract easily, and  pacemaker cells  of the conducting system. The muscle cells make up the bulk (99%) of cells in the atria and ventricles. These contractile cells are connected by  intercalated discs  which allow a rapid response to impulses of  action potential  from the pacemaker cells. The intercalated discs allow the cells to act as a  syncytium  and enable the contractions that pump blood through the heart and into the  major arteries . [ 8 ]  The pacemaker cells make up 1% of cells and form the conduction system of the heart. They are generally much smaller than the contractile cells and have few  myofibrils  which gives them limited contractibility. Their function is similar in many respects to  neurons . [ 8 ]  Cardiac muscle tissue has  autorhythmicity , the unique ability to initiate a cardiac action potential at a fixed rate\u2014spreading the impulse rapidly from cell to cell to trigger the contraction of the entire heart. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2133", "text": "There are specific  proteins expressed  in cardiac muscle cells. [ 26 ] [ 27 ]  These are mostly associated with muscle contraction, and bind with  actin ,  myosin ,  tropomyosin , and  troponin . They include  MYH6 ,  ACTC1 ,  TNNI3 ,  CDH2  and  PKP2 . Other proteins expressed are  MYH7  and  LDB3  that are also expressed in skeletal muscle. [ 28 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2134", "text": "The pericardium is the sac that surrounds the heart. The tough outer surface of the pericardium is called the fibrous membrane. This is lined by a double inner membrane called the serous membrane that produces  pericardial fluid  to lubricate the surface of the heart. [ 29 ]  The part of the serous membrane attached to the fibrous membrane is called the parietal pericardium, while the part of the serous membrane attached to the heart is known as the visceral pericardium. The pericardium is present in order to lubricate its movement against other structures within the chest, to keep the heart's position stabilised within the chest, and to protect the heart from infection. [ 30 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2135", "text": "Heart tissue, like all cells in the body, needs to be supplied with  oxygen ,  nutrients  and a way of removing  metabolic wastes . This is achieved by the coronary circulation, which includes  arteries ,  veins , and  lymphatic vessels . Blood flow through the coronary vessels occurs in peaks and troughs relating to the heart muscle's relaxation or contraction. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2136", "text": "Heart tissue receives blood from two arteries which arise just above the aortic valve. These are the  left main coronary artery  and the  right coronary artery . The left main coronary artery splits shortly after leaving the aorta into two vessels, the  left anterior descending  and the  left circumflex artery . The left anterior descending artery supplies heart tissue and the front, outer side, and septum of the left ventricle. It does this by branching into smaller arteries\u2014diagonal and septal branches. The left circumflex supplies the back and underneath of the left ventricle. The right coronary artery supplies the right atrium, right ventricle, and lower posterior sections of the left ventricle. The right coronary artery also supplies blood to the atrioventricular node (in about 90% of people) and the sinoatrial node (in about 60% of people). The right coronary artery runs in a groove at the back of the heart and the left anterior descending artery runs in a groove at the front. There is significant variation between people in the anatomy of the arteries that supply the heart  [ 31 ]  The arteries divide at their furthest reaches into smaller branches that join at the edges of each arterial distribution. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2137", "text": "The  coronary sinus  is a large vein that drains into the right atrium, and receives most of the venous drainage of the heart. It receives blood from the  great cardiac vein  (receiving the left atrium and both ventricles), the  posterior cardiac vein  (draining the back of the left ventricle), the  middle cardiac vein  (draining the bottom of the left and right ventricles), and  small cardiac veins . [ 32 ]  The  anterior cardiac veins  drain the front of the right ventricle and drain directly into the right atrium. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2138", "text": "Small lymphatic networks called  plexuses  exist beneath each of the three layers of the heart. These networks collect into a main left and a main right trunk, which travel up the groove between the ventricles that exists on the heart's surface, receiving smaller vessels as they travel up. These vessels then travel into the atrioventricular groove, and receive a third vessel which drains the section of the left ventricle sitting on the diaphragm. The left vessel joins with this third vessel, and travels along the pulmonary artery and left atrium, ending in the  inferior tracheobronchial node . The right vessel travels along the right atrium and the part of the right ventricle sitting on the diaphragm. It usually then travels in front of the ascending aorta and then ends in a brachiocephalic node. [ 33 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2139", "text": "The heart receives nerve signals from the  vagus nerve  and from nerves arising from the  sympathetic trunk . These nerves act to influence, but not control, the heart rate.  Sympathetic nerves  also influence the force of heart contraction. [ 34 ]  Signals that travel along these nerves arise from two paired  cardiovascular centres  in the  medulla oblongata . The vagus nerve of the  parasympathetic nervous system  acts to decrease the heart rate, and nerves from the  sympathetic trunk  act to increase the heart rate. [ 8 ]  These nerves form a network of nerves that lies over the heart called the  cardiac plexus . [ 8 ] [ 33 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2140", "text": "The vagus nerve is a long, wandering nerve that emerges from the  brainstem  and provides parasympathetic stimulation to a large number of organs in the thorax and abdomen, including the heart. [ 35 ]  The nerves from the sympathetic trunk emerge through the T1\u2013T4  thoracic ganglia  and travel to both the sinoatrial and atrioventricular nodes, as well as to the atria and ventricles. The ventricles are more richly innervated by sympathetic fibers than parasympathetic fibers. Sympathetic stimulation causes the release of the neurotransmitter  norepinephrine  (also known as  noradrenaline ) at the  neuromuscular junction  of the cardiac nerves [ citation needed ] . This shortens the repolarisation period, thus speeding the rate of depolarisation and contraction, which results in an increased heart rate. It opens chemical or ligand-gated sodium and calcium ion channels, allowing an influx of  positively charged ions . [ 8 ]  Norepinephrine binds to the  beta\u20131 receptor . [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2141", "text": "The heart is the first functional organ to develop and starts to beat and pump blood at about three weeks into  embryogenesis . This early start is crucial for subsequent embryonic and  prenatal development ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2142", "text": "The heart derives from  splanchnopleuric mesenchyme  in the neural plate which forms the  cardiogenic region . Two  endocardial tubes  form here that fuse to form a primitive heart tube known as the  tubular heart . [ 36 ]  Between the third and fourth week, the heart tube lengthens, and begins to fold to form an S-shape within the pericardium. This places the chambers and major vessels into the correct alignment for the developed heart. Further development will include the formation of the septa and the valves and the remodeling of the heart chambers. By the end of the fifth week, the septa are complete, and by the ninth week, the heart valves are complete. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2143", "text": "Before the fifth week, there is an opening in the fetal heart known as the  foramen ovale . The foramen ovale allowed blood in the fetal heart to pass directly from the right atrium to the left atrium, allowing some blood to bypass the lungs. Within seconds after birth, a flap of tissue known as the  septum primum  that previously acted as a valve closes the foramen ovale and establishes the typical cardiac circulation pattern. A depression in the surface of the right atrium remains where the foramen ovale was, called the fossa ovalis. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2144", "text": "The  embryonic  heart begins beating at around 22 days after conception (5 weeks after the last normal menstrual period, LMP). It starts to beat at a rate near to the mother's which is about 75\u201380  beats per minute  (bpm). The embryonic heart rate then accelerates and reaches a peak rate of 165\u2013185 bpm early in the early 7th week (early 9th week after the LMP). [ 37 ] [ 38 ]  After 9 weeks (start of the  fetal  stage) it starts to decelerate, slowing to around 145 (\u00b125) bpm at birth. There is no difference in female and male heart rates before birth. [ 39 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2145", "text": "The heart functions as a pump in the  circulatory system  to provide a continuous  flow of blood  throughout the body. This circulation consists of the  systemic circulation  to and from the body and the  pulmonary circulation  to and from the lungs. Blood in the pulmonary circulation exchanges  carbon dioxide  for oxygen in the lungs through the process of  respiration . The systemic circulation then transports oxygen to the body and returns carbon dioxide and relatively deoxygenated blood to the heart for transfer to the lungs. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2146", "text": "The  right heart  collects deoxygenated blood from two large veins, the  superior  and  inferior   venae cavae . Blood collects in the right and left atrium continuously. [ 8 ]  The superior vena cava drains blood from above the  diaphragm  and empties into the upper back part of the right atrium. The inferior vena cava drains the blood from below the diaphragm and empties into the back part of the atrium below the opening for the superior vena cava. Immediately above and to the middle of the opening of the inferior vena cava is the opening of the thin-walled coronary sinus. [ 8 ]  Additionally, the  coronary sinus  returns deoxygenated blood from the myocardium to the right atrium. The blood collects in the right atrium. When the right atrium contracts, the blood is pumped through the  tricuspid valve  into the right ventricle. As the right ventricle contracts, the tricuspid valve closes and the blood is pumped into the pulmonary trunk through the pulmonary valve. The pulmonary trunk divides into pulmonary arteries and progressively smaller arteries throughout the lungs, until it reaches  capillaries . As these pass by  alveoli  carbon dioxide is  exchanged  for oxygen. This happens through the passive process of  diffusion ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2147", "text": "In the  left heart , oxygenated blood is returned to the left atrium via the pulmonary veins. It is then pumped into the left ventricle through the  mitral valve  and into the aorta through the aortic valve for systemic circulation. The aorta is a large artery that branches into many smaller arteries,  arterioles , and ultimately capillaries. In the capillaries, oxygen and nutrients from blood are supplied to body cells for metabolism, and exchanged for carbon dioxide and waste products. [ 8 ]  Capillary blood, now deoxygenated, travels into  venules  and veins that ultimately collect in the superior and inferior vena cavae, and into the right heart."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2148", "text": "The cardiac cycle is the sequence of events in which the heart contracts and relaxes with every heartbeat. [ 10 ]  The period of time during which the ventricles contract, forcing blood out into the aorta and main pulmonary artery, is known as  systole , while the period during which the ventricles relax and refill with blood is known as  diastole . The atria and ventricles work in concert, so in systole when the ventricles are contracting, the atria are relaxed and collecting blood. When the ventricles are relaxed in diastole, the atria contract to pump blood to the ventricles. This coordination ensures blood is pumped efficiently to the body. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2149", "text": "At the beginning of the cardiac cycle, the ventricles are relaxing. As they do so, they are filled by blood passing through the open  mitral  and  tricuspid  valves. After the ventricles have completed most of their filling, the atria contract, forcing further blood into the ventricles and priming the pump. Next, the ventricles start to contract. As the pressure rises within the cavities of the ventricles, the mitral and tricuspid valves are forced shut. As the pressure within the ventricles rises further, exceeding the pressure with the aorta and pulmonary arteries, the aortic and pulmonary valves open. Blood is ejected from the heart, causing the pressure within the ventricles to fall. Simultaneously, the atria refill as blood flows into the right atrium through the superior and  inferior vena cavae , and into the left atrium through the pulmonary veins. Finally, when the pressure within the ventricles falls below the pressure within the aorta and pulmonary arteries, the aortic and pulmonary valves close. The ventricles start to relax, the mitral and tricuspid valves open, and the cycle begins again. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2150", "text": "Cardiac output (CO) is a measurement of the amount of blood pumped by each ventricle (stroke volume) in one minute. This is calculated by multiplying the stroke volume (SV) by the beats per minute of the heart rate (HR). So that: CO = SV x HR. [ 8 ] \nThe cardiac output is normalized to body size through  body surface area  and is called the  cardiac index ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2151", "text": "The average cardiac output, using an average stroke volume of about 70mL, is 5.25 L/min, with a normal range of 4.0\u20138.0 L/min. [ 8 ]  The stroke volume is normally measured using an  echocardiogram  and can be influenced by the size of the heart, physical and mental condition of the individual,  sex ,  contractility , duration of contraction,  preload  and  afterload . [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2152", "text": "Preload  refers to the filling pressure of the atria at the end of diastole, when the ventricles are at their fullest. A main factor is how long it takes the ventricles to fill: if the ventricles contract more frequently, then there is less time to fill and the preload will be less. [ 8 ]  Preload can also be affected by a person's blood volume. The force of each contraction of the heart muscle is proportional to the preload, described as the  Frank-Starling mechanism . This states that the force of contraction is directly proportional to the initial length of muscle fiber, meaning a ventricle will contract more forcefully, the more it is stretched. [ 8 ] [ 40 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2153", "text": "Afterload , or how much pressure the heart must generate to eject blood at systole, is influenced by  vascular resistance . It can be influenced by narrowing of the heart valves ( stenosis ) or contraction or relaxation of the peripheral blood vessels. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2154", "text": "The strength of heart muscle contractions controls the stroke volume. This can be influenced positively or negatively by agents termed  inotropes . [ 41 ]  These agents can be a result of changes within the body, or be given as drugs as part of treatment for a medical disorder, or as a form of  life support , particularly in  intensive care units . Inotropes that increase the force of contraction are \"positive\" inotropes, and include  sympathetic  agents such as  adrenaline ,  noradrenaline  and  dopamine . [ 42 ]  \"Negative\" inotropes decrease the force of contraction and include  calcium channel blockers . [ 41 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2155", "text": "The normal rhythmical heart beat, called  sinus rhythm , is established by the heart's own pacemaker, the  sinoatrial node  (also known as the sinus node or the SA node). Here an electrical signal is created that travels through the heart, causing the heart muscle to contract. The sinoatrial node is found in the upper part of the  right atrium  near to the junction with the superior vena cava. [ 43 ]  The electrical signal generated by the sinoatrial node travels through the right atrium in a radial way that is not completely understood. It travels to the left atrium via  Bachmann's bundle , such that the muscles of the left and right atria contract together. [ 44 ] [ 45 ] [ 46 ]  The signal then travels to the  atrioventricular node . This is found at the bottom of the right atrium in the  atrioventricular septum , the boundary between the right atrium and the left ventricle. The septum is part of the  cardiac skeleton , tissue within the heart that the electrical signal cannot pass through, which forces the signal to pass through the atrioventricular node only. [ 8 ]  The signal then travels along the  bundle of His  to left and right  bundle branches  through to the ventricles of the heart. In the ventricles the signal is carried by specialized tissue called the  Purkinje fibers  which then transmit the electric charge to the heart muscle. [ 47 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2156", "text": "The normal  resting heart rate  is called the  sinus rhythm , created and sustained by the  sinoatrial node , a group of pacemaking cells found in the wall of the right atrium. Cells in the sinoatrial node do this by creating an  action potential . The  cardiac action potential  is created by the movement of specific  electrolytes  into and out of the pacemaker cells. The action potential then spreads to nearby cells. [ 48 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2157", "text": "When the sinoatrial cells are resting, they have a negative charge on their membranes. A rapid influx of  sodium  ions causes the membrane's charge to become positive; this is called  depolarisation  and occurs spontaneously. [ 8 ]  Once the cell has a sufficiently high charge, the sodium channels close and  calcium  ions then begin to enter the cell, shortly after which  potassium  begins to leave it. All the ions travel through  ion channels  in the membrane of the sinoatrial cells. The potassium and calcium start to move out of and into the cell only once it has a sufficiently high charge, and so are called  voltage-gated . Shortly after this, the calcium channels close and  potassium channels  open, allowing potassium to leave the cell. This causes the cell to have a negative resting charge and is called  repolarisation . When the membrane potential reaches approximately \u221260 mV, the potassium channels close and the process may begin again. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2158", "text": "The ions move from areas where they are concentrated to where they are not. For this reason sodium moves into the cell from outside, and potassium moves from within the cell to outside the cell. Calcium also plays a critical role. Their influx through slow channels means that the sinoatrial cells have a prolonged \"plateau\" phase when they have a positive charge. A part of this is called the  absolute refractory period . Calcium ions also combine with the regulatory protein  troponin C  in the  troponin complex  to enable  contraction  of the cardiac muscle, and separate from the protein to allow relaxation. [ 49 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2159", "text": "The adult resting heart rate ranges from 60 to 100 bpm. The resting heart rate of a  newborn  can be 129 beats per minute (bpm) and this gradually decreases until maturity. [ 50 ]  An athlete's heart rate can be lower than 60 bpm. During exercise the rate can be 150 bpm with maximum rates reaching from 200 to 220 bpm. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2160", "text": "The normal  sinus rhythm  of the heart, giving the resting heart rate, is influenced by a number of factors. The  cardiovascular centres  in the brainstem control the sympathetic and parasympathetic influences to the heart through the vagus nerve and sympathetic trunk. [ 51 ]  These cardiovascular centres receive input from a series of receptors including  baroreceptors , sensing the stretching of blood vessels and  chemoreceptors , sensing the amount of oxygen and carbon dioxide in the blood and its pH. Through a series of reflexes these help regulate and sustain blood flow. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2161", "text": "Baroreceptors are stretch receptors located in the  aortic sinus ,  carotid bodies , the venae cavae, and other locations, including pulmonary vessels and the right side of the heart itself. Baroreceptors fire at a rate determined by how much they are stretched, [ 52 ]  which is influenced by blood pressure, level of physical activity, and the relative distribution of blood. With increased pressure and stretch, the rate of baroreceptor firing increases, and the cardiac centers decrease sympathetic stimulation and increase parasympathetic stimulation. As pressure and stretch decrease, the rate of baroreceptor firing decreases, and the cardiac centers increase sympathetic stimulation and decrease parasympathetic stimulation. [ 8 ]  There is a similar reflex, called the atrial reflex or  Bainbridge reflex , associated with varying rates of blood flow to the atria. Increased venous return stretches the walls of the atria where specialized baroreceptors are located. However, as the atrial baroreceptors increase their rate of firing and as they stretch due to the increased blood pressure, the cardiac center responds by increasing sympathetic stimulation and inhibiting parasympathetic stimulation to increase heart rate. The opposite is also true. [ 8 ]  Chemoreceptors present in the carotid body or adjacent to the aorta in an aortic body respond to the blood's oxygen, carbon dioxide levels. Low oxygen or high carbon dioxide will stimulate firing of the receptors. [ 53 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2162", "text": "Exercise and fitness levels, age, body temperature,  basal metabolic rate , and even a person's emotional state can all affect the heart rate. High levels of the hormones  epinephrine , norepinephrine, and  thyroid hormones  can increase the heart rate. The levels of electrolytes including calcium, potassium, and sodium can also influence the speed and regularity of the heart rate;  low blood oxygen , low  blood pressure  and  dehydration  may increase it. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2163", "text": "Cardiovascular diseases , which include diseases of the heart, are the leading cause of death worldwide. [ 54 ]  The majority of cardiovascular disease is noncommunicable and related to lifestyle and other factors, becoming more prevalent with ageing. [ 54 ]  Heart disease is a major cause of death, accounting for an average of 30% of all deaths in 2008, globally. [ 12 ]  This rate varies from a lower 28% to a high 40% in  high-income countries . [ 13 ]  Doctors that specialise in the heart are called  cardiologists . Many other medical professionals are involved in treating diseases of the heart, including  doctors ,  cardiothoracic surgeons ,  intensivists , and  allied health practitioners  including  physiotherapists  and  dieticians . [ 55 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2164", "text": "Coronary artery disease, also known as ischemic heart disease, is caused by  atherosclerosis \u2014a build-up of fatty material along the inner walls of the arteries. These fatty deposits known as atherosclerotic plaques  narrow  the coronary arteries, and if severe may reduce blood flow to the heart. [ 56 ]  If a narrowing (or stenosis) is relatively minor then the patient may not experience any symptoms. Severe narrowings may cause chest pain ( angina ) or breathlessness during exercise or even at rest. The thin covering of an atherosclerotic plaque can rupture, exposing the fatty centre to the circulating blood. In this case a clot or thrombus can form, blocking the artery, and restricting blood flow to an area of heart muscle causing a myocardial infarction (a heart attack) or  unstable angina . [ 57 ]  In the worst case this may cause  cardiac arrest , a sudden and utter loss of output from the heart. [ 58 ]   Obesity ,  high blood pressure , uncontrolled  diabetes , smoking and high  cholesterol  can all increase the risk of developing atherosclerosis and coronary artery disease. [ 54 ] [ 56 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2165", "text": "Heart failure is defined as a condition in which the heart is unable to pump enough blood to meet the demands of the body. [ 59 ]  Patients with  heart failure  may experience breathlessness especially when lying flat, as well as ankle swelling, known as  peripheral oedema . Heart failure is the result of many diseases affecting the heart, but is most commonly associated with  ischemic heart disease ,  valvular heart disease , or high blood pressure. Less common causes include various  cardiomyopathies . Heart failure is frequently associated with weakness of the heart muscle in the ventricles (systolic heart failure), but can also be seen in patients with heart muscle that is strong but stiff (diastolic heart failure). The condition may affect the left ventricle (causing predominantly breathlessness), the right ventricle (causing predominantly swelling of the legs and an elevated  jugular venous pressure ), or both ventricles. Patients with heart failure are at higher risk of developing dangerous heart rhythm disturbances or  arrhythmias . [ 59 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2166", "text": "Cardiomyopathies are diseases affecting the muscle of the heart. Some cause abnormal thickening of the heart muscle ( hypertrophic cardiomyopathy ), some cause the heart to abnormally expand and weaken ( dilated cardiomyopathy ), some cause the heart muscle to become stiff and unable to fully relax between contractions ( restrictive cardiomyopathy ) and some make the heart prone to abnormal heart rhythms ( arrhythmogenic cardiomyopathy ). These conditions are often genetic and can be  inherited , but some such as dilated cardiomyopathy may be caused by damage from toxins such as alcohol. Some cardiomyopathies such as hypertrophic cardiomopathy are linked to a higher risk of sudden cardiac death, particularly in athletes. [ 8 ]  Many cardiomyopathies can lead to heart failure in the later stages of the disease. [ 59 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2167", "text": "Healthy heart valves allow blood to flow easily in one direction, and prevent it from flowing in the other direction. A diseased heart valve may have a narrow opening ( stenosis ), that restricts the flow of blood in the forward direction. A valve may otherwise be leaky, allowing blood to leak in the reverse direction ( regurgitation ). Valvular heart disease may cause breathlessness, blackouts, or chest pain, but may be asymptomatic and only detected on a routine examination by hearing abnormal heart sounds or a  heart murmur . In the developed world, valvular heart disease is most commonly caused by degeneration secondary to old age, but may also be caused by infection of the heart valves ( endocarditis ). In some parts of the world  rheumatic heart disease  is a major cause of valvular heart disease, typically leading to mitral or aortic stenosis and caused by the body's immune system reacting to a  streptococcal  throat infection. [ 60 ] [ 61 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2168", "text": "While in the healthy heart, waves of electrical impulses originate in the  sinus node  before spreading to the rest of the atria, the  atrioventricular node , and finally the ventricles (referred to as a  normal sinus rhythm ), this normal rhythm can be disrupted. Abnormal heart rhythms or arrhythmias may be asymptomatic or may cause palpitations, blackouts, or breathlessness. Some types of arrhythmia such as  atrial fibrillation  increase the long term risk of  stroke . [ 62 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2169", "text": "Some arrhythmias cause the heart to beat abnormally slowly, referred to as a  bradycardia  or bradyarrhythmia. This may be caused by an  abnormally slow sinus node  or damage within the cardiac conduction system ( heart block ). [ 63 ]  In other arrhythmias the heart may beat abnormally rapidly, referred to as a  tachycardia  or tachyarrhythmia. These arrhythmias can take many forms and can originate from different structures within the heart\u2014some arise from the atria (e.g.  atrial flutter ), some from the atrioventricular node (e.g.  AV nodal re-entrant tachycardia ) whilst others arise from the ventricles (e.g.  ventricular tachycardia ). Some tachyarrhythmias are caused by scarring within the heart (e.g. some forms of  ventricular tachycardia ), others by an irritable focus (e.g. focal  atrial tachycardia ), while others are caused by additional abnormal conduction tissue that has been present since birth (e.g.  Wolff-Parkinson-White syndrome ). The most dangerous form of heart racing is  ventricular fibrillation , in which the ventricles quiver rather than contract, and which if untreated is rapidly fatal. [ 64 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2170", "text": "The sac which surrounds the heart, called the pericardium, can become inflamed in a condition known as  pericarditis . This condition typically causes chest pain that may spread to the back, and is often caused by a viral infection ( glandular fever ,  cytomegalovirus , or  coxsackievirus ). Fluid can build up within the pericardial sac, referred to as a  pericardial effusion . Pericardial effusions often occur secondary to pericarditis, kidney failure, or tumours, and frequently do not cause any symptoms. However, large effusions or effusions which accumulate rapidly can compress the heart in a condition known as  cardiac tamponade , causing breathlessness and potentially fatal low blood pressure. Fluid can be removed from the pericardial space for diagnosis or to relieve tamponade using a syringe in a procedure called  pericardiocentesis . [ 65 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2171", "text": "Some people are born with hearts that are abnormal and these abnormalities are known as congenital heart defects. They may range from the relatively minor (e.g.  patent foramen ovale , arguably a variant of normal) to serious life-threatening abnormalities (e.g.  hypoplastic left heart syndrome ). Common abnormalities include those that affect the heart muscle that separates the two side of the heart (a \"hole in the heart\", e.g.  ventricular septal defect ). Other defects include those affecting the heart valves (e.g.  congenital aortic stenosis ), or the main blood vessels that lead from the heart (e.g.  coarctation of the aorta ). More complex syndromes are seen that affect more than one part of the heart (e.g.  Tetralogy of Fallot )."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2172", "text": "Some congenital heart defects allow blood that is low in oxygen that would normally be returned to the lungs to instead be pumped back to the rest of the body. These are known as  cyanotic congenital heart defects  and are often more serious. Major congenital heart defects are often picked up in childhood, shortly after birth, or even before a child is born (e.g.  transposition of the great arteries ), causing breathlessness and a lower rate of growth. More minor forms of congenital heart disease may remain undetected for many years and only reveal themselves in adult life (e.g.,  atrial septal defect ). [ 66 ] [ 67 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2173", "text": "Channelopathies  can be categorized based on the organ system they affect. In the cardiovascular system, the electrical impulse required for each heart beat is provided by the  electrochemical gradient  of each heart cell. Because the beating of the heart depends on the proper movement of ions across the surface membrane, cardiac ion channelopathies form a major group of heart diseases. [ 68 ] [ 69 ]  Cardiac ion channelopathies may explain some of the cases of  sudden death syndrome  and  sudden arrhythmic death syndrome . [ 70 ]  Long QT syndrome is the most common form of cardiac channelopathy."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2174", "text": "Heart disease is diagnosed by the taking of a  medical history , a  cardiac examination , and further investigations, including  blood tests ,  echocardiograms ,  electrocardiograms , and  imaging . Other invasive procedures such as  cardiac catheterisation  can also play a role. [ 76 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2175", "text": "The cardiac examination includes inspection, feeling the chest with the hands ( palpation ) and listening with a stethoscope ( auscultation ). [ 77 ] [ 78 ]  It involves assessment of  signs  that may be visible on a person's hands (such as  splinter haemorrhages ), joints and other areas. A person's pulse is taken, usually at the  radial artery  near the wrist, in order to assess for the rhythm and strength of the pulse. The  blood pressure  is taken, using either a manual or automatic  sphygmomanometer  or using  a more invasive measurement  from within the artery. Any elevation of the  jugular venous pulse  is noted. A person's  chest  is felt for any transmitted vibrations from the heart, and then listened to with a stethoscope."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2176", "text": "Typically, healthy hearts have only two audible  heart sounds , called S1 and S2. The  first heart sound  S1, is the sound created by the closing of the atrioventricular valves during ventricular contraction and is normally described as \"lub\". The  second heart sound , S2, is the sound of the semilunar valves closing during ventricular diastole and is described as \"dub\". [ 8 ]  Each sound consists of two components, reflecting the slight difference in time as the two valves close. [ 79 ]  S2 may  split  into two distinct sounds, either as a result of inspiration or different valvular or cardiac problems. [ 79 ]  Additional heart sounds may also be present and these give rise to  gallop rhythms . A  third heart sound , S3 usually indicates an increase in ventricular blood volume. A  fourth heart sound  S4 is referred to as an atrial gallop and is produced by the sound of blood being forced into a stiff ventricle. The combined presence of S3 and S4 give a quadruple gallop. [ 8 ] \n Heart murmurs  are abnormal heart sounds which can be either related to disease or benign, and there are several kinds. [ 80 ]  There are normally two heart sounds, and abnormal heart sounds can either be extra sounds, or \"murmurs\" related to the flow of blood between the sounds. Murmurs are graded by volume, from 1 (the quietest), to 6 (the loudest), and evaluated by their relationship to the heart sounds, position in the cardiac cycle, and additional features such as their radiation to other sites, changes with a person's position, the frequency of the sound as determined by the side of the  stethoscope  by which they are heard, and site at which they are heard loudest. [ 80 ]  Murmurs may be caused by  damaged heart valves  or congenital heart disease such as  ventricular septal defects , or may be heard in normal hearts. A different type of sound, a  pericardial friction rub  can be heard in cases of pericarditis where the inflamed membranes can rub together."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2177", "text": "Blood tests play an important role in the diagnosis and treatment of many cardiovascular conditions."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2178", "text": "Troponin  is a sensitive  biomarker  for a heart with insufficient blood supply. It is released 4\u20136 hours after injury and usually peaks at about 12\u201324 hours. [ 42 ]  Two tests of troponin are often taken\u2014one at the time of initial presentation and another within 3\u20136 hours, [ 81 ]  with either a high level or a significant rise being diagnostic. A test for  brain natriuretic peptide  (BNP) can be used to evaluate for the presence of heart failure, and rises when there is increased demand on the left ventricle. These tests are considered  biomarkers  because they are highly specific for cardiac disease. [ 82 ]  Testing for the  MB form of creatine kinase  provides information about the heart's blood supply, but is used less frequently because it is less specific and sensitive. [ 83 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2179", "text": "Other blood tests are often taken to help understand a person's general health and risk factors that may contribute to heart disease. These often include a  full blood count  investigating for  anaemia , and  basic metabolic panel  that may reveal any disturbances in electrolytes. A  coagulation screen  is often required to ensure that the right level of anticoagulation is given.  Fasting lipids  and  fasting blood glucose  (or an  HbA1c  level) are often ordered to evaluate a person's  cholesterol  and diabetes status, respectively. [ 84 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2180", "text": "Using surface electrodes on the body, it is possible to record the electrical activity of the heart. This tracing of the electrical signal is the electrocardiogram (ECG) or (EKG). An ECG is a  bedside test  and involves the placement of ten leads on the body. This produces a \"12 lead\" ECG (three extra leads are calculated mathematically, and one lead is  electrically ground , or earthed). [ 85 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2181", "text": "There are five prominent features on the ECG: the  P wave  (atrial depolarisation), the  QRS complex  (ventricular depolarisation) [ h ]  and the  T wave  (ventricular repolarisation). [ 8 ]  As the heart cells contract, they create a current that travels through the heart. A downward deflection on the ECG implies cells are becoming more positive in charge (\"depolarising\") in the direction of that lead, whereas an upward inflection implies cells are becoming more negative (\"repolarising\") in the direction of the lead. This depends on the position of the lead, so if a wave of depolarising moved from left to right, a lead on the left would show a negative deflection, and a lead on the right would show a positive deflection. The ECG is a useful tool in detecting  rhythm disturbances  and in detecting insufficient blood supply to the heart. [ 85 ]  Sometimes abnormalities are suspected, but not immediately visible on the ECG.  Testing when exercising  can be used to provoke an abnormality or an ECG can be worn for a longer period such as a 24-hour  Holter monitor  if a suspected rhythm abnormality is not present at the time of assessment. [ 85 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2182", "text": "Several  imaging  methods can be used to assess the anatomy and function of the heart, including  ultrasound  ( echocardiography ),  angiography ,  CT ,  MRI , and  PET, scans . An echocardiogram is an ultrasound of the heart used to measure the heart's function, assess for valve disease, and look for any abnormalities. Echocardiography can be conducted by a probe on the chest ( transthoracic ), or by a probe in the  esophagus  ( transesophageal ). A typical echocardiography report will include information about the width of the valves noting any  stenosis , whether there is any backflow of blood ( regurgitation ) and information about the blood volumes at the end of systole and diastole, including an  ejection fraction , which describes how much blood is ejected from the left and right ventricles after systole. Ejection fraction can then be obtained by dividing the volume ejected by the heart (stroke volume) by the volume of the filled heart (end-diastolic volume). [ 86 ]  Echocardiograms can also be conducted under circumstances when the body is more stressed, in order to examine for signs of lack of blood supply. This  cardiac stress test  involves either direct exercise, or where this is not possible, injection of a drug such as  dobutamine . [ 78 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2183", "text": "CT scans,  chest X-rays  and other forms of imaging can help evaluate the heart's size, evaluate for signs of  pulmonary oedema , and indicate whether there is  fluid around the heart . They are also useful for evaluating the aorta, the major blood vessel which leaves the heart. [ 78 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2184", "text": "Diseases affecting the heart can be treated by a variety of methods including lifestyle modification, drug treatment, and surgery."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2185", "text": "Narrowings of the coronary arteries (ischemic heart disease) are treated to relieve symptoms of chest pain caused by a partially narrowed artery (angina pectoris), to minimise heart muscle damage when an artery is completely occluded ( myocardial infarction ), or to prevent a myocardial infarction from occurring. Medications to improve angina symptoms include  nitroglycerin ,  beta blockers , and calcium channel blockers, while preventative treatments include  antiplatelets  such as  aspirin  and  statins , lifestyle measures such as stopping smoking and weight loss, and treatment of risk factors such as high blood pressure and diabetes. [ 87 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2186", "text": "In addition to using medications, narrowed heart arteries can be treated by expanding the narrowings or redirecting the flow of blood to bypass an obstruction. This may be performed using a  percutaneous coronary intervention , during which narrowings can be expanded by passing small balloon-tipped wires into the coronary arteries, inflating the balloon to expand the narrowing, and sometimes leaving behind a metal scaffold known as a stent to keep the artery open. [ 88 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2187", "text": "If the narrowings in coronary arteries are unsuitable for treatment with a percutaneous coronary intervention, open surgery may be required. A  coronary artery bypass graft  can be performed, whereby a blood vessel from another part of the body (the  saphenous vein ,  radial artery , or  internal mammary artery ) is used to redirect blood from a point before the narrowing (typically the  aorta ) to a point beyond the obstruction. [ 88 ] [ 89 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2188", "text": "Diseased heart valves that have become abnormally narrow or abnormally leaky may require surgery. This is traditionally performed as an open surgical procedure to replace the damaged heart valve with a tissue or metallic  prosthetic valve . In some circumstances, the  tricuspid  or  mitral  valves can be repaired  surgically , avoiding the need for a valve replacement. Heart valves can also be treated percutaneously, using techniques that share many similarities with percutaneous coronary intervention.  Transcatheter aortic valve replacement  is increasingly used for patients consider very high risk for open valve replacement. [ 60 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2189", "text": "Abnormal heart rhythms ( arrhythmias ) can be treated using antiarrhythmic drugs. These may work by manipulating the flow of electrolytes across the cell membrane (such as  calcium channel blockers ,  sodium channel blockers ,  amiodarone , or  digoxin ), or modify the autonomic nervous system's effect on the heart ( beta blockers  and  atropine ). In some arrhythmias such as atrial fibrillation which increase the risk of stroke, this risk can be reduced using anticoagulants such as  warfarin  or  novel oral anticoagulants . [ 62 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2190", "text": "If medications fail to control an arrhythmia, another treatment option may be  catheter ablation . In these procedures, wires are passed from a  vein  or  artery  in the leg to the heart to find the abnormal area of tissue that is causing the arrhythmia. The abnormal tissue can be intentionally damaged, or ablated, by  heating  or  freezing  to prevent further heart rhythm disturbances. Whilst the majority of arrhythmias can be treated using minimally invasive catheter techniques, some arrhythmias (particularly  atrial fibrillation ) can also be treated using open or  thoracoscopic  surgery, either at the time of other cardiac surgery or as a standalone procedure. A  cardioversion , whereby an electric shock is used to stun the heart out of an abnormal rhythm, may also be used."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2191", "text": "Cardiac devices in the form of  pacemakers  or  implantable defibrillators  may also be required to treat arrhythmias. Pacemakers, comprising a small battery powered generator implanted under the skin and one or more leads that extend to the heart, are most commonly used to treat abnormally  slow heart rhythms . [ 63 ]  Implantable defibrillators are used to treat serious life-threatening rapid heart rhythms. These devices monitor the heart, and if dangerous heart racing is detected can automatically deliver a shock to restore the heart to a normal rhythm. Implantable defibrillators are most commonly used in patients with heart failure,  cardiomyopathies , or inherited arrhythmia syndromes."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2192", "text": "As well as addressing the underlying cause for a patient's heart failure (most commonly  ischemic heart disease  or  hypertension ), the mainstay of heart failure treatment is with medication. These include drugs to prevent fluid from accumulating in the lungs by increasing the amount of urine a patient produces ( diuretics ), and drugs that attempt to preserve the pumping function of the heart ( beta blockers ,  ACE inhibitors  and  mineralocorticoid receptor antagonists ). [ 59 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2193", "text": "In some patients with heart failure, a specialised pacemaker known as  cardiac resynchronisation therapy  can be used to improve the heart's pumping efficiency. [ 63 ]  These devices are frequently combined with a defibrillator. In very severe cases of heart failure, a small pump called a  ventricular assist device  may be implanted which supplements the heart's own pumping ability. In the most severe cases, a  cardiac transplant  may be considered. [ 59 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2194", "text": "Humans have known about the heart since ancient times, although its precise function and anatomy were not clearly understood. [ 90 ]  From the primarily religious views of earlier societies towards the heart,  ancient Greeks  are considered to have been the primary seat of scientific understanding of the heart in the ancient world. [ 91 ] [ 92 ] [ 93 ]   Aristotle  considered the heart to be the organ responsible for creating blood;  Plato  considered the heart as the source of circulating blood and  Hippocrates  noted blood circulating cyclically from the body through the heart to the lungs. [ 91 ] [ 93 ]   Erasistratos  (304\u2013250 BCE) noted the heart as a pump, causing dilation of blood vessels, and noted that arteries and veins both radiate from the heart, becoming progressively smaller with distance, although he believed they were filled with air and not blood. He also discovered the heart valves. [ 91 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2195", "text": "The Greek physician  Galen  (2nd century CE) knew blood vessels carried blood and identified venous (dark red) and arterial (brighter and thinner) blood, each with distinct and separate functions. [ 91 ]  Galen, noting the heart as the hottest organ in the body, concluded that it provided heat to the body. [ 93 ]  The heart did not pump blood around, the heart's motion sucked blood in during diastole and the blood moved by the pulsation of the arteries themselves. [ 93 ]  Galen believed the arterial blood was created by venous blood passing from the left ventricle to the right through 'pores' between the ventricles. [ 90 ]  Air from the lungs passed from the lungs via the pulmonary artery to the left side of the heart and created arterial blood. [ 93 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2196", "text": "These ideas went unchallenged for almost a thousand years. [ 90 ] [ 93 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2197", "text": "The earliest descriptions of the  coronary  and pulmonary circulation systems can be found in the  Commentary on Anatomy in Avicenna's Canon , published in 1242 by  Ibn al-Nafis . [ 94 ]  In his manuscript, al-Nafis wrote that blood passes through the pulmonary circulation instead of moving from the right to the left ventricle as previously believed by Galen. [ 95 ]  His work was later translated into  Latin  by  Andrea Alpago . [ 96 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2198", "text": "In Europe, the teachings of Galen continued to dominate the academic community and his doctrines were adopted as the official canon of the Church.  Andreas Vesalius  questioned some of Galen's beliefs of the heart in  De humani corporis fabrica  (1543), but his  magnum opus  was interpreted as a challenge to the authorities and he was subjected to a number of attacks. [ 97 ]   Michael Servetus  wrote in  Christianismi Restitutio  (1553) that blood flows from one side of the heart to the other via the lungs. [ 97 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2199", "text": "A breakthrough in understanding the flow of blood through the heart and body came with the publication of  De Motu Cordis  (1628) by the English physician  William Harvey . Harvey's book completely describes the systemic circulation and the mechanical force of the heart, leading to an overhaul of the Galenic doctrines. [ 93 ]   Otto Frank  (1865\u20131944) was a German physiologist; among his many published works are detailed studies of this important heart relationship.  Ernest Starling  (1866\u20131927) was an important English physiologist who also studied the heart. Although they worked largely independently, their combined efforts and similar conclusions have been recognized in the name \" Frank\u2013Starling mechanism \". [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2200", "text": "Although  Purkinje fibers  and the  bundle of His  were discovered as early as the 19th century, their specific role in the  electrical conduction system of the heart  remained unknown until  Sunao Tawara  published his monograph, titled  Das Reizleitungssystem des S\u00e4ugetierherzens , in 1906. Tawara's discovery of the  atrioventricular node  prompted  Arthur Keith  and  Martin Flack  to look for similar structures in the heart, leading to their discovery of the  sinoatrial node  several months later. These structures form the anatomical basis of the electrocardiogram, whose inventor,  Willem Einthoven , was awarded the Nobel Prize in Medicine or Physiology in 1924. [ 98 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2201", "text": "The first  heart transplant  in a human ever performed was by  James Hardy  in 1964, using a chimpanzee heart, but the patient died within 2 hours. [ 99 ]  The first human to human heart transplantation was performed in 1967 by the South African surgeon  Christiaan Barnard  at  Groote Schuur Hospital  in  Cape Town . [ 100 ] [ 101 ]  This marked an important milestone in  cardiac surgery , capturing the attention of both the medical profession and the world at large. However, long-term survival rates of patients were initially very low.  Louis Washkansky , the first recipient of a donated heart, died 18 days after the operation while other patients did not survive for more than a few weeks. [ 102 ]  The American surgeon  Norman Shumway  has been credited for his efforts to improve transplantation techniques, along with pioneers  Richard Lower ,  Vladimir Demikhov  and  Adrian Kantrowitz . As of March 2000, more than 55,000 heart transplantations have been performed worldwide. [ 103 ]  The first successful transplant of a heart from a  genetically modified  pig to a human in which the patient lived for a longer time, was performed January 7, 2022 in  Baltimore  by heart surgeon  Bartley P. Griffith , recipient was David Bennett (57) this successfully extended his life until 8 March 2022 (1 month and 30 days). [ 104 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2202", "text": "By the middle of the 20th century,  heart disease  had surpassed infectious disease as the leading cause of death in the United States, and it is currently the leading cause of deaths worldwide. Since 1948, the ongoing  Framingham Heart Study  has shed light on the effects of various influences on the heart, including diet, exercise, and common medications such as aspirin. Although the introduction of  ACE inhibitors  and  beta blockers  has improved the management of chronic heart failure, the disease continues to be an enormous medical and societal burden, with 30 to 40% of patients dying within a year of receiving the diagnosis. [ 105 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2203", "text": "As one of the vital organs, the heart was long identified as the center of the entire body, the seat of life, or emotion, or reason, will, intellect, purpose or the mind. [ 106 ]  The heart is an emblematic symbol in many religions, signifying \"truth, conscience or moral courage in many religions\u2014the temple or throne of God in Islamic and  Judeo-Christian  thought; the divine centre, or  atman , and the  third eye  of transcendent wisdom in  Hinduism ; the diamond of purity and essence of the  Buddha ; the  Taoist  centre of understanding.\" [ 106 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2204", "text": "In the  Hebrew Bible , the word for heart,  lev , is used in these meanings, as the seat of emotion, the mind, and referring to the anatomical organ. It is also connected in function and symbolism to the stomach. [ 107 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2205", "text": "An important part of the concept of the  soul  in  Ancient Egyptian religion  was thought to be the heart, or  ib . The  ib  or metaphysical heart was believed to be formed from one drop of blood from the child's mother's heart, taken at conception. [ 108 ]  To ancient Egyptians, the heart was the seat of  emotion ,  thought , will, and  intention . This is evidenced by  Egyptian  expressions which incorporate the word  ib , such as  Awi-ib  for \"happy\" (literally, \"long of heart\"),  Xak-ib  for \"estranged\" (literally, \"truncated of heart\"). [ 109 ]  In Egyptian religion, the heart was the key to the afterlife. It was conceived as surviving death in the nether world, where it gave evidence for, or against, its possessor. The heart was therefore not removed from the body during mummification, and was believed to be the center of intelligence and feeling, and needed in the afterlife. [ 110 ]  It was thought that the heart was examined by  Anubis  and a variety of  deities  during the  Weighing of the Heart  ceremony. If the heart weighed more than the feather of  Maat , which symbolized the ideal standard of behavior. If the scales balanced, it meant the heart's possessor had lived a just life and could enter the afterlife; if the heart was heavier, it would be devoured by the monster  Ammit . [ 111 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2206", "text": "The  Chinese  character for \"heart\", \u5fc3, derives from a comparatively realistic depiction of a heart (indicating the heart chambers) in  seal script . [ 112 ]  The Chinese word  x\u012bn  also takes the metaphorical meanings of \"mind\", \"intention\", or \"core\", and is often translated as \"heart-mind\" as the ancient Chinese believed the heart was the center of human cognition. [ 113 ]   In Chinese medicine , the heart is seen as the center of  \u795e  sh\u00e9n  \"spirit, consciousness\". [ 114 ]  The heart is associated with the  small intestine ,  tongue , governs the  six organs and five viscera , and belongs to fire in the five elements. [ 115 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2207", "text": "The Sanskrit word for heart is  h\u1e5bd  or  h\u1e5bdaya , found in the oldest surviving Sanskrit text, the  Rigveda . In Sanskrit, it may mean both the anatomical object and \"mind\" or \"soul\", representing the seat of emotion.  Hrd  may be a cognate of the word for heart in Greek, Latin, and English. [ 116 ] [ 117 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2208", "text": "Many  classical  philosophers and scientists, including  Aristotle , considered the heart the seat of thought,  reason , or emotion, often disregarding the brain as contributing to those functions. [ 118 ]  The identification of the heart as the seat of  emotions  in particular is due to the  Roman  physician  Galen , who also located the seat of the passions in the  liver , and the seat of reason in the brain. [ 119 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2209", "text": "The heart also played a role in the  Aztec  system of belief. The most common form of human sacrifice practiced by the Aztecs was heart-extraction. The Aztec believed that the heart ( tona ) was both the seat of the individual and a fragment of the Sun's heat ( istli ). To this day, the Nahua consider the Sun to be a heart-soul ( tona-tiuh ): \"round, hot, pulsating\". [ 120 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2210", "text": "Indigenous leaders from Alaska to Australia came together in 2020 to deliver a message to the world that humanity needs to shift from the mind to the heart, and let our heart be in charge of what we do. [ 121 ]  The message was made into a film, which highlighted that humanity must open their hearts to restore balance to the world. [ 122 ]  Kumu Sabra Kauka, a Hawaiian studies educator and tradition bearer summed up the message of the film saying \"Listen to your heart. Follow your path. May it be clear, and for the good of all.\" [ 121 ]   The film was led by Illarion Merculieff from the  Aleut  (Unangan) tribe. Merculieff has written that Unangan Elders referred to the heart as a \"source of wisdom\", \"a deeper portal of profound interconnectedness and awareness that exists between humans and all living things\". [ 123 ] [ 124 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2211", "text": "In  Catholicism , there has been a long tradition of veneration of the heart, stemming from worship of the wounds of  Jesus Christ  which gained prominence from the mid sixteenth century. [ 125 ]  This tradition influenced the development of the medieval Christian  devotion  to the  Sacred Heart of Jesus  and the parallel veneration of the  Immaculate Heart of Mary , made popular by  John Eudes . [ 126 ]  There are also many references to the heart in the Christian Bible, including \"Blessed are the pure in heart, for they will see God\", [ 127 ]  \"Above all else, guard your heart, for everything you do flows from it\", [ 128 ]  \"For where your treasure is, there your heart will be also\", [ 129 ]  \"For as a man thinks in his heart, so shall he be.\" [ 130 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2212", "text": "The expression of a  broken heart  is a cross-cultural reference to  grief  for a lost one or to unfulfilled  romantic love ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2213", "text": "The notion of \" Cupid 's arrows\" is ancient, due to  Ovid , but while Ovid describes Cupid as wounding his victims with his arrows, it is not made explicit that it is the  heart  that is wounded. The familiar iconography of Cupid shooting little  heart symbols  is a  Renaissance  theme that became tied to  Valentine's Day . [ 106 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2214", "text": "In certain  Trans-New Guinea languages , such as  Foi  and Momoona, the heart and seat of emotions are  colexified , meaning they share the same word. [ 131 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2215", "text": "Animal hearts are widely consumed as a type of  offal . As they are almost entirely muscle, they are high in protein. They are often included in dishes with other internal organs, for example in the  pan-Ottoman   kokoretsi ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2216", "text": "Chicken  hearts are considered to be  giblets , and are often grilled on skewers; examples of this are  Japanese   h\u0101to yakitori ,  Brazilian   churrasco de cora\u00e7\u00e3o , and  Indonesian   chicken heart satay . [ 132 ]  They can also be pan-fried, as in  Jerusalem mixed grill . In  Egyptian cuisine , they can be used, finely chopped, as part of  stuffing  for chicken. [ 133 ]  Many recipes combined them with other giblets, such as the  Mexican   pollo en menudencias [ 134 ]  and the  Russian   ragu iz kurinyikh potrokhov . [ 135 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2217", "text": "The hearts of beef, pork, and mutton can generally be interchanged in recipes. [ citation needed ]  As heart is a hard-working muscle, it makes for \"firm and rather dry\" meat, [ 136 ]  so is generally slow-cooked. Another way of dealing with toughness is to  julienne  the meat, as in  Chinese  stir-fried heart. [ 137 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2218", "text": "Beef  heart is valued for its high meat quality and low price, being commonly disregarded in conventional meat pricing. It can be cut into  steaks , comparable in quality to the more expensive cuts of meat from the same animal, though it is distinguished by a lack of a discernible grain. It was historically eaten in the United States as a cost-saving measure, but is today also eaten as an independently desirable ingredient. [ 138 ]  Beef heart may be grilled or braised. [ 139 ]  In the  Peruvian   anticuchos de coraz\u00f3n , barbecued beef hearts are grilled after being tenderized through long  marination  in a spice and vinegar mixture. An  Australian  recipe for \"mock goose\" is actually braised stuffed beef heart. [ 140 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2219", "text": "Pork  heart can be stewed, poached, braised, [ 141 ]  or made into sausage. The  Balinese   oret  is a sort of  blood sausage  made with pig heart and blood. A  French  recipe for  c\u0153ur de porc \u00e0 l'orange  is made of braised heart with an orange sauce."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2220", "text": "The size of the heart varies among the different animal  groups , with hearts in  vertebrates  ranging from those of the smallest mice (12\u00a0mg) to the blue whale (600\u00a0kg). [ 142 ]  In vertebrates, the heart lies in the middle of the ventral part of the body, surrounded by a  pericardium . [ 143 ]  which in some fish may be connected to the  peritoneum . [ 144 ]  In all vertebrates, the heart has an asymmetric orientation, almost always on the left side. According to one theory, this is caused by a  developmental axial twist  in the early embryo. [ 145 ] [ 146 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2221", "text": "The sinoatrial node is found in all  amniotes  but not in more primitive vertebrates. In these animals, the muscles of the heart are relatively continuous, and the sinus venosus coordinates the beat, which passes in a wave through the remaining chambers. Since the sinus venosus is incorporated into the right atrium in amniotes, it is likely  homologous  with the SA node. In teleosts, with their vestigial sinus venosus, the main centre of coordination is, instead, in the atrium. The rate of heartbeat varies enormously between different species, ranging from around 20 beats per minute in  codfish  to around 600 in  hummingbirds [ 147 ]  and up to 1,200 bpm in the  ruby-throated hummingbird . [ 148 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2222", "text": "Adult  amphibians  and most  reptiles  have a  double circulatory system , meaning a circulatory system divided into arterial and venous parts. However, the heart itself is not completely separated into two sides. Instead, it is separated into three chambers\u2014two atria and one ventricle. Blood returning from both the systemic circulation and the lungs is returned, and blood is pumped simultaneously into the systemic circulation and the lungs. The double system allows blood to circulate to and from the lungs which deliver oxygenated blood directly to the heart. [ 149 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2223", "text": "In reptiles, other than  snakes , the heart is usually situated around the middle of the thorax. In terrestrial and arboreal snakes, it is usually located nearer to the head; in aquatic species the heart is more centrally located. [ 150 ]  There is a heart with three chambers: two atria and one ventricle. The form and function of these hearts are different from mammalian hearts due to the fact that snakes have an elongated body, and thus are affected by different environmental factors. In particular, the snake's heart relative to the position in their body has been influenced greatly by gravity. Therefore, snakes that are larger in size tend to have a higher  blood pressure  due to gravitational change. [ 150 ]  The ventricle is incompletely separated into two-halves by a wall ( septum ), with a considerable gap near the pulmonary artery and aortic openings. In most reptilian species, there appears to be little, if any, mixing between the bloodstreams, so the aorta receives, essentially, only oxygenated blood. [ 147 ] [ 149 ]  The exception to this rule is  crocodiles , which have a four-chambered heart. [ 151 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2224", "text": "In the heart of  lungfish , the septum extends partway into the ventricle. This allows for some degree of separation between the de-oxygenated bloodstream destined for the lungs and the oxygenated stream that is delivered to the rest of the body. The absence of such a division in living amphibian species may be partly due to the amount of respiration that occurs through the skin; thus, the blood returned to the heart through the venae cavae is already partially oxygenated. As a result, there may be less need for a finer division between the two bloodstreams than in lungfish or other  tetrapods . Nonetheless, in at least some species of amphibian, the spongy nature of the ventricle does seem to maintain more of a separation between the bloodstreams. Also, the original valves of the  conus arteriosus  have been replaced by a spiral valve that divides it into two parallel parts, thereby helping to keep the two bloodstreams separate. [ 147 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2225", "text": "Archosaurs  ( crocodilians  and  birds ) and  mammals  show complete separation of the heart into two pumps for a total of four heart chambers; it is thought that the four-chambered heart of archosaurs evolved independently from that of mammals. In crocodilians, there is a small opening, the  foramen of Panizza , at the base of the arterial trunks and there is some degree of mixing between the blood in each side of the heart, during a dive underwater; [ 152 ] [ 153 ]  thus, only in birds and mammals are the two streams of blood\u2014those to the pulmonary and systemic circulations\u2014permanently kept entirely separate by a physical barrier. [ 147 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2226", "text": "The heart evolved no less than 380\u00a0million years ago in  fish . [ 154 ]  Fish have what is often described as a two-chambered heart, [ 155 ]  consisting of one atrium to receive blood and one ventricle to pump it. [ 156 ]  However, the fish heart has entry and exit compartments that may be called chambers, so it is also sometimes described as three-chambered [ 156 ]  or four-chambered, [ 157 ]  depending on what is counted as a chamber. The atrium and ventricle are sometimes considered \"true chambers\", while the others are considered \"accessory chambers\". [ 158 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2227", "text": "Primitive fish have a four-chambered heart, but the chambers are arranged sequentially so that this primitive heart is quite unlike the four-chambered hearts of mammals and birds. The first chamber is the  sinus venosus , which collects deoxygenated blood from the body through the  hepatic  and  cardinal veins . From here, blood flows into the atrium and then to the powerful muscular ventricle where the main pumping action will take place. The fourth and final chamber is the  conus arteriosus , which contains several valves and sends blood to the  ventral aorta . The ventral aorta delivers blood to the gills where it is oxygenated and flows, through the  dorsal aorta , into the rest of the body. (In  tetrapods , the ventral aorta has divided in two; one half forms the  ascending aorta , while the other forms the pulmonary artery). [ 147 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2228", "text": "In the adult fish, the four chambers are not arranged in a straight row but instead form an S-shape, with the latter two chambers lying above the former two. This relatively simple pattern is found in  cartilaginous fish  and in the  ray-finned fish . In  teleosts , the conus arteriosus is very small and can more accurately be described as part of the aorta rather than of the heart proper. The conus arteriosus is not present in any  amniotes , presumably having been absorbed into the ventricles over the course of evolution. Similarly, while the sinus venosus is present as a vestigial structure in some reptiles and birds, it is otherwise absorbed into the right atrium and is no longer distinguishable. [ 147 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2229", "text": "Arthropods  and most  mollusks  have an open circulatory system. In this system, deoxygenated blood collects around the heart in cavities ( sinuses ). This blood slowly permeates the heart through many small one-way channels. The heart then pumps the blood into the  hemocoel , a cavity between the organs. The heart in arthropods is typically a muscular tube that runs the length of the body, under the back and from the base of the head. Instead of blood the circulatory fluid is  haemolymph  which carries the most commonly used  respiratory pigment , copper-based  haemocyanin  as the oxygen transporter. Haemoglobin is only used by a few arthropods. [ 159 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2230", "text": "In some other invertebrates such as  earthworms , the circulatory system is not used to transport oxygen and so is much reduced, having no veins or arteries and consisting of two connected tubes. Oxygen travels by diffusion and there are five small muscular vessels that connect these vessels that contract at the front of the animals that can be thought of as \"hearts\". [ 159 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2231", "text": "Squids and other cephalopods  have two \"gill hearts\" also known as  branchial hearts , and one \"systemic heart\". [ 160 ]  The branchial hearts have two atria and one ventricle each, and pump to the  gills , whereas the systemic heart pumps to the body. [ 161 ] [ 162 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2232", "text": "Only the  chordates  (including vertebrates) and the  hemichordates  have a central \"heart\", which is a vesicle formed from the thickening of the  aorta  and contracts to pump blood. This suggests a presence of it in the last  common ancestor of these groups  (may have been lost in the  echinoderms )."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2233", "text": "This article incorporates text from the  CC BY  book:  OpenStax College,  Anatomy & Physiology. OpenStax CNX. 30 July 2014."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2234", "text": "In  cardiology , an  accessory pathway  is an additional electrical connection between two parts of the  heart . [ 1 ]  These pathways can lead to abnormal heart rhythms ( arrhythmias ) associated with symptoms of  palpitations . Some pathways may activate a region of  ventricular  muscle earlier than would normally occur, referred to as pre-excitation, and this may be seen on an  electrocardiogram .   The combination of an accessory pathway that causes pre-excitation with arrhythmias is known as  Wolff\u2013Parkinson\u2013White syndrome . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2235", "text": "Accessory pathways are often diagnosed using an electrocardiogram, but characterisation and location of the pathway may require an  electrophysiological study .  Accessory pathways may not require any treatment, but those causing symptoms may be treated with medication including  calcium channel antagonists ,  beta blockers  or  flecainide . [ 3 ]   Alternatively, the electrical conduction through an accessory pathways can be abolished using  catheter ablation , potentially offering a permanent cure. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2236", "text": "The most common sites for accessory pathways are connections between muscle tissue in the  atria  and the ventricles (atrio-ventricular pathways), bypassing the  atrioventricular node .  Rarer sites include connections between atrial muscle and the  conducting tissue  within the ventricles (atrio-fascicular pathways), between the atrioventricular node and the muscle tissue of the ventricle (nodo-ventricular pathways), and between the conducting tissue of the ventricle and the ventricular muscle (fasciculo-ventricular pathways).  These rarer accessory pathways are sometimes collectively referred to as Mahaim pathways or Mahaim fibres. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2237", "text": "Mahaim pathways are typically seen on the right side of the heart, with their ventricular connection lying within or close to the right bundle branch. [ 4 ]   The fibres often conduct slowly and in one direction only - from the atria to the ventricles (antegrade conduction); not from the ventricles to the atria (retrograde conduction). Unlike most atrio-ventricular accessory pathways which conduct electrical impulses at a relatively fixed speed, conduction through a Mahaim pathway varies according to how rapidly it is stimulated. More frequent stimulation leads to slower conduction, known as decremental conduction. [ 4 ]  If conduction to the ventricles occurs solely through the pathway (maximal pre-excitation), as occurs during arrhythmias like antidromic  atrioventricular re-entrant tachycardia , the ECG appearance is of  QRS complexes  with a  left bundle branch block  morphology which can be mistaken for  ventricular tachycardia .   However, due to their slow decremental conduction, during sinus rhythm the 12-lead ECG will often show little pre-excitation. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2238", "text": "The  heart  is a muscular organ situated in the  mediastinum . It consists of four chambers, four valves, two main arteries (the coronary arteries), and the conduction system. The left and right sides of the heart have different functions: the right side receives de-oxygenated blood through the  superior  and  inferior   venae cavae  and pumps blood to the lungs through the  pulmonary artery , and the left side receives saturated blood from the lungs."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2239", "text": "The heart has the shape of a pyramid, with its apex pointing towards the left nipple while its base forms the posterior surface of the heart. Other surfaces are the anterior, inferior (or diaphragmatic), and two pulmonary surfaces facing the lungs. Its longest dimension (apical to base) is broadly 12\u201313\u00a0cm, while the average weight is 250 grams in females and 300 grams in males. [ 1 ]  Its primary role is to receive the blood from the body, pump it to the lungs to be oxygenated, and receive it once more to pump it again to the rest of the human body tissues. Heart rate, defined as the number of times the heart beats per minute, can fluctuate due to the body's varying needs for oxygen and nutrients. [ 2 ]  In addition, heart rates can increase when the sympathetic nervous system is activated but decrease when the parasympathetic nervous system is activated. [ 3 ]  The sympathetic nervous system can prepare the body for stressful situations by defaulting to \u201cfight or flight\u201d. The parasympathetic nervous system on the other hand regulates \u201crest and digest\u201d when at ease or safe. [ 4 ]  Although the parasympathetic nervous system prevails, specific mental, physical, or environmental stressors trigger the sympathetic nervous system, and thus, increase heart rate. [ 5 ]  The right side of the heart (which consists of the  right atrium  and the  right ventricle ) receives the desaturated blood, while the left side (consisting of the  left atrium  and  left ventricle ) receives the oxygenated blood."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2240", "text": "The  pericardium  is a thick membrane that covers the heart. It consists of two layers: the fibrous pericardium and the serous pericardium. It forms two recesses: the transverse recess and oblique recess. The transverse recess lies behind the  aorta  and  pulmonary trunk , while the oblique recess lies behind the left atrium. [ 6 ]  The serous pericardium is thin and covers the heart. It is also called the epicardium. The fibrous pericardium is much thicker. Together they form the pericardial cavity, a thin sac hosting a small amount of fluid. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2241", "text": "The four cardiac valves are kept in their place partly because of the  fibrous skeleton  of the heart, which is a collection of  connective tissue . It consists of the right fibrous trigone (which along with the membranous  septum  forms the  central fibrous body ), the left right fibrous trigone, and the conus tendon. The right fibrous trigone is the strongest part of the skeleton. It lies to the right of the  aortic valve  and connects it with the  mitral  and  tricuspid  valves. It is pierced by the  bundle of His . Lastly, the aortomitral curtain is also a part of the fibrous skeleton; it is formed by fibrous tissue connecting two of three of the aortic valve leaflets (the right and non-coronary leaflet) with anterior leaflet of the mitral valve. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2242", "text": "The heart has four chambers: the  left and right atriums  and the  left and right ventricles . They form a shallow groove at the line of their junction, which form the atrioventricular groove. The  atrioventricular groove  hosts major  coronary arteries  while they travel along to the line of attachment of  atrioventricular valves . The right and left ventricles are separated by a  septum , which corresponds to the  interventricular grooves  that travel from the  posterior  to the anterior surface of the heart."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2243", "text": "The right atrium lies among the two  venae cavae , behind and somewhat right of the  sternum . It is right and anterior to the left atrium. [ 9 ]  It consists of the venous component (or sina venarum), which is the main, smooth part of the right atrium (auricula or atrium proper). This venous component includes the right appendage, the front and lateral wall of right atrium, and the vestibule of the  tricuspid valve . [ 10 ] [ 11 ]  The venous component receives the blood from superior and inferior venae cavae. [ 12 ]  What separates the two components is the inside appearance of the wall. While the sina venarum has smooth walls, the characteristic of the auricula are the thick muscle bundles that make it appear somewhat rough. [ 11 ]  Sina venarum corresponds to the  right horn of sinus venosus  of the  embryonic heart . [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2244", "text": "Externally, the most prominent features of the heart are the right appendage (or right auricle), the  sulcus terminalis , and the  coronary sulcus . [ 12 ]  The right appendage is pyramidal in shape, with its base opening at the sina venarum. [ 12 ]  The sulcus terminalis, or terminal groove, is a shallow groove that travels from the IVC to the SVC and separates the right appendage from the venous compartment of the right ventricle. [ 12 ] [ 10 ]  At the upper end of sulcus terminalis lies the  sinoatrial node . [ 13 ]  The sinoatrial node receives blood supply from a branch of the right coronary artery or circumflex artery in 55% and 45% of people respectively. This artery is called the sinus nodal artery, and it is sometimes visible through the open sternum. [ 13 ]  Another groove, which runs somewhat parallel and posterior to sulcus terminalis, is Waterstone's groove (also known as Sondergaard's groove). [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2245", "text": "Internally, the  crista terminalis  is a prominent muscle bundle from which the  pectinate muscles  of the right atrium originate. The terminal crest corresponds to the external sulcus terminalis. [ 14 ] [ 12 ]  The  fossa ovalis  lies on the interatrial wall and is the remnant of the prenatal atrial communication. [ 12 ]  The opening of the inferior vena cava is guarded by the  Eustachian valve , while next to it lies the  Thebesian valve  that guards the  orifice  of the  coronary sinus . [ 15 ]  The thebesian veins also drain into the right atrium. [ 16 ]  Most of the right atrium is  trabeculated , as it is covered with pectinate muscles that run parallel to one another. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2246", "text": "The right ventricle receives blood from the right atrium through the tricuspid valve and pumps it to the lungs. [ 18 ]  The right ventricle lies behind the sternum and forms a large part of the sternodiaphragmatical surface of the heart. Its inferior surface lies over the central tendon of the diaphragm. The right ventricle consists of an inlet portion that receives blood from the right atrium through the tricuspid valve. There is an apical portion that approaches- but does not reach- the apex of the heart; this apical portion is packed with rough trabeculations. The last portion is a muscular outlet portion (infudibulum) that pumps the blood to the pulmonary artery. [ 17 ] The atrioventricular groove, a groove that harbors the right coronary artery of the heart, marks the separation of the atrium and the ventricle. Internally, the  crista supraventricularis , a muscular thickener, separates the right ventricle into two spaces."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2247", "text": "The left atrium lies to the left and slightly posterior of the right atrium. The pulmonary artery and aorta are located in front of the left atrium. The left atrium is slightly smaller than the right atrium and consists of the venous component, which receives saturated blood from the lungs via four pulmonary veins, the vestibule, and a narrow appendage. The venous component forms a large part of the posterior wall of the heart and the anterior wall of the  oblique pericardial sinus . [ 19 ] The appendage of the left atrium is a narrow, finger-like entity that contains small pectinate muscles. Its small orifice lies anterior of the left superior pulmonary vein and lateral to the mitral valve. The tip of the appendage can be found in various positions. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2248", "text": "The left ventricle is made of thick muscle walls because a lot of power is needed to push blood to the arterial system of the body. It is conical in shape and it is longer than the right ventricle in length, it also occupies part of the anterior (sternocostal), inferior (diaphragmatical), and left wall of heart. The left ventricle forms the apex of the heart and it receives blood from the left atrium through the mitral valve and pumps it to the body through the aortic valve. It consists of an inlet portion (ostium venosum), an outlet portion (ostium arteriosum), and an apical portion. [ 21 ]  The anterolateral and posteromedial papillary muscles are two strong papillary muscles within the left ventricle that anchor the two leaflets of the mitral valve (the valve between left atrium and ventricle consists of two leaflets). While these two muscles have a thick muscular base, they separate into various tendinous cords before entering the leaflets of the mitral valve. [ 22 ]  The apical portion is conical and consists of fine trabeculations. [ 23 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2249", "text": "The heart is supplied blood from two arterial systems: left and right. The major arteries of the two systems travel within the atrioventricular groove and form a crown shape, thus they are named \"coronary arteries\". There is significant variation of which system provides blood to the inferior surface of the heart. If the PDA starts from the right coronary artery, then the coronary circulation is named as \"right dominance\", which is the case with 60% of the general population. The arteries are located in the subepicardium, so they are easily visible in the human eye, but in some cases, especially at their initial course, may be sited within the myocardium. [ 24 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2250", "text": "The right coronary artery usually lies just above the aortic valve, within the aortic root, in the right coronary sinus that is the anterior surface of the aortic root. It travels anteriorly and slightly to the right to reach the atrioventricular groove; it enters the groove and follows it path to reach the cardiac crux, the place where atrioventricular groove meets the interatrial and interventricular grooves at the posterior surface of the heart. The right coronary artery provides blood to the wall of the right heart and some areas of the left heart though its branches. [ 24 ]  The right coronary system mostly supplies the right ventricle and atrium, apart from the anterior interventricular septum and a small area neighboring the course of the left anterior descending artery. [ 27 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2251", "text": "The left main coronary artery begins at the posterior sinus of the aortic root. It is the largest coronary artery, as the myocardium supplied by this artery is larger than the coronary artery, although it becomes short as soon as it separates in the anterior interventricular (also known as  left anterior descending  or LAD) and circumflex artery. [ 27 ]  The LAD travels within the interventricular groove and gives of diagonal and septal branches. Diagonal branches supply the anterior surface of the heart while septal branches supply the muscle mass of the  interventricular septum ; the first one supplies the atrioventricular bundle at the point of its bifurcation. [ 27 ]  The circumflex artery is embedded within the atrioventricular groove, travels laterally to the left and curves to the posterior surface of the heart, where it usually diminishes at the crux area (where it sometimes supplies the posterior descending artery (in case of left dominance)). [ 27 ]  The left coronary system mainly supplies the left heart and a large part of the interventricular septum. [ 27 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2252", "text": "Two separate systems of returning blood from the myocardial mass to the cardiac cavities. The major system consists of the coronary sinus, a wide vessel that collects blood from smaller veins and drains it to the right atrium. The smaller system consists of smaller veins that are draining the inner part of cardiac mass directly to cardiac cavities, most commonly to right atrium. [ 28 ]  There are three distinct lymphatic drainage plexuses in the heart; after  anastomosing  each other, they end up in a  brachiocephalic  node. [ 29 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2253", "text": "In approximately 1% of humans, coronary arteries originate in a not typical position. Among that 1%, the most common abnormality is circumflex arising from right coronary artery, instead of left main artery and usually does not pose any problem. Other abnormalities are coronary arteries originating from a not typical sinus and then traveling either between the aorta and pulmonary artery, or intramural. In both cases, outside pressure causes ischaemia and thus angina. [ 30 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2254", "text": "There are four major  valves in the heart , two  atrioventricular valves  (connecting one atrium to a ventricle) and two arterial (or  semilunar ) valves guarding the outflow of blood from the human heart. Each atrioventricular valve (tricuspid and mitral valves) consists of the leaflets, the annulus, the tendinous cords, the papillary muscles, and the supporting muscle mass. Semilunar valves (pulmonary and aortic valves) consists of leaflets, the sinuses and the interleaflet triangles. [ 31 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2255", "text": "Aortic valve is in between the muscular left ventricle and the fibroelastic aorta, the biggest artery of the human body. Its three leaflet close when hydrostatic pressure applies over the valve, while kept open during the ejection phase of the cardiac cycle, when blood is pushed out of the heart by the contracting musculare of the left ventricle. [ 32 ]  Histologically, the leaflets are fibrous in their core, covered with endothelium; [ 33 ] [ 34 ]   a thickening at their free edge, is named  node of Arantius . The aortic leaflets are hinged at the beginning of the aorta, at very first part of aortic sinus. Their line of attachement is not circular, it rather creates a corona, nonetheless it is commonly named as \" aortic ring \". [ 33 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2256", "text": "Each of the three aortic valve leaflets is named after the orifice of the coronary artery located above the leaflet- one is named non-coronary leaflet as it lacks a coronary ostium. [ 34 ]  Left and right leaflet originate from the muscle fibers of left ventricle, [ 35 ]  while non coronary leaflet is in continuation with mitral valve's anterior leaflet forming the  aortic-mitral curtain . [ 34 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2257", "text": "Mitral valve separates left atrium with left ventricle. It consists of the two mitral leaflets, (anterior and posterior) sited within the mitral annulus.  Chordae tendineae  are attached to the ventricular surfaces and the free edges of the two leaflets. Chordae are also attached to the two papillary muscles of left ventricle. Anterior leaflet is much larger than the posterior leaflet but posterior has a broader base, approaching two thirds of circumflex  [ 36 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2258", "text": "Tricuspid valve separates right chambers- atrium from ventricle. As its name suggest, it has 3 leaflets (anterior, posterior and septal), all attached at the annulus of the leaflet that notably lacks any fibrotic tissue. [ 37 ]  Apart from the leaflets and annulus, it also consists of three papillary muscles and three sets of chordae tendineae. [ 38 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2259", "text": "Conduction system is a network of  cardiac muscle fibers  aiming to generate and transduce signals in the heart, so to produce  contraction of the heart  and thus  pulse . Normally, the signal is generated at  sinus node , also known as sinoatrial node, since it lies on the right atrial wall, near the orifice of  superior vena cava . Usually, a rather large artery, named sinus artery, supplies the node. Various pathways initiate from sinus node, and carry the signal through the wall of both right and left atrium. They all end in  atrioventricular node . This latter node lies on the floor of atrioventricular septum, just above the orifice of Coronary Sinus. From the atrioventricular node, the buddle of His, that travels along the interventricular septum and spits the to left and right buddle branches. They supply left and right ventricle respectively. [ 39 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2260", "text": "The  Caerphilly Heart Disease Study , also known as the  Caerphilly Prospective Study  (CaPS), is an  epidemiological  prospective  cohort , set up in 1979 in a representative population sample drawn from  Caerphilly , a typical small town in  South Wales , UK. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2261", "text": "The initial aim was to examine relationships between a wide range of social, lifestyle,  dietary  and other factors with incident  vascular disease . Opportunity was also taken, in collaboration with a range of clinical and laboratory colleagues, to collect data on a wide range of factors with possible relevance to diseases other than vascular, and at the same time to collect clinical information on  incident  disease events.\nThe study was initiated by Professor  Peter Elwood , Director of the  Medical Research Council  (MRC) Epidemiology Unit for South Wales.  The work has so far led to over 400 publications in the  medical press ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2262", "text": "In 1948, an MRC epidemiological unit was set up in  Cardiff , South Wales, under  Professor Archie Cochrane .  Peter Elwood  joined Cochrane in 1963 and together they promoted long-term studies of representative population samples. They also conducted  randomised controlled trials  to test a variety of clinical hypotheses. Undoubtedly, the most important of their joint studies was a randomised controlled trial of  aspirin  showing a reduction of vascular mortality. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2263", "text": "Reported in the  British Medical Journal  in 1974, this was the first study to demonstrate a protective role for aspirin in the reduction of death and  reinfarction . [ 3 ]  The British Medical Journal recognised this article as one of the 50 most frequently cited papers published between 1945 and 1989. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2264", "text": "Following this trial, Elwood and his research team set up the Caerphilly Heart Disease Study, [ 1 ]  with their primary focus on vascular disease, and the identification of predictors for  platelet activity  and  thrombosis . Caerphilly was chosen for the work because the population was fairly stable, it had age and social class structures similar to that of the whole UK population, and there was a high incidence of  ischaemic heart disease  compared with the rest of the UK."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2265", "text": "In 1979, all men aged between 45 and 59 years, who were on the  electoral registers  and/or general practice lists for Caerphilly and the adjoining villages of  Abertridwr ,  Senghenydd ,  Trethomas ,  Bedwas  and  Machen  were invited to co-operate in a long-term health study.  2,512 subjects (89% of the total eligible population) agreed to participate and were examined in Phase 1 (baseline) between July 1979 and September 1983. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2266", "text": "Since then, the men have been re-examined seven times (at five-year intervals) with approximately 95% of the surviving men co-operating in each re-examination. Many questions and tests have been repeated, but the opportunity has also been taken to include new questionnaires and tests.  In the early phases of the study, samples of  fasting blood  were collected for extensive testing and long-term storage, and on occasions urine and other biological samples were also taken, and aliquots stored.  Thus, while the initial aims of the study focused upon vascular disease, the wealth of data collected has enabled the testing of a large number of hypotheses relevant to other diseases too. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2267", "text": "From the start of the study, the term ' Collaborative ' was usually added to the title, paying tribute to the many physicians, laboratory technicians and other colleagues, expert in a wide range of clinical and metabolic disciplines, who were actively involved in the work. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2268", "text": "Heart disease  prevalence  is far greater in men than women \u2013 therefore women were not included in the study.  A far larger sample size would have been required if women had been the focus of the study, and unfortunately, the available resources were not sufficient for this. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2269", "text": "The work in Caerphilly was often linked with the Speedwell Study, a similar study operating in nearby  Bristol , 60\u00a0km away. The survey techniques were similar and a number of questionnaires and biological tests were used in both the studies. This enabled a number of joint reports on vascular disease, and in particular on the relevance of  blood lipids , to be based on the five thousand subjects within the two cohorts together."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2270", "text": "Initially, the study was funded by the Medical Research Council and led by Peter Elwood.  Following Elwood's retirement in 1995 the study continued under the leadership of Dr John Gallacher ( Cardiff University ) and Professor Yoav Ben-Shlomo ( Bristol University ), together with Dr John Yarnell ( Queen's University ) and Professor Tony Bayer (Cardiff University).  Financial support was obtained from the  British Heart Foundation  and the  Alzheimer's Society . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2271", "text": "The Caerphilly Study's research strategy was to identify factors showing an association with vascular disease (and other diseases), and then to test these associations in randomised controlled trials and statistical analysis."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2272", "text": "The  Framingham Heart Study , a much earlier cohort study in the US, had already shown that  cholesterol  is an important predictive factor for heart disease, [ 5 ]  and studies of US Veterans had shown that  raised blood pressure  is a major factor in stroke. [ 6 ]  The Caerphilly Study re-tested these predictors together with  lipid fractions  and high-density  lipoproteins  (total  HDL , HDL2 and HDL3). [ 7 ]  More recently,  arterial resistance  and its contribution to  blood pressure  has also been studied within the cohort. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2273", "text": "The randomised controlled trial of  aspirin  had shown that blood  platelets  play a key role in vascular disease. [ 2 ]  The Caerphilly Study focused on this by developing a large data-bank of platelet testing during the early phases of the study. Platelet collection and analysis was undertaken in close collaboration with Dr John O'Brien, Consultant Haematologist in St Mary's Hospital, Portsmouth, Professor Serge Renaud, a Director of Research in the  French National Institute of Health and Medical Research  in  Lyon , and Professor  Rod Flower  FRS, then at the  University of Bath . The work was done in a specially equipped mobile platelet laboratory, lent to the Caerphilly team by Serge Renaud, and towed by him from INSERM in Lyon, France, to the  Miners' Hospital . [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2274", "text": "Detailed work was also completed on thrombosis and  haemostatic  factors with the active involvement of John O'Brien and in collaboration with Professor Gordon Lowe, in the  Institute of Cardiovascular and Medical Sciences . [ 10 ] [ 11 ] [ 12 ] [ 13 ] [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2275", "text": "At baseline, a 1:3 sample (668 men) completed a 7-day weighed dietary intake record.  Data on the dietary intake of each subject in the cohort was collected during each phase of the study."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2276", "text": "Ten years into the study a detailed package of  cognitive function  tests were performed by each subject. These tests have been repeated several times [ 15 ]  and later enabled the evaluation of factors with possible relevance to  cognitive decline  and  dementia ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2277", "text": "The Caerphilly Study gave opportunity to study the relationship between lifestyle choices and health in a representative population sample drawn from a typical small town in the UK. [ 16 ]  \nThe participants were asked detailed questions at baseline and at subsequent examinations about lifestyle behaviours, enabling the men to be classified in terms of five healthy behaviours:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2278", "text": "These healthy behaviours displayed significant negative associations with cognitive impairment and dementia, with participant disease outcomes falling as the number of healthy behaviours followed increased. Men who followed four or five of the healthy behaviours during 30 years of follow-up experienced on average a 73% reduction in diabetes, a 67% reduction in vascular disease, a 35% reduction in cancer (attributable to non-smoking alone) and a 64% reduction in cognitive impairment and dementia. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2279", "text": "Healthy behaviours are the responsibility of each individual, [ 17 ]  and <1% of the men in the Caerphilly Study followed all five, with only 5% following four consistently. [ 16 ]  Comparisons with data collected in the 2009 Welsh Health Survey indicate that while the pattern of behaviours has changed, the proportions of subjects following four or five of the healthy behaviours has scarcely altered over the past 30 years. [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2280", "text": "The Caerphilly Study estimated the likely effect of increased healthy living within the community by supposing that each man in the Caerphilly cohort had each been urged at the start of the study in 1979 to adopt just one additional healthy behaviour. If only half of them had complied, then over the following 30 years 12% fewer would have developed diabetes; 6% fewer would have had a vascular disease event; 13% fewer would have developed dementia; and there would have been 5% fewer deaths. [ 16 ]  A video summarising this work is available on YouTube. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2281", "text": "Participants were asked to obtain from a close female relative the details of their own  birth weight  and how they had been fed as infants.  Over half of the men obtained these details, and results showed that having been  breast fed  conferred some protection against the loss of cognitive function later in life, particularly in those whose birth weight had been low. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2282", "text": "Smoking, alcohol intake and leisure activities are lifestyle factors which were found to be predictive of cognitive function. [ 21 ]  Significant associations were also between cognitive function and  blood rheology  and negative associations with both  haematocrit  and plasma viscosity, but not with the thrombotic potential of blood, as indicated by  fibrinogen  level. [ 22 ]  These relationships appear to be direct, and not through underlying long-term disease processes. Sleep pattern, and in particular severe daytime sleepiness, was also predictive of vascular dementia. [ 23 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2283", "text": "In diabetic subjects, it was found that poor control of blood sugar was associated with a lower cognitive function, and diabetes per se, but none of the components of  metabolic syndrome , other than high blood pressure, were predictive of worse cognition. [ 24 ]  Hearing loss was also found to be predictive of later cognitive impairment and incident dementia. [ 25 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2284", "text": "The main objective of the work on  platelets  was to identify an aspect of platelet morphology or activity with predictive power for incident vascular disease, which could be developed as a  screening test  to identify subjects at high risk of a vascular event. In addition to number and size of the platelets, three tests of platelet aggregation were performed, several being repeated after five years. A stressed template bleeding time test was also performed on each man. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2285", "text": "No prediction for heart disease was shown by any aspect of platelet morphology nor any platelet test, nor by the bleeding time test.  An unexpected finding was that the men who had had the most active platelets in two tests, based on platelet rich plasma and whole blood, had the lowest subsequent risk of an incident ischaemic stroke. [ 26 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2286", "text": "Detailed analyses of the dietary data identified a number of food items related to vascular disease risk. The consumption of fatty fish was associated with lower levels of  blood lipids , [ 27 ]  and a reduction in vascular disease mortality was confirmed in a randomised trial. [ 28 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2287", "text": "Milk consumption was found to be associated with a small reduction in the metabolic syndrome, [ 29 ]  and reductions in ischaemic heart disease, ischaemic stroke and diabetes, [ 30 ]  and these findings were confirmed in later overviews and meta-analyses. [ 31 ]  A reduction in blood pressure associated with milk consumption is well recognised, but new work in Caerphilly also identified a reduction in arterial stiffness associated with milk consumption. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2288", "text": "The consumption of fruit and vegetables was shown to be positively associated with blood antioxidant levels. [ 32 ]  Detailed work with Serge Renaud on platelet activity showed a beneficial relationship between a low alcohol consumption and platelet aggregation, but an enhanced response to  thrombin  with binge drinking, confirming previous work in animals. [ 33 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2289", "text": "A detailed questionnaire of sleep pattern was included in one of the re-examinations of the men. In addition to the association with cognitive function already mentioned, [ 23 ]  there was evidence of an increase in ischaemic stroke in men whose sleep is frequently disturbed, and an association between daytime sleepiness and a significant increase in ischaemic heart disease. [ 34 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2290", "text": "Many analyses of foods and dietary factors were conducted, as well as an examination of  Helicobacter pylori  and other infections, and vascular disease risk. [ 35 ] [ 36 ] [ 37 ]  A reduction in vascular disease mortality was found in those subjects most sexually active. [ 38 ]  Relationships between vascular disease and psychiatric symptoms, [ 39 ] [ 40 ]  noise exposure, [ 41 ] [ 42 ]  and hearing loss [ 25 ]  were also identified."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2291", "text": "Cardiac excitation-contraction coupling  ( Cardiac   EC coupling )  describes the series of events, from the production of an  electrical impulse (action potential)  to the  contraction  of  muscles  in the  heart . [ 1 ]  This process is of vital importance as it allows for the  heart  to beat in a controlled manner, without the need for conscious input. EC coupling results in the sequential  contraction  of the  heart muscles  that allows  blood  to be pumped, first to the  lungs  ( pulmonary circulation ) and then around the rest of the body ( systemic circulation ) at a rate between 60 and 100 beats every minute, when the body is at rest. [ 2 ]  This rate can be altered, however, by  nerves  that work to either increase heart rate ( sympathetic nerves ) or decrease it ( parasympathetic nerves ), as the body's  oxygen  demands change. Ultimately,  muscle contraction  revolves around a  charged atom (ion) ,  calcium (Ca 2+ ) , [ 3 ]  which is responsible for converting the electrical energy of the  action potential  into mechanical energy (contraction) of the muscle. This is achieved in a region of the muscle cell, called the  transverse tubule  during a process known as  calcium induced calcium release . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2292", "text": "Located in the wall of the  right atrium  is a group of specialised cells, called the  Sinoatrial node (SAN) .  These cells, unlike most other  cells  within the  heart , can spontaneously produce  action potentials . [ 5 ]  These  action potentials  travel along the  cell membrane (sarcolemma) , as impulses, passing from one cell to the next through channels, in structures known as  gap junctions . [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2293", "text": "Certain regions of the  sarcolemma  penetrate deep into the  cell . These are known as  transverse-tubules (t-tubules) ; which are also found in  skeletal muscle cells  and allow for the  action potential  to travel into the centre of the cell. [ 7 ]  Special  proteins  called  L-type calcium channels (also known as dihydropyridine receptors (DHPR))  are located on the  t-tubule membrane , and are activated by the action potential. Activated DHPRs open, forming a  channel , that allows Ca 2+  to pass into the cell. This increase in Ca 2+ , then binds to and activates another  receptor , called a  type 2 ryanodine receptor (RyR2) , located on the membrane of a structure known as the  sarcoplasmic reticulum (SR) . The  SR  is a  Ca 2+  stored within the cell and is located very close to the T-tubule. Activation of  RyR2  causes it to open, releasing even more  Ca 2+  into the  cell , this release of calcium is called a  calcium spark . This means that the initial flow of Ca 2+  into the  cell , causes a larger release of  Ca 2+  within the  cell , therefore the process is called  calcium induced calcium release (CICR) . [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2294", "text": "The increase in Ca 2+ , produced by CICR, now does two things. Firstly, it binds to the intracellular side of the DHPR, signalling the channels to close and preventing further influx of Ca 2+  into the cell. Secondly Ca 2+  indirectly activates  proteins , called  myofilaments , resulting in  muscle contraction . The two main myofilaments in  cardiac  (and  skeletal )  muscle  are  actin  and  myosin . Ca 2+  binds to a protein called  troponin , which is bound to the actin filament. This binding causes a shape change in the troponin which exposes areas on the  actin , to which the head of the  myosin  filament binds. The binding of the  myosin head  to  actin  is known as a cross-bridge. A  molecule , called   adenosine triphosphate (ATP)  which is produced by an intracellular structure called a  mitochondrion , is then used, as a source of energy, to help move the myosin head, carrying the actin. As a result, the actin slides across the myosin filament shortening the muscle. This is called a power stroke.  Myosin  then detaches from the  actin  and resets itself back to its original position, binding to another part of the  actin  and producing another power stroke, shortening the  muscle  further. This process continues, with the myosin head moving in a motion similar to that of an oar rowing a boat, until the  Ca 2+  level within the cell decreases (see figure 1). [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2295", "text": "Contraction ends when the Ca 2+  is removed from the cell. When this happens, the troponin changes back to its original shape, blocking the binding sites on  actin  and preventing the formation of crossbridges. This decrease in  Ca 2+  within the  cell  is brought about by a variety of  proteins , known collectively as  ion transporters . The main pumps involved are: the  sarcoplasmic reticulum Ca 2+ -ATPase , which pumps  Ca 2+  back into the SR, the  Sarcolemmal sodium-calcium exchanger , which pumps one  Ca 2+  out of the cell, in exchange for 3 sodium ions being pumped into the cell,  the  Sarcolemmal Ca 2+ -ATPase , which uses ATP to pump  Ca 2+  directly out of the cell and the  Mitochondrial Ca 2+  Uniport system , which pumps  Ca 2+  into the mitochondria. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2296", "text": "Sympathetic nerves work by releasing a protein ( neurotransmitter ) called  noradrenaline  which binds to a specific receptor ( beta 1 adrenoceptor ) located in the  sarcolemma  and the  t-tubule membrane  of  cardiac cells . This activates a protein, called a G-protein and results in a series of reactions (known as a  cyclic AMP pathway ) that leads to the production of a  molecule  called  cAMP  ( cyclic adenosine monophosphate ). In the SAN  cAMP  binds to an  ion channel  involved in action potential initiation, speeding up the production of the  action potential  (see  sinoatrial node  for more detail). cAMP also, activates a  protein  called  protein kinase A  ( PKA ). PKA affects both the  L-type calcium channels (also known as dihydropyridine receptors (DHPR))  and  RyR , increasing the rise in Ca  2+  within the contractile  cells  and therefore increasing rate of  muscle contraction . PKA also affects the  myofilaments  as well as a  protein  called  phospholamban  (PLB; see  sarcoplasmic reticulum  for more details), speeding up the rate of  Ca 2+ decline  in the cell and so speeding up  muscle relaxation . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2297", "text": "Parasympathetic nerves work by releasing a neurotransmitter called acetylcholine (ACh) which binds to specific receptor ( M2 muscarinic receptor ) on the sarcolemma of both SAN cells and ventricular cells. This again activates a  G-protein . However this G-protein works by inhibiting, the cAMP pathway, therefore, preventing the sympathetic nervous system from increasing heart rate. As well as this, in the SAN, the G-protein activates specific potassium channel, that opposes action potential initiation (see  SAN  for more details), thus slowing heart rate. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2298", "text": "Cardiac physiology  or  heart function  is the study of healthy, unimpaired function of the  heart : involving blood flow;  myocardium  structure; the electrical conduction system of the heart; the cardiac cycle and cardiac output and how these interact and depend on one another."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2299", "text": "The heart functions as a pump and acts as a double pump in the  cardiovascular system  to provide a continuous circulation of blood throughout the body. This circulation includes the  systemic circulation  and the  pulmonary circulation . Both circuits transport blood but they can also be seen in terms of the gases they carry. The pulmonary circulation collects oxygen from the lungs and delivers carbon dioxide for exhalation. The systemic circuit transports oxygen to the body and returns relatively de-oxygenated blood and carbon dioxide to the pulmonary circuit. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2300", "text": "Blood flows through the heart in one direction, from the atria to the ventricles, and out through the  pulmonary artery  into the pulmonary circulation, and the  aorta  into the systemic circulation. The pulmonary artery (also trunk) branches into the left and right  pulmonary arteries  to supply each lung. Blood is prevented from flowing backwards ( regurgitation ) by the tricuspid, bicuspid, aortic, and pulmonary valves. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2301", "text": "The function of the  right heart , is to collect de-oxygenated blood, in the right atrium, from the body via the superior vena cava, inferior vena cava and from the coronary sinus and pump it, through the tricuspid valve, via the  right ventricle , through the semilunar  pulmonary valve  and into the pulmonary artery in the pulmonary circulation where carbon dioxide can be  exchanged  for oxygen in the lungs. This happens through the passive process of  diffusion . In the  left heart  oxygenated blood is returned to the left atrium via the pulmonary vein. It is then pumped into the left ventricle through the bicuspid valve and into the aorta for systemic circulation. Eventually in the systemic capillaries exchange with the tissue fluid and cells of the body occurs; oxygen and nutrients are supplied to the cells for their metabolism and exchanged for carbon dioxide and waste products [ 1 ]  In this case, oxygen and nutrients exit the systemic capillaries to be used by the cells in their metabolic processes, and carbon dioxide and waste products will enter the blood. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2302", "text": "The ventricles are stronger and thicker than the atria, and the muscle wall surrounding the left ventricle is thicker than the wall surrounding the right ventricle due to the higher force needed to pump the blood through the  systemic circulation .  Atria  facilitate circulation primarily by allowing uninterrupted venous flow to the heart, preventing the inertia of interrupted venous flow that would otherwise occur at each ventricular systole. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2303", "text": "Cardiac muscle tissue has  autorhythmicity , the unique ability to initiate a  cardiac action potential  at a fixed rate \u2013 spreading the impulse rapidly from cell to cell to trigger the  contraction  of the entire heart. This autorhythmicity is still modulated by the  endocrine  and  nervous systems . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2304", "text": "There are two types of cardiac muscle cell:  cardiomyocytes  which have the ability to contract easily, and modified cardiomyocytes the  pacemaker cells  of the conducting system. The cardiomyocytes make up the bulk (99%) of cells in the atria and ventricles. These contractile cells respond to impulses of  action potential  from the pacemaker cells and are responsible for the contractions that pump blood through the body. The pacemaker cells make up just (1% of cells) and form the conduction system of the heart. They are generally much smaller than the contractile cells and have few of the  myofibrils  or  myofilaments  which means that they have limited contractibility. Their function is similar in many respects to  neurons . [ 1 ]  The  bundle of His  and  Purkinje fibres  are specialised cardiomyocytes that function in the conduction system."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2305", "text": "Cardiomyocytes , are considerably shorter and have smaller diameters than skeletal  myocytes . Cardiac muscle (like skeletal muscle) is characterized by  striations  \u2013 the stripes of dark and light bands resulting from the organised arrangement of myofilaments and  myofibrils  in the  sarcomere  along the length of the cell.  T (transverse) tubules  are deep invaginations from the  sarcolemma  (cell membrane) that penetrate the cell, allowing the electrical impulses to reach the interior. In cardiac muscle the T-tubules are only found at the  Z-lines . [ 1 ]  When an  action potential  causes cells to contract,  calcium  is released from the  sarcoplasmic reticulum  of the cells as well as the T tubules. The calcium release triggers sliding of the  actin  and  myosin  fibrils leading to contraction. [ 3 ]  A plentiful supply of  mitochondria  provide the energy for the contractions. Typically, cardiomyocytes have a single, central nucleus, but can also have two or more. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2306", "text": "Cardiac muscle cells branch freely and are connected by junctions known as  intercalated discs  which help the synchronized contraction of the muscle. [ 4 ]  The  sarcolemma  (membrane) from adjacent cells bind together at the intercalated discs. They consist of  desmosomes , specialized linking  proteoglycans ,  tight junctions , and large numbers of  gap junctions  that allow the passage of ions between the cells and help to synchronize the contraction. Intercellular  connective tissue  also helps to strongly bind the cells together, in order to withstand the forces of contraction. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2307", "text": "Cardiac muscle undergoes  aerobic respiration  patterns, primarily metabolizing lipids and carbohydrates. Oxygen from the lungs attaches to  haemoglobin  and is also stored in the  myoglobin , so that a plentiful supply of oxygen is available.  Lipids , and  glycogen  are also stored within the  sarcoplasm  and these are broken down by mitochondria to release  ATP . The cells undergo  twitch-type contractions  with long  refractory periods  followed by brief relaxation periods when the heart fills with blood for the next cycle. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2308", "text": "It is not very well known how the electric signal moves in the atria. It seems that it moves in a radial way, but  Bachmann's bundle  and  coronary sinus  muscle play a role in conduction between the two atria, which have a nearly simultaneous  systole . [ 5 ] [ 6 ] [ 7 ]  While in the ventricles, the signal is carried by specialized tissue called the  Purkinje fibers  which then transmit the electric charge to the  myocardium . [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2309", "text": "If embryonic heart cells are separated into a Petri dish and kept alive, each is capable of generating its own electrical impulse followed by contraction. When two independently beating embryonic cardiac muscle cells are placed together, the cell with the higher inherent rate sets the pace, and the impulse spreads from the faster to the slower cell to trigger a contraction. As more cells are joined, the fastest cell continues to assume control of the rate. A fully developed adult heart maintains the capability of generating its own electrical impulse, triggered by the fastest cells, as part of the cardiac conduction system. The components of the cardiac conduction system include the  atrial  and  ventricular syncytium , the sinoatrial node, the atrioventricular node, the  bundle of His  (atrioventricular bundle), the  bundle branches , and the Purkinje cells. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2310", "text": "Normal  sinus rhythm  is established by the  sinoatrial (SA) node , the heart's  pacemaker . The SA node is a specialized grouping of cardiomyocytes in the upper and back walls of the right atrium very close to the opening of the  superior vena cava . The SA node has the highest rate of  depolarization . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2311", "text": "This impulse spreads from its initiation in the SA node throughout the atria through specialized internodal pathways, to the atrial myocardial contractile cells and the atrioventricular node. The internodal pathways consist of three bands (anterior, middle, and posterior) that lead directly from the SA node to the next node in the conduction system, the atrioventricular node. The impulse takes approximately 50 ms (milliseconds) to travel between these two nodes. The relative importance of this pathway has been debated since the impulse would reach the atrioventricular node simply following the cell-by-cell pathway through the contractile cells of the myocardium in the atria. In addition, there is a specialized pathway called Bachmann's bundle or the interatrial band that conducts the impulse directly from the right atrium to the left atrium. Regardless of the pathway, as the impulse reaches the atrioventricular septum, the connective tissue of the cardiac skeleton prevents the impulse from spreading into the myocardial cells in the ventricles except at the atrioventricular node. [ 1 ]  The electrical event, the wave of depolarization, is the trigger for muscular contraction. The wave of depolarization begins in the right atrium, and the impulse spreads across the superior portions of both atria and then down through the contractile cells. The contractile cells then begin contraction from the superior to the inferior portions of the atria, efficiently pumping blood into the ventricles. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2312", "text": "The atrioventricular (AV) node is a second cluster of specialized myocardial conductive cells, located in the inferior portion of the right atrium within the atrioventricular septum. The septum prevents the impulse from spreading directly to the ventricles without passing through the AV node. There is a critical pause before the AV node depolarizes and transmits the impulse to the atrioventricular bundle. This delay in transmission is partially attributable to the small diameter of the cells of the node, which slow the impulse. Also, conduction between nodal cells is less efficient than between conducting cells. These factors mean that it takes the impulse approximately 100 ms to pass through the node. This pause is critical to heart function, as it allows the atrial cardiomyocytes to complete their contraction that pumps blood into the ventricles before the impulse is transmitted to the cells of the ventricle itself. With extreme stimulation by the SA node, the AV node can transmit impulses maximally at 220 per minute. This establishes the typical maximum heart rate in a healthy young individual. Damaged hearts or those stimulated by drugs can contract at higher rates, but at these rates, the heart can no longer effectively pump blood. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2313", "text": "Arising from the AV node, the bundle of His, proceeds through the interventricular septum before dividing into two  bundle branches , commonly called the left and right bundle branches. The left bundle branch has two fascicles. The left bundle branch supplies the left ventricle, and the right bundle branch the right ventricle. Since the left ventricle is much larger than the right, the left bundle branch is also considerably larger than the right. Portions of the right bundle branch are found in the moderator band and supply the right papillary muscles. Because of this connection, each papillary muscle receives the impulse at approximately the same time, so they begin to contract simultaneously just prior to the remainder of the myocardial contractile cells of the ventricles. This is believed to allow tension to develop on the chordae tendineae prior to right ventricular contraction. There is no corresponding moderator band on the left. Both bundle branches descend and reach the apex of the heart where they connect with the Purkinje fibers. This passage takes approximately 25 ms. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2314", "text": "The Purkinje fibers are additional myocardial conductive fibers that spread the impulse to the myocardial contractile cells in the ventricles. They extend throughout the myocardium from the apex of the heart toward the atrioventricular septum and the base of the heart. The Purkinje fibers have a fast inherent conduction rate, and the electrical impulse reaches all of the ventricular muscle cells in about 75 ms. Since the electrical stimulus begins at the apex, the contraction also begins at the apex and travels toward the base of the heart, similar to squeezing a tube of toothpaste from the bottom. This allows the blood to be pumped out of the ventricles and into the aorta and pulmonary trunk. The total time elapsed from the initiation of the impulse in the SA node until depolarization of the ventricles is approximately 225 ms. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2315", "text": "Action potentials are considerably different between conductive and contractive cardiomyocytes. While sodium  Na +  and potassium  K +  ions play essential roles,  calcium ions  Ca 2+  are also critical for both types of cell. Unlike skeletal muscles and neurons, cardiac conductive cells do not have a stable resting potential. Conductive cells contain a series of sodium  ion channels  that allow a normal and slow influx of sodium ions that causes the membrane potential to rise slowly from an initial value of \u221260 mV up to about \u201340 mV. The resulting movement of sodium ions creates spontaneous  depolarization  (or prepotential depolarization). [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2316", "text": "At this point,  calcium channels  open and Ca 2+  enters the cell, further depolarizing it at a more rapid rate until it reaches a value of approximately +5 mV. At this point, the calcium ion channels close and  potassium channels  open, allowing outflux of K +  and resulting in repolarization. When the membrane potential reaches approximately \u221260 mV, the K +  channels close and Na +  channels open, and the prepotential phase begins again. This process gives the autorhythmicity to cardiac muscle. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2317", "text": "There is a distinctly different electrical pattern involving the contractile cells. In this case, there is a rapid depolarization, followed by a plateau phase and then repolarization. This phenomenon accounts for the long  refractory periods  required for the cardiac muscle cells to pump blood effectively before they are capable of firing for a second time. These cardiac myocytes normally do not initiate their own electrical potential, although they are capable of doing so, but rather wait for an impulse to reach them. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2318", "text": "Contractile cells demonstrate a much more stable resting phase than conductive cells at approximately \u221280 mV for cells in the atria and \u221290 mV for cells in the ventricles. Despite this initial difference, the other components of their action potentials are virtually identical. In both cases, when stimulated by an action potential, voltage-gated channels rapidly open, beginning the positive-feedback mechanism of depolarization. This rapid influx of positively charged ions raises the membrane potential to approximately +30 mV, at which point the sodium channels close. The rapid depolarization period typically lasts 3\u20135 ms. Depolarization is followed by the plateau phase, in which membrane potential declines relatively slowly. This is due in large part to the opening of the slow Ca 2+  channels, allowing Ca 2+  to enter the cell while few K +  channels are open, allowing K +  to exit the cell. The relatively long plateau phase lasts approximately 175 ms. Once the membrane potential reaches approximately zero, the Ca 2+  channels close and K +  channels open, allowing K +  to exit the cell. The repolarization lasts approximately 75 ms. At this point, membrane potential drops until it reaches resting levels once more and the cycle repeats. The entire event lasts between 250 and 300 ms. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2319", "text": "The absolute refractory period for cardiac contractile muscle lasts approximately 200 ms, and the relative refractory period lasts approximately 50 ms, for a total of 250 ms. This extended period is critical, since the heart muscle must contract to pump blood effectively and the contraction must follow the electrical events. Without extended refractory periods, premature contractions would occur in the heart and would not be compatible with life. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2320", "text": "Calcium ions play two critical roles in the physiology of cardiac muscle. Their influx through slow calcium channels accounts for the prolonged plateau phase and absolute refractory period. Calcium ions also combine with the regulatory protein  troponin  in the  troponin complex . Both roles enabling the myocardium to function properly. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2321", "text": "Approximately 20 percent of the calcium required for contraction is supplied by the influx of Ca 2+  during the plateau phase. The remaining Ca 2+  for contraction is released from storage in the sarcoplasmic reticulum. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2322", "text": "The pattern of prepotential or spontaneous depolarization, followed by rapid depolarization and repolarization just described, are seen in the SA node and a few other conductive cells in the heart. Since the SA node is the pacemaker, it reaches threshold faster than any other component of the conduction system. It will initiate the impulses spreading to the other conducting cells. The SA node, without nervous or endocrine control, would initiate a heart impulse approximately 80\u2013100 times per minute. Although each component of the conduction system is capable of generating its own impulse, the rate progressively slows from the SA node to the Purkinje fibers. Without the SA node, the AV node would generate a heart rate of 40\u201360 beats per minute. If the AV node were blocked, the atrioventricular bundle would fire at a rate of approximately 30\u201340 impulses per minute. The bundle branches would have an inherent rate of 20\u201330 impulses per minute, and the Purkinje fibers would fire at 15\u201320 impulses per minute. While a few exceptionally trained aerobic athletes demonstrate resting heart rates in the range of 30\u201340 beats per minute (the lowest recorded figure is 28 beats per minute for  Miguel Indurain , a cyclist)\u2013for most individuals, rates lower than 50 beats per minute would indicate a condition called bradycardia. Depending upon the specific individual, as rates fall much below this level, the heart would be unable to maintain adequate flow of blood to vital tissues, initially resulting in decreasing loss of function across the systems, unconsciousness, and ultimately death. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2323", "text": "The period of time that begins with contraction of the atria and ends with ventricular relaxation is known as the cardiac cycle. The period of contraction that the heart undergoes while it pumps blood into circulation is called systole. The period of relaxation that occurs as the chambers fill with blood is called diastole. Both the atria and ventricles undergo systole and diastole, and it is essential that these components be carefully regulated and coordinated to ensure blood is pumped efficiently to the body. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2324", "text": "Fluids, move from regions of high pressure to regions of lower pressure. Accordingly, when the heart chambers are relaxed (diastole), blood will flow into the atria from the higher pressure of the veins. As blood flows into the atria, the pressure will rise, so the blood will initially move passively from the atria into the ventricles. When the action potential triggers the muscles in the atria to contract (atrial systole), the pressure within the atria rises further, pumping blood into the ventricles. During ventricular systole, pressure rises in the ventricles, pumping blood into the pulmonary trunk from the right ventricle and into the aorta from the left ventricle. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2325", "text": "At the beginning of the cardiac cycle, both the atria and ventricles are relaxed (diastole). Blood is flowing into the right atrium from the superior and inferior venae cavae and the coronary sinus. Blood flows into the left atrium from the four pulmonary veins. The two atrioventricular valves, the tricuspid and mitral valves, are both open, so blood flows unimpeded from the atria and into the ventricles. Approximately 70\u201380 percent of ventricular filling occurs by this method. The two semilunar valves, the pulmonary and aortic valves, are closed, preventing backflow of blood into the right and left ventricles from the pulmonary trunk on the right and the aorta on the left. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2326", "text": "Contraction of the atria follows depolarization, represented by the  P wave  of the ECG. As the atrial muscles contract from the superior portion of the atria toward the atrioventricular septum, pressure rises within the atria and blood is pumped into the ventricles through the open atrioventricular (tricuspid, and mitral or bicuspid) valves. At the start of atrial systole, the ventricles are normally filled with approximately 70\u201380 percent of their capacity due to inflow during diastole. Atrial contraction, also referred to as the \"atrial kick,\" contributes the remaining 20\u201330 percent of filling. Atrial systole lasts approximately 100 ms and ends prior to ventricular systole, as the atrial muscle returns to diastole. [ 1 ]   hala' Bold text'"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2327", "text": "Ventricular systole follows the depolarization of the ventricles and is represented by the  QRS complex  in the ECG. It may be conveniently divided into two phases, lasting a total of 270 ms. At the end of atrial systole and just prior to ventricular contraction, the ventricles contain approximately 130 mL blood in a resting adult in a standing position. This volume is known as the end diastolic volume (EDV) or preload. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2328", "text": "Initially, as the muscles in the ventricle contract, the pressure of the blood within the chamber rises, but it is not yet high enough to open the semilunar (pulmonary and aortic) valves and be ejected from the heart. However, blood pressure quickly rises above that of the atria that are now relaxed and in diastole. This increase in pressure causes blood to flow back toward the atria, closing the tricuspid and mitral valves. Since blood is not being ejected from the ventricles at this early stage, the volume of blood within the chamber remains constant. Consequently, this initial phase of ventricular systole is known as isovolumic contraction, also called isovolumetric contraction. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2329", "text": "In the second phase of ventricular systole, the ventricular ejection phase, the contraction of the ventricular muscle has raised the pressure within the ventricle to the point that it is greater than the pressures in the pulmonary trunk and the aorta. Blood is pumped from the heart, pushing open the pulmonary and aortic semilunar valves. Pressure generated by the left ventricle will be appreciably greater than the pressure generated by the right ventricle, since the existing pressure in the aorta will be so much higher. Nevertheless, both ventricles pump the same amount of blood. This quantity is referred to as  stroke volume . Stroke volume will normally be in the range of 70\u201380 mL. Since ventricular systole began with an EDV of approximately 130 mL of blood, this means that there is still 50\u201360 mL of blood remaining in the ventricle following contraction. This volume of blood is known as the end systolic volume (ESV). [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2330", "text": "Ventricular relaxation, or diastole, follows repolarization of the ventricles and is represented by the  T wave  of the ECG. It too is divided into two distinct phases and lasts approximately 430 ms. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2331", "text": "During the early phase of ventricular diastole, as the ventricular muscle relaxes, pressure on the remaining blood within the ventricle begins to fall. When pressure within the ventricles drops below pressure in both the pulmonary trunk and aorta, blood flows back toward the heart, producing the dicrotic notch (small dip) seen in blood pressure tracings. The semilunar valves close to prevent backflow into the heart. Since the atrioventricular valves remain closed at this point, there is no change in the volume of blood in the ventricle, so the early phase of ventricular diastole is called the isovolumic ventricular relaxation phase, also called isovolumetric ventricular relaxation phase. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2332", "text": "In the second phase of ventricular diastole, called late ventricular diastole, as the ventricular muscle relaxes, pressure on the blood within the ventricles drops even further. Eventually, it drops below the pressure in the atria. When this occurs, blood flows from the atria into the ventricles, pushing open the tricuspid and mitral valves. As pressure drops within the ventricles, blood flows from the major veins into the relaxed atria and from there into the ventricles. Both chambers are in diastole, the atrioventricular valves are open, and the semilunar valves remain closed. The cardiac cycle is complete. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2333", "text": "One of the simplest methods of assessing the heart's condition is to  listen  to it using a  stethoscope . [ 1 ]  In a healthy heart, there are only two audible  heart sounds , called S1 and S2. The first heart sound S1, is the sound created by the closing of the atrioventricular valves during ventricular contraction and is normally described as \"lub\". The second heart sound, S2, is the sound of the semilunar valves closing during ventricular diastole and is described as \"dub\". [ 1 ]  Each sound consists of two components, reflecting the slight difference in time as the two valves close. [ 9 ]  S2 may  split  into two distinct sounds, either as a result of inspiration or different valvular or cardiac problems. [ 9 ]  Additional heart sounds may also be present and these give rise to  gallop rhythms . A  third heart sound , S3 usually indicates an increase in ventricular blood volume. A  fourth heart sound  S4 is referred to as an atrial gallop and is produced by the sound of blood being forced into a stiff ventricle. The combined presence of S3 and S4 give a quadruple gallop. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2334", "text": "Heart murmurs  are abnormal heart sounds which can be either pathological or benign and there are numerous kinds. [ 10 ]  Murmurs are graded by volume, from 1) the quietest, to 6) the loudest, and evaluated by their relationship to the heart sounds and position in the cardiac cycle. [ 9 ]   Phonocardiograms  can record these sounds. [ 1 ]  Murmurs can result from narrowing (stenosis), regurgitation or insufficiency of any of the main heart valves but they can also result from a number of other disorders, including  atrial  and  ventricular septal defects . [ 9 ]  One example of a murmur is  Still's murmur , which presents a musical sound in children, has no symptoms and disappears in adolescence. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2335", "text": "A different type of sound, a  pericardial friction rub  can be heard in cases of pericarditis where the inflamed membranes can rub together. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2336", "text": "The resting heart rate of a newborn can be 120 beats per minute (bpm) and this gradually decreases until maturity and then gradually increases again with age. The adult resting heart rate ranges from 60 to 100 bpm. Exercise and fitness levels, age and  basal metabolic rate  can all affect the heart rate. An athlete's heart rate can be lower than 60 bpm. During exercise the rate can be 150 bpm with maximum rates reaching from 200 and 220 bpm. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2337", "text": "The normal  sinus rhythm  of the heart rate is generated by the  SA node . It is also influenced by  central  factors through  sympathetic  and  parasympathetic  nerves [ 3 ] :\u200a116\u201322\u200a  of the two paired  cardiovascular centres  of the  medulla oblongata . Activity is increased via sympathetic stimulation of the cardioaccelerator nerves, and inhibited via parasympathetic stimulation by the  vagus nerve . During rest vagal stimulation normally predominates as, left unregulated, the SA node would initiate a  sinus rhythm  of approximately 100 bpm. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2338", "text": "Both sympathetic and parasympathetic stimuli flow through the paired  cardiac plexus  near the base of the heart. Without any nervous stimulation, the SA node would establish a sinus rhythm of approximately 100 bpm. Since resting rates are considerably less than this, it becomes evident that parasympathetic stimulation normally slows HR. [ 1 ]  The cardioaccelerator center also sends additional fibers, forming the cardiac nerves via sympathetic ganglia (the cervical ganglia plus superior thoracic ganglia T1\u2013T4) to both the SA and AV nodes, plus additional fibers to the atria and ventricles. The ventricles are more richly innervated by sympathetic fibers than parasympathetic fibers. Sympathetic stimulation causes the release of the neurotransmitter  norepinephrine  (also known as  noradrenaline ) at the  neuromuscular junction  of the cardiac nerves. This shortens the repolarization period, thus speeding the rate of depolarization and contraction, which results in an increased heartrate. It opens chemical or ligand-gated sodium and calcium ion channels, allowing an influx of positively charged ions. [ 1 ]  Norepinephrine binds to the beta\u20131 receptor.  High blood pressure  medications are used to block these receptors and so reduce the heart rate. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2339", "text": "The cardiovascular centres receive input from a series of visceral receptors with impulses traveling through visceral sensory fibers within the vagus and sympathetic nerves via the cardiac plexus. Among these receptors are various  proprioreceptors ,  baroreceptors , and  chemoreceptors , plus stimuli from the  limbic system  which normally enable the precise regulation of heart function, via cardiac reflexes. Increased physical activity results in increased rates of firing by various proprioreceptors located in muscles, joint capsules, and tendons. The cardiovascular centres monitor these increased rates of firing, suppressing parasympathetic stimulation or increasing sympathetic stimulation as needed in order to increase blood flow. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2340", "text": "Similarly, baroreceptors are stretch receptors located in the aortic sinus, carotid bodies, the venae cavae, and other locations, including pulmonary vessels and the right side of the heart itself. Rates of firing from the baroreceptors represent blood pressure, level of physical activity, and the relative distribution of blood. The cardiac centers monitor baroreceptor firing to maintain cardiac homeostasis, a mechanism called the baroreceptor reflex. With increased pressure and stretch, the rate of baroreceptor firing increases, and the cardiac centers decrease sympathetic stimulation and increase parasympathetic stimulation. As pressure and stretch decrease, the rate of baroreceptor firing decreases, and the cardiac centers increase sympathetic stimulation and decrease parasympathetic stimulation. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2341", "text": "There is a similar reflex, called the atrial reflex or  Bainbridge reflex , associated with varying rates of blood flow to the atria. Increased venous return stretches the walls of the atria where specialized baroreceptors are located. However, as the atrial baroreceptors increase their rate of firing and as they stretch due to the increased blood pressure, the cardiac center responds by increasing sympathetic stimulation and inhibiting parasympathetic stimulation to increase HR. The opposite is also true. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2342", "text": "In addition to the  autonomic nervous system , other factors can affect this. These include epinephrine, norepinephrine, and thyroid hormones; levels of various ions including calcium, potassium, and sodium; body temperature; hypoxia; and pH balance . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2343", "text": "Factors that increase heart rate also trigger an increase in stroke volume. As with skeletal muscles the heart can increase in size and efficiency with exercise. [ 1 ]  Thus endurance athletes such as  marathon runners  may have a heart that has  hypertrophied  by up to 40%. [ 3 ] :\u200a1063\u201364\u200a  The difference between maximum and minimum cardiac outputs is known as the cardiac reserve and this measures the residual capacity to pump blood. [ 1 ]  Heart rates may reach up to 185\u2013195 in exercise, depending on how fit a person is. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2344", "text": "Cardiac output (CO) is a measurement of the amount of blood pumped by each ventricle (stroke volume, SV) in one minute. To calculate this, multiply stroke volume (SV), by heart rate (HR), in  beats per minute . [ 1 ]  It can be represented by the equation: CO = HR x SV [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2345", "text": "SV is normally measured using an  echocardiogram  to record end diastolic volume (EDV) and end systolic volume (ESV), and calculating the difference: SV = EDV \u2013 ESV. SV can also be measured using a specialized catheter, but this is an invasive procedure and far more dangerous to the patient. A mean SV for a resting 70-kg (150-lb) individual would be approximately 70 mL. There are several important variables, including size of the heart, physical and mental condition of the individual, sex, contractility, duration of contraction, preload or EDV, and afterload or resistance. Normal range for SV would be 55\u2013100 mL. An average resting HR would be approximately 75 bpm but could range from 60 to 100 in some individuals. [ 1 ]  Using these numbers, (which refer to each ventricle, not both) the mean CO is 5.25 L/min, with a range of 4.0\u20138.0 L/min. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2346", "text": "SVs are also used to calculate ejection fraction, which is the portion of the blood that is pumped or ejected from the heart with each contraction. To calculate ejection fraction, SV is divided by EDV. Despite the name, the ejection fraction is normally expressed as a percentage. Ejection fractions range from approximately 55\u201370 percent, with a mean of 58 percent. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2347", "text": "Many of the factors that regulate the heart rate also affect cardiac function by altering the  stroke volume . While a number of variables are involved, stroke volume is dependent upon the difference between end diastolic volume and end systolic volume. The three primary factors involved are  preload ,  afterload  and  contractility . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2348", "text": "Preload  is another way of expressing EDV. Therefore, the greater the EDV, the greater the preload. A main factor is ventricular filling time. The faster the contractions are, the shorter the filling time and both the EDV and preload are lower. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2349", "text": "The relationship between ventricular stretch and contraction has been stated in the  Frank-Starling mechanism  which says that the force of contraction is directly proportional to the initial length of muscle fibre. So that the greater the stretch of the ventricle the greater the contraction. Any sympathetic stimulation to the venous system will increase venous return to the heart and ventricular filling. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2350", "text": "The ventricles must develop a certain tension to pump blood against the resistance of the vascular system. This tension is called  afterload . When the resistance is increased particularly due to  stenotic  valve damage the afterload must necessarily increase. A decrease in normal vascular resistance can also occur. Different cardiac responses operate to restore homeostasis of the pressure and blood flow. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2351", "text": "The ability of the myocardium to contract, (its  contractility ), controls the stroke volume which determines the end systolic volume. The greater the contraction the greater the stroke volume and the smaller the end systolic volume. Positive or negative  inotropic factors  via sympathetic and parasympathetic stimulation respectively, can increase or decrease the force of contractions. Sympathetic stimulation triggers the release of norepinephrine from the cardiac nerves and also stimulates the  adrenal cortex  to secrete both epinephrine and norepinephrine. These secretions increase the heart rate, subsequent metabolic rate and contractility. Parasympathetic stimulation stimulates the release of  acetylcholine  (ACh) from the  vagus nerve  which decreases contractility, and stroke volume which increases end systolic volume. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2352", "text": "Several synthetic drugs have been developed that can act either as a stimulant or inhibitor inotrope. The stimulant inotropes, such as  Digoxin , cause higher concentrations of calcium ions which increase contractility. Excess calcium ( hypercalcemia ) is also a positive inotrope. Drugs that are negative inotropes include  beta blockers  and  calcium channel blockers .  Hypoxia ,  acidosis ,  hyperkalemia  are also negative inotropic agents. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2353", "text": "The  cardiac plexus  is a  plexus  of nerves situated at the base of the  heart  that innervates the heart."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2354", "text": "The cardiac plexus is divided into a superficial part, which lies in the concavity of the  aortic arch , and a deep part, between the aortic arch and the  trachea . The two parts are, however, closely connected. The  sympathetic  component of the cardiac plexus comes from  cardiac nerves , which originate from the sympathetic trunk. The  parasympathetic  component of the cardiac plexus originates from the  cardiac branches of the vagus nerve ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2355", "text": "The superficial part of the cardiac plexus lies beneath the  aortic arch , in front of the  right pulmonary artery . It is formed by the superior cervical cardiac branch of the left  sympathetic trunk  and the inferior cardiac branch of the left  vagus nerve . [ 1 ]  A small ganglion, the  cardiac ganglion of Wrisberg , is occasionally found connected with these nerves at their point of junction. This ganglion, when present, is situated immediately beneath the arch of the aorta, on the right side of the  ligamentum arteriosum ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2356", "text": "The superficial part of the cardiac plexus gives branches to:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2357", "text": "The deep part of the cardiac plexus is situated in front of the bifurcation of the  trachea  (known as the  carina ), above the point of division of the pulmonary artery, and behind the aortic arch. It is formed by the cardiac nerves derived from the cervical ganglia of the sympathetic trunk, and the cardiac branches of the vagus and  recurrent laryngeal nerves ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2358", "text": "The only cardiac nerves which do not enter into the formation of the deep part of the cardiac plexus are the superior cardiac nerve of the left sympathetic trunk, and the lower of the two superior cervical cardiac branches from the left vagus nerve, which pass to the superficial part of the plexus."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2359", "text": "The branches from the right half of the deep part of the cardiac plexus pass, some in front of, and others behind, the right pulmonary artery; the former, the more numerous, transmit a few filaments to the anterior pulmonary plexus, and are then continued onward to form part of the anterior coronary plexus; those behind the pulmonary artery distribute a few filaments to the right atrium, and are then continued onward to form part of the posterior coronary plexus."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2360", "text": "The left half of the deep part of the plexus is connected with the superficial part of the cardiac plexus, and gives filaments to the left atrium, and to the anterior pulmonary plexus, and is then continued to form the greater part of the posterior coronary plexus."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2361", "text": "This article incorporates text in the  public domain  from  page 984  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2362", "text": "According to the  cardiocentric hypothesis , the heart is the primary location of human emotions, cognition, and awareness. [ 1 ]  This notion may be traced back to ancient civilizations such as  Egypt  and  Greece , where the heart was regarded not only as a physical organ but also as a repository of emotions and wisdom. [ 2 ]   Aristotle , a well-known Greek philosopher in this field, contributed to the notion by thinking the heart to be the centre of both emotions and intellect. He believed that the heart was the center of the psycho-physiological system and that it was responsible for controlling sensation, thought, and body movement. He also observed that the heart was the origin of the veins in the body and that the existence of  pneuma  in the heart was to function as a messenger, traveling through blood vessels to produce sensation. [ 3 ]  This point of view remained throughout history, spanning the  Middle Ages  and  Renaissance , influencing medical and intellectual debate. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2363", "text": "An opposing theory called \"cephalocentrism\", which proposed that the  brain  played the dominant role in controlling the body, was first introduced by  Pythagoras  in 550 BC, who argued that the soul resides in the brain and is immortal. [ 4 ]  His statements were supported by  Plato ,  Hippocrates , and  Galen of Pergamon . Plato believed that the body is a \"prison\" of the mind and soul and that in death the mind and soul become separated from the body, meaning that neither one of them could die. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2364", "text": "In  ancient Egypt , people believed that the heart is the seat of the soul and the origin of the channels to all other parts of the body, including  arteries ,  veins ,  nerves , and  tendons . The heart was also depicted as determining the fate of ancient Egyptians after they died. It was believed that  Anubis , the god of  mummification , would weigh the deceased person's heart against a feather. If the heart was too heavy, it would be considered guilty and consumed by the  Ammit , a mythological creature. If it was lighter than the feather, the spirit of the deceased would be allowed to go to  heaven . Therefore, the heart was kept in the mummy while other organs were generally removed. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2365", "text": "However, the  ancient Greeks ,  Aristotle  promoted the cardiocentric hypothesis based on his experience with animal dissection. [ 7 ]  He found that certain primitive animals could move and feel without the brain, and so deduced that the brain was not responsible for movement or feeling. Apart from that, he pointed out that the brain was at the top of the body, far from the centre of the body, and felt cold. He also performed anatomical examinations after strangling the specimen, which would cause  vasoconstriction  of the  arterioles  in the  lungs . This likely had the effect of forcing blood to engorge the veins and make them more visible in the following dissection. Aristotle observed that the heart was the origin of the veins in the body, and concluded that the heart was the centre of the psycho-physiological system. He also stated that the existence of  pneuma  in the heart was to function as a messenger, traveling through blood vessels to produce sensation. Movement of body parts was thought to be controlled by the heart as well. From Aristotle's perspective, the heart was composed of  sinews  which allowed the body to move. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2366", "text": "In the fourth century BC,  Diocles of Carystus  reasserted that the heart was the physiological centre of sensation and thought. He also recognised that the heart had two cardiac ears. Although Diocles also proposed that the  left brain  was responsible for intelligence and the  right one  was for sensation, he believed that the heart was dominant over the brain for listening and understanding. [ 9 ]   Praxagoras of Cos  was a follower of Aristotle's cardiocentric theory and was the first one to distinguish arteries and veins. He conjectured that arteries carry pneuma while transporting blood. [ clarification needed ]  He also proved that a  pulse  can be detected from the arteries and explained that the arteries' ends narrowed into nerves. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2367", "text": "Lucretius  stated around 55 BCE, \"The dominant force in the whole body is that guiding principle which we term mind or intellect. This is firmly lodged in the midregion of the breast. Here is the place where fear and alarm pulsate. Here is felt the caressing touch of joy. Here, then, is the seat of the intellect and the mind.\" [ 11 ] [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2368", "text": "Cardiocentrism is accepted in the  Quran . [ 13 ]  The Islamic philosopher and physician  Avicenna  followed  Galen of Pergamon , believing that one's spirit was confined in three chambers of the brain and accepted that nerves originate from the brain and  spinal cord , which control body movement and sensation. However, he maintained the earlier cardiocentric hypothesis. He stated that activation for voluntary movement began in the heart and was then transported to the brain. Similarly, messages were delivered from a peripheral environment to the brain and then via the  vagus nerve  to the heart. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2369", "text": "In the Middle Ages, the German Catholic friar  Albertus Magnus  made contributions to physiology and biology. His treatise was based on Galen's cephalocentric theory and was profoundly affected by Avicenna's preeminent Canon, which itself had been influenced by Aristotle. He combined these ideas in a new way which suggested that nerves branched off from the brain but that the origin was the heart. He concluded that philosophically, all matters originated from the heart, and in the corporeal explanation, all nerves started from the brain. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2370", "text": "William Harvey , an early modern English physiologist, also agreed with Aristotle's cardiocentric view. He was the first to describe the basic operation of the circulatory system, by which blood was pumped by the heart to the rest of the body, in detail. He explained that the heart was the centre of the body and the source of life in his treatise  De Motu Cordis et Sanguinis in Animalibus ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2371", "text": "Hippocrates of Kos was the first to suggest that the brain was the seat of the soul and intelligence. From his treatise  De morbo sacro , he pointed out that the brain controls the rest of the body and is responsible for sensation and understanding. Apart from that, he believed that all feelings originated from the brain."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2372", "text": "Galen of Pergamon was a biologist and physician. His approach to the investigation of the brain was due to his rigorous anatomical methodology. He pointed out that only correct dissection will support the incontrovertible statement. He reached the conclusion that the brain was responsible for sensation and thought, and that nerves originated at the spinal cord and brain. [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2373", "text": "The \"little brain in the heart\" is an intricate system of nerve cells that control and regulate the heart's activity. It is also called the intrinsic cardiac nervous system (ICNS). [ 15 ]  It consists of about 40,000 neurons that form clusters or ganglia around the heart, especially near the top where the blood vessels enter and exit. These neurons communicate with each other and with the brain through chemical and electrical signals. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2374", "text": "The intrinsic cardiac nervous system has several functions, such as:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2375", "text": "Cardioprotection   includes all mechanisms and means that contribute to the preservation of the heart by reducing or even preventing myocardial damage. [ 1 ]  Cardioprotection encompasses several regimens that have shown to preserve function and viability of  cardiac muscle  cell tissue subjected to  ischemic insult  or  reoxygenation . Cardioprotection includes strategies that are implemented before an  ischemic event  ( preconditioning , PC), during an ischemic event (perconditioning, PerC) and after the event and during reperfusion (postconditioning, PostC). [ 2 ]  These strategies can be further stratified by performing the intervention locally or remotely, creating classes of conditioning known as remote  ischemic PC  (RIPC), remote ischemic PostC and remote ischemic PerC. [ 2 ]  Classical (local)  preconditioning  has an early phase with an immediate onset lasting 2\u20133 hours that protects against  myocardial infarction . [ 3 ]  The early phase involves  post-translational modification  of preexisting proteins, brought about by the activation of  G protein-coupled receptors  as well as downstream  MAPK's  and  PI3/Akt . These signaling events act on the  ROS -generating  mitochondria , activate  PKC\u03b5  and the Reperfusion Injury Salvage Kinase (RISK) pathway, preventing  mitochondrial permeability transition pore  (MTP) opening. [ 4 ]  The late phase with an onset of 12\u201324 hours that lasts 3\u20134 days and protects against both infarction and reversible postischemic contractile dysfunction, termed  myocardial stunning . [ 5 ] [ 6 ] [ 7 ]  This phase involves the synthesis of new cardioprotective  proteins  stimulated by  nitric oxide  (NO),  ROS  and  adenosine  acting on kinases such as  PKC\u03b5  and  Src , which in turn activate  gene transcription  and upregulation of late PC molecular players (e.g.,  antioxidant  enzymes,  iNOS ). [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2376", "text": "A role for PKC\u03b5 in more contemporary cardioprotection strategies including RIPC, [ 9 ]  local PostC, [ 10 ]  and remote PostC [ 11 ]  have been either demonstrated or suggested. It was shown that PKC\u03b5 translocates from the  cytosolic  to the particulate fraction upon RIPC induction and that the protection conferred by RIPC can be inhibited with the PKC inhibitor  chelerythrine [ 12 ] [ 13 ]  Similarly, in models of local PostC,  phosphorylation  and activation of PKC\u03b5 has been shown to be induced and PKC\u03b5 inhibition attenuated the beneficial effects of these regimens. [ 14 ] [ 15 ]  A recent study showed that blocking  Hsp90  function with  geldanamycin  inhibits PostC protection and PKC\u03b5 translocation. [ 16 ]  Additional studies are required to investigate a role for PKC\u03b5 in remote PostC and PerC, as this has not been conclusively demonstrated."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2377", "text": "Cardiovascular physiology  is the study of the  cardiovascular system , specifically addressing the  physiology  of the  heart  (\"cardio\") and  blood vessels  (\"vascular\")."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2378", "text": "These subjects are sometimes addressed separately, under the names  cardiac physiology  and  circulatory physiology . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2379", "text": "Although the different aspects of cardiovascular physiology are closely interrelated, the subject is still usually divided into several subtopics. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2380", "text": "Under most circumstances, the body attempts to maintain a steady  mean arterial pressure . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2381", "text": "When there is a major and immediate decrease (such as that due to  hemorrhage  or  standing up ), the body can increase the following:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2382", "text": "In turn, this can have a significant impact upon several other variables:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2383", "text": "The  heart of Fr\u00e9d\u00e9ric Chopin  was separated from his body after he died in  Paris , France, on 17 October 1849, aged 39. The Polish composer  Fr\u00e9d\u00e9ric Chopin  had a fear of being  buried alive  and requested that his physician  Jean Cruveilhier  perform an autopsy. While Chopin's body was buried at the  P\u00e8re Lachaise Cemetery  in Paris, his heart was immersed in alcohol (probably  cognac ) and placed in an oak container."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2384", "text": "Before his death, one of Chopin's last requests was that his eldest sister,  Ludwika J\u0119drzejewicz , take his heart to Poland to be buried at a local church. She complied with his wishes, smuggling his heart through customs at the Austrian border, past Russian border agents and into Poland. It was given to the  Holy Cross Church  in  Warsaw  and kept in the catacombs. After a local journalist discovered the heart in a box, it was transferred to the upper part of the church in 1879 and immured in a pillar."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2385", "text": "During the  Warsaw Uprising  in 1944, Chopin's heart was taken from the church by Nazi officials to the headquarters of  SS  commander  Erich von dem Bach-Zelewski . It was later returned to the Polish people and sent to  Milan\u00f3wek  for safekeeping. On 17 October 1945, a delegation transported the heart back to Warsaw, where it was returned to its place in the Holy Cross Church."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2386", "text": "Speculation as to the reason for Chopin's premature death led to requests by scholars and scientists to conduct an analysis of the heart tissue. While he was said to have died from  tuberculosis , it was speculated that he may have had  cystic fibrosis . A request to sample the heart tissue was refused by the Polish government, but the heart's container was secretly removed from the pillar for a visual inspection in 2014. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2387", "text": "Composer  Fr\u00e9d\u00e9ric Chopin  had poor health throughout his life. He suffered from respiratory problems, chronic diarrhea, and weight loss. [ 2 ]  As an adult, he weighed less than 45 kilograms (99\u00a0lb). [ 3 ]  In 1849, knowing that he would soon die, Chopin made arrangements for his funeral. He had a fear of being  buried alive  ( taphophobia ) and requested to his sister that his heart be removed from his body and taken to Warsaw to be buried at a local church. [ 4 ] [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2388", "text": "Chopin died in Paris on 17 October 1849. On the day before his death, Chopin requested that his physician,  Jean Cruveilhier , conduct an autopsy. During the autopsy, Cruveilhier removed Chopin's heart and submerged it in alcohol, probably  cognac . [ 6 ]  His body was buried in Paris at the  P\u00e8re Lachaise Cemetery , while his heart was placed in a crystal jar that was hermetically sealed. Months later, in early 1850, his sister transported the heart to Poland. [ 7 ]  The heart would eventually come to be treated as an exceptional artefact within the  culture of Poland , afforded the respect usually reserved for saintly relics. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2389", "text": "In early January 1850, Chopin's eldest sister,  Ludwika J\u0119drzejewicz , returned from France by rail to Poland with her daughter and her brother's heart. She carried the heart with her, concealing its container underneath her cloak or skirt [ 6 ]  as she smuggled it through a customs inspection at the Austrian border and past Russian border agents into Poland. [ 4 ]  Soviet music historian  Igor Boelza  wrote about her journey, explaining that J\u0119drzejewicz had hidden \"a small oak trunk under her dress. In it was a casket made of ebony wood, containing a precious vessel holding Chopin's heart\". [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2390", "text": "Chopin's heart arrived in Warsaw and was kept by his sister and mother, resting on top of a dresser at the home of J\u0119drzejewicz and the Kalasanty family. [ 5 ]  Prior to J\u0119drzejewicz's death in 1855, she may have arranged for the transfer of the heart to Warsaw's  Holy Cross Church . There was opposition within the church's clergy to having the heart in the upper part of the church, as Chopin was not a saint. [ 5 ]  Instead, the heart was tucked away in the church's catacombs and lay there undisturbed and unlabeled for over two decades. In 1878, journalist Adam P\u0142ug found the heart in a box and wrote about his discovery in a Warsaw journal. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2391", "text": "The clergy of the church were persuaded to move the heart in part due to the fact that the heart of novelist  Klementyna Hoffmanowa  was being kept in the  Wawel Cathedral . With the support of apostolic administrator  Antoni Ksawery Sotkiewicz , the heart was moved to the upper part of the church on 1 March 1879 and immured in the first pillar on the left, facing towards the church's great  nave . The transfer of the heart took place in secret due to fears that Tsarist authorities would seize it. Composer  W\u0142adys\u0142aw \u017bele\u0144ski  was one of the organizers of the transfer ceremony, which was attended by around a dozen people. [ 5 ] [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2392", "text": "On 29 February 1880, Chopin's heart was consecrated. A tablet carved from  Carrara marble  by sculptor  Leonard Marconi  and dedicated to the memory of Chopin was installed on the pillar a week later. A biblical verse from  Matthew 6:21  was inscribed onto one of the plaques: \"For where your treasure is, there your heart will be also.\" [ 5 ] [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2393", "text": "For decades, the heart was the sole public monument in Warsaw honoring Chopin that the Tsarist authorities allowed. It drew \"covert displays of nationalist fervor\". Once  Poland achieved independence  in 1918, it became an open shrine. [ 7 ]  In 1926, Archbishop Antoni Szlagowski said of Chopin: \"All our past sings in him, all our slavery cries in him, the beating heart of the nation, the great king of sorrows.\" [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2394", "text": "After the German Army  captured Warsaw  in 1939, performances of Chopin's music were banned, the  Fryderyk Chopin Institute  was shuttered, and the  Fr\u00e9d\u00e9ric Chopin Monument  in \u0141azienki Park was destroyed. [ 5 ]  During the 1944  Warsaw Uprising , the Holy Cross Church was damaged and captured by the Nazis. A German priest by the name of Schulze requested that the occupying forces be allowed to take possession of Chopin's heart for safekeeping. It was taken by  SS  officer  Heinz Reinefarth [ 7 ]  and then given to SS commander  Erich von dem Bach-Zelewski , who kept it at his headquarters as part of his collection of curios. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2395", "text": "As the occupation was drawing to a close, Bach-Zelewski, known for his  brutal suppression of the uprising , returned the heart. Polish journalist  Andrzej Pettyn \u00a0[ pl ] , who wrote a definitive account of Chopin's heart, [ 5 ]  wrote that Bach-Zelewski's gesture \"aimed at reducing his own fault and presenting himself to the world in a more favorable light.\" [ 7 ]  Bach-Zelewski ordered that Chopin's heart be transferred to the   auxiliary bishop of Warsaw   Antoni Szlagowski \u00a0[ pl ] . German officials arranged for a film crew to document the transfer of the heart to Szlagowski as a part of  Nazi propaganda . At the moment the urn containing the heart was to be handed over, the spotlights they were using malfunctioned, an event for which Szlagowski said to his colleagues: \"Thank the Lord. This time these barbarians will not succeed in their propaganda ploy.\" [ 7 ]  Szlagowski had the heart transferred to St. Hedwig Church in  Milan\u00f3wek , escorted by a contingent of German soldiers. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2396", "text": "Upon the arrival of Chopin's heart in Milan\u00f3wek, it was hidden out of fear that the Germans would try to repossess it. The heart was briefly kept at the house of a professor named Antoniewicz and the apartment of the pianist Maria Findeisen. Thereafter, the heart was kept by Archbishop Szlagowski, atop a piano, in his private chapel until October 1945. A small wooden casket was created to hold the urn.  Bronis\u0142aw Edward Sydow \u00a0[ pl ] , a member of the board of the Fryderyk Chopin Institute, approached officials from the  Provisional Government of National Unity  to arrange a ceremonial return of the heart to the Holy Cross Church, which by that time had been mostly restored. The Executive Committee of the National Celebration of the Return of Chopin's Heart to Warsaw was established on 18 September 1945. [ 5 ]  Sydow asked to check the condition of the relic and examined the heart in Milan\u00f3wek. The container was opened and Sydow observed:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2397", "text": "The urn consisted of an outer box made of oak, smooth, on a dark bylaid, in which there is a second mahogany box polished with  marquetry  (porte lines) embellished. Recessed in the lid is a silver plate in the form of a heart, with an engraved inscription containing Frederic Chopin's birth and death dates. This box is surrounded by lead plates for protection from moisture. Inside this box is a large crystal jar hermetically sealed, in which, in transparent alcohol, is Chopin's perfectly preserved heart. What is striking is the size of the heart, for a figure of average height it is immeasurably large. Presumably under the influence of heart disease, which primarily contributed to Chopin's early death, in addition to tuberculosis. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2398", "text": "On 17 October 1945, the 96th anniversary of Chopin's death, the urn containing his heart was handed over to Leopold Petrzyk in Milan\u00f3wek in St. Hedwig Church's courtyard. A delegation including pianist  Boles\u0142aw Woytowicz  then transported it by car to  \u017belazowa Wola , the village where Chopin was born, via a meandering 90-kilometre (56\u00a0mi) route taking it through  Grodzisk Mazowiecki  and B\u0142onie. Crowds lined up along the route, which was adorned with white and red Polish flags. [ 5 ] [ 7 ]  Petrzyk passed the urn along to then-President  Boles\u0142aw Bierut , who handed it over to Warsaw mayor  Stanis\u0142aw To\u0142wi\u0144ski \u00a0[ pl ] . Following a short concert by pianist  Henryk Sztompka \u00a0[ pl ] , the delegation proceeded to Warsaw. There,  Wiktor Grodzicki \u00a0[ pl ]  gave a welcoming speech, saying in part:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2399", "text": "This heart first beat 135 years ago, in nearby \u017belazowa Wola, and soon began to beat more vividly to the sound of a folk song resounding from peasant huts, and when not many years had passed, the same peasant, Masurian song, amplified a thousandfold by Chopin's heart and genius, was already resounding throughout Europe, and today, 96 years after that heart stopped beating \u2013 it resounds throughout the world, bearing witness to the immortal values of our song, our culture and our nation. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2400", "text": "After the heart arrived in Warsaw, an afternoon commemorative service at Holy Cross Church was broadcast to the nation, with both the president and the prime minister of Poland in attendance. [ 9 ]  A eulogy given by musicology professor  Hieronim Feicht \u00a0[ pl ]  was described by the newspaper  \u017bycie Warszawy  as \"a profound analysis of the artistic values of Chopin's music\". The heart was then returned to the pillar beneath a bust of Chopin created by sculptor  Andrzej Pruszy\u0144ski \u00a0[ pl ] . [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2401", "text": "Over the years, speculation about the cause of Chopin's death led to calls to examine the heart. In 2008, scholars requested that a  DNA analysis  of the heart's tissue be conducted to determine if Chopin had died from  cystic fibrosis  rather than tuberculosis. Cystic fibrosis was unknown during his lifetime and was thought to be a better explanation for his symptoms. [ 7 ]  The request was refused by the Polish government. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2402", "text": "On 14 April 2014, a group of church officials, scientists and representatives from the  Fryderyk Chopin Institute  disinterred the jar containing Chopin's heart. Researchers examined the heart in secret, though they limited themselves to a visual inspection and did not open the jar. They took photographs, applied sealing wax to the jar, and only revealed that they had made an inspection five months later. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2403", "text": "The scientists published their findings in a 2017 article in  The American Journal of Medicine . They wrote that the floppy and massively engorged heart appeared to have been removed using the \"French method\"\u2014pulling it out and severing the  aorta  and  pulmonary artery . The surface of the heart had a frosted appearance, being covered with a \"fine, whitish, massive fibrillary coating\". Hemorrhagic effusions were observed, as were three small white-glass nodules. The authors of the article concluded that Chopin had  pericarditis  which was brought on by tuberculosis. [ 11 ]  A letter to the editor published in the  American Journal of Medicine  called the diagnosis of tuberculosis into question. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2404", "text": "Another inspection of the heart is not expected to take place until 2064. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2405", "text": "52\u00b014\u203219.3\u2033N   21\u00b01\u203201.1\u2033E \ufeff / \ufeff 52.238694\u00b0N 21.016972\u00b0E \ufeff /  52.238694; 21.016972"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2406", "text": "The  crista terminalis  (also known as the  terminal crest , [ citation needed ]  or  crista terminalis of  His [ 1 ] ) is a vertical ridge on the [ 2 ] :\u200a56\u200a  posterolateral [ 3 ]  inner surface of the adult  right atrium  extending between the  superior vena cava , and the  inferior vena cava . [ 2 ] :\u200a56\u200a  The crista terminalis denotes where the junction of the embryologic  sinus venosus  and the right atrium occurred during  embryonic development . [ 3 ]  It forms a boundary between the rough [ 2 ] :\u200a56\u200a  trabecular [ 4 ]  portion and  the smooth, sinus venosus-derived portion (sinus venarum)  of the internal surface of the right atrium. The  sinoatrial node  is located within the crista terminalis. [ 2 ] :\u200a56"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2407", "text": "The crista terminalis generally takes the form of a smooth-surfaced, crescent-shaped thickened portion of heart muscle at the opening into the right atrial appendage. [ citation needed ]  It consists of fibromuscular tissue. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2408", "text": "On the external aspect of the right atrium, corresponding to the crista terminalis, is a groove - the  terminal sulcus . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2409", "text": "The crista terminalis provides the origin for the  pectinate muscles . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2410", "text": "The  sinoatrial node  is located in the superior part of the crista terminalis at the junction of the right atrium, and  superior vena cava . [ 2 ] :\u200a60"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2411", "text": "During the development of the human heart, the right horn and transverse portion of the  sinus venosus  ultimately become incorporated with and form a part of the adult  right atrium . [ 1 ]  The right sinus horn [ 4 ]  of the sinus venosus develops into the  sinus venarum ; in the adult right atrium, the portion of right atrium derived from the sinus venosus has a smooth inner surface. [ 2 ] :\u200a56"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2412", "text": "A prominent crista terminalis may be mistaken for a cardiac mass during heart imaging; a prominent crista terminalis appears as a hyperechoic ridge on  echocardiography , and homogenous to adjacent atrial wall on CT and MRI. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2413", "text": "Decellularized homografts  are  donated  human  heart valves  which have been modified via  tissue engineering . Several techniques exist for  decellularization  with the majority based on detergent or enzymatic protocols which aim to eliminate all donor cells while preserving the mechanical properties of the remaining matrix. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2414", "text": "Aortic valve  disease affects the valve between the  left ventricle  and the  aorta , and can be present as a  congenital condition  at birth or caused by other factors. Several therapeutic options are open to patients once the indication for  aortic valve replacement  has been confirmed. One option is replacement using a  mechanical valve . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2415", "text": "This, however, necessitates a strict lifelong  anticoagulation  regime to avoid cerebral  thromboembolism . These blood thinners hold an inherent risk for severe bleeding episodes, which affects both professional and leisure activities and the majority of patients opt to not use mechanical valves for this reason. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2416", "text": "Biological  prostheses , i.e.  pericardial heart valves  of animal origin ( xenogenic ), offer a viable alternative. However, in particular for young patients, it has been found that xenogenic valves do not provide satisfactory durability and rapid valve degeneration can occur within months. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2417", "text": "A further avenue open to patients is a so-called  Ross operation , an extensive surgical procedure in which the diseased aortic valve is replaced by the patient's  pulmonary valve  ( autograft ). The pulmonary valve then needs to be replaced by a heart valve prosthesis. A drawback of this method is that it can frequently result in a \"two-valve\" diseased heart, as almost all autografts are impaired by progressive dilatation in the long term, and the pulmonary valve prosthesis, often a conventional  cryopreserved   homograft , is subject to the same rate of degeneration as all biological valves. This can thereby lead to frequent reoperations [ 3 ]  which have a substantially higher mortality rate due to postoperative adhesions. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2418", "text": "The lack of durable heart valve prostheses for young patients has driven forward research in  tissue engineering  approaches for valve replacement. Current tissue-engineering concepts are based on either artificial  polymeric  or biological scaffolds, derived from donated human tissue ( allogeneic ) or animals (xenogenic). While more readily available, there have been reports of dramatic failure in the use of xenogeneic matrices in  paediatric  patients, leading to scepticism regarding their application. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2419", "text": "Total artificial tissue-engineered heart valve concepts are currently under development and would solve many unmet clinical demands, such as the permanent availability of different sizes and lengths. These concepts have shown good results in the technical implementation of valved polymeric conduit production and have successfully been used for  in vitro  and  in vivo  seeding of different (stem) cell lines. However,  preclinical  testing in long-term animal models has yet to deliver satisfactory results due to a lack of mechanical, leading to early failure of the valvular function. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2420", "text": "Aortic valve replacement using a  homograft  in orthotopic position was first performed over 50 years ago on 24 July 1962 by  Donald Ross  at  Guy's Hospital ,  London  and has been assessed in prospective randomized studies, e.g. in comparison to the Ross procedure. [ 7 ]  Aortic valve replacement using conventional  cryopreserved  homografts is currently performed only in about 3% of all patients, mostly to treat acute aortic valve  endocarditis .1 Severe  calcification  of conventional homografts frequently occurs and is the main reason for its restrictive use, however, current guidelines confirm homografts as a valid alternative for young patients requiring anatomical reconstruction of the outflow tract. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2421", "text": "DPH have been clinically implanted since 2002 in paediatric patients. [ 8 ]  The indications mainly include patients with pulmonary diseases such as pulmonary valve stenosis, atresia or insufficiency. They have shown excellent early to midterm clinical performance, challenging conventional  cryopreserved  homografts as the \"gold standard\" for pulmonary valve replacement in congenital heart disease. [ 9 ] [ 10 ]  Compared to cryopreserved homograft, decellularized pulmonary homografts have shown less degeneration and had to be explanted less. [ 11 ]  The main limitation is the low availability of such homografts and the higher costs."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2422", "text": "DAH developed at  Hannover Medical School  (MHH) have shown sufficient mechanical stability for the systemic circulation at the greatest possible extent of antigen elimination and have been validated in long-term animal models. [ 12 ]  The first DAH was implanted in human in the year 2008. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2423", "text": "A multicenter european study of aortic valve replacement with the use of DAH in 106 pediatric patients published in 2020 showed outcome data comparable to Ross procedure and mechanical aortic valve implantation and better results compared to cryopreserved homografts. In comparison to Ross procedure, early mortality rates were lower in DAH patients (2,2% versus 4,2%), however this trend was not statistically significant. Complications due to coronary reimplantation during DAH implantation occurred in 3.8% and progressive valve degeneration in 10%. [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2424", "text": "A multicenter european study in both pediatric and adult patients compared DAH with Ross procedure and showed almost identical results regarding valve degeneration and freedom from explantation. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2425", "text": "The  Evans County Heart Study  was a long-term  cardiovascular  study on residents of  Evans County, Georgia . The study, which was funded by the  National Institute of Health , began in July, 1958, and was last updated as recent as May 2016. It resulted in more than 560 published papers that ultimately showed the importance of  HDL cholesterol . [ 1 ]  The study was conducted by Dr.  Curtis Gordon Hames , a  family doctor  from  Claxton, Georgia . [ 2 ]  The study took place in Evans Country because the area had a high death count due to heart complications, such as  heart disease and other cardiovascular diseases . The studies showed that there was a significant abundance of heart conditions within a variety of ethnicities. People as young as fourteen and as old as seventy-four participated in the tests, and were divided into different age groups; however only males were eligible for the study. Anyone as old as one-hundred years old could be eligible, and any younger."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2426", "text": "The study involved 6,596 people from Evans County and 3,921 people from  Bulloch County . The study population from Evans county consisted of African-American and  Caucasian  males, ages 40\u201374, along with a 15-39 year old group that were involved in other studies. Then, the people were divided up into 10 random, equal in size, random samples. Also, a 50% random sample of the 15-39 year old group was taken by including people from the first five samples solely. By comprising this type of sampling, secular trends in disease patterns, along with possible aging of laboratory reagents were randomized. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2427", "text": "The study was done in Evans County, Georgia. Evans County is located in the southeastern portion of the United States. It is situated on the coastal plain estimating around 60 miles inland from the seaport of  Savannah, GA . Around half of the population lives on farms while the other half lives in meager little villages. An example is  Claxton . Claxton is a town that has a population of 2,000, about 40 percent of which is black. [ 4 ]  The white population of Evans County was large enough to provide an adequate number for the study, but the black population was considered too small and some blacks from the Bulloch county were incorporated into this study. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2428", "text": "The study can be categorized as a  cohort study  due to the longevity of the research and its focus on the residents of  Evans County, Georgia . It was the leader in the field of  epidemiology  to analyze effects and differences of  coronary heart disease  on race. [ 6 ]  The study aimed to determine how  cardiovascular disease  affected different races among a specific population. To determine the population size, a specific census was conducted in the county for the study during the first two months of 1960, recording 6,596 persons. [ 3 ]   From there, the study population included a total of 3,377 residents within Evans County. These residents included a group of randomly selected blacks and whites age 40-74 and an additional group of blacks were selected from Bulloch sub-County. A group of 15-39 year old residents were also selected into this group mainly to participate in other experiments as well. The study population was subsequently randomly divided into 10 groups. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2429", "text": "The examination process consisted of two cardiovascular tests including \"history and physical,  blood pressure  determination, standard  electrocardiogram  and chest  X-ray , and  cholesterol  determination.\" [ 3 ]  Ninety-two percent of the study population responded with an examination process. Therefore, data from 3,102 residents was obtained through the process. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2430", "text": "Using a prospective cohort model, the investigators sought to examine the entire population of the county aged over 40 years and half the population aged between 15 and 39 years. They ultimately achieved a 92% response rate for a total study population of 3,102 residents. From 1960 to 1962, each participant was given an initial examination in which serum cholesterol, blood pressure, weight, height and the participant's responses to a number of health behavior and medical history questions. A follow-up consisting of a similar battery of tests was completed from 1967 to 1969. For 90.9% of the study population, a physical similar to the preliminary one was completed. For another 7.9%, health status was ascertained by a phone survey of either subject or a family member. The total rate of follow-up was 98.8%. Factors assessed at the time of follow-up were systolic and diastolic blood pressure, serum cholesterol level, cigarette smoking, body weight,  hematocrit  value, ECG abnormalities and diet. Socioeconomic status was also assessed for whites, but not for blacks, as little variability was found in this factor among black subjects. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2431", "text": "A central finding of the study was that, across race and social class differences, factors associated with increased risk of  coronary heart disease  (CHD) did so equally for blacks and whites whether the risk factors were considered singly or in combination. CHD incidence remained markedly higher for white  Evans County  residents. The only  social grouping  of white residents that had equally low incidence of CHD was white  sharecroppers , which was attributed to higher rates of  physical activity  among sharecroppers when compared to whites of higher  socioeconomic status . [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2432", "text": "A strength of the study was the high response rate of the population in its entirety, one of only two of its kind to successfully examine an entire community. The publication of the initial study results did not include statistical analysis. Hames attributes his decision to avoid statistical analysis to the unique design of the study. He wrote, \u201c\u2026it certainly is not clear to us [the investigators] what differences such tests could make in our interpretations in the context of this study\u2026 the population over 40 does not constitute a sample of some universe. They are a  universe .\u201d [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2433", "text": "The  Framingham Heart Study  is a long-term, ongoing  cardiovascular   cohort study  of residents of the city of  Framingham ,  Massachusetts . The study began in 1948 with 5,209 adult subjects from Framingham, and is now on its third generation of participants. [ 1 ]   Prior to the study almost nothing was known about the  epidemiology  of hypertensive or  arteriosclerotic cardiovascular disease . [ 2 ]  Much of the now-common knowledge concerning heart disease, such as the effects of  diet ,  exercise , and common medications such as  aspirin , is based on this  longitudinal study . It is a project of the  National Heart, Lung, and Blood Institute , in collaboration with (since 1971)  Boston University . [ 1 ]   Various health professionals from the hospitals and universities of  Greater Boston  staff the project."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2434", "text": "In 1948, the study was commissioned by the\n United States Congress , with multiple communities being considered for study.  The final choice was between Framingham, Massachusetts, and  Paintsville, Kentucky . Framingham was chosen when residents showed more general interest in heart research than Paintsville. Thomas Royle Dawber was director of the study from 1949 to 1966. He was appointed as chief epidemiologist shortly after the start of the project, when it was not progressing well. [ 3 ]  The study had been intended to last 20 years; however, interest grew in part due to Dr. Dawber's efforts to promote the study and engage in fundraising after he had been transferred to Boston to accept a chairmanship of preventive medicine. By 1968, it was debated whether the original study had served its purpose and should be terminated as scheduled. A committee gathered and considered that, after 20 years of research, the Framingham study should come to an end, since their hypothesis had been tested and extensive information concerning heart diseases had been gathered. Despite this conclusion, Congress failed to accept the recommendation, instead voting to continue the study. The study has been split into different segments, or \"cohorts\". [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2435", "text": "William P. Castelli  is a former director of the Framingham Heart Study. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2436", "text": "Over 3,000 peer-reviewed scientific papers have been published related to the Framingham Heart Study. It is generally accepted that the work is outstanding in its scope and duration, and overall is considered very useful. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2437", "text": "It was rightly assumed from the start of the Framingham Heart Study that cardiac health can be influenced by lifestyle and environmental factors, and by inheritance. The Framingham Heart Study is the source of the term  risk factor . Before the Framingham Heart Study, doctors had little sense of heart disease prevention. In the 1950s, it was believed that clogging of arteries and narrowing of arteries ( atherosclerosis ,  arteriosclerosis ) were normal parts of aging, and that they occurred universally as people became older. High blood pressure ( hypertension ) and elevated serum cholesterol ( hypercholesterolemia ) were also seen as normal consequences of aging in the 1950s, and no treatment was available. These and further risk factors, such as  homocysteine , were gradually discovered over the years. [ 5 ] [ 6 ] [ 7 ] [ 8 ] [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2438", "text": "The Framingham Heart Study, along with other important large studies, such as the  Seven Countries Study  and the  Nurses' Health Study , also showed that  healthy diet , not being  overweight  or  obese , and regular  exercise  are all important in maintaining good health, and that there are differences in cardiovascular risk between men and women. [ 10 ] [ 11 ]  Along with other important studies about smoking, such as the  British Doctors Study , it also confirmed that cigarette  smoking  is a highly significant factor in the development of heart disease, leading in many cases to  angina pectoris ,  myocardial infarction  (MI), and coronary death. [ 12 ] [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2439", "text": "Recently the Framingham studies have come to be regarded as overestimating risk, particularly in the lower risk groups, such as for UK populations. [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2440", "text": "One question in  evidence-based medicine  is how closely the people in a study resemble the patient with whom the health care professional is dealing. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2441", "text": "Researchers recently used contact information given by subjects over the last 30 years to map the  social network  of friends and family in the study. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2442", "text": "The 10-year  cardiovascular risk  of an individual can be estimated with the  Framingham Risk Score , including for individuals without known cardiovascular disease. The Framingham Risk Score is based on findings of the Framingham Heart Study. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2443", "text": "Major findings from the Framingham Heart Study, according to the researchers themselves: [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2444", "text": "The Framingham Heart Study participants, and their children and grandchildren, voluntarily consented to undergo a detailed  medical history ,  physical examination , and  medical tests  every three to five years, [ 21 ]  creating a wealth of data about physical and mental health, especially about cardiovascular disease. A nonprofit charity, called Friends of the Framingham Heart Study, was founded to help defray study costs and spread awareness of heart issues. Membership is limited to participants. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2445", "text": "In recent years, scientists have been carrying out genetic research within the Framingham Heart Study."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2446", "text": "Inheritance patterns in families, [ 22 ]  heritability and genetic correlations, [ 23 ]  molecular markers, [ 24 ]  and associations have been studied. The association studies include traditional genetic association studies, i.e., looking for associations of cardiovascular risk with gene polymorphisms ( single-nucleotide polymorphisms , SNPs) in candidate genes, and genome wide association studies (GWAS). [ 9 ]  For example, one genome wide study, called the 100 K Study, included almost 1400 participants of the Framingham Heart Study (from the original cohort, and the offspring cohort), and revealed a genetic variant associated with obesity.  The researchers were able to replicate this particular result in four other populations. [ 25 ]  Further, the SHARe Study (SNP Health Association Resource Study) uncovered new candidate genes, and confirmed already known candidate genes (for homocysteine and vitamin B12 levels) in participants of the Framingham Heart Study. [ 26 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2447", "text": "Because of these exciting  genomic  results, the Framingham Heart Study has been described as \"on its way to becoming the gold standard for cardiovascular genetic epidemiology\". [ 27 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2448", "text": "However, clinically, despite these (and other) efforts, the aggregate effect of genes on cardiovascular disease risk beyond that of traditional cardiovascular risk factors has not been established. [ 28 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2449", "text": "The  Framingham Risk Score  is a sex-specific  algorithm  used to estimate the 10-year  cardiovascular risk  of an individual. The Framingham Risk Score was first developed based on data obtained from the  Framingham Heart Study , to estimate the 10-year risk of developing coronary heart disease. [ 1 ]  In order to assess the 10-year  cardiovascular disease  risk,  cerebrovascular events ,  peripheral artery disease  and  heart failure  were subsequently added as disease outcomes for the 2008 Framingham Risk Score, on top of  coronary heart disease . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2450", "text": "The Framingham Risk Score is one of a number of scoring systems used to determine an individual's chances of developing cardiovascular disease. A number of these scoring systems are available online. [ 3 ] [ 4 ]  Cardiovascular risk scoring systems give an estimate of the probability that a person will develop cardiovascular disease within a specified amount of time, usually 10 to 30 years. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2451", "text": "Because they give an indication of the risk of developing cardiovascular disease, they also indicate who is most likely to benefit from prevention. For this reason, cardiovascular risk scores are used to determine who should be offered preventive drugs such as drugs to lower blood pressure and drugs to lower cholesterol levels. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2452", "text": "For example, nearly 30% of coronary heart disease (CHD) events in both men and women were singularly attributable to blood pressure levels that exceeded high normal (\u2265130/85), showing that blood pressure management and monitoring is paramount both to cardiovascular health and prediction of outcomes. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2453", "text": "Because risk scores such as the Framingham Risk Score give an indication of the likely benefits of prevention, they are useful for both the individual patient and for the clinician in helping decide whether lifestyle modification and preventive medical treatment and for patient education, by identifying men and women at increased risk for future cardiovascular events. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2454", "text": "Coronary heart disease  (CHD) risk at 10 years in percent can be calculated with the help of the Framingham Risk Score. Individuals with  low risk  have 10% or less CHD risk at 10 years, with  intermediate risk  10-20%, and with  high risk  20% or more. However, it should be remembered that  these categorisations are arbitrary . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2455", "text": "A more useful metric is to consider the effects of treatment. If a group of 100 persons has a 20% ten-year risk of cardiovascular disease it means that we should expect that 20 of these 100 individuals will develop cardiovascular disease (coronary heart disease or stroke) in the next 10 years and eighty of them will not develop cardiovascular disease in the next 10 years. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2456", "text": "If they were to take a combination of treatments (for example drugs to lower cholesterol levels plus drugs to lower blood pressure) that reduced their risk of cardiovascular disease by half it means that 10 of these 100 individuals should be expected to develop cardiovascular disease in the next 10 years and 90 of them should not be expected to develop cardiovascular disease. If that was the case then 10 of these individuals would have avoided cardiovascular disease by taking treatment for 10 years; 10 would get cardiovascular disease whether or not they took treatment, and 80 would not have got cardiovascular disease whether or not they took treatment. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2457", "text": "Despite their widespread popularity, randomized trials assessing the impact of using cardiovascular disease risk scores show limited impact on patient outcomes. Although there is good evidence that targeting individuals with high total CVD risk is the most efficient way to reduce CVD-related morbidity and mortality, to date trials assessing the usefulness of risk scores at helping clinicians target high risk patients show limited benefit. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2458", "text": "It is important to recognize that the strongest predictor of cardiovascular risk in any risk equation is age. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2459", "text": "Cardiovascular disease  is common in the general population, affecting the majority of adults. It includes: [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2460", "text": "An individual's risk for future cardiovascular events is modifiable, by lifestyle changes and preventive medical treatment. Lifestyle changes can include stopping  smoking ,  healthy diet , regular  exercise , etc. Preventive medical treatment can include a  statin , mini dose  aspirin , treatment for  hypertension , etc. It is important to be able to predict the risk of an individual patient, in order to decide when to initiate lifestyle modification and preventive medical treatment. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2461", "text": "Multiple risk models for the prediction of cardiovascular risk of individual patients have been developed. One such key  risk model  is the Framingham Risk Score. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2462", "text": "The Framingham Risk Score is based on findings from the  Framingham Heart Study . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2463", "text": "The Framingham Risk Score has been validated in the US, both in men and women, both in European Americans and African Americans. [ 9 ]  While several studies have claimed to improve on the FRS, there is little evidence for any improved prediction beyond the Framingham risk score  [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2464", "text": "The Framingham Risk Score predicts only future coronary heart disease (CHD) events, however, it does not predict future total cardiovascular events, meaning that it does not predict risk for stroke, transient ischemic attack (TIA), and heart failure. These also important patient outcomes were included in the 2008  Framingham General Cardiovascular Risk Score . [ 2 ]  The predicted risk for an individual usually is higher with the 2008 Framingham General Cardiovascular Risk Score than with the 2002 Framingham Risk Score. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2465", "text": "The Framingham Risk Score could overestimate (or underestimate) risk in populations other than the US population, [ 11 ] [ 12 ]  and within the US in populations other than European Americans and African Americans, e.g. Hispanic Americans and Native Americans. [ 13 ]  It is not yet clear if this limitation is real, or appears to be real because of differences in methodology, etc. As a result, other countries may prefer to use another risk score, e.g.  SCORE  (HeartScore is the interactive version of SCORE - Systematic COronary Risk Evaluation), [ 14 ]  which has been recommended by the  European Society of Cardiology  in 2007. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2466", "text": "If possible, a  cardiology  professional should select the risk prediction model which is most appropriate for an individual patient and should remember that this is only an estimate. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2467", "text": "The current version of the Framingham Risk Score was published in 2008. The publishing body is the ATP III, i.e. the \u00abAdult Treatment Panel III\u00bb, an expert panel of the  National Heart, Lung, and Blood Institute , which is part of the  National Institutes of Health  (NIH), USA."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2468", "text": "The prior version was published in 2002  [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2469", "text": "The original Framingham Risk Score had been published in 1998. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2470", "text": "The first Framingham Risk Score included age, sex, LDL cholesterol, HDL cholesterol, blood pressure (and also whether the patient is treated or not for his/her hypertension), diabetes, and smoking. It estimated the 10-year risk for coronary heart disease (CHD). It performed well and correctly predicted a 10-year risk for CHD in American men and women of European and African descent. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2471", "text": "The updated version was modified to include  dyslipidemia , age range, hypertension treatment, smoking, and total cholesterol, and it excluded  diabetes , because Type 2 diabetes meanwhile was considered to be a CHD Risk Equivalent, having the same 10-year risk as individuals with prior CHD. Patients with Type 1 diabetes were considered separately with slightly less aggressive goals; while at increased risk, no study had shown them to be at equivalent risk for CHD as those with previously diagnosed coronary disease or Type 2 diabetes. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2472", "text": "Some patients without known CHD have risk of cardiovascular events that is comparable to that of patients with established CHD. Cardiology professionals refer to such patients as having a CHD risk equivalent. These patients should be managed as patients with known CHD. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2473", "text": "CHD risk equivalents are patients with a 10-year risk for  MI  or  coronary death  >20%.   CHD risk equivalents are primarily other clinical forms of atherosclerotic disease.   The   National Cholesterol Education Program  NCEP's ATP III guidelines also list diabetes as a CHD risk equivalent since it also has a 10-year risk for CHD around 20%.   NCEP ATP III CHD risk equivalents are:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2474", "text": "The Framingham/ATP III criteria were used to estimate CHD risk in the USA. Data from 11,611 patients from a very large study, the  NHANES  III, were used. The patients were 20 to 79 years of age and had no self-reported CHD, stroke, peripheral arterial disease, or diabetes. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2475", "text": "The results: 82% of patients had low risk (10% or less CHD risk at 10 years). 16% had intermediate risk (10-20%). 3% had high risk (20% or more). [ 23 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2476", "text": "High risk was most commonly found in patients with advanced age and was more common in men than women. [ medical citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2477", "text": "Age : 20\u201334 years: Minus 7 points. 35\u201339 years: Minus 3 points. 40\u201344 years: 0 points. 45\u201349 years: 3 points. 50\u201354 years: 6 points. 55\u201359 years: 8 points. 60\u201364 years: 10 points. 65\u201369 years: 12 points. 70\u201374 years: 14 points. 75\u201379 years: 16 points."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2478", "text": "Total cholesterol, mg/dL :"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2479", "text": "If cigarette smoker : Age 20\u201339 years: 9 points. \u2022 Age 40\u201349 years: 7 points. \u2022 Age 50\u201359 years: 4 points. \u2022 Age 60\u201369 years: 2 points. \u2022 Age 70\u201379 years: 1 point."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2480", "text": "All non smokers : 0 points."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2481", "text": "HDL cholesterol, mg/dL : 60 or higher: Minus 1 point. 50-59: 0 points. 40-49: 1 point. Under 40: 2 points."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2482", "text": "Systolic blood pressure, mm Hg : Untreated: Under 120: 0 points. 120-129: 1 point. 130-139: 2 points. 140-159: 3 points. 160 or higher: 4 points. \u2022 Treated: Under 120: 0 points. 120-129: 3 points. 130-139: 4 points. 140-159: 5 points. 160 or higher: 6 points."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2483", "text": "10-year risk in\u00a0% : Points total: Under 9 points: <1%. 9-12 points: 1%. 13-14 points: 2%. 15 points: 3%. 16 points: 4%. 17 points: 5%. 18 points: 6%. 19 points: 8%. 20 points: 11%. 21=14%, 22=17%, 23=22%, 24=27%, >25= Over 30%"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2484", "text": "Age : 20\u201334 years: Minus 9 points. 35\u201339 years: Minus 4 points. 40\u201344 years: 0 points. 45\u201349 years: 3 points. 50\u201354 years: 6 points. 55\u201359 years: 8 points. 60\u201364 years: 10 points. 65\u201369 years: 11 points. 70\u201374 years: 12 points. 75\u201379 years: 13 points."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2485", "text": "If cigarette smoker : Age 20\u201339 years: 8 points. \u2022 Age 40\u201349 years: 5 points. \u2022 Age 50\u201359 years: 3 points. \u2022 Age 60\u201369 years: 1 point. \u2022 Age 70\u201379 years: 1 point."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2486", "text": "Systolic blood pressure, mm Hg : Untreated: Under 120: 0 points. 120-129: 0 points. 130-139: 1 point. 140-159: 1 point. 160 or higher: 2 points. \u2022 Treated: Under 120: 0 points. 120-129: 1 point. 130-139: 2 points. 140-159: 2 points. 160 or higher: 3 points."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2487", "text": "10-year risk in\u00a0% :\nPoints total:\n0 point:  <1%.\n1-4 points: 1%.\n5-6 points: 2%.\n7 points: 3%.\n8 points: 4%.\n9 points: 5%.\n10 points: 6%.\n11 points: 8%.\n12 points: 10%.\n13 points: 12%.\n14 points: 16%.\n15 points: 20%.\n16 points: 25%.\n17 points or more: Over 30%. [ 24 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2488", "text": "Not only coronary heart disease (CHD) events but also further risks can be predicted. Risk prediction models for cardiovascular disease outcomes other than CHD events have also been developed by the Framingham Heart Study researchers. Amongst others, a risk score for 10-year risk for  atrial fibrillation  has been developed. [ 25 ] [ 26 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2489", "text": "The  Giant Heart  exhibit, originally called the \"Engine of Life\" exhibit, is one of the most popular and notable exhibits at the  Franklin Institute . [ 1 ]  Built in 1953, the exhibit is roughly two stories tall and 35-feet in diameter. A walk-through exhibit, visitors can explore the different areas of the  heart . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2490", "text": "Visiting The Giant Heart has become a tradition or \"right of passage\" for many school-aged children, particularly on field trips, in the Philadelphia-area."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2491", "text": "The original idea for the walk-through heart exhibit came from Dr. Mildred Pfeiffer, a  physician  and Director of  Cardiovascular Diseases  at the  Pennsylvania Department of Health  who would travel giving lectures about the heart and heart health; she proposed the idea of the heart in an effort to have a centralized resource that people could visit and learn of the heart. [ 3 ] [ 4 ]  The original materials used to construct the heart were  papier-m\u00e2ch\u00e9 ,  chicken wire  and  lumber ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2492", "text": "The Giant Heart was supposed to have only been on display for six months. [ 5 ]  It was the idea of physician Mildred Pfeiffer, who designed The Giant Heart with a medical illustrator and engineer. [ 5 ]  It was originally made out of wood, chicken wire and papier-m\u00e2ch\u00e9. [ 5 ]  However, The Giant Heart became a popular attraction and the Franklin Institute opted to keep it. More than 70 years later, it remains one of the most visited exhibits at The Franklin Institute. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2493", "text": "The Giant Heart is 100 times larger than the average human heart. [ 5 ]  As visitors walk-through The Giant Heart there is signage pointing out which part of the \"heart\" they are walking past. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2494", "text": "The deeper visitors walk deeper into the heart, the sound of a heartbeat gets louder and louder. [ 5 ]  The sound of the heartbeat was originally computer generated, but as part of the 2019 renovations, it was replaced by the sound of a real human heartbeat. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2495", "text": "Stephanie Farr writing in  The Philadelphia Inquirer  said that The Giant Heart has a \"universally recognized-but-hard-to-define odor.\" [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2496", "text": "Located next to The Giant Heart is the Bio-science exhibit, which aims to teaching and sparking interest among visitors in the science of the human body."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2497", "text": "In 1979, The Giant Heart was rebuilt with fiberglass. [ 5 ]  The Giant Heart was remodeled and updated in 2004 and 2019. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2498", "text": "39\u00b057\u203230\u2033N   75\u00b010\u203223\u2033W \ufeff / \ufeff 39.95837\u00b0N 75.17319\u00b0W \ufeff /  39.95837; -75.17319"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2499", "text": "Heart nanotechnology  is the \"Engineering of functional systems at the molecular scale\" (\"Nanotechnology Research\"). [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2500", "text": "Nanotechnology  deals with structures and materials that are approximately one to one-hundred nanometers in length. At this microscopic level,  quantum mechanics  take place and are in effect, resulting in behaviors that would seem quite strange compared to what humans see with the naked eye (regular matter). Nanotechnology is used for a wide variety of fields of technology, ranging from  energy  to  electronics  to  medicine . In the category of medicine, nanotechnology is still relatively new and has not yet been widely adopted by the field. It is possible that nanotechnology could be the new breakthrough of medicine and may eventually be the solution and cure for many of the health problems that humans encounter. Nanotechnology may lead to the cure for illnesses such as the  common cold , diseases, and  cancer .  It is already starting to be used as a treatment for some serious health issues; more specifically it is being used to treat the  heart  and cancer. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2501", "text": "Nanotechnology in the field of medicine is more commonly referred to as  nanomedicine . Nanomedicine that deals with helping the heart is really starting to take off and gain in popularity compared to most of the other fields that nanomedicine currently has to offer.  There are several heart problems that nanotechnology has promising evidence of being effective in the treatment of  heart disease  in the near future."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2502", "text": "It should hopefully be able to treat  heart valves  that are defective; and detect and treat  arterial plaque  in the heart (\"Nanotechnology Made Clear\").  Nanomedicine should be able to help heal the hearts of people that have already been victims of heart disease and  heart attacks .  On the other hand, it will also play a key role in finding people with a high risk of having heart disease, and will be able to help prevent heart attacks from happening in the first place.  Nanotechnology of the heart is a lot less invasive than surgery because everything is occurring at a minuscule level in the body compared to relatively large tissues that are dealt with in surgery.  With our technology today,  heart surgeries  are performed to treat the damaged heart tissue that resulted from a heart attack.  This is a major surgery that usually takes a couple of months to recover from (\"WebMD - Better Information. Better Health\").  During this period, patients are extremely limited in the activities that they can do.  This long recovery process is an inconvenience to the patients, and with the growth of medicine it most likely won't be very long before a more efficient method for treating heart attack patients will be developed and used. [ citation needed ]  The method that is the frontrunner to replace major heart surgery is the use of nanotechnology.  There are a couple alternate ways to heart surgery that nanotechnology will potentially be able to offer in the future."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2503", "text": "With people that have heart disease or that have suffered a heart attack, their hearts are often damaged and weakened.  The more minor forms of  heart failure  do not require surgery and are often treated with  medications  (\"WebMD - Better Information. Better Health\").  The use of nanotechnology on treating damaged hearts will not replace these milder heart problems, but rather the more serious heart problems that currently require surgery or sometimes even  heart transplants ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2504", "text": "A group of engineers, doctors and materials scientists at  MIT  and  Children's Hospital Boston  have teamed together and are starting the movement of finding a way to use nanotechnology to strengthen the weakened heart tissue (\"MIT - Massachusetts Institute of Technology\"). The first method uses nanotechnology combined with  tissue engineering , and gold  nanowires  are placed and woven into the damaged parts of the heart, essentially replacing the non-functioning or dead tissues. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2505", "text": "The other approach would potentially use minuscule  nanoparticles  that would travel through the body and find dying heart tissue.  The nanoparticles would be carrying objects such as \" stem cells ,  growth factors , drugs and other therapeutic compounds,\". [ 2 ]   Then the nanoparticles would release the compounds and inject them into the damaged heart tissue.  This would theoretically lead to the regeneration of the tissue. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2506", "text": "Being able to fix cardiac tissue that has been damaged from a heart attack or heart disease is not very simple and it is one of the major challenges today in the field of tissue engineering (\" Popular Science \"). This is because heart cells are not the easiest objects to create in a lab.  It takes an enormous amount of special care and work to develop the cells so that they beat in sync with one another (\"Popular Science\"). Even after the heart cells have finally been made, it is also a large task to insert the cells into the inoperable parts of the heart and to get them working in unison with the tissues that were still working properly (\"Popular Science\")."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2507", "text": "There have been several successful examples of this with the use of a \"stem-cell- based heart patch developed by  Duke University  researchers,\" (\"Popular Science\").  The  biomaterials  that make up the patch are usually made of either biological polymers like  alginate  or synthetic polymers such as  polylactic acid  (\"Nature Nanotechnology\").  These materials are good at organizing the cells into functioning tissues; however they act as insulators and are poor conductors of electricity, which is a major problem especially in the heart (\"Nature Nanotechnology\"). Since the electrical signals that are sent between calcium ions are what control when the  cardiomyocytes  of the heart contract, which makes the heart beat, the stem-cell heart patch is not very efficient and not as effective as doctors would like it to be (\"Popular Science\"). The results of the patch not being very conductive is that the cells are not able to attain a smooth, continuous beat throughout the entire tissue containing the stem cells.  This results in the heart not functioning properly, which in turn could mean that more heart problems might arise due to the implanting of the stem cells."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2508", "text": "Recently [ when? ]  there have been some new developments in the field of nanotechnology that will be more efficient than the poorly conducting stem-cell-based patch (\"Nature Nanotechnology\"). Scientists and researchers found a way for these stem cell patches (also known as tissue scaffolds) to be conductive and therefore become exponentially [ citation needed ]  more effective (\"Nature Nanotechnology\").  They found that by growing gold nanowires into and through the patches, they were able to greatly increase the  electrical conductivity . [ 2 ]   The nanowires are thicker than the original scaffold and the cells are better organized as well. [ 2 ]  There is also an increase in production of the proteins needed for muscle calcium binding and contraction. [ 2 ]  The gold nanowires poke through the stem cell's scaffolding material, which strengthens the electrical communication between surrounding heart cells. [ 2 ]   Without the nanowires, the stem cell patches produced a minute current and the cells would only beat in small clusters at the stimulation origin. [ 2 ]  With the nanowires, the cells seem to contract together even when they are clustered far away from the source of stimulation. [ 2 ]  The use of gold nanowires with the stem cell heart patches is still a relatively new concept and it will probably be awhile before they will be used in humans. It is hoped that the nanowires will be tested in live animals in the near future. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2509", "text": "Another way that nanotechnology will potentially be used to help fix damaged heart tissues is through the use of guided nanoparticle \"missiles\". [ 2 ]   These nanoparticles can cling to and attach to artery walls and secrete medicine at a slow rate (\"MIT-Massachusetts Institute of Technology\"). The particles, known as nanoburrs due to the fact that they are coated with little protein fragments that stick to and target certain proteins.  The nanoburrs can be made to release the drug that is attached to them over the course of several days (\"MIT-Massachusetts Institute of Technology\").  They are unique compared to regular drugs because they can find the particular damaged tissue, attach to it, and release the drug payload that is attached to it (\"MIT-Massachusetts Institute of Technology\"). What happens is the nanoburrs are targeted to a certain structure, known as the  basement membrane ; this membrane lines the arterial walls and is only present if the area is damaged. Nanoburrs could be able to carry drugs that are effective in treating the heart, and also potentially carry stem cells to help regenerate the damaged heart tissue (\"MIT-Massachusetts Institute of Technology\")."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2510", "text": "The particles are made up of three different layers and are sixty nanometers in diameter (\"MIT-Massachusetts Institute of Technology\").The outer layer is a coating of  polymer  called PEG, and its job is to protect the drug from disintegrating while it is traveling through the body.  The middle layer consists of a fatty substance and the inner core contains the actual drug along with a polymer chain, which controls the amount of time it will take before the drug is released (\"MIT-Massachusetts Institute of Technology\")."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2511", "text": "In a study done on rats, the nanoparticles were injected directly into the rat's tail and they still were able to reach the desired target (the left  carotid artery ) at a rate that was twice the amount of the non-targeted nanoparticles (\"MIT-Massachusetts Institute of Technology\"). Because the particles can deliver drugs over a long period of time, and can be injected intravenously, the patients would not need to have multiple repeated injections, or invasive surgeries on the heart which would be a lot more convenient. The only downside to this is that the existing delivery approaches are invasive, requiring either a direct injection into the heart,  catheter  procedures, or surgical implants. [ 2 ]   There is no question, however, that the future of heart repairs and heart disease/attack prevention will definitely involve the use of nanotechnology in some way. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2512", "text": "Polyketal nanoparticles are pH-sensitive, hydrophobic nanoparticles formulated from poly(1-4-phenyleneacetone dimethylene ketal). [ 3 ]  They are an acid-sensitive vehicle of drug delivery, specifically designed for targeting the environments of tumors, phagosomes, and inflammatory tissue. [ 3 ]  In such acidic environments, these nanoparticles undergo accelerated hydrolysis into low molecular weight hydrophilic compounds, consequently releasing their therapeutic contents at a faster rate. [ 3 ]  Unlike polyester-based nanoparticles, polyketal nanoparticles do not generate acidic degradation products following hydrolysis  [ 3 ] [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2513", "text": "Post- myocardial infarction , inflammatory  leukocytes  invade the  myocardium . Leukocytes contain high amounts of  Nicotinamide adenine dinucleotide phosphate  (NADPH) and Nox2. [ 5 ] [ 6 ]  Nox2 and NADPH oxidase combine to act as a major source of cardiac  superoxide  production, which in excess can lead to  myocyte  hypertrophy, apoptosis, fibrosis, and increased matrix  metalloproteinase -2 expression. [ 5 ]  In a mouse-model study by Somasuntharam et al. 2013, polyketal nanoparticles were used as a delivery vehicle for  siRNA  to target and inhibit Nox2 in the infarcted heart. [ 7 ]  Following intramyocardial injection in vivo, Nox2-siRNA nanoparticles prevented  upregulation  of Nox2-NADPH  oxidase , and improved  fractional shortening . [ 7 ]  When taken up by macrophages in the myocardium following a MI, the nanoparticles degraded in the acidic environment of the  endosomes / phagosomes , releasing Nox2-specific siRNA into the  cytoplasm . [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2514", "text": "Polyketal nanoparticles have also been used in the infarcted mouse heart to prevent  ischemia - reperfusion injury  caused by  reactive oxygen species  (ROS). [ 8 ]  Levels of the  antioxidant  Cu/Zn-superoxide dismutase (SOD1), which scavenges harmful ROS, decrease following MI. [ 9 ]  SOD1-enacapsulated polyketal nanoparticles are able to scavenge reperfusion-injury induced ROS. [ 8 ]  Furthermore, this treatment improved fractional shortening, suggesting the benefit of targeted delivery by polyketals. One of the key advantages of polyketal use is that they do not exacerbate the inflammatory response, even when administered at concentrations exceeding therapeutic limits. [ 10 ]  In contrast to commonly used  poly(lactic-co-glycolic acid)  (PLGA) nanoparticles, polyketal nanoparticle administration in mice instigates little recruitment of inflammatory cells. [ 10 ]  Additionally, intramuscular injection of polyketals into the leg of rats shows no significant increases in inflammatory  cytokines  such as  IL-6 ,  IL-1\u00df ,  TNF-\u03b1  and  IL-12 . [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2515", "text": "The  Most Sacred Heart of Jesus  ( Latin :  Cor Jesu Sacratissimum ) is one of the most widely practised and well-known  Catholic devotions , wherein the heart of  Jesus Christ  is viewed as a symbol of \"God's boundless and passionate love for mankind\". [ 1 ]  This devotion to Christ is predominantly used in the  Catholic Church , followed by  high church   Anglicans , and some  Western Rite Orthodox . In the  Latin Church , the liturgical  Solemnity of the Most Sacred Heart of Jesus  is celebrated on the third Friday after  Pentecost . [ 2 ]  The 12 promises of the Most Sacred Heart of Jesus are also popular."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2516", "text": "The devotion is especially concerned with what the church deems to be the long-suffering love and compassion of the heart of Christ towards humanity. The popularization of this devotion in its modern form is derived from a Roman Catholic  nun  from  France ,  Margaret Mary Alacoque , who said she learned the devotion from Jesus during a series of  apparitions  to her between 1673 and 1675, [ 3 ]  and later, in the 19th century, from the mystical revelations of another Catholic nun in  Portugal ,  Mary of the Divine Heart , a  religious sister  of the  congregation of the Good Shepherd , who requested in the name of Christ that  Pope Leo XIII  consecrate the entire world to the Sacred Heart of Jesus. Predecessors to the modern devotion arose unmistakably in the  Middle Ages  in various facets of  Catholic mysticism , particularly with  Gertrude the Great . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2517", "text": "The Sacred Heart is often depicted in  Christian art  as a flaming heart [ 5 ]  shining with divine light, pierced by the lance-wound, encircled by the  crown of thorns , surmounted by a cross, and bleeding. Sometimes, the image is shown shining within the bosom of Christ with his wounded hands pointing at the heart. The wounds and crown of thorns allude to the manner of  Christ's passion , while the flames represent a furnace of ardent love. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2518", "text": "Historically, the devotion to the Sacred Heart is an outgrowth of devotion to what is believed to be Christ's sacred humanity. [ 7 ]  During the first ten centuries of Christianity, there is nothing to indicate that any worship was rendered to the wounded Heart of Jesus. [ 8 ]  The revival of religious life and the zealous activity of  Bernard of Clairvaux  and  Francis of Assisi  in the twelfth and thirteenth centuries, together with the enthusiasm of the Crusaders returning from the Holy Land, gave a rise to devotion to the Passion of Jesus Christ and particularly to practices in honour of the  Sacred Wounds . [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2519", "text": "Devotion to the Sacred Heart developed out of the devotion to the Holy Wounds, in particular to the Sacred Wound in the side of Jesus. The first indications of devotion to the Sacred Heart are found in the eleventh and twelfth centuries in the fervent atmosphere of the  Benedictine  or  Cistercian   monasteries . [ 10 ]  It is impossible to say with certainty what were its first texts or who were its first devotees."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2520", "text": "Bernard of Clairvaux ( d.  1153) said that the piercing of Christ's side revealed his goodness and the charity of his heart for humanity. The earliest known hymn to the Sacred Heart,  \"Summi Regis Cor Aveto\" , is believed to have been written by the Norbertine Herman Joseph (d. 1241) of Cologne, Germany. The hymn begins: \"I hail Thee kingly Heart most high.\""}
{"_id": "WikiPedia_Muscular_system$$$corpus_2521", "text": "From the 13th to the 16th centuries, the devotion was propagated but it did not seem to have been embellished. It was everywhere practised by individuals and by different religious congregations, such as the  Franciscans ,  Dominicans , and  Carthusians . Among the Franciscans the devotion to the Sacred Heart of Jesus has its champions in  Bonaventure  (d. 1274) in his  Vitis Mystica  (\"Mystic Vine\") and John de la Verna. [ 11 ]  Bonaventure wrote: \"Who is there who would not love this wounded heart? Who would not love in return Him, who loves so much?\" [ 12 ]  It was, nevertheless, a private, individual devotion of the mystical order. Nothing of a general movement had been inaugurated, except for similarities found in the devotion to the  Five Holy Wounds  by the Franciscans, in which the wound in Jesus's heart figured most prominently."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2522", "text": "Bonaventure's  Opusculum 3, Lignum vitae  (a part from which is the reading for the  Divine Office  on the Solemnity of the Sacred Heart) refers to the heart as the fountain from which God's love poured into one's life:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2523", "text": "Take thought now, redeemed man, and consider how great and worthy is he who hangs on the cross for you. His death brings the dead to life, but at his passing heaven and earth are plunged into mourning and hard rocks are split asunder. It was a divine decree that permitted one of the soldiers to open his sacred side with a lance. This was done so that the Church might be formed from the side of Christ as he slept the sleep of death on the cross, and so that the Scripture might be fulfilled: 'They shall look on him whom they pierced'. The blood and water, which poured out at that moment, were the price of our salvation. Flowing from the secret abyss of our Lord's heart as from a fountain, this stream gave the sacraments of the Church the power to confer the life of grace, while for those already living in Christ it became a spring of living water welling up to life everlasting. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2524", "text": "According to  Thomas Merton ,  Lutgarde  (d. 1246), a Cistercian mystic of  Aywieres , Belgium, was one of the great precursors of the devotion to the Sacred Heart of Jesus. A contemporary of Francis of Assisi, she \"entered upon the mystical life with a vision of the pierced Heart of the Saviour, and had concluded her mystical espousals with the Incarnate Word by an exchange of hearts with Him.\" [ 14 ]  Sources say that Christ came in a visitation to Lutgarde, offering her whatever gift of grace she should desire; she asked for a better grasp of Latin, that she might better understand the word of God and sing God's praise. Christ granted her request and Lutgarde's mind was flooded with the riches of psalms, antiphons, readings, and responsories. However, a painful emptiness persisted. She returned to Christ, asking to return his gift, and wondering if she might, just possibly, exchange it for another. \"And for what would you exchange it?\" Christ asked. \"Lord, I would exchange it for your Heart.\" Christ then reached into Lutgarde and, removing her heart, replaced it with his own, at the same time hiding her heart within his breast. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2525", "text": "Mechtilde of Helfta  (d. 1298) became an ardent devotee and promoter of Jesus' heart after it was the subject of many of her visions. The idea of hearing the heartbeat of God was very important to medieval saints who nurtured devotion to the Sacred Heart. [ 16 ]  Mechtilde reported that Jesus appeared to her in a vision and commanded her to love him ardently, and to honor his sacred heart in the  Blessed Sacrament  as much as possible. He gave her his heart as a pledge of his love, as a place of refuge during her life and as her consolation at the hour of her death. From this time Mechtilde had an extraordinary devotion for the Sacred Heart, and said that if she had to write down all the favors and all the blessings which she had received by means of this devotion, a large book would not contain them. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2526", "text": "Gertrude the Great  was an early devotee of the Sacred Heart of Jesus. [ 18 ]  Book 2 of the  Herald of Divine Love  ( Latin :  Legatus divin\u00e6 pietatis ) vividly describes Gertrude's visions, which show a considerable elaboration on the hitherto ill-defined veneration of Christ's heart. Bernard articulated this in his commentary on the  Song of Songs . The women of  Helfta  \u2013 Gertrude foremost, who surely knew Bernard's commentary, and to a somewhat lesser extent the two Mechthildes \u2013 experienced this devotion centrally in their mystical visions. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2527", "text": "In the 16th century, the devotion passed from the domain of  mysticism  into that of  Christian asceticism . It was established as a devotion with prayers already formulated and special exercises, found in the writings of Lanspergius (d. 1539) of the  Carthusians  of Cologne, the Benedictine  Louis de Blois  (d. 1566)  Abbot  of  Liessies  in  Hainaut ,  John of Avila  (d. 1569), and  Francis de Sales  (d. 1622)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2528", "text": "The historical record from that time shows an early bringing to light of the devotion. Ascetic writers spoke of it, especially those of the  Society of Jesus  (Jesuits). The image of the Sacred Heart of Jesus was everywhere in evidence, largely due to the Franciscan devotion to the  Five Wounds  and to the Jesuits placing the image on the title-page of their books and on the walls of their churches."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2529", "text": "The first to establish the theological basis for the devotion was Polish Jesuit  Kasper Dru\u017cbicki  (1590\u20131662) in his book  Meta cordium \u2013 Cor Jesu  ( The goal of hearts \u2013 Heart of Jesus ). Not much later  John Eudes  wrote an office, and promoted a feast for it. John Eudes is regarded as \"tireless apostle of the devotion of the Sacred Hearts\", [ 20 ]  entitling him as 'Father', doctor and apostle of the liturgical cult of the hearts of Jesus and Mary. [ 21 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2530", "text": "Little by little, the devotion to the Sacred Hearts became distinct, and on 31 August 1670 the first feast of the Sacred Heart of Jesus was celebrated in the Grand Seminary of  Rennes .  Coutances  followed suit on October 20, a day with which the  Eudist  feast was from then on to be connected. The feast soon spread to other dioceses, and the devotion was likewise adopted in various religious communities. It gradually came into contact with the devotion begun by  Margaret Mary Alacoque  at  Paray-le-Monial , and the two merged."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2531", "text": "The most significant source for the devotion to the Sacred Heart in the form it is known today was Margaret Mary Alacoque (1647\u20131690), a nun of the  Order of the Visitation of Holy Mary , who claimed to have received Sacred Heart revelations from  Jesus Christ  between 1673 and 1675 in the Burgundian French village of  Paray-le-Monial ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2532", "text": "The first apparition took place on 27 December 1673, the day of the feast of Saint  John the Evangelist , during which Jesus allowed Margaret Mary to rest her head upon his heart, telling her that he wanted to make his love known to all mankind and that he had chosen her to spread the devotion to his Sacred Heart. Right after this, she had a vision of his heart with a crown of thorns, surrounded by flames and above which a cross was planted. [ 22 ]  This representation will become the popular image of the Sacred Heart which Margaret Mary used to propagate the devotion."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2533", "text": "Between 1674 and 1675, other apparitions followed in which  Jesus Christ  revealed to Alacoque different forms of devotion to the Sacred Heart. The  First Fridays Devotion , which is the reception of  Holy Communion  on nine first Fridays of each month, was revealed to her through a \"Great Promise\" of final penance granted to those who practice this act of  reparation . [ 23 ]  Margaret Mary also said that she was instructed to spend an hour every Thursday night, from eleven to midnight, to pray and meditate on Jesus' agony in the Garden of Gethsemane. Her prayers intended to ask mercy for sinners as well as to make reparation for the abandonment Jesus felt from his apostles in the garden. This practice is now known as the \" Holy Hour \" [ 24 ]  and is also frequently performed during an hour of  Eucharistic adoration ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2534", "text": "During the  octave  of  Corpus Christi  in 1675, probably on June 16, the vision known as the \"great revelation\" reportedly took place, where Jesus said: \"Behold the heart which has so loved men that it has spared nothing, even to exhausting and consuming itself, in order to testify its love; and in return, I receive from the greater part only ingratitude, by their irreverence and sacrilege, and by the coldness and contempt they have for me in this sacrament of love.\" [ 25 ]  He then asked Margaret Mary for a feast of reparation of the Friday after the octave of Corpus Christi, bidding her consult her confessor  Claude de la Colombi\u00e8re , then superior of the small Jesuit house at Paray-le-Monial. [ 26 ]  This request was transmitted and the  feast of the Sacred Heart  was progressively instituted throughout the Church. The feast later became a  solemnity  in the  liturgical calendar , a feast of the highest rank, celebrated eight days after the Feast of Corpus Christi just as Jesus requested. On 21 June 1675, following that apparition, Claude consecrated himself to the Sacred Heart, making him the first person to be  consecrated to the Sacred Heart of Jesus  after Margaret Mary, and began spreading the devotion. [ 27 ] [ 28 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2535", "text": "De la Colombi\u00e8re directed her to write an account of the apparitions, which he discreetly circulated in France and England. After his death on 15 February 1682, his journal of spiritual retreats was found to contain a copy in his handwriting of the account that he had requested of Margaret Mary, together with a few reflections on the usefulness of the devotion. This journal, including the account \u2013 an \"offering\" to the Sacred Heart in which the devotion was explained \u2013 was published at Lyon in 1684. The little book was widely read, especially at Paray-le-Monial. Margaret Mary reported feeling \"dreadful confusion\" over the book's contents, but resolved to make the best of it, approving of the book for the spreading of her cherished devotion. Along with the Visitandines, priests,  religious , and laymen espoused the devotion, particularly the  Capuchins . The reported apparitions served as a catalyst for the promotion of the devotion to the Sacred Heart. [ 29 ]  In 1691 Jesuit priest John Croiset wrote a book called  De la D\u00e9votion au Sacr\u00e9 C\u0153ur , and  Joseph de Gallifet  promoted the devotion. The mission of propagating the new devotion was especially confided to the religious of the Visitation and to the priests of the Society of Jesus."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2536", "text": "Alacoque said that in her apparitions Jesus promised specific blessings to those who practice devotion to his Sacred Heart. The last promise, also called the \"Great Promise\", is a promise of final penance granted to those who practice the First Fridays Devotion."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2537", "text": "Another source for the devotion to the Sacred Heart of Jesus was  Mary of the Divine Heart  (1863\u20131899), a  religious sister  from the  Congregation of Our Lady of Charity of the Good Shepherd , who reported to have received several  interior locutions  and visions of Jesus Christ. The first interior locution Mary of the Divine Heart reported was during her youth spent with the family in the  Castle of Darfeld \u00a0[ de ] , near  M\u00fcnster , Germany, and the last vision and private revelation was reported during her presence as mother superior in the Convent of the Sisters of the Good Shepherd in  Porto , Portugal."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2538", "text": "Based on the messages she said she received in her revelations of Christ, on 10 June 1898 her confessor at the Good Shepherd monastery wrote to  Pope Leo XIII  stating that Mary of the Divine Heart had received a message from Christ, requesting the pope to consecrate the entire world to the Sacred Heart. The pope initially attached no credence to it and took no action. However, on 6 January 1899 she sent another letter asking that in addition to the consecration, the first Fridays of the month be observed in honor of the Sacred Heart."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2539", "text": "Mary of the Divine Heart died in her monastery in  Portugal  when the church was singing the first vespers of the Sacred Heart of Jesus on 8 June 1899. The following day, in  Annum sacrum ,  Pope Leo XIII  consecrated the entire world to the Sacred Heart of Jesus."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2540", "text": "Mary of the Divine Heart said that in her mystical experiences Jesus Christ inspired her to build a shrine dedicated to his Sacred Heart. According to the writings of Sister Mary of the Divine Heart, Jesus said: \"I will make it a place of graces. I will distribute copiously graces to all who live in this house [the convent], those who live here now, those who will live here after, and even to their relatives.\" [ 30 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2541", "text": "She did not live to see this come to fruition. The imposing  Church of the Sacred Heart of Jesus  (also referred as Church of the Good Shepherd or Sanctuary of the Sacred Heart of Jesus) was built between 14 July 1957 and 21 April 1966, in the civil parish of  Ermesinde  in north  Portugal , and consecrated to the Heart of Christ in fulfillment of the vow made by the nun. She is buried in the Church of the Sacred Heart of Jesus in  Ermesinde ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2542", "text": "In 1353,  Pope Innocent VI  instituted a Mass honoring the mystery of the Sacred Heart. [ 29 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2543", "text": "In 1693 the  Holy See  imparted  indulgences  to the Confraternities of the Sacred Heart, and in 1697 granted the feast to the Visitandines with the Mass of the Five Wounds, but refused a feast common to all, with special Mass and Office. The devotion spread, particularly in religious communities. The  Marseille plague  in 1720 furnished perhaps the first occasion for a solemn consecration and public worship outside of religious communities. Other cities of southern Europe followed the example of Marseille."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2544", "text": "After Pope Leo XIII received correspondence from Mary of the Divine Heart asking him to consecrate the entire world to the Sacred Heart of Jesus, he commissioned a group of theologians to examine the petition on the basis of revelation and sacred tradition. The outcome of this investigation was positive, and in 1899 he decreed that the consecration of the entire human race to the Sacred Heart of Jesus should take place on 11 June 1899. The  encyclical letter  also encouraged the entire Roman Catholic episcopate to promote the  First Friday Devotions , established June as the Month of the Sacred Heart, and included the  Prayer of Consecration to the Sacred Heart . [ 31 ]  The idea of this act, which Leo XIII called \"the great act\" of his pontificate."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2545", "text": "Pope Pius X  decreed that the consecration of the human race performed by Leo XIII be renewed each year. Pius X also granted a Pontifical decree for the imposition of a golden crown to the lowly foot of a statue of the Sacred Heart of Jesus in the  Nevers Cathedral  on 9 July 1908 (via the Archbishop of  Nevers  and  Besancon , Francois Leon Gauthey, both signed and notarized by the  Sacred Congregation of Rites )."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2546", "text": "Pope Pius XI  affirmed the church's position with respect to Margaret Mary Alacoque's visions of Jesus Christ by stating that Jesus had \"manifested Himself\" to Alacoque and had \"promised her that all those who rendered this honor to his Heart would be endowed with an abundance of heavenly graces\". [ 32 ]  His encyclical letter  Miserentissimus Redemptor  (1928) reaffirmed the importance of consecration and reparation to the Sacred Heart of Jesus."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2547", "text": "By inserting the \"Great Promise\" of the First Fridays Devotion into the  Bull of Canonization  of  Margaret Mary Alacoque  on 13 May 1920,  Pope Benedict XV  encouraged the practice of this  act of reparation  of the  first nine fridays  in honor of the Sacred Heart. [ 33 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2548", "text": "Pope Pius XII , on the occasion of the 100th anniversary of Pius IX's institution of the feast, instructed the entire Latin Church at length on the devotion to the Sacred Heart in his encyclical letter  Haurietis aquas  of 15 May 1956. On 15 May 2006, the 50th anniversary of that encyclical,  Pope Benedict XVI  sent a letter to  Peter Hans Kolvenbach , the  Superior General of the Society of Jesus , reaffirming the importance of the devotion to the Sacred Heart of Jesus. On 24 October 2024,  Pope Francis  published his fourth encyclical, the 28,000-word  Dilexit nos  (\"He loved us\"), which reflects on the philosophical and theological meaning of \"the heart\" and addresses the importance of the devotion to the Sacred Heart in a contemporary context. [ 34 ] [ 35 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2549", "text": "Worship of the Sacred Heart mainly consists of several  devotions , practices,  consecrations ,  hymns , the salutation of the Sacred Heart, and the  Litany of the Sacred Heart . It is common in Roman Catholic services."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2550", "text": "Since  c. \u20091850 , groups, congregations, and countries have  consecrated  themselves to the Sacred Heart."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2551", "text": "By a law voted on 24 July 1873, the  Basilica of the Sacred Heart  of Montmartre known as  National Vow , is declared of public utility by the  National Assembly  of 1871. On 16 June 1875, the  Archbishop of Paris , Cardinal Guibert layed the first stone of the basilica, honoring after two hundred years the fourth request of Jesus reported by Margaret Mary Alacoque from 16 June 1675. [ 36 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2552", "text": "On 25 March 1874, by petition of president  Gabriel Garc\u00eda Moreno  and  archbishop  Jos\u00e9 Ignacio Checa y Barba,  Ecuador  was the first country in the world to be  consecrated to the Sacred Heart  by legislative decree. [ 37 ] [ 38 ] [ 39 ] [ 40 ]  Since then, more than twenty countries have followed and consecrated themselves either by decree or at the initiative of their respective national Church, some of which renewed their consecration a few times. [ 41 ] [ 42 ]  On 22 June 1902,  Colombia  was consecrated by decree with the agreement of president  Jos\u00e9 Manuel Marroqu\u00edn . [ 43 ] [ 44 ] [ 45 ]  On 30 May 1919,  Spain  was officially consecrated to the Sacred Heart by  King Alfonso XIII . [ 46 ] [ 47 ] [ 48 ] [ 49 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2553", "text": "In the  Catholic tradition , the Sacred Heart has been closely associated with  Acts of Reparation to Jesus Christ . In his  encyclical   Miserentissimus Redemptor ,  Pope Pius XI  stated: \"The spirit of expiation or reparation has always had the first and foremost place in the worship given to the Most Sacred Heart of Jesus.\" [ 50 ]  The  Golden Arrow Prayer  directly refers to the Sacred Heart."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2554", "text": "The  Feast of the Sacred Heart  is a  solemnity  in the  liturgical calendar  of the  Latin Church . It is celebrated on the third Friday after  Pentecost , which was up until the changes in the  General Roman Calendar of Pope Pius XII  referred to as the Friday after the  octave  of Corpus Christi. It is the last feast day of the year that is dependent on the date of  Easter . The acts of  consecration ,  reparation , and  devotion  were introduced when the feast of the Sacred Heart was declared. Some Anglican Franciscans keep the feast under the name  (The) Divine Compassion of Christ . [ 51 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2555", "text": "The month of June is traditionally devoted in a special way to the veneration of the Sacred Heart. [ 52 ] [ 53 ] [ 54 ]  Masses, novenas, and the recitation of devotional prayers in honor of the Sacred Heart are traditionally observed."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2556", "text": "A personal  prayer of consecration to the Sacred Heart  was written by Saint  Margaret Mary Alacoque , [ 55 ]  allegedly under the inspiration of Jesus, which she wrote to the priest John Croiset, recommending that he include it in the book he was to publish about her revelations \"It comes from Him, and He would not agree to its omission.\" [ 56 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2557", "text": "On 25 May 1899,  Pope Leo XIII  wrote an  Act of Consecration of the Human Race to the Sacred Heart  in his  encyclical  letter  Annum sacrum , [ 57 ]  with the influence of  Mary of the Divine Heart  and in response to demands received over 25 years."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2558", "text": "On 19 May 1908, a particular family consecration prayer known as the Act of Consecration of the Family to the Sacred Heart was approved and granted with an indulgence by  Pope Pius X . [ 58 ] [ 59 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2559", "text": "The  First Fridays Devotion  is a devotion to offer  reparations for sins  to the  Eucharist  and in honor of the Sacred Heart, which had its origin in the  apparitions of Christ  reported by  Margaret Mary Alacoque . This devotion to the Sacred Heart of Jesus was fully approved by the Catholic Church [ 33 ]  and a \"Great Promise\" of final penance was made to those who practice the First Fridays Devotion. The devotion consists of several practices that are performed on the first Fridays of nine consecutive months. On these days, a person is to attend  Mass  and receive the Eucharist. If the need arises, in order to receive communion in a state of grace, a person should also make use of the  sacrament of penance  before attending Mass. [ 60 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2560", "text": "Alacoque stated that she received a vision of Jesus in which she was instructed to spend an hour every Thursday night as a reparation and to pray and meditate on his  agony in the Garden of Gethsemane . [ 61 ]  This practice later became widespread among Roman Catholics and became the devotion of the  Holy Hour , a devotional tradition of spending an hour in prayers or in  Eucharistic adoration  in the presence of the Eucharist."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2561", "text": "The act of enthroning the Sacred Heart entails placing an image of the Sacred Heart of Jesus in a place of honor in the home after a time of prayerful preparation. [ 62 ]  Many families will also place an image of the Immaculate Heart of Mary in tandem with the Sacred Heart image. [ 63 ] [ a ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2562", "text": "The practice of the home enthronement of the Sacred Heart was started by R. Mateo Crawley-Boevey, a priest of the  Congregation of the Sacred Hearts of Jesus and Mary , in 1907, having visited the apparition chapel in  Paray-le-Monial . [ 66 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2563", "text": "Enthronement of the Sacred Heart is promoted by the National Enthronement Center in Fairhaven, Massachusetts, [ 67 ]  the Sacred Heart Apostolate of Knoxville, Tennessee, Sacred Heart Columbus in Columbus, Ohio, [ 68 ]  and the Sacred Heart Enthronement Network, a 501(c)(3) located in Columbus, Ohio. [ 69 ]  It is also endorsed by the  World Apostolate of F\u00e1tima ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2564", "text": "The  Scapular of the Sacred Heart  and the  Scapular of the Sacred Hearts of Jesus and Mary  are  devotional articles  worn by some  Catholics . [ 70 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2565", "text": "An early form of the Scapular of the Sacred Heart were cloth  badges  bearing an image of the Heart of Jesus. made and distributed by Margaret Mary Alacoque. [ 70 ]  Following the claims by Estelle Faguette that the  Virgin Mary had appeared  to her at  Pellevoisin  in 1876 and requested a scapular of the Sacred Heart of Jesus, a scapular of the proposed design was approved by the Congregation of Rites in 1900. It bears the representation of the Sacred Heart of Jesus on one side and that of the Virgin Mary under the title of Mother of Mercy on the other side. [ 71 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2566", "text": "The  Litany of the Sacred Heart of Jesus  is common in Roman Catholic services and occasionally is found in  Anglican  services."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2567", "text": "There is also a  Morning offering  to the Sacred Heart."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2568", "text": "The \" Alliance of the Hearts of Jesus and Mary \" is a phrase coined by  Pope John Paul II  during his Angelus Address of September 15, 1985 when he mentioned that devotion to the  Sacred Heart of Jesus  and to the  Immaculate Heart of Mary , \"...though distinct, they are interrelated....\" [ 72 ]  symposia were held on the concept during the 1980s and 1990s. [ 73 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2569", "text": "It was not until the seventeenth century when devotion to the Immaculate Heart of Mary was popularized by  John Eudes . Although Eudes always associated the two Hearts, he began his devotional teachings with the Heart of Mary, and then extended it to the Sacred Heart of Jesus. [ 74 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2570", "text": "In the eighteenth and nineteenth centuries both devotions grew, particularly through the popularity of the  Miraculous Medal , depicting the Heart of Jesus thorn-crowned and the Heart of Mary pierced with a sword. [ 75 ]  The devotions and associated prayers grew into the twentieth century through the reported messages of  Our Lady of F\u00e1tima  saying that the Heart of Jesus wishes to be honored together with the Heart of Mary. [ 76 ]  In the 1956 encyclical  Haurietis aquas , Pope Pius XII encouraged both devotions."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2571", "text": "The Sacred Heart crowned with thorns is depicted on the reverse side of the  Miraculous Medal , [ 77 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2572", "text": "The Carillon-Sacr\u00e9-Coeur flag has been adopted by the  Soci\u00e9t\u00e9 Saint-Jean-Baptiste  in Qu\u00e9bec."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2573", "text": "Religious imagery depicting the Sacred Heart is frequently featured in homes. Ireland was consecrated to the Sacred Heart on  Passion Sunday  1873 by the bishops of Ireland, which led to the  Sacred Heart lamp  becoming a common devotional object in Irish homes. [ 78 ]  Sometimes the image is part of a set, along with the  Immaculate Heart of Mary . However, the  Sacred Congregation of Rites  stated in 1879 that images of the hearts of Jesus or Mary were not appropriate for being placed on the  altar  for Mass, although are appropriate for \"private devotion\". [ 79 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2574", "text": "Sacred Heart  is a name used for many Catholic institutions, including schools, colleges, and hospitals in many countries. It is also the name of many Catholic parishes, and religious congregations."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2575", "text": "Peter Coudrin  of France founded the  Congregation of the Sacred Hearts of Jesus and Mary  on 24 December 1800. A  religious order  of the Latin Church, the order carried out  missionary  work in  Hawaii . [ 80 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2576", "text": "Clelia Merloni from  Forl\u00ec  (Italy) founded the  Congregation of the Apostles of the Sacred Heart of Jesus  in  Viareggio , Italy, on 30 May 1894. [ 81 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2577", "text": "Devotion to the Sacred Heart may be found in some  Eastern Catholic Churches , particularly the  Ukrainian . [ 82 ]  Others see it as an example of  liturgical Latinisation . Many Eastern churches observe a comparable feast of \"Jesus, Lover of Mankind\", celebrated on July 17."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2578", "text": "Heart: A History  is a 2018 book by  Sandeep Jauhar . In the book Jauhar discusses the historical experiments and procedures done in the past and how innovations can be taken for granted. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2579", "text": "The book begins with Jauhar discussing his personal health and family history, focusing on heart-related issues. He gives his opinion and talks about the advances in technology that have come about in the past few decades and how they have shaped the way doctors practice  cardiology  today.  Jauhar also discusses the old views that people had about the heart and why this was the last organ that was operated upon due to cultural perspectives and the level of difficulty.  He further notes several of his personal experiences as a cardiologist and states that the heart is still the center of attention of the body. Jauhar mentions research and experiments conducted on animals and humans, which he sees as unethical by modern standards while stating that without them society would not have the experience or procedures that are currently used."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2580", "text": "Jauhar also covers the effects of emotions on the heart and how he believes stressors can significantly damage a person's heart. He states that doctors have lowered the risk of dying from a heart attack in a hospital to 3 percent, which he does not believe can be improved much further. He notes the difficulty for physicians to help patients prevent common stressors and that it has become easy to prescribe medicine for cholesterol. Finally, Jauhar advises that  yoga , meditation, and activities that help emotions should be taught in schools and the medical field."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2581", "text": "Critical reception for the book has been positive, [ 2 ] [ 3 ] [ 4 ]  and received reviews from  The New Statesman ,  The Globe and Mail ,  and  Financial Express . [ 5 ] [ 6 ] [ 7 ]   The Washington Post  and  Business Standard  both wrote favorable reviews, with the former stating that it was \"a fascinating education for those of us who harbor this most hallowed organ but know little about it.\u201d [ 8 ] [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2582", "text": "Interbeat interval  ( IBI ) is a scientific term used in the study of the  mammalian   heart ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2583", "text": "Interbeat interval is a scientific term used in reference to the time interval between individual beats of the  mammalian   heart . Interbeat interval is abbreviated \"IBI\" and is sometimes written with a hyphen, \"inter-beat interval\". It is also sometimes referred to as a \"beat-to-beat\" interval."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2584", "text": "IBI is generally measured in units of milliseconds. In normal heart function, each IBI value varies from beat to beat. This natural variation is known as  heart rate variability  (HRV). However, certain cardiac conditions may cause the individual IBI values to become nearly constant, resulting in the HRV being nearly zero. This can happen, for example, during periods of exercise as the heart rate increases and the beats become regular. Certain illnesses can cause the heart rate to increase and become uniform as well, such as when a subject is afflicted by an infection."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2585", "text": "A number of instruments have been developed for specifically recording individual IBI values. Generally, the instruments are used in basic cardiology research, as there is yet no specific condition whose IBI statistics can be used to diagnose the condition or guide treatment for the condition. However, HRV is an active field of research, and IBI analysis can yield a rich amount of data that holds promise for future medical applications."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2586", "text": "\" Lady & Peebles \" is the nineteenth episode of the  fourth season  of the American  animated television series   Adventure Time . The episode was written and storyboarded by Cole Sanchez and  Rebecca Sugar , from a story by Patrick McHale,  Kent Osborne , and  Pendleton Ward . It originally aired on  Cartoon Network  on August 20, 2012. The episode guest stars  George Takei  as Ricardio."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2587", "text": "The series follows the adventures of  Finn  (voiced by  Jeremy Shada ), a human boy, and his best friend and adoptive brother  Jake  (voiced by  John DiMaggio ), a dog with magical powers to change shape and grow and shrink at will. In this episode,  Princess Bubblegum  (voiced by  Hynden Walch ) and Lady Rainicorn (voiced by  Niki Yang ) go searching for Finn and Jake, who have been missing for three weeks after fighting with the  Ice King  (voiced by  Tom Kenny ). It is revealed that Ricardio, the Ice King's living heart, has trapped them and wishes to marry Bubblegum. Bubblegum eventually defeats Ricardio in hand-to-hand combat, and saves the day."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2588", "text": "\"Lady & Peebles\" featured the return of Takei, who had previously voiced Ricardio in the  first season  episode, \" Ricardio the Heart Guy \". Several video games inspired elements of the episode, including  The Legend of Zelda: Majora's Mask ,  Eternal Darkness: Sanity's Requiem  and  Amnesia: The Dark Descent . \"Lady & Peebles\" was watched by 2.754 million people and received largely positive critical attention, with Oliver Sava of  The A.V. Club  praising Takei's voice acting, and Richard Whittaker of  The Austin Chronicle  applauding the female-centric nature of the episode. The episode was later nominated for an  Annie Award ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2589", "text": "Princess Bubblegum and Lady Rainicorn investigate a mysterious black ice cave, fearing that Finn and Jake may have been captured by the Ice King on a routine expedition. Once inside the cave, Lady and Bubblegum enter into a biologically-engineered dungeon and are attacked by mysterious hand-like creatures that attempt to grab them. Lady manages to phase through a wall, and the two hear the Ice King's voice coming from a  ventilation shaft . Inside the shaft, the two are attacked by a giant tongue before they enter into a room covered with eyes. As Bubblegum and Lady approach the room's exit, the eyes activate and shoot laser at the duo, incapacitating Lady."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2590", "text": "Bubblegum plods on in the dark, carrying an unconscious Lady around her shoulders. Suddenly, she stumbles upon the  disemboweled  body of the oblivious Ice King. From the dark, Ricardio, the living heart of the Ice King, introduces himself, tossing an unconscious Finn and Jake into the light. Ricardio reveals that he built himself both a body as well as the dungeon complex in an attempt to impress Bubblegum. He reveals that he wishes to marry her; Bubblegum agrees to marry Ricardio if he can beat her in  hand-to-hand combat . After a short fight, Bubblegum disarms Ricardio and forces him to flee, wounded, into the darkness. Later, at the Candy Kingdom, Finn, Jake, the Ice King, and Lady recover, and Lady reveals to Jake that she is pregnant."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2591", "text": "\"Lady & Peebles\" was storyboarded by  Rebecca Sugar  and Cole Sanchez, from a story by Patrick McHale,  Kent Osborne , and  Pendleton Ward . It was directed by  Larry Leichliter  with  Adam Muto  serving as creative director and  Nick Jennings  serving as art director. [ 2 ]  Sugar, the eventual creator of the Cartoon Network series  Steven Universe , began working on said program's pilot episode while she was storyboarding this episode. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2592", "text": "The episode features the return of the anthropomorphic heart villain Ricardio, played by  George Takei , a character that  Tom Kenny  called \"the valentine from Hell\". [ 4 ]  Takei had previously played the role in the  season one  episode \" Ricardio the Heart Guy \". [ 5 ]  In the commentary track for the episode, Sugar explained that she saw Bubblegum as the victim of sexual harassment by Ricardio, and that the only way for her to solve the problem was for her to turn the situation around and somehow overcome Ricardio's chauvinism. In the episode, this was metaphorically depicted by having Bubblegum best him in combat. Sugar reveled in the fact that she got to draw Bubblegum ripping off Ricardio's leg and beating him with, noting that she had been wanting to featuring such a scene in her art since she was in high school. [ 6 ]   Robert Ryan Cory , a character designer most known for his work on the  Nickelodeon  series  SpongeBob SquarePants , storyboarded the panels featuring Princess Bubblegum stomping on Ricardio and grinding her foot into his face. Because he drew the panels, lead character designer Andy Ristaino also allowed Cory to finalize the character designs for the scene. He later posted them on his official  Flickr  account. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2593", "text": "The episode reveals that Lady Rainicorn is pregnant with Jake's children. This plot point would later be revisited in the  fifth season  episode \"Jake the Dad\". [ 5 ] [ 8 ]  In the first draft of the ending, Lady Rainicorn was supposed to break up with Jake because he was causing her to be too stressed. However, the crew decided this was a bad idea, and it was changed to Rainicorn telling Jake that she is pregnant. [ 9 ]  As with all of Lady's dialogue, it was originally planned for the pregnancy revelation to be in Korean, but the crew felt that such a revelation would be lost on most of the audience. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2594", "text": "Several video games inspired elements of the episode. Ricardio's bio-engineered body was based on the finale incarnation of  Majora , a character from the eponymous video game  The Legend of Zelda: Majora's Mask  (2000).  The general look of Ricardio's dungeon was inspired by the video games  Eternal Darkness: Sanity's Requiem  (2002) and the game  Amnesia: The Dark Descent  (2010). [ 10 ]  The climactic scene with Ricardio was also supposed to have featured more  body imagery ; for instance, Ricardio was originally slated to have been seated on a giant hand-throne, and the hole in the Ice King's chest was to have been more graphic. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2595", "text": "\"Lady & Peebles\" first aired on  Cartoon Network  on August 8, 2012. The episode was viewed by 2.754 million viewers and scored a 0.5  Nielsen rating  in the 18- to 49-year-old demographic. Nielsen ratings are  audience measurement  systems that determine the audience size and composition of  television programming  in the United States, which means that the episode was seen by 0.5 percent of all households aged 18 to 49 years old were watching television at the time of the episode's airing. [ 11 ]  The episode first saw physical release as part of the 2013  Fionna and Cake  DVD, which included 16 episodes from the series' first three seasons. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2596", "text": "Critical reception to the episode was largely positive. Sava awarded the episode a \"B+\", and wrote that Ricardio is \"always welcome on this series, largely due to Takei\u2019s delightful voice work.\" [ 5 ]  Furthermore, he praised the way that Takei delivered his lines, noting that \"there\u2019s a theatrical smarminess to his vocals that is a stark contrast to the Ice King\u2019s nasality\", and that \"Takei always sounds like he\u2019s having a great time reading the ridiculous lines that are written for him.\" [ 5 ]  Sava also wrote positively of Bubblegum's character, noting that she \"dominates this episode\" and that the \"episode reveals a side of her that we rarely see, and hopefully we\u2019ll get more of badass PB in the future.\" [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2597", "text": "Richard Whittaker of  The Austin Chronicle  wrote that the episode is \"Princess Bubblegum-centric\", which, along with the  third season  episode \" Fionna and Cake \", provides the female fans of the show an opportunity to see female characters acting in situations normally reserved for Finn and Jake. [ 13 ]  The  Entertainment Examiner  named the episode as one of the \"memorable\" episodes that appeared on the 2013 DVD release  Fionna and Cake . [ 14 ]  The episode was nominated for an  Annie Award  for \"Storyboarding in an Animated Television/Broadcast Production\" at the  40th Annie Awards , although the episode did not win. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2598", "text": "Lateral hearts , also known as  pseudohearts  or  commissural vessels , are blood vessels on either side of the alimentary canal of some  annelids  that pump blood from the dorsal vessel to the ventral vessel."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2599", "text": "The lateral hearts of  Lumbricus terrestris  are located in body segments 6\u201311. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2600", "text": "This  annelid -related article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2601", "text": "A  heart\u2013lung transplant  is a procedure carried out to replace both failing  heart  and  lungs  in a single operation. Due to a shortage of suitable donors and because both heart and lung have to be transplanted together, it is a rare procedure; only about a hundred such transplants are performed each year in the United States. [ United States-centric ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2602", "text": "The patient is  anesthetised . When the donor organs arrive, they are checked for fitness; if any organs show signs of damage, they are discarded and the operation cancelled."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2603", "text": "Once suitable donor organs are present, the surgeon makes an incision starting above and finishing below the sternum, cutting all the way to the bone. The skin edges are retracted to expose the sternum. Using a bone saw, the sternum is cut down the middle. Rib spreaders are inserted in the cut, and spread the ribs to give access to the heart and lungs of the patient."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2604", "text": "The patient is connected to a  heart\u2013lung machine , which circulates and oxygenates blood. The surgeon removes the failing heart and lungs. Most surgeons endeavour to cut blood vessels as close as possible to the heart to leave room for trimming, especially if the donor heart is of a different size than the original organ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2605", "text": "The donor heart and lungs are positioned and sewn into place. As the donor organs warm up to body temperature, the lungs begin to inflate. The heart may  fibrillate  at first \u2013 this occurs because the  cardiac muscle  fibres are not contracting synchronously. Internal paddles can be used to apply a small electric shock to the heart to restore proper rhythm."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2606", "text": "Once the donor organs are functioning normally, the heart\u2013lung machine is withdrawn, and the chest is closed."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2607", "text": "Most candidates for heart\u2013lung transplants have life-threatening damage to both their heart and lungs. In the US, most prospective candidates have between twelve and twenty-four months to live. At any one time, there are about 250 people registered for heart\u2013lung transplantation at the  United Network for Organ Sharing  (UNOS) in the US, of which around forty will die before a suitable donor is found. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2608", "text": "Conditions which may necessitate a heart\u2013lung transplant include:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2609", "text": "Candidates for a heart\u2013lung transplant are usually required to be:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2610", "text": "Most patients spend several days in  the intensive care unit  after the operation. If there are no complications (e.g.,  infection ,  rejection ), some are able to return home after just two weeks in hospital. Patients will be given  anti-rejection drugs  and  antibiotics  to prevent infection as the anti-rejection drugs weakens the immune system. A schedule of frequent follow up visits is necessary."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2611", "text": "The success rate of heart\u2013lung transplants has improved significantly in recent years. The British  National Health Service  states that the survival rate is now around 85%, one year after the transplant was performed. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2612", "text": "In 2004, there were only 39 heart\u2013lung transplants performed in the entire United States and only 75 worldwide. By comparison, in that same year there were 2,016 heart and 1,173 lung transplants. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2613", "text": "Norman Shumway  laid the groundwork for heart lung transplant with his experiments into heart transplant at  Stanford  in the mid-1960s. [ citation needed ]  Shumway conducted the first adult heart transplant in the US in 1968. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2614", "text": "The first successful heart transplant was performed in South Africa in 1967. [ 4 ]  The first successful heart\u2013lung transplant was performed at Stanford in the United States, by  Bruce Reitz  on  Mary Gohlke  in 1981. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2615", "text": "Magdi Yacoub  performed the first heart-lung transplant in the United Kingdom in 1983. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2616", "text": "Australia's first heart-lung transplant was conducted by  Victor Chang  at  St Vincent's Hospital, Sydney  in 1986. [ 7 ]  Iran's first heart-lung transplant was performed in Tehran in 2002. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2617", "text": "The  moderator band  (also known as  septomarginal trabecula [ 1 ] ) is a band of  cardiac muscle  found in the right  ventricle  of the  heart . [ 2 ] [ 3 ] [ 4 ]  It is well-marked in  sheep  and some other animals, including humans. It extends from the base of the anterior  papillary muscle  of the  tricuspid valve  to the  ventricular septum . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2618", "text": "The moderator band is located in the right ventricle. [ 2 ] [ 3 ]  The moderator band connects the base of the anterior papillary muscles of the tricuspid valve to the ventricular septum. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2619", "text": "The moderator band is important because it carries part of the right bundle branch of the  atrioventricular bundle  of the  conduction system of the heart  to the anterior  papillary muscle . [ 1 ]  This shortcut across the chamber of the ventricle ensures equal conduction time in the left and right ventricles, allowing for coordinated contraction of the anterior papillary muscle. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2620", "text": "The moderator band is often used by  radiologists  and  obstetricians  to more easily identify the  right ventricle  in  prenatal   ultrasound ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2621", "text": "From its attachments it was thought to prevent overdistension of the  ventricle , and was named the \"moderator band\". It was first described by  Leonardo da Vinci  in his exploration of human anatomy."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2622", "text": "The  Egyptian hieroglyph  for \"perfect, complete\" (with the extended meanings of \"good, pleasant, well,  beautiful \") in  Gardiner's sign list  is numbered  F35 ; its phonetic value is  nfr , with a reconstructed pronunciation of  [nafir] [ 2 ]  and a  conventional Egyptological vocalization  of  nefer ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2623", "text": "The  triliteral Egyptian hieroglyph  F35 ('nfr') has sometimes been explained as a representation of a  lute ; however, Egyptologists today no longer consider this hypothesis likely. Rather than a lute, the hieroglyph is actually a representation of the  heart  and  trachea . [ 1 ]  It originally may have been the  esophagus  and heart. The striations of the  windpipe  only appear in the hieroglyph following the  Old Kingdom of Egypt . The lower part of the sign has always clearly been the heart, for the markings clearly follow the form of a  sheep 's heart. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2624", "text": "The term  nfr  has been incorporated into many names in Ancient Egypt. Examples include  Nefertiti ,  Nefertari , and  Neferhotep ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2625", "text": "Some scholars suggest that it was used in ancient Egyptian construction where 'nfrw' was used to denote 'level zero' of a building and in accounting where 'nfr' would refer to a zero balance. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2626", "text": "This  ancient Egypt  biographical article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2627", "text": "The  heart of the Brazilian emperor  Dom Pedro I  has been preserved since his death in 1834. The organ is kept in a glass jar, with  formaldehyde , in the  Church of Our Lady of Lapa \u00a0[ pt ] . The container is kept in an urn, locked under lock and key. [ 1 ]  The heart is considered a relic by the Portuguese government. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2628", "text": "Dom Pedro I's body is buried in  S\u00e3o Paulo , in the crypt of the  Monument to Independence . By decision of the monarch himself, as one of his last requests in life, the heart was separated and kept in Portugal. [ 1 ]  Dom Pedro I asked that the heart be preserved in  Porto  because of the relevance of the city in the  dispute  for the Portuguese throne between Dom Pedro I (known as Dom Pedro IV in Portugal) and his brother  Dom Miguel . [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2629", "text": "After the emperor's death from tuberculosis in September 1834, a series of royal and ecclesiastical agreements were made so that, in February 1835, the heart was finally sent to Porto, kept in a gilded silver vase, wrapped in a black velvet-lined case, inside the Church of Our Lady of Lapa. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2630", "text": "In 2022, after its exhibition in the context of the  Bicentennial of Brazil's Independence \u00a0[ pt ] , it was reported that the organ has a swollen appearance, possibly due to the material initially used in its conservation by the doctor  Jo\u00e3o Fernandes Tavares \u00a0[ pt ] , before being kept in formaldehyde. [ 5 ]  The conditions of the heart are the subject of research in the field of  forensic anthropology . [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2631", "text": "On September 23, 1834, on the eve of his death, Dom Pedro I wrote a  letter  addressed to the Brazilian public, [ a ]  in which he declares his wish regarding the fate of his remains after death: [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2632", "text": "Brazilians! I leave my heart to the heroic City of  Porto , theater of my true glory, and the rest of my mortal spoils to the City of  Lisbon , place of my birth; but you possess the most precious relic, the living emanation of my being,  my son ! My only son! [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2633", "text": "Dom Pedro was not the first monarch to determine, while he was still alive, that his heart should be separated from his body and preserved or buried. Even during the  Middle Ages , monarchs such as  Robert I of Scotland ,  Richard I of England , and  Henry I of England  had their hearts buried in different locations than the rest of their bodies. [ 8 ] [ 9 ] [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2634", "text": "After Dom Pedro died of tuberculosis, his daughter,  Maria II of Portugal , decided to fulfill her father's wish. [ 11 ]  As narrated by  Am\u00e9lie of Leuchtenberg , Dom Pedro's widow, in a letter to her daughter  Janu\u00e1ria of Bragan\u00e7a , an autopsy of the body was performed, revealing a swollen and heavy right lung and an enlarged-looking heart. [ 12 ] [ 13 ]  The exhumation of D. Pedro's remains, performed in 2013 by a team from the  Museum of Archaeology and Ethnology at the University of S\u00e3o Paulo \u00a0[ pt ] , determined that part of the ribs on the right side of the body had been cut, probably for the removal of the heart during the time of autopsy and embalming. [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2635", "text": "However, the late emperor had not made it clear in which part of the city of Porto his heart should be kept, and soon a dispute ensued. The queen, Maria II, and the then bishop of Lisbon,  Francisco de S\u00e3o Lu\u00eds , had chosen the  Lapa Church , which had been frequented frequently by Pedro. However, the  Porto City Council \u00a0[ pt ]  had favored the chapel of S\u00e3o Vicente in the  S\u00e9 of Porto . [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2636", "text": "Finally, the decision was made in February 1836 that the relic of the heart would finally be kept at Lapa. On February 4, the heart set sail across the  Tagus  River toward the city of Porto aboard the warship  Jorge IV , commanded by Colonel  Baltazar de Almeida Pimentel \u00a0[ pt ]  and a guard of honor composed of 70 soldiers. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2637", "text": "Arriving in  Ribeira \u00a0[ pt ]  after a 3-day trip, the delegation was received with an official ceremony, where the urn containing the heart was handed over to the Chamber of Porto, along with its key. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2638", "text": "The original urn was composed of an outer part made of  mahogany  and an inner part made of silver. Later, the heart was placed inside a hermetically sealed glass vase, which is contained inside the silver urn. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2639", "text": "In the context of the bicentennial celebrations of the  Independence of Brazil , Dom Pedro I's heart was transported to Brazil and exhibited in  Bras\u00edlia . [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2640", "text": "The coming of the body to Brazil was idealized by  Nise Yamaguchi  in the first half of 2022, in dialogue with President  Jair Bolsonaro , and the descendants of Dom Pedro, Federal Deputy  Luiz Philippe de Orl\u00e9ans e Bragan\u00e7a  and  Bertrand of Orl\u00e9ans-Braganza . [ 18 ]  The deputy, great-great-great-grandson of Dom Pedro I, is said to have traveled to Porto, where he made contact with those responsible for the Lapa Church and with members of the City Council. [ 18 ]  The  Brazilian Embassy in Lisbon \u00a0[ pt ]  and the Brazilian consulate got involved in the negotiation, proposing that the heart be temporarily loaned for the bicentennial festivities. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2641", "text": "Both the City Council and the Third Order of Lapa showed no opposition to the proposal, provided that the safety of the heart was ensured. The  President of the Portuguese Republic ,  Marcelo Rebelo de Sousa , had been consulted, and suggested that the loan of the relic be in fact carried out. [ 19 ]  To ensure that the heart would not be damaged during transport to Brazil, an expert study was ordered by the National Institute of Legal Medicine, conducted by researchers from the  Faculty of Medicine of the University of Porto \u00a0[ pt ]  and the  Abel Salazar Biomedical Sciences Institute . [ 19 ] [ 20 ]  The study concluded that there would be no risk to the relic, provided it was transported in a pressurized chamber on the plane. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2642", "text": "Thus, in a session on July 18, the Porto City Council unanimously approved the proposal for the loan of the heart. The approved proposal considers that all costs related to transport will be the responsibility of the  Brazilian government , and establishes the legal basis for the effective transfer of the relic. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2643", "text": "On July 22, the heart was brought from Portugal in a  Brazilian Air Force  plane, and received with honors as head of state, transported in the presidential  Rolls-Royce Silver Wraith , and escorted by the  1st Cavalry Regiment of Guards \u00a0[ pt ] . Finally, an official session was held with President Jair Bolsonaro on the ramp of the  Planalto Palace . [ 21 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2644", "text": "The solemnity and the exposition of Dom Pedro I's heart were criticized, especially for the cost of the transfer and the morbidity of the tributes. [ 22 ]  It was also criticized the fact that, with the coming of the organ to Brazil, Dom Pedro I's last request was not respected, since he had asked for the heart to remain in Portugal. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2645", "text": "Media related to  Pedro I's heart  at Wikimedia Commons"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2646", "text": "Psychai  are the diminutive, winged  shades  of the dead in  Greek mythology  and some fifth century BC funerary lekythoi. [ 1 ]  Although commonly translated as \" soul \" today, in the epics of  Homer , it meant \"life\" [ 2 ]  and did not have any connection to consciousness or psychological functions in the living. It is only later, at the end of the fifth century BC in the works of other poets such as  Pindar , that the word acquires its meaning relating to being the principal seat of intellect, emotion, and will. [ 3 ]  From there, it became possible to translate  psyche  as \"heart\" or \"soul\". [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2647", "text": "In  Islamic philosophy , the  qalb  ( Arabic :  \u0642\u0644\u0628 ) or heart is the center of the human personality. The  Quran  mentions \"qalb\" 132 times and its root meaning suggests that the heart is always in a state of motion and transformation. According to the Quran and the  traditions of Muhammad , the heart plays a central role in human existence, serving as the source of good and evil, right and wrong. In  Islam ,  God  is more concerned with the motives of one's heart than their actions. The heart is also a medium for God's  revelations  to human beings, and is associated with virtues such as  knowledge ,  faith ,  purity ,  piety , love, and  repentance . Without purification, however, the heart can become plagued with negative attributes such as  sickness , sinfulness, evil, and hate."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2648", "text": "Theologically, the heart is regarded as the  barzakh  or  isthmus  between  this world  and  the next , and between the visible and invisible worlds, the human realm, and the realm of the  Spirit ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2649", "text": "The Quran frequently employs the term \"qalb\" (heart), which appears 132 times, and at times substitutes it with similar terms. The word's root meaning denotes concepts of change, transformation, and fluctuation, implying that the heart is constantly in motion and may undergo reversal or alteration. [ 2 ]  The Quran uses the term \"heart\" in various ways that highlight its central role in human existence. These diverse uses of the word imply that its original meaning - involving ideas of turning, changing, and overturning - remains relevant, as the heart is regarded as the source of good and evil, right and wrong. The Quran teaches that both believers and non-believers possess hearts. [ 2 ]  In general, the Quran portrays the heart \"as the locus of that which makes a human being human, the center of the human personality\". This importance of the heart is due to the profound relationship between humans and God, with the heart being the point of convergence where they can meet God. This interaction is multidimensional, encompassing both cognitive and moral dimensions. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2650", "text": "God pays special attention to the heart, as it is viewed as the true center of a person. Quranic verses highlight that God is more concerned with the motives of one's heart than their actions. While mistakes can be forgiven, the intentions of the heart are critical. [ 2 ]  For example, in 33:5 the Quran states: \"There is no fault in you if you make mistakes, but only in what your hearts premeditate\". In 2:225, it says: \"God will\nnot take you to task for a slip in your oaths; but He will take you to task for what your hearts have earned; and God is Forgiving, Clement\" (cf. 2:118, 8:70). [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2651", "text": "According to the Quran, the heart serves as a medium for God's revelations to human beings. Prophets receive revelations in their hearts, and it is also a place for vision, understanding, and remembrance. The heart plays a crucial role in fostering faith and directing guidance towards the right path. However, it can also serve as a breeding ground for doubt, denial, unbelief, and misguidance, which Satan may try to instill. The heart is associated with virtues such as purity, piety, love, and repentance, but these virtues are not inherent and must be instilled and nurtured by God. Without God's purification, the heart can become plagued with negative attributes such as sickness, sinfulness, evil, and hate. [ 3 ]  The heart is meant to be open and receptive to the divine guidance, light, and love. However, the hearts of those who do wrong can become hard and harsh. The Quran teaches that God has sent down a beautiful scripture, and those who fear Him tremble when they read it, causing their skin and hearts to soften. However, if the heart is not receptive, it can become hard like stone, or even harder, as the hearts of some have become. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2652", "text": "Muhammad frequently used supplications, where he called upon God as the one who makes hearts fluctuate or turn about. He described the heart as being like a feather in the desert, blown by the wind to and fro. One of his wives reported that he used to pray for his heart to be fixed in God's religion, and when she asked him about it, he explained that every person's heart lies between two fingers of God and that God can make it go straight or swerve as He wishes. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2653", "text": "The Prophet (peace and blessings of Allah be upon him) said, A Muslim is the brother of another Muslim.  He will not oppress him.  Don't look down on him.   Taqwa  resides here ( Qalb ).  With this he pointed three times towards his chest.  It is enough for a man to be evil that he despises his Muslim brother.  It is forbidden for every Muslim to take one another's blood, his wealth and his honor."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2654", "text": "In Islamic thought, the heart is considered the core of human being, encompassing not only physical and emotional aspects but also intellectual and spiritual aspects. It serves as a connection between individuals and the larger, transcendent realms of existence. According to  Seyyed Hossein Nasr , modern society rejects the importance of heart-knowledge because it fails to recognize the existence of individuals beyond their individualistic levels of being. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2655", "text": "The heart is not a center of our being; it is the supreme center, its uniqueness resulting from the metaphysical principle that for any specific realm of manifestation there must exist a principle of unity. The heart is the barzakh or isthmus between this world and the next, between the visible and invisible worlds, between the human realm and the realm of the Spirit, between the horizontal and vertical dimensions of existence. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2656", "text": "The assessment of the  regional function of the heart  is a good tool for early detection of deterioration in certain parts of the  heart  wall before a cardiac arrest is  diagnosed . One of the most accurate measures of changes in regional function is the use of  strain  as a measure of the regional function of  cardiac muscle ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2657", "text": "One of the most important indicators of heart problems is described as the  weakening  of  cardiac function . This means that the heart's ability to circulate blood throughout the body is diminished. Before this becomes a problem for other organs of the body, it is beneficial to detect early progress of the disease in the heart wall muscle itself. This can be detected, when the proper device is used, as weakening of the contractility of a part of the heart muscle. Hence, it is described as a change in regional function. The weakening of regional function does not always lead to a weakening in overall cardiac function. This will depend on a number of factors, including the degree of regional weakening and its extent inside the wall."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2658", "text": "The myocytes of the heart (also called the myocardial fibers) are arranged in a general circumferential direction in the ventricles. In the  left ventricle  (LV), the fiber will change gradually in direction from a certain longitudinal-circumferential direction in the outer layer of the heart (epicardium) to another angulated direction almost orthogonal in the inner wall (endocardium), becoming overwhelmingly circumferential somewhere halfway in the middle of the wall. It is, therefore, perceived that measuring the strain in the circumferential direction is a good indicator of the contractility of the fibers."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2659", "text": "There are different ways to measure the regional function of the wall. It has been proposed to measure the speed of the LV wall motion, the thickening of the wall, or other changes in the shape of small regions of the wall as it contracts and relaxes. The latter is best measured using the mechanical quantity called \u201cstrain.\"  Strain can be described as the percentile change in spacing between two points on a deforming object."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2660", "text": "Because strain is measured between two points, that strain, therefore, describes the change in distance along the direction connecting the two points. If we think of a rubber band that is stretched, the strain along the band will have a positive value for stretching, i.e., when selecting two points placed along the band length. At the same time, the bandwidth will decrease, resulting in a negative strain orthogonal to the band's length. In the case of the heart, it has become conventional to use certain directions for measuring strain:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2661", "text": "This is the strain measured along the thickness of the wall. In fact, it measures the wall thickening. In a normal heart, the radial strain is positive as measured from end-diastole."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2662", "text": "For the LV and RV, it is the strain that measured the shortening (or relaxation) of the wall muscle from the base of the ventricles to the apex. In a normal heart, the longitudinal strain is negative as measured from end diastole."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2663", "text": "This is the third strain component whose direction is orthogonal to both the radial and longitudinal. One way to see it is the reduction of the circumference of the LV chamber as seen in a short-axis view. The annular shape of the LV wall will change and become thicker (radial strain) with a smaller inner circle (circumferential strain). In a normal heart, the circumferential strain or positives negative as measured from end-diastole."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2664", "text": "Note that:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2665", "text": "Peak contraction:  This is the point of time when the rubber band is smallest. In the case of the LV of the heart, it can be identified as end-systole. However, end-systole describes a global change in the chamber, which is the sum of the contraction of the regions. Because of the different timing of activation of the wall region and other factors, the end-systole does not coincide exactly with the peak contractions of the regions. In a normal heart, these times should be close enough for efficient pumping by the heart, but they are not exactly the same. When the variance in time exceeds a certain degree, the heart becomes more dyssynchronous."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2666", "text": "Peak stretching:  Similar to peak contraction, peak stretching is the instant when the rubber band is at its maximum length. In the case of the LV, it will correspond with end-diastole, and with the same comment about the variance in end-systole."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2667", "text": "Strain can be measured by various medical imaging modalities. Of special interest is using  echocardiography  or  magnetic resonance imaging (MRI) . In echocardiography, strain can be measured by using  Tissue Doppler Imaging (TDI)  or  Speckle Tracking Echocardiography (STE) . Using MRI, strain and deformation can be measured, noninvasively, using MRI Tagging and  Harmonic Phase Analysis (HARP) , [ 1 ]   Strain Encoding (SENC) , or Tissue Tracking. The latter is similar to STE, although the MRI images do not show significant heterogeneity within the tissue to track."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2668", "text": "One of the applications is using peak circumferential strain to the viability of the myocardium. [ 2 ] [ 3 ]  The figure shows this relation, as well as converting the strain value into the typical qualitative assessment as normal, hypokinetic, akinetic, and dyskinetic for the wall motion."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2669", "text": "Redirect to:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2670", "text": "\" Ricardio the Heart Guy \" is the seventh episode of the  first season  of the American  animated television series   Adventure Time . The episode was written and storyboarded by Bert Youn  and Sean Jimenez, from a story by  Merriwether Williams ,  Tim McKeon  and  Adam Muto . It originally aired on  Cartoon Network  on April 26, 2010. The episode guest stars  George Takei  as the title character, Ricardio."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2671", "text": "The series follows the adventures of  Finn  (voiced by  Jeremy Shada ), a human boy, and his best friend and adoptive brother  Jake  (voiced by  John DiMaggio ), a dog with magical powers to change shape and grow and shrink at will. In this episode, Finn believes that Princess Bubblegum's (voiced by  Hynden Walch ) new friend, a heart named Ricardio, is evil, and is proven right after learning that Ricardio is the heart of the  Ice King  (voiced by  Tom Kenny ). Ricardio reveals that he wants to \"make out\" with Bubblegum's heart, but he is defeated by Finn and Jake."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2672", "text": "Ricardio would become a minor recurring villain, reappearing in the  fourth season  entry \" Lady & Peebles \". After the episode aired, series composer Casey James Basichis posted a video explaining his inspiration and the method in which he produced the music featured in the episode. Basichis largely scored the episode with opera music, because he felt the genre suited Ricardio. \"Ricardio the Heart Guy\" was watched by 1.91 million people and received largely positive critical attention, with many reviews praising Takei's voice work."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2673", "text": "After the Ice King captures Princess Bubblegum, Finn and Jake manage to save her. Bubblegum is so happy that she decides to throw a party for Finn as a thank you. Finn makes a Paper Crane for Bubblegum as a gift, but Jake says that Finn has a crush on her, which Finn denies. When they arrive at the party, however, no one notices them; everyone, including Bubblegum, is too preoccupied with a heart-shaped man named Ricardio. He and Bubblegum begin discussing scientific topics on the dance floor, which leaves Finn feeling jealous."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2674", "text": "Finn begins to think that Ricardio is a villain, but Jake just notes that Finn is jealous. However, the two spy on Ricardio to see if he is evil or not. They see Ricardio going into a dumpster and acquiring a rope and broken bottles. Then they see him throwing the Ice King into the dumpster, so they decide to question Ricardio about being a super-villain. Finn punches Ricardio right when Bubblegum comes. Mad and upset, she takes Ricardio away. However, the Ice King soon crawls toward Finn and Jake, looking sickly. He reveals that Ricardio is actually his own heart, which gained sentience after the Ice King performed a failed love spell. Ricardio desires to cut out Bubblegum's heart and make it his bride."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2675", "text": "Finn and Jake race to Bubblegum's castle and find her tied to a chair, with Ricardio about to rip her heart out. Finn and Jake then fight Ricardio and manage to beat him up. The Ice King crawls into the castle and places Ricardio back into his chest. Later during dinner, Bubblegum tells Finn that he does not need to be jealous anymore, but Finn denies that he was jealous in the first place."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2676", "text": "\"Ricardio the Heart Guy\" was written and  storyboarded  by Bert Youn and Sean Jimenez, from a story by  Merriwether Williams , Tim McKeon, and Adam Muto. Directed by  Larry Leichliter , the episode introduces the recurring villain Ricardio, played by  George Takei , a character that  Tom Kenny  later called \"the valentine from Hell\". [ 2 ]  Takei later reprised the role in the season four episode \"Lady and Peebles\". [ 3 ]  Initial drafts of the character featured him looking more like an anthropomorphic heart, complete with arteries and ventricles. [ 4 ]  Ricardio is one of the few individuals in the  Adventure Time  universe to have a highly detailed face; during the commentary for the episode, his design was compared to that of the face on the moon in the 1902 French silent film  Le Voyage dans la Lune , based on  H.G. Wells 's 1901 novel  The First Men in the Moon . [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2677", "text": "After the episode aired, series composer Casey Basichis posted a video explaining his inspiration and method of producing the music featured in the episode. According to the video, Basichis created a \"skeleton\" of the score in his shower using his voice and a ukulele; the audio was captured on a phone. Originally, the score was going to have a \" New York City , taxi, and  jazz \" feel, but Basichis was unhappy with the genre choice, and changed the feel. [ 6 ]  For the music that played while the Ice King interacted with Ricardio, Basichis was inspired by the score from the original  seven-minute short . In addition, opera singer Karen Vuong lent her voice to the episode. According to Basichis, Vuong was able to record her vocals successfully in one take. Basichis chose opera because he knew it had a reputation for being \"sickeningly intellectual\" and \"preoccupied with murder\", traits that he felt suited Ricardio. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2678", "text": "\"Ricardio the Heart Guy\" first aired on  Cartoon Network  on April 26, 2010. The episode was watched by 1.91 million viewers, and scored a 1.3/2 percent  Nielsen household rating , meaning that it was seen by 1.3 percent of all households and 2 percent of all households watching television at the time of the episode's airing. [ 7 ]  The episode first saw physical release as part of the 2011  Adventure Time: My Two Favorite People  DVD, which included 12 episodes from the series' first two seasons. [ 8 ]  It was later re-released as part of the complete first season DVD in July 2012; commentary for the episode was also included on the DVD. [ 9 ] [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2679", "text": "The episode garnered mostly positive reviews from critics. Matt Fowler of  IGN , in a review of the  My Two Favorite People  DVD, noted that while \"the idea of a walking, talking heart named Ricardio [\u2026] who plans to cut out Princess Bubblegum's heart is potent nightmare fuel\", the show nevertheless \"finds a way to make that grim idea accessible and fun.\" [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2680", "text": "Takei's appearance as Ricardio gained critical favor. Charlie Anders of  io9  named Takei's appearance in the episode as one of his \"greatest moments\", noting, \"how could we have missed that Takei did the voice for this sleazy science-talking heart on  Adventure Time , our new favorite show?\" [ 12 ]  Tyler Foster of  DVD Talk  called Ricardio one of the highlights of the season. [ 13 ]   The A.V. Club  reviewer Oliver Sava, in a review for \"Lady & Peebles\", wrote that Ricardio is \"always welcome on this series, largely due to Takei\u2019s delightful voice work.\" [ 3 ]  Furthermore, he praised the way that Takei delivered his lines, noting that \"there\u2019s a theatrical smarminess to his vocals that is a stark contrast to the Ice King\u2019s nasality\", and that \"Takei always sounds like he\u2019s having a great time reading the ridiculous lines that are written for him.\" [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2681", "text": "The  Seven Countries Study  is an  epidemiological   longitudinal study  directed by  Ancel Keys  at what is today the  University of Minnesota  Laboratory of Physiological Hygiene & Exercise Science (LPHES). Begun in 1956 with a yearly grant of US$200,000 from the  U.S. Public Health Service , the study was first published in 1978 and then followed up on its subjects every five years thereafter."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2682", "text": "As the world's first multicountry epidemiological study, it systematically examined the relationships between lifestyle, diet,  coronary heart disease  and  stroke  in different populations from different regions of the world. It directed attention to the causes of coronary heart disease and stroke, but also showed that an individual\u2019s risk can be changed."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2683", "text": "Writing in 1975, project officer Henry Blackburn identified two \"strikingly polar attitudes\", characterising them as persisting \"academic\" and \"pragmatic\" views with \"much talk from each and little listening between.\" [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2684", "text": "In the 1940s, a University of Minnesota researcher,  Ancel Keys , postulated that the apparent epidemic of heart attacks in middle-aged American men was related to their mode of life and possibly modifiable physical characteristics. He first explored this idea in a group of Minnesota business and professional men (executives aged 45 to 55) that he recruited into a prospective study in 1947, the first of many  cohort studies  eventually mounted internationally. The U.S. Public Health Service agreed to fund the study (and then set up and proceeded to fund the  Framingham Heart Study  on a larger scale). The Minnesota men were followed through 1981 and the first major report appeared in 1963 after the fifteen-year follow-up study. [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2685", "text": "The study contributed much to survey methods and confirmed larger studies that reported earlier on the predictive value for heart attack of several characteristics, the now-traditional risk factors of  blood pressure  and blood  cholesterol  level and cigarette  smoking . Keys traveled widely with his wife Margaret who tested people's serum cholesterol. They sent their samples back to Minnesota for analysis. In 1952, Keys's hypothesis that coronary heart disease could be related to diet was first published in  Voeding  in The Netherlands. [ 4 ]  His work in post-wartime  Naples  led him to seek organization and funding for studies of different populations, as did his subsequent work in  Uganda ;  Cape Town , South Africa;  Sardinia ;  Bologna ; and  Ilomantsi , Finland; and with Japanese men living in  Hawaii  and in  Japan . He decided to concentrate on men living in  villages , rather than those in cities where the population moved around frequently. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2686", "text": "In the mid-1950s, with improved methods and design, Keys recruited collaborating researchers in seven countries to mount the first cross-cultural comparison of heart attack risk in populations of men engaged in traditional occupations in cultures contrasting in diet, especially in the proportion of fat calories of different composition, the Seven Countries Study still under observation today."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2687", "text": "The Seven Countries Study was formally started in fall 1958 in  Yugoslavia . In total, 12,763 males, 40\u201359 years of age, were enrolled as 16 cohorts, in seven countries, in four regions of the world (United States, Northern Europe, Southern Europe, Japan). One cohort is in the United States, two cohorts in Finland, one in the Netherlands, three in Italy, five in Yugoslavia (two in  Croatia , and three in  Serbia ), two in Greece, and two in Japan. The entry examinations were performed between 1958 and 1964 with an average participation rate of 90%, lowest in the US, with 75% and highest in one of the Japanese cohorts, with 100%. [ 5 ]  The study has continued for more than 50 years."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2688", "text": "The Seven Countries Study suggested that the risk and rates of  heart attack and stroke  (CVR), both at the population level and at the individual level,  correlated  directly and independently to the level of total serum cholesterol, in seven sampled out countries. It demonstrated that the correlation between blood cholesterol level and coronary heart disease (CHD) risk from 5 to 40 years follow-up is found consistently across different specially selected cultures in these seven countries. Cholesterol and obesity correlated with increased mortality from cancer. [ 6 ] [ 7 ] [ 8 ]  The Seven Countries Study suggested that elevated blood pressure ( hypertension ) was correlated with risk of coronary heart disease and stroke. It showed that the  mortality rate  after a coronary heart disease event or stroke was associated with the level of hypertension. In several cohorts of the study, stroke deaths exceeded deaths from coronary heart disease. [ 9 ] [ 10 ]  It hinted that differences in overall mortality between the different regions of the seven countries are largely associated with variation in cardiovascular mortality. [ 11 ]  Coronary deaths in the United States and Northern Europe greatly exceeded those in Southern Europe, even when controlled for age, cholesterol, blood pressure, smoking, physical activity, and weight."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2689", "text": "The Seven Countries Study was investigated further in regard to an eating pattern loosely characterized as the  Mediterranean Diet . [ 12 ] [ 13 ] [ 14 ] [ 11 ] [ 15 ]  What exactly is meant by \"Mediterranean Diet\" today, was detailed by  Antonia Trichopoulou  (wife of  Dimitrios Trichopoulos ), [ 16 ]  and Anna Ferro-Luzzi. [ 17 ]  The diet was publicized and popularized by Greg Drescher of the Oldways Preservation and Exchange Trust and by  Walter Willett  of the  Harvard School of Public Health . [ 18 ] [ 19 ] [ 20 ] [ 21 ] [ 22 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2690", "text": "The Seven Countries Study also showed that the slowly changing habits of a population in the Mediterranean region, from a healthy, active lifestyle and diet, to a less active lifestyle and a diet influenced by the  Western pattern diet , significantly correlated with increased risk of heart disease. [ 23 ] [ 24 ]  Meanwhile, it has been confirmed by other researchers that there is an inverse association between adherence to the  Mediterranean Diet  and the incidence of fatal and non- fatal heart disease in initially healthy middle-aged adults in the Mediterranean region. [ 25 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2691", "text": "The Seven Countries Study, along with other studies, e.g., the  Framingham Heart Study  and the  Nurses' Health Study , showed the importance of  overweight ,  obesity  and regular  exercise  as health issues. [ 26 ] [ 27 ] [ 28 ] [ 29 ]  It showed a correlation between good cardiovascular health and dementia in the general population. It also showed that cardiovascular risk factors in mid life are significantly associated with increased risk of dementia death later in life. [ 30 ]  It indicated that cigarette smoking is a highly significant predictor of the development of coronary heart disease, leading to excess rates of  angina pectoris ,  myocardial infarction  (MI) and coronary death, along with other studies about smoking, e.g., the Framingham Heart Study and the  British Doctors Study . [ 31 ] [ 32 ] [ 33 ] [ 34 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2692", "text": "Initial results from the Seven Countries Study in North Karelia (Finland) prompted public pressure for the authorities to act to reduce historically high levels of chronic disease in the region. The results influenced a subsequent public health program, the  North Karelia Project , which ran from 1972 until 1997, and which had among its aims a reduction in levels of peoples' saturated fat intake. [ 35 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2693", "text": "Subcutaneous implantable cardioverter defibrillator , or  S-ICD,  is an implantable medical device for detecting and terminating   ventricular tachycardia  and  ventricular fibrillation  in patients at risk of sudden cardiac arrest. [ 1 ]  It is a type of  implantable cardioverter defibrillator  but unlike the transvenous ICD, the S-ICD lead is placed just under the skin, leaving the heart and veins untouched."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2694", "text": "The S-ICD was developed to reduce the risk of complications associated with transvenous leads. [ 2 ]  Potential complications, such as infections in the bloodstream and the need to remove or replace the leads in the heart, are minimised or entirely eliminated with the S-ICD system."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2695", "text": "The generator is smaller than the S-ICD generator, which may result in a less visible implanted device. This could improve the time needed to get used to the implantable device, although this is subjective. The procedure can usually be done under local anesthesia and light sedation. The transvenous ICD is capable of  pacing  for  bradycardia  and delivering  antitachycardia pacing  (ATP).   However, device-related complications were numerically more frequent in patients with transvenous ICDs, inappropriate shocks are less frequent that in those with subcutaneous ICDs. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2696", "text": "The leads go into the vein and heart and will grow into the heart wall over time. This may increase the chance of complications if the leads need to be removed or replaced, as the procedure to extract an intracardiac leads can be a challenge. Because the leads need to go into the heart they need to be relatively thin and flexible, since they have to pass through (and remain in) the heart valve(s) and need to flex with every heartbeat. This makes the leads more vulnerable to lead fracture (and therefore complications). It has been demonstrated that  device-related complications were numerically more frequent in patients with transvenous ICDs. [ 3 ]  Due to the position of the pulse generator under the collarbone, it can be more visible with clothing with low neckline."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2697", "text": "Patients who are relatively older, who need ICD for secondary prevention, or who have concomitant bradycardia requiring pacing, or heart failure requiring  cardiac resynchronisation therapy  are more suitable for transvenous ICD implantation. An older patient with ischemic cardiomyopathy and documented symptomatic ventricular tachycardia is a typical example. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2698", "text": "The lead does not go into the heart, which means it leaves the veins and the heart completely intact. This reduces chance of complications (e.g. systemic infections). Because the lead does not go into the heart it can be thicker and more robust. This minimizes / reduces the chance of lead fracture. In the event the system needs to be explanted, the procedure is a relatively simple surgical procedure."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2699", "text": "The pulse generator is larger than most transvenous ICD pulse generators. This could result in a longer time needed to get used to it, although this is subjective. Depending on the physique of a person, the S-ICD may be more visible with bare chest. The procedure usually requires deep sedation or general anaesthesia, as creating a larger pocket between the muscles and tunnelling the lead over the sternum, as well as performing defibrillation threshold testing, can be quite painful. The S-ICD can deliver only temporary post-shock pacing, but cannot otherwise address bradycardia and cannot deliver anti-tachycardia pacing.  Inappropriate shocks were numerically more frequent in those with subcutaneous ICDs. [ 3 ]  Defibrillation testing has traditionally been considered mandatory in patients with subcutaneous implantable cardioverter\u2013defibrillator to confirm appropriate ventricular fibrillation detection. [ 5 ]  However, PRAETORIAN-DFT  randomised clinical trial  is aiming to demonstrate non-inferiority of omitting DFT in patients undergoing S-ICD implantation in which the S-ICD system components are optimally positioned by calculated PRAETORIAN score. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2700", "text": "Patients who are relatively younger, who need ICD for primary prevention, and who do not require pacing or cardiac resynchronisation therapy, are more suitable for S-ICD implantation. A young survivor of aborted  sudden cardiac death  is a typical example."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2701", "text": "Vagal tone  is activity of the  vagus nerve  (the 10th  cranial nerve ) and a fundamental component of the  parasympathetic  branch of the  autonomic nervous system . This branch of the nervous system is not under conscious control and is largely responsible for the regulation of several body compartments at rest. Vagal activity results in various effects, including:  heart rate  reduction,  vasodilation/constriction  of  vessels , glandular activity in the  heart ,  lungs , and  digestive tract , liver, immune system regulation as well as control of gastrointestinal sensitivity, motility and inflammation. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2702", "text": "In this context, tone specifically refers to the continual nature of baseline parasympathetic action that the vagus nerve exerts. While baseline vagal input is constant, the degree of stimulation it exerts is regulated by a balance of inputs from  sympathetic  and  parasympathetic  divisions of the autonomic nervous system, with parasympathetic activity generally being dominant.  Vagal tone is frequently used to assess heart function, and is also useful in assessing emotional regulation and other processes that alter, or are altered by, changes in parasympathetic activity. [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2703", "text": "Measurements of vagal tone can be performed by means of either invasive or noninvasive procedures. Invasive procedures are in the minority and include vagus nerve stimulation by specific manual, breathing or electrical techniques. Noninvasive techniques mainly rely on the investigation of  heart rate  and  heart rate variability . [ 4 ] [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2704", "text": "In most cases, vagal tone is not measured directly. Instead the processes affected by the  vagus nerve  \u2013 specifically heart rate and heart rate variability \u2013 are measured and used as a surrogate for vagal tone. Increased vagal tone (and thus vagal action) is generally associated with a lower heart rate and increased heart rate variability. However, during  graded orthostatic tilt , vagal tone withdrawal is an indirect indicator of cardiovascular fitness. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2705", "text": "Heart rate  is largely controlled by the heart's internal pacemaker activity. In a healthy heart, the main pacemaker is a collection of cells on the border of the  atria  and  vena cava  called the  sinoatrial node . Heart cells exhibit automaticity, the ability to generate  electrical activity  independent of external stimulation. The electrical activity spontaneously generated by the sinoatrial node sets the pace for the rest of the heart. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2706", "text": "In absence of  external stimuli, sinoatrial pacing generally, while awake, maintains the heart rate in the range of 60\u2013100 beats per minute (bpm). [ 8 ]  The two branches of the  autonomic nervous system  work together to increase or slow the heart rate. The vagus nerve acts on the sinoatrial node, slowing its conduction and modulating vagal tone, via the  neurotransmitter   acetylcholine  and downstream changes to  ionic currents  and calcium of heart cells. [ 4 ]   Because of its effect on heart rate, and cardio health, vagal tone can be measured and understood by examining its correlation to heart rate modulation and  heart rate variability . [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2707", "text": "Respiratory sinus arrhythmia (RSA) is typically a benign, normal variation in heart rate that occurs during each breathing cycle: the heart rate increases when breathing in and decreases when breathing out. [ 1 ]  RSA was first recognized by  Carl Ludwig  in 1847 [ 9 ]  but is still imperfectly understood. [ 10 ]  It has been observed in humans from the early stages of life through adulthood, [ 11 ] [ 1 ]  and is found in several different species. [ 12 ] [ 13 ] [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2708", "text": "During  inhalation , the  intra-thoracic pressure  lowers due to the contraction and downward movement of the  diaphragm  and the expansion of the chest cavity.  Atrial pressure  is also lowered as a result, causing increased blood flow to the heart, which in turn decreases  baroreceptors  firing response which diminishes vagal tone. This causes an increase in heart rate. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2709", "text": "During  exhalation , the diaphragm relaxes, moving upward, and decreases the size of the chest cavity, causing an increase in intrathoracic pressure. This increase in pressure inhibits  venous return  to the heart resulting in both reduced atrial expansion and increased activation of baroreceptors. This relieves the suppression of vagal tone and leads to a decreased heart rate. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2710", "text": "Respiratory sinus arrhythmia (RSA) is frequently used as a noninvasive method for investigating vagal tone, in physiological, behavioral, and several clinical studies. [ 16 ] [ 17 ] [ 18 ]  This can be done using  electrocardiography  (ECG) recording, [ 19 ]  although other methods are also being developed that take advantage of the interactions between ECG and  respiration . [ 20 ] [ 15 ]  Interpretation of RSA measurements must be done with care, however, as several factors including differences between individuals can change the relationship between RSA and vagal tone. [ 21 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2711", "text": "It has been suggested that RSA may have evolved to save energy for both cardiac and respiratory systems by reducing the heart rate [ 22 ]  and by suppressing ineffective ventilation during the ebb of  perfusion  (delivery of blood from arteries to capillaries for oxygenation and nutrition). [ 23 ] [ 24 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2712", "text": "RSA has been found to increase in subjects in resting state and to decrease in states of stress or tension. It is increased in supine position and decreased in prone position, and is on average higher and more pronounced during the day as compared to the night. [ 22 ]   RSA has also been extensively used to quantify vagal tone withdrawal in  graded orthostatic tilt . [ 7 ] [ 25 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2713", "text": "Typically, expression of RSA decreases with age. [ 26 ]   However, adults in excellent cardiovascular health, such as endurance runners, swimmers, and cyclists, are likely to have a more pronounced RSA. Professional athletes on average maintain very high vagal tone and consequently higher RSA levels. RSA is less prominent in individuals with diabetes and cardiovascular disease. [ 27 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2714", "text": "Vagal tone research has the potential to offer insight into social behavior, social interactions, and human psychology.  Much of this work has been focused on  newborns  and  children . [ 26 ]  Baseline vagal tone can be used either as a potential predictor of behavior or as a signal of mental health (particularly  emotion regulation ,  anxiety , and  internalizing  and  externalizing disorders ). [ 28 ] [ 29 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2715", "text": "The  polyvagal theory  by  Porges  is an influential model of how the vagal pathways respond to novelty and to stressful external stimuli. [ 30 ] [ 31 ] [ 32 ]  The theory proposes that there are two vagal systems, one that is shared with  reptiles  and  amphibia  and a second, more recent, system that is unique to  mammals . The two pathways behave differently and can work against each other. This theory can account for several  psychophysiological  phenomena and  psychosomatic illnesses . [ 30 ] [ 26 ]  However, recent studies indicate that the vagal \"system\" described by Porges as being unique to mammals existed long before the evolution of mammals. [ 33 ] [ 34 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2716", "text": "There are several methods of estimating vagal tone other than measuring RSA, including:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2717", "text": "Vena amoris  is a  Latin  name meaning, literally, \"vein of love.\"  It describes a special blood vein that was once believed to flow directly from the   fourth finger  of the left hand to the  heart . [ 1 ]  This belief has been cited in Western cultures as one of the reasons the  engagement ring  and/or  wedding ring  was placed on the fourth finger, or \" ring finger \". This myth dates back to the  Medieval Ages ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2718", "text": "While science now accepts that all blood veins flow to the heart, this was not understood at the time and would not be proven until the 17th century by the physician  William Harvey . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2719", "text": "The earliest known occurrence of the phrase  vena amoris  was from  Henry Swinburne , an English ecclesiastical lawyer whose work covering marriage, \"A Treatise of Espousal or Matrimonial Contracts\", was published posthumously in 1686.  Swinburne identifies the  vena amoris  as a vein of blood passing to the heart, found in the fourth finger of the left hand. He states that a wedding ring on that finger signifies that \"as they give their hands each to other, so likewise they should give their hearts also, whereunto that vein is extended.\" [ 3 ]  He cites unnamed ancient sources for this belief and purports an Egyptian connection, most likely referring to a work by the fourth century Roman writer  Macrobius ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2720", "text": "Macrobius, in Saturnalia VII, refers to the connection between the ring finger and the heart but implies that it is a nerve rather than a vein. In this work, the belief is stated to have originated in Egypt."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2721", "text": "...after turning up some books on anatomy, I discovered the truth: that there is a certain nerve which has its origin in the heart and runs from there to the finger next to the little finger of the left hand, where it ends entwined with the rest of the nerves of that finger; and that this is the reason why it seemed good to the men of old to encircle that finger with a ring, as though to honor it with a crown. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2722", "text": "Another early reference, not specifying the hand, was by  Isidore of Seville  in his 7th century work  De ecclesiasticis officiis  XX, 8:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2723", "text": "Men have begun to wear a ring on their fourth finger starting from the thumb, since there is a vein here which links it to the heart\u2014something which the ancients thought worth noting and honouring.\n [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2724", "text": "References to this vein continue in England until the 17th century, when more came to be understood about the circulatory system. Until then, the  vena amoris  figured into various remedies affecting the heart. Some thought that the simple wearing of a ring on this finger, or pinching the finger, would alleviate ailments. [ 6 ]  It was sometimes referred to as the  leech-finger  due to blood-letting practices."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2725", "text": "While the placement of wedding rings has varied greatly over time and place, the  vena amoris  has always been identified in the fourth finger, next to the little finger. [ 1 ]  \nMost sources point to it being in the left hand, but some, like Isidore of Seville, do not specify a hand. Today many western countries follow a tradition of placing wedding rings on the fourth finger of the right hand instead. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2726", "text": "Venous hum  is a benign  auscultatory  phenomenon caused by the normal flow of blood through the  jugular veins . [ 1 ]  At rest, 20% of cardiac output flows to the brain via the internal carotid and vertebral arteries; this drains via the  internal jugular veins . The rush of blood from these veins to the  brachiocephalic vein  can cause the vein walls to vibrate, creating a humming noise which can often be heard by the subject."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2727", "text": "Typically, a peculiar humming sound is heard in the upper chest near the  clavicle , emanating from the  supraclavicular fossa  just lateral to the  sternocleidomastoid muscle , usually more obviously on the right side than on the left. The sound may radiate to the upper sternal border on either side. [ 2 ]  Though the exact mechanism is still unclear, it has been suggested that the hum occurs when otherwise silent laminar flow through the internal jugular vein is disturbed by deformation of this vessel at the level of the  transverse process  of the  atlas  during head rotation. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2728", "text": "The venous hum is heard throughout the  cardiac cycle , though is typically louder during  diastole . It may be easier to hear when sitting, when the chin is elevated, or when the head is rotated contralaterally (away from the location of the sound); deep inspiration and hyperkinetic circulatory states (e.g.  hyperthyroidism ) can also increase its intensity. [ 2 ]  It may be loud enough to result in audible  pulsatile tinnitus . It is by far the most common type of normal continuous murmur, universal in healthy children, and frequently present in healthy young adults, especially during pregnancy. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2729", "text": "The humming may be confused with a  heart murmur , which may be a symptom of a potentially serious condition. The difference is easily detected by placing light pressure on the internal jugular vein when listening to the heart, which will immediately abolish or change the venous hum, whereas a true heart murmur will be unaffected by this maneuver. The murmur also disappears when the patient is in the  supine position  or may disappear if the subject turns their head to one side. It is also known by the names \"nun's murmur\" and \"bruit de diable\" (noise of devils)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2730", "text": "While a venous hum may provoke consultation with a healthcare professional, the hum itself is entirely harmless and is the product of ordinary cardiac physiology. Abnormal and potentially serious conditions such as  thyrotoxicosis  and  anemia , by augmenting blood flow through the jugular veins, can nonetheless initiate or reinforce the venous hum, making it more noticeable, [ 4 ]  and manipulation of the sound with various maneuvers has often helped physicians discover and diagnose cardiovascular disorders. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2731", "text": "Acquired non-inflammatory myopathy (ANIM)  is a neuromuscular disorder primarily affecting skeletal muscle, most commonly in the limbs of humans, resulting in a weakness or dysfunction in the muscle. [ 1 ]  A  myopathy  refers to a problem or abnormality with the  myofibrils , which compose muscle tissue. In general, non-inflammatory myopathies are a grouping of muscular diseases not induced by an  autoimmune -mediated  inflammatory  pathway. These muscular diseases usually arise from a  pathology  within the muscle tissue itself rather than the nerves innervating that tissue. ANIM has a wide spectrum of causes which include drugs and toxins, nutritional imbalances, acquired metabolic dysfunctions such as an acquired defect in protein structure, and infections. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2732", "text": "Acquired non-inflammatory myopathy is a different diagnosis than  inflammatory myopathy . Inflammatory myopathies are a direct result of some type of autoimmune mediated pathway whereas ANIM is not the result of a dysfunction of the immune system. [ 2 ]  In addition, the cause of inflammatory myopathy is relatively unknown, whereas many causal agents for ANIM have been discovered which typically affect the structural integrity and function of the muscle fibers. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2733", "text": "Most myopathies are typically first diagnosed and classified as an  idiopathic  inflammatory myopathy. [ 2 ] [ 3 ] [ 4 ] [ 5 ]  However, a diagnosis of ANIM occurs when the cause of the myopathy is found to not arise from an autoimmune mechanism. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2734", "text": "Patients with acquired non-inflammatory myopathy typically experience weakness, cramping, stiffness, and  tetany , most commonly in skeletal muscle surrounding the limbs and upper shoulder girdle. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2735", "text": "The most commonly reported symptoms are:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2736", "text": "Acquired non-inflammatory myopathy can be caused by a variety of factors including metabolic abnormalities, drugs, nutritional deficiency, trauma, and upstream abnormalities resulting in decreased function.  Two of the most common causes of ANIM are  hyperthyroidism  and excessive steroid use, while many drugs used to treat  rheumatism  are known to be inducing agents.  Most cases of ANIM can be linked to drugs or dietary abnormalities. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2737", "text": "It is not uncommon for drugs to damage muscle fibers. Particular families of drugs are known to induce myopathies on the molecular level, thus altering organelle function such as the mitochondria. Use of multiple drugs from these families in conjunction with one another can increase the risk of developing a myopathy. [ 6 ]  Many of the drugs associated with inducing myopathies in patients are found in rheumatology practice. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2738", "text": "Many dietary factors and aberrations can induce ANIM.  Chemical imbalances brought on by abnormal diets may either affect the muscle directly or induce abnormal functionality in upstream pathways."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2739", "text": "Trauma  to any muscle is also a common cause for acute ANIM.  This is due to muscular contusions and partial or complete loss of function for affected muscle groups. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2740", "text": "A patient's history is one of the key factors in diagnosing acquired non-inflammatory myopathy. The history is used not only to analyze the time frame with which the patient began to express symptoms, but to also see if the disease is within the patient's family history, to check medication or drug use history, and to see if the patient has had any trauma due to illness or infection. Basic exams will test for where the muscle weakness is and how weak it is. This is performed by testing for proximal and distal muscle strength, as well as testing for any signs of  neurogenic  symptoms such as impaired sensation, deep tendon reflexes, and atrophy. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2741", "text": "If needed, more advanced equipment can be used to help determine whether a patient has ANIM. This includes:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2742", "text": "When examining the serum levels of muscle enzymes, the relative levels of  creatine kinase ,  aldolase ,  aspartate aminotransferase ,  alanine aminotransferase , and  lactate dehydrogenase  are closely examined. Abnormal levels of these proteins are indicative of both  inflammatory myopathy  and ANIM. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2743", "text": "EMGs are particularly useful in locating the affected muscle groups, as well as determining the distribution of the myopathy throughout the cell. EMGs measure several indicators of myopathies such as: [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2744", "text": "Magnetic Resonance Imaging will elicit edema in inflammatory patients, but it will most likely show nothing in patients with ANIM and if it does, it will show some  atrophy . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2745", "text": "If an individual's ANIM is a result of a metabolite defect, then additional tests are required. These tests are directed at enzyme function at rest and during exercise, and enzyme intermediates. Molecular  genetic testing  is often used to determine if there was any predisposition to the expressed symptoms. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2746", "text": "During vigorous  ischemic  exercise, skeletal muscle functions anaerobically, generating lactate and ammonia a coproduct of muscle myoadenylate deaminase (AMPD) activity. The forearm ischemic exercise test takes advantage of this physiology and has been standardized to screen for disorders of glycogen metabolism and AMPD deficiency. Patients with a glycogen storage disease manifest a normal increase in ammonia but no change from baseline of lactate, whereas in those with AMPD deficiency, lactate levels increase but ammonia levels do not. If ischemic exercise testing gives an abnormal result, enzyme analysis must be performed on muscle to confirm the putative deficiency state because false-positive results can occur. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2747", "text": "Treatment for acquired noninflammatory myopathy is directed towards resolution of the underlying condition, pain management, and muscle rehabilitation.\nDrug induced ANIMs can be reversed or improved by tapering off of the drugs and finding alternative care. [ 6 ]   Hyperthyroidism induced ANIM can be treated through anti-thyroid drugs, surgery, and not eating foods high in Iodine such as kelp.  Treatment of the hyperthyroidism results in complete recovery of the myopathy. [ 7 ]    ANIM caused by  vitamin D deficiency  can easily be resolved by taking vitamin supplements and increasing one's exposure to direct sunlight. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2748", "text": "Pain can be managed through massaging affected areas and the use of  nonsteroidal anti-inflammatory drugs  (NSAIDs).\nExercise, physical therapy, and occupational therapy can be used to rehabilitate affected muscle areas and resist the  atrophy  process. [ 2 ]  The use of walkers, canes, and braces may assist with the mobility of the affected individual. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2749", "text": "A diagnostic test for statin-associated auto-immune necrotizing myopathy will be available soon in order to differentiate between different types of myopathies during diagnosis. The presence of abnormal spontaneous electrical activity in the resting muscles indicates an irritable myopathy and is postulated to reflect the presence of an active necrotising myopathic process or unstable muscle membrane potential. However, this finding has poor sensitivity and specificity for predicting the presence of an  inflammatory myopathy  on biopsy. Further research into this spontaneous electrical activity will allow for a more accurate differential diagnosis between the different myopathies. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2750", "text": "Currently a muscle biopsy remains a critical test, unless the diagnosis can be secured by genetic testing. Genetic testing is a less invasive test and if it can be improved upon that would be ideal. Molecular genetic testing is now available for many of the more common metabolic myopathies and muscular dystrophies. These tests are costly and are thus best used to confirm rather than screen for a diagnosis of a specific myopathy. It is the hope of researchers that as these testing methods improve in function, both costs and access will become more manageable [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2751", "text": "The increased study of muscle pathophysiology is of importance to researchers as it helps to better differentiate inflammatory versus non-inflammatory and to aim treatment as part of the differential diagnosis. Certainly classification schemes that better define the wide range of myopathies will help clinicians to gain a better understanding of how to think about these patients. Continued research efforts to help appreciate the pathophysiology will improve clinicians ability to administer the most appropriate therapy based on the particular variety of myopathy. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2752", "text": "The mechanism for myopathy in individuals with low vitamin D is not completely understood. A decreased availability of 250HD leads to mishandling of cellular calcium transport to the sarcoplasmic reticulum and mitochondria, and is associated with reduced actomyosin content of myofibrils. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2753", "text": "Amyotrophy  is progressive wasting of  muscle  tissues. Muscle pain is also a symptom. It can occur in middle-aged males with  type 2 diabetes . It also occurs with  motor neuron disease ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2754", "text": "The following are considered  differential diagnosis  for amyotrophy: [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2755", "text": "A  compartment syndrome  is an increased pressure within a muscular compartment [ 1 ]  that compromises the circulation to the muscles."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2756", "text": "Diffuse tightness and tenderness over the entire belly of the tibialis anterior muscle that does not respond to elevation or  pain medication  can be early warning signs and suggestive of Anterior Compartment Syndrome.  Other common symptoms include excessive swelling that causes the  skin  to become hot, stretched and glossy.  Pain,  paresthesias , and tenderness in both the ischemic muscles and the region supplied by the deep  common fibular nerve  are exhibited by patients with this condition.  Sensitivity to passive stretch and active contraction are common, and tend to increase the symptoms. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2757", "text": "A compartment space is anatomically determined by an unyielding  fascial  (and  osseous ) enclosure of the muscles.  The anterior compartment syndrome of the  lower leg  (often referred to simply as anterior compartment syndrome), can affect any and all four muscles of that compartment:  tibialis anterior ,  extensor hallucis longus ,  extensor digitorum longus , and  peroneus tertius . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2758", "text": "This term is often mistakenly used to describe various related/proximal conditions, including Anterior  Shin Splints .  It is important to distinguish between the two, as shin splints rarely causes serious health problems, while Anterior Compartment Syndrome can lead to irreversible damage. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2759", "text": "The true compartment syndrome arises due to increased  pressure within the unyielding  anterior compartment of the leg .  The pressure obstructs venous outflow, which causes further swelling and increased pressure.  The resultant  ischemia  leads to  necrosis  (death of tissue) of the muscles and nerves.  The process can begin with swelling of the tibialis anterior, extensor hallucis longus, extensor digitorum longus, and/or the peroneus tertius muscles in response to strong  eccentric contractions  sufficient to produce postexercise soreness. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2760", "text": "If these symptoms are observed/experienced it is important to contact a physician specializing in  sports medicine  ( MD / DO ), a  doctor of podiatric medicine  (DPM), or other qualified health care professional immediately so as to get the appropriate advice/treatment before serious damage occurs. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2761", "text": "The 5 Ps of Anterior Compartment Syndrome:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2762", "text": "The only option to treat acute compartment syndrome is surgery. The procedure, called a fasciotomy, involves a surgeon cutting open the skin and the fascia to relieve the pressure. Options to treat chronic compartment syndrome include physiotherapy, shoe inserts, and anti-inflammatory medications. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2763", "text": "Benign acute childhood myositis  (BACM) is a syndrome characterized by muscle weakness and pain in the lower limbs that develop in children after a recent viral illness. It is transient with a spontaneous clinical resolution within 1 week. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2764", "text": "Prodromal symptoms are typically fever, cough, and rhinorrhea. BACM symptoms that follow are most frequently calf pain, gait complaints, and inability to walk. [ 2 ]  The condition is self-limited and full restitution can be expected. In very rare cases, however,  rhabdomyolysis  may develop. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2765", "text": "Affected are preschool and school-age children with a male predominance. [ 2 ]  In one study, the median age was 6 years (range 2\u201313.2 years). [ 1 ]  It has been estimated that BACM has an incidence of 2.69 cases per 100,000 children (<18 years) during epidemic seasons and 0.23 cases during non-epidemic seasons. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2766", "text": "The history of a preceding influenza-like infection followed by the typical symptoms of acute onset of symmetrical calf pain and gait problems together with an isolated finding of a high level of  creatine kinase  suggests the diagnosis of BACM. [ 4 ]   Myoglobinuria  is rare and points to the possibility of the development of rhabdomyolysis and kidney failure. [ 2 ] [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2767", "text": "Guillain-Barr\u00e9 syndrome  (GBS) is the main consideration in the differential diagnosis. It needs to be quickly excluded as early intervention in GBS is indicated. Other conditions under possible consideration are  dermatomyositis ,  muscular dystrophy ,  juvenile idiopathic arthritis ,  transient synovitis of the hip ,  osteomyelitis , and  myalgia . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2768", "text": "Few muscle biopsies have been conducted. Results may show normal findings or features of inflammation and necrosis. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2769", "text": "A number of different preceding viral infections have been reported, most commonly  influenza A  and  B . The condition appears to be more prevalent during late fall, winter, and spring. [ 2 ]  Other virus infections that have been linked to BACM are those caused by  Parainfluenza ,  Coxsackievirus ,  Adenovirus ,  Echovirus , and  Mycoplasma pneumonia . [ 1 ] \nViral myositis after viral infections may also occur in adults, and viruses, such as COVID-19, have been reported as a rare cause of myositis. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2770", "text": "BACM may be alarming to parents and lead to unnecessary extensive tests. [ 4 ]  Treatment consists of oral analgesics, rest, and adequate hydration. [ 1 ]  Hospitalization is usually not necessary. Full recovery can be expected within a week, however, recurrences can occur."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2771", "text": "in 1957 Lundberg reported on a group of patients with a condition he named  myalgia cruris epidemica , [ 7 ]  seemingly the first description of BACM. Other terms later used include  influenza-associated myositis, viral myositis, acute myositis [ 2 ]  Middleton and colleagues reported on BACM as  severe myositis after influenza  in 1970. [ 8 ]  Viral myositis may occur also in later years."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2772", "text": "Cataplexy  is a sudden and transient episode of muscle weakness accompanied by full conscious awareness, typically triggered by emotions such as laughing, crying, or terror. [ 1 ]  Cataplexy is the first symptom to appear in about 10% of cases of  narcolepsy , [ 2 ]  caused by an autoimmune destruction of hypothalamic neurons that produce the neuropeptide  hypocretin  (also called orexin), which regulates  arousal  and has a role in stabilization of the transition between wake and sleep states. [ 3 ]  Cataplexy without narcolepsy is rare and the cause is unknown."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2773", "text": "The term cataplexy originates from the  Greek  \u03ba\u03b1\u03c4\u03ac ( kata , meaning \"down\"), and \u03c0\u03bb\u1fc6\u03be\u03b9\u03c2 ( pl\u0113xis , meaning \"strike\") [ 4 ]   and it was first used around 1880 in German physiology literature to describe the phenomenon of tonic immobility also known as \" playing possum \" (in reference to the  opossum 's behavior of feigning death when threatened). [ 4 ]  In the same year the French neuropsychiatrist Jean-Baptiste G\u00e9lineau coined the term 'narcolepsy' and published some clinical reports that contained details about two patients who had similar conditions to those of current narcoleptic cases. [ 5 ]  Nevertheless, the onset that he reported was in adulthood, as compared to current cases reported in childhood and adolescence. [ 6 ]  Even if he preferred the term 'astasia' instead of 'cataplexy', the case that he described remains iconic for the diagnosis of full narcoleptic  syndrome . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2774", "text": "Cataplexy manifests itself as muscular  weakness  which may range from a barely perceptible slackening of the facial  muscles  to complete muscle  paralysis  with postural collapse. [ 7 ]  Attacks are brief, most lasting from a few seconds to a couple of minutes, and typically involve dropping of the jaw, neck weakness, and/or buckling of the knees. Even in a full-blown collapse, people are usually able to avoid injury because they learn to notice the feeling of the cataplectic attack approaching and the fall is usually slow and progressive. [ 8 ]  Speech may be slurred and  vision  may be impaired (double vision, inability to focus), but hearing and  awareness  remain normal. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2775", "text": "Cataplexy attacks are self-limiting and resolve without the need for medical intervention. If the person is reclining comfortably, they may transition into sleepiness,  hypnagogic hallucinations , or a period of  REM  sleep. While cataplexy worsens with fatigue, it is different from  narcoleptic sleep attacks  and is usually, but not always, triggered by strong emotional reactions such as  laughter ,  anger ,  surprise ,  awe , and  embarrassment , or by sudden physical effort, especially if the person is caught off guard. [ 9 ]  One well-known example of this was the reaction of  1968 Olympic   long jump  medalist  Bob Beamon  on learning that he had broken the previous world record by over 0.5\u00a0meters (almost 2\u00a0feet). [ 10 ] [ additional citation(s) needed ] [ medical citation needed ]  Cataplectic attacks may occasionally occur spontaneously, with no identifiable emotional trigger. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2776", "text": "Cataplexy is considered secondary when it is due to specific lesions in the brain that cause a depletion of the hypocretin neurotransmitter. Secondary cataplexy is associated with specific lesions located primarily in the lateral and posterior hypothalamus. Cataplexy due to  brainstem  lesions is uncommon particularly when seen in isolation. The lesions include tumors of the brain or brainstem and arterio-venous malformations. Some of the tumors include  astrocytoma ,  glioblastoma ,  glioma , and  subependymoma . These lesions can be visualized with brain imaging, however in their early stages they can be missed. Other conditions in which cataplexy can be seen include  ischemic  events,  multiple sclerosis ,  head injury ,  paraneoplastic syndromes , infections such as  encephalitis , and more rarely  Niemann Pick disease . Cataplexy may also occur transiently or permanently due to lesions of the hypothalamus that were caused by surgery, especially in difficult tumor resections. These lesions or generalized processes disrupt the hypocretin neurons and their pathways. The neurological process behind the lesion impairs pathways controlling the normal inhibition of muscle tone drop, consequently resulting in  muscle atonia . [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2777", "text": "A phenomenon of  REM sleep , muscular paralysis, occurs at an inappropriate time. This loss of  tonus  is caused by massive inhibition of  motor neurons  in the spinal cord. When this happens during waking, the patient who had a cataplectic attack loses muscular control. As in REM sleep, the person continues to breathe and is able to control eye movements. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2778", "text": "The hypothalamus region of the brain regulates basic functions of hormone release, emotional expression and sleep. One study concluded that the neurochemical  hypocretin , also known as orexin, which is regulated by the hypothalamus, was significantly reduced in study participants with symptoms of cataplexy. Hypocretin regulates sleep and states of arousal. Hypocretin deficiency is further associated with decreased levels of  histamine  and  epinephrine , chemicals important in promoting wakefulness, arousal and alertness. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2779", "text": "The diagnosis of narcolepsy and cataplexy is usually made by symptom presentation. Presenting with the tetrad of symptoms (excessive daytime sleepiness, sleep-onset paralysis, hypnagogic hallucinations, and cataplexy symptoms) is strong evidence of the diagnosis of narcolepsy. A multiple sleep latency test [ clarification needed ]  is often conducted to quantify daytime sleepiness. [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2780", "text": "Cataplexy can sometimes be misdiagnosed as a  seizure disorder , and people with narcolepsy are often misdiagnosed with other conditions such as  psychiatric disorders  or  emotional problems , it can take years for someone to get the proper diagnosis. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2781", "text": "Cataplexy is treated with medications. Treatment for narcolepsy and cataplexy can be divided to those that act on the excessive daytime sleepiness (EDS) and those that improve cataplexy. Most patients require lifelong use of medications. [ 15 ]  Most treatments in humans will act only symptomatically and do not target the loss of the orexin-producing neurons. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2782", "text": "When treating cataplexy, all three systems\u2014 adrenergic ,  cholinergic  and  dopaminergic \u2014must be considered. The adrenergic system can be inhibited by antidepressants. In mouse models, cataplexy is regulated by the dopaminergic system via the  D2-like receptor , which when blocked decreases cataplectic attacks. [ clarification needed ]  The role of the cholinergic system has been observed in canine models, where stimulation of this system may lead to severe cataplexy episodes. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2783", "text": "There are no behavioral treatments. People with  narcolepsy  will often try to avoid thoughts and situations that they know are likely to evoke strong emotions and thereby trigger cataplectic attacks. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2784", "text": "Gamma-hydroxybutyrate , also known as  sodium oxybate , has been found to be effective at reducing the number of cataplexy episodes. [ 18 ] [ 19 ]  Sodium oxybate is generally safe [ 19 ]  and is typically the recommended treatment. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2785", "text": "Sodium oxybate is a natural metabolite of GABA. Its main target is the dopaminergic system because at pharmacological concentrations it acts as an agonist and modulates the dopamine neurotransmitters and dopaminergic signalling. [ 17 ]  It is the only drug authorised by the  EMA  to treat the whole disease in adults, and by the  FDA  to treat patients who have cataplexy with the indication to be used for combating excessive daytime sleepiness. [ 4 ] [ 20 ]  This drug helps to normalise  sleep architecture  and inhibits the intrusion REM sleep elements like paralysis during the day. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2786", "text": "If the above treatment is not possible,  venlafaxine  is recommended. [ 20 ]  Evidence for benefit is not as good. [ clarification needed ] [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2787", "text": "Previous treatments include  tricyclic antidepressants  such as  imipramine ,  clomipramine  or  protriptyline . [ 8 ]   Monoamine oxidase inhibitors  may be used to manage both cataplexy and the REM sleep-onset symptoms of sleep paralysis and  hypnagogic hallucinations . [ 21 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2788", "text": "In clinical practice, venlafaxine and   clomipramine  are the most common antidepressants used to treat cataplexy. If the patient wishes to have a sedative effect, then clomipramine is prescribed. The effect of these drugs is to suppress the REM component and to increase the brainstem monoaminergic levels. [ 4 ]  Improvement can be seen within 48 hours after the drug is administered and at doses smaller than the ones used in depression. [ 17 ]  Nonetheless, antidepressants are not approved by the FDA for the treatment of cataplexy; [ 20 ]  some jurisdictions have approved clomipramine for this use, however. [ 22 ] [ 23 ] [ 24 ]  Frequently, tolerance is developed by the patients and typically the risk of cataplexy rebound or \"status cataplecticus\" appears when their intake is abruptly interrupted. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2789", "text": "Narcolepsy with cataplexy is considered an autoimmune-mediated disorder, so some therapies based on this hypothesis have been developed. Immunological therapies developed include: [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2790", "text": "The histaminergic neurons have a very important role in preserving consciousness and in helping maintain wakefulness  and remain active during cataplexy. In narcolepsy, there seems to be an increase in these neurons, possibly to compensate for hypocretin loss. [ 25 ]  A promising therapy would be to increase the activation of histaminergic neurons by an inverse agonist of the histamine H3 receptor, which enhances histamine release in hypothalamus. [ 17 ]  An inverse agonist of the histamine H3 is  Pitolisant . [ 26 ]  Results after testing on animals have indicated increased wakefulness in normal animals, decreased sleepiness and blocked the abnormal transitions from REM sleep to awake state in the hypocretin knock-out mice. [ 17 ]  Also placebo-controlled studies suggest some positive effects of  Pitolisant  on cataplexy symptoms increasing the levels of alertness and wakefulness. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2791", "text": "There are several protective devices used that can help to manage the dangers as a results of falls due to cataplexies:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2792", "text": "It is important for people with narcolepsy and cataplexy to work with their healthcare team to determine the best protective devices for their specific needs and to ensure their safety and well-being."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2793", "text": "Research is being conducted on hypocretin gene therapy and hypocretin cell transplantation for narcolepsy-cataplexy. [ 27 ] [ 28 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2794", "text": "A  charley horse  is an American term for a very painful involuntary  cramp , most commonly occurring in the  legs  (usually located in the  calf muscle ) and/or foot, lasting anywhere from a few seconds to a couple of days. The phrase formerly referred more commonly to bruising of the  quadriceps  muscle of the anterior or lateral thigh, or  contusion  of the femur, that commonly results in a  haematoma  and sometimes several weeks of pain and disability. In this latter sense, such an injury is known as  dead leg . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2795", "text": "Dead legs and charley horses are two different types of injuries: A charley horse involves the muscles contracting without warning, and can last from a few seconds to a couple days. A dead leg often occurs in  contact sports , such as football, when an athlete suffers a knee or other blunt trauma to the lateral quadriceps causing a haematoma or temporary  paresis  and  antalgic gait  as a result of pain. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2796", "text": "Colloquially, taking a hit in the thigh area (thigh contusion) can also be referred to as a  charley horse [ 1 ]  or even simply as a  charley. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2797", "text": "The first known use of the term was in 1886 [ 3 ]  in a West Virginia newspaper. The originator of the phrase is credited to two baseball players,  Jack Glasscock  and  Joe Quest . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2798", "text": "Charley horses have many possible causes directly resulting from high or low pH or substrate concentrations in the blood, including  hormonal imbalances ,  dehydration , low levels of  magnesium ,  potassium , or  calcium  (evidence has been mixed), [ 5 ] [ 6 ] [ 7 ]  side effects of medication, or, more seriously, diseases such as  amyotrophic lateral sclerosis  and  neuropathy . [ 8 ]  Charley horses seem to be most common in individuals who engage in strenuous physical activities, such as those who work in construction or play sports. They are also a common complaint during  pregnancy . [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2799", "text": "Relief is given by massaging or stretching the leg or foot in the opposite direction of the cramp. Relief also comes from standing up, which serves to counter the muscle-tightening signal. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2800", "text": "Chronic progressive external ophthalmoplegia  ( CPEO ) is a type of eye disorder characterized by slowly progressive inability to move the eyes and eyebrows. [ 1 ]  It is often the only feature of  mitochondrial disease , in which case the term CPEO may be given as the  diagnosis . In other people suffering from mitochondrial disease, CPEO occurs as part of a  syndrome  involving more than one part of the body, such as  Kearns\u2013Sayre syndrome . Occasionally CPEO may be caused by conditions other than mitochondrial diseases."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2801", "text": "CPEO is a rare disease that may affect those of all ages, but typically manifests in the young adult years.  CPEO is the most common manifestation of  mitochondrial myopathy , occurring in an estimated two-thirds of all cases of mitochondrial myopathy. Patients typically present with  ptosis  (drooping eyelids). Other diseases like  Graves' disease ,  myasthenia gravis  and glioma that may cause an external  ophthalmoplegia  must be ruled out. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2802", "text": "CPEO is a slowly progressing disease. It may begin at any age and progresses over a period of 5\u201315 years. [ 1 ]  The first presenting symptom of  ptosis  is often unnoticed by the patient until the lids droop to the point of producing a visual field defect. Often, patients will tilt the head backwards to adjust for the slowly progressing ptosis of the lids. In addition, as the ptosis becomes complete, the patients will use the frontalis (forehead) muscle to help elevate the lids. The ptosis is typically bilateral but may be unilateral for a period of months to years before the fellow lid becomes involved. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2803", "text": "Ophthalmoplegia (the inability or difficulty to move the eye) is usually symmetrical, therefore, patients are not affected by diplopia (double vision). The progressive ophthalmoplegia is often unnoticed till decreased ocular motility limits peripheral vision. Often someone else will point out the ocular disturbance to the patient. Patients will move their heads to adjust for the loss of peripheral vision caused by inability to abduct or adduct the eye. All directions of gaze are affected; however, downward gaze appears to be best spared. This is in contrast to  progressive supranuclear palsy  (PSP), which typically affects vertical gaze and spares horizontal gaze. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2804", "text": "Mitochondrial retinopathy has been described in CPEO which presents with a spectrum of distinct retinal phenotypes. This includes mild, focal pigmentary abnormalities on funduscopy and widespread granular pigmented fundus alterations. Mild, asymptomatic retinopathy might be underreported; severe retinopathy may be associated with significant vision loss.  [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2805", "text": "Weakness of extraocular muscle groups including, the  orbicularis oculi  muscle as well as facial and limb muscles may be present in up to 25% of patients with CPEO. As a result of the orbicularis oculi weakness, patients may suffer from exposure keratopathy (damage to cornea) from the inability to close the eyes tightly. Frontalis muscle weakness may exacerbate the ptotic lids with the inability to compensate for the ptosis. Facial muscles may be involved which lead to atrophy of facial muscle groups producing a thin, expressionless face with some having difficulty with chewing.  Neck, shoulder and extremity weakness with atrophy may affect some patients and can be mild or severe. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2806", "text": "Mild visual impairment was seen in 95% of patients that were evaluated using the Visual Function Index (VF-14). [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2807", "text": "The  ciliary muscles  that control the lens shape and the iris muscles are often unaffected by CPEO. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2808", "text": "Additional symptoms are variable, and may include exercise intolerance,  cataracts , hearing loss, sensory axonal neuropathy,  ataxia , clinical depression,  hypogonadism , and  parkinsonism . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2809", "text": "Kearns\u2013Sayre syndrome  is characterized by onset before 15 years of age of CPEO, heart block and pigmentary retinopathy. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2810", "text": "Mitochondrial DNA  which is transmitted from the mother, encodes proteins that are critical to the respiratory chain required to produce  adenosine triphosphate  (ATP).  Deletions or mutations to segments of mtDNA lead to defective function of oxidative phosphorylation.  This may be made evident in highly oxidative tissues like skeletal muscle and heart tissue.  However,  extraocular muscles  contain a volume of mitochondria that is several times greater than any other muscle group.  As such, this results in the preferential ocular symptoms of CPEO. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2811", "text": "Multiple mtDNA abnormalities exist which cause CPEO.  One mutation is located in a conserved region of mitochondrial tRNA at nucleotide 3243 in which there is an A to G nucleotide transition.  This mutation is associated with both CPEO and  mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes  (MELAS). [ 4 ]  A common deletion found in one-third of CPEO patients is a 4,977 base pair segment found between a 13 base pair repeat. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2812", "text": "The mtDNA that is affected maybe a single or multiple point deletion, with associated nuclear DNA deletions.  One study showed that mtDNA deletion seen in CPEO patients also had an associated nuclear DNA deletion of the  Twinkle gene  which encodes specific mitochondrial protein; Twinkle. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2813", "text": "Whether a tissue is affected is correlated with the amount of oxidative demands in relation to the amount of mtDNA deletion. [ citation needed ] In most cases, PEO occurs due to a sporadic deletion or duplication within the mitochondrial DNA. [ 6 ]  However, transmission from the mother to the progeny appears only in few cases. Both  autosomal dominant  and  autosomal recessive  inheritance can occur, autosomal recessive inheritance being more severe.  Dominant and recessive forms of PEO can be caused by genetic mutations in the  ANT1 ,  POLG ,  POLG2  and  PEO1  genes. [ 7 ] [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2814", "text": "It is important to differentiate CPEO from other pathologies that may cause an ophthalmoplegia.  There are specific therapies used for these pathologies. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2815", "text": "CPEO is diagnosed via muscle biopsy. On examination of muscle fibers stained with  G\u00f6m\u00f6ri trichrome stain , one can see an accumulation of enlarged mitochondria. This produces a dark red staining of the muscle fibers given the name \"ragged red fibers\".  While ragged red fibers are seen in normal aging, amounts in excess of normal aging give a diagnosis of a mitochondrial myopathy. [ citation needed ]   Polymerase chain reaction  (PCR) from a sample of blood or muscle tissue can determine a mutation of the mtDNA. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2816", "text": "Elevated acetylcholine receptor antibody level which is typically seen in myasthenia gravis has been seen in certain patients of mitochondrial associated ophthalmoplegia. [ 9 ] \nIt is important to have a dilated eye exam to determine if there is pigmentary retinopathy that may signify  Kearns\u2013Sayre syndrome  which is associated with cardiac abnormalities. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2817", "text": "MRI may be helpful in the diagnosis, in one study volumes of medial rectus, lateral rectus, and inferior rectus muscles in CPEO were not smaller than normal (in contrast to the profound atrophy typical of neurogenic paralysis). Although volumes of the superior rectus muscle-levator complex and superior oblique were significantly reduced. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2818", "text": "There is currently no defined treatment to ameliorate the muscle weakness of CPEO.  Treatments used to treat other pathologies causing ophthalmoplegia has not been shown to be effective. [ citation needed ]  Experimental treatment with tetracycline has been used to improve ocular motility in one patient. [ 11 ]  Coenzyme Q 10  has also been used to treat this condition. [ 12 ]  However, most neuro-ophthalmologists do not ascribe to any treatment. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2819", "text": "Ptosis associated with CPEO may be corrected with surgery to raise the lids, [ 13 ]  however due to weakness of the orbicularis oculi muscles, care must be taken not to raise the lids in excess causing an inability to close the lids.  This results in an exposure keratopathy.  Therefore, rarely should lid surgery be performed and only by a neuro-ophthalmologist familiar with the disease. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2820", "text": "The most common strabismus finding is large angle exotropia which can be treated by maximal bilateral eye surgery, but due to the progressive nature of the disease, strabismus may recur. [ 14 ]  Those that have  diplopia  as a result of asymmetric ophthalmoplegia may be corrected with prisms or with surgery to create a better alignment of the eyes. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2821", "text": "Compton-North congenital myopathy , also known as  congenital lethal myopathy, Compton-North type , is a rare, fatal  genetic disorder  of pre-natal onset that results in death shortly after birth and is characterized by  fetal akinesia  and movement restriction,  polyhydramnios , severe  hypotonia  of neonatal-onset, generalized weakness of the respiratory, bulbar, and skeletal muscles, presence of multiple congenital muscular contractures. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2822", "text": "Additional features include premature birth, low birth weight, failure to thrive, abnormal reflexes,  scaphocephaly ,  hypertelorbitism , oval-shaped face, small hands,  single transverse palmar crease ,  high-arched palate ,  arachnodactyly , and  camptodactyly  (causing overlapping fingers). Ultrastructural findings include sarcomeric disruptions, Z-band disorganization, and an absence of integrin alpha7, beta2-syntrophin, alpha-dystrobrevin. [ 3 ]  Only four infants from a heavily  consanguineous   Egyptian Australian  family have been described in the medical literature, [ 4 ]  and it is caused by homozygous mutations in the  CNTN1  gene, located in  chromosome 12 . [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2823", "text": "The condition wasn't named after the doctors who first discovered the condition, but rather the doctors who first described it in detail: Dr. Alison G. Compton and Dr. Kathryn N. North. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2824", "text": "This  genetic disorder  article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2825", "text": "In  pathology , a  contracture  is a shortening of  muscles , tendons, skin, and nearby soft tissues that causes the  joints  to shorten and become very stiff, preventing normal movement. [ 1 ] [ 2 ]  A contracture is usually permanent, but less commonly can be temporary (such as in  McArdle disease ), [ 3 ]  or resolve over time but reoccur later in life (such as in  Bethlem myopathy  1). [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2826", "text": "It is usually in response to prolonged  hypertonic   spasticity  in a concentrated muscle area, such as is seen in the tightest muscles of people with conditions like  spastic cerebral palsy , but can also be due to the congenital abnormal development of muscles and connective tissue in the womb."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2827", "text": "Contractures develop usually when normally elastic tissues such as muscles or tendons are replaced by inelastic tissues ( fibrosis ). This results in the shortening and hardening of these tissues, ultimately causing rigidity, joint deformities and a total loss of movement around the joint."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2828", "text": "Most of the  physical therapy ,  occupational therapy  and other exercise regimens targeted towards people with  spasticity  focuses on trying to prevent contractures from happening in the first place. However, research on sustained traction of connective tissue in approaches such as adaptive yoga has demonstrated that contracture can be reduced, [ 5 ]  at the same time that tendency toward spasticity is addressed."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2829", "text": "Contractures can have a variety of causes other than spasticity. In regards to muscle, these include (but not limited to):"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2830", "text": "Wound contraction , where the edges of the skin are pulled together to close the wound, is a normal part of  wound healing . However, large wounds and abnormal wound healing cause skin contractures by excessively tightening the skin and limiting movement. [ 6 ] [ 7 ] [ 8 ]  A skin contracture due to a burn is known as a  burn scar contracture ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2831", "text": "Large areas of missing skin (such as large burns, grazes, and gouges) drastically reduce the area of skin causing it to become tight when pulled together during wound healing. [ 6 ] [ 7 ]  Scars initially lack elasticity with synthesis of elastic tissue fibres ( elastogenesis ) being a function of duration and site of the scar. [ 9 ]  Deep wounds and abnormal wound healing causes abnormal scarring such as  hypertrophic scars . [ 8 ]  Studies on hypertrophic scars have shown a lack of improvement to both elasticity and stiffness suggesting a prolonged healing phase without amelioration seen in a normal wound-healing curve. [ 10 ] [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2832", "text": "Surgery can help alleviate skin contractures in the form of skin grafts and removal of hypertrophic scars. [ 8 ] [ 6 ]  For hypertrophic scars, timing is important when considering surgery, as over time scars will mature and may show decreased contractures along with flattening, softening, and repigmentation without surgical intervention. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2833", "text": "A  cramp  is a sudden, involuntary, painful  skeletal   muscle contraction [ 1 ] [ 2 ]  or overshortening associated with electrical activity; [ 3 ]  while generally temporary and non-damaging, they can cause significant  pain  and a  paralysis -like immobility of the affected muscle. A cramp usually goes away on its own over a period of several seconds or (sometimes) minutes. [ 4 ]  Cramps are common and tend to occur at rest, usually at night (nocturnal leg cramps). [ 2 ] [ 5 ]  They are also often associated with  pregnancy ,  physical exercise  or overexertion, and age (common in older adults); in such cases, cramps are called  idiopathic , because there is no underlying pathology. In addition to those benign conditions cramps are also associated with many  pathological  conditions. [ 2 ] [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2834", "text": "Cramp definition is narrower than the definition of muscle  spasm : spasms include any involuntary abnormal muscle contractions, while cramps are sustained and painful. [ 1 ] [ 7 ]  True cramps can be distinguished from other cramp-like conditions. Cramps are different from  muscle contracture , which is also painful and involuntary, but which is electrically silent. The main distinguishing features of cramps from  dystonia  are suddenness with acute onset of pain, involvement of only one muscle and spontaneous resolution of cramps or their resolution after stretching the affected muscle. [ 2 ]   Restless leg syndrome  is not considered the same as muscle cramps and should not be confused with rest cramps. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2835", "text": "Skeletal muscle cramps may be caused by  muscle fatigue  or a lack of  electrolytes [ citation needed ]  such as  sodium  (a condition called  hyponatremia ),  potassium  (called  hypokalemia ), or  magnesium  (called  hypomagnesemia [ 8 ] ). Some skeletal muscle cramps do not have a known cause. [ 6 ]  Motor neuron disorders (e.g.,  amyotrophic lateral sclerosis ),  metabolic disorders  (e.g.,  liver failure ), some medications (e.g.,  diuretics  and inhaled  beta\u2010agonists ), and  haemodialysis  may also cause muscle cramps. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2836", "text": "Causes of cramping include [ 9 ]   hyperflexion ,  hypoxia , exposure to large changes in temperature, dehydration, or  low blood salt . Muscle cramps can also be a symptom or complication of  pregnancy ;  kidney  disease;  thyroid  disease;  hypokalemia ,  hypomagnesemia , or  hypocalcaemia  (as conditions);  restless legs syndrome ;  varicose veins ; [ 10 ]  and  multiple sclerosis . [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2837", "text": "As early as 1965, researchers observed that leg cramps and restless legs syndrome can result from excess  insulin , sometimes called  hyperinsulinemia . [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2838", "text": "Under normal circumstances,  skeletal muscles  can be voluntarily controlled. Skeletal muscles that cramp the most often are the  calves ,  thighs , and  arches of the foot , and in North America are sometimes called a \" Charley horse \" or a \"corky\". Such cramping is associated with strenuous physical activity and can be intensely painful; however, they can even occur while inactive and relaxed. Around 40% of people who experience skeletal cramps are likely to endure extreme muscle pain, and may be unable to use the entire limb that contains the \"locked-up\" muscle group. It may take up to a week for the muscle to return to a pain-free state, depending on the person's fitness level, age, and several other factors. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2839", "text": "Nocturnal  leg cramps are involuntary muscle contractions that occur in the  calves ,  soles  of the feet, or other muscles in the body during the night or (less commonly) while resting. The duration of nocturnal leg cramps is variable, with cramps lasting anywhere from a few seconds to several minutes. Muscle soreness may remain after the cramp itself ends. These cramps are more common in older people. [ 13 ]  They happen quite frequently in teenagers and in some people while exercising at night. Besides being painful, a nocturnal leg cramp can cause much  distress  and  anxiety . [ 14 ]  The precise cause of these cramps is unclear. Potential contributing factors include  dehydration , low levels of certain minerals ( magnesium ,  potassium ,  calcium , and  sodium , although the evidence has been mixed), [ 15 ] [ 16 ] [ 17 ]  and reduced blood flow through muscles attendant in prolonged sitting or lying down. Nocturnal leg cramps (almost exclusively calf cramps) are considered \"normal\" during the late stages of pregnancy. [ 18 ]  They can, however, vary in intensity from mild to extremely painful. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2840", "text": "A lactic acid buildup around muscles can trigger cramps; however, they happen during anaerobic respiration when a person is exercising or engaging in an activity where the heartbeat rises. Medical conditions associated with leg cramps are cardiovascular disease, hemodialysis, cirrhosis, pregnancy, and lumbar canal stenosis. Differential diagnoses include  restless legs syndrome ,  claudication ,  myositis , and  peripheral neuropathy . All of them can be differentiated through careful history and physical examination. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2841", "text": "Gentle  stretching  and  massage , putting some pressure on the affected leg by walking or standing, or taking a warm bath or shower may help to end the cramp. [ 19 ]  If the cramp is in the calf muscle, dorsiflexing the foot (lifting the toes back toward the shins) will stretch the muscle and provide almost immediate relief. There is limited evidence supporting the use of magnesium,  calcium channel blockers ,  carisoprodol , and  vitamin B 12 . [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2842", "text": "Quinine  is no longer recommended for treatment of nocturnal leg cramps due to potential fatal hypersensitivity reactions and  thrombocytopenia .  Arrhythmias ,  cinchonism , and  hemolytic uremic syndrome  can also occur at higher dosages. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2843", "text": "Various medications may cause nocturnal leg cramps: [ 17 ] [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2844", "text": "Statins  may sometimes cause  myalgia  and cramps among other possible side effects.  Raloxifene  (Evista) is a medication associated with a high incidence of leg cramps. Additional factors, which increase the probability for these side effects, are physical exercise, age, history of cramps, and  hypothyroidism . Up to 80% of athletes using statins experience significant adverse muscular effects, including cramps; [ 21 ]  the rate appears to be approximately 10\u201325% in a typical statin-using population. [ 22 ] [ 23 ]  In some cases, adverse effects disappear after switching to a different statin; however, they should not be ignored if they persist, as they can, in rare cases, develop into more serious problems.  Coenzyme Q10  supplementation can be helpful to avoid some statin-related adverse effects, but currently there is not enough evidence to prove the effectiveness in avoiding myopathy or myalgia. [ 24 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2845", "text": "Stretching, massage, and drinking plenty of liquids may be helpful in treating simple muscle cramps. [ 25 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2846", "text": "The antimalarial drug  quinine  is a traditional treatment that may be slightly effective for reducing the number of cramps, the intensity of cramps, and the number of days a person experiences cramps. Quinine has not been shown to reduce the duration (length) of a muscle cramp. [ 6 ]  Quinine treatment may lead to haematologic and cardiac toxicity. Due to its low effectiveness and negative side effects, its use as a medication for treating muscle cramps is not recommended by the FDA. [ 26 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2847", "text": "Magnesium is commonly used to treat muscle cramps. Moderate quality evidence indicates that magnesium is not effective for treating or preventing cramps in older adults. [ 6 ]  It is not known if magnesium helps cramps due to pregnancy, liver  cirrhosis , other medical conditions, or exercising. [ 6 ]  Oral magnesium treatment does not appear to have significant major side effects, however, it may be associated with diarrhea and nausea in 11\u201337% of people who use this medicine. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2848", "text": "With exertional heat cramps due to  electrolyte abnormalities  (primarily potassium loss and not calcium, magnesium, and sodium), appropriate fluids and sufficient potassium improves symptoms. [ 27 ]   Vitamin B complex ,  naftidrofuryl ,  lidocaine , and  calcium channel blockers  may be effective for muscle cramps. [ 26 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2849", "text": "Adequate conditioning, stretching, mental preparation, hydration, and electrolyte balance are likely helpful in preventing muscle cramps. [ 25 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2850", "text": "Cricopharyngeal spasms  occur in the  cricopharyngeus muscle  of the  pharynx . Cricopharyngeal spasm is an uncomfortable but harmless and  temporary  disorder."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2851", "text": "There are two  sphincters  in the  oesophagus . They are normally contracted and they relax when one swallows so that food can pass through them going to the  stomach . They then squeeze closed again to prevent regurgitation of the stomach contents and prevent air from entering the digestive system. If this normal contraction becomes a  spasm , these symptoms begin."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2852", "text": "Causes include stress and anxiety. Other causes are not yet clear."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2853", "text": "The condition persists in the  autonomic nervous system  even when the original stress is relieved."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2854", "text": "An assumption in  psychiatry  is that a lack of  serotonin  can be associated with  depression  and  anxiety . A further assumption is that a low levels of serotonin can causes spasms in the cervical area. [ 1 ]  A plausible explanation for the cricopharyngeal spasms is a lack of neurotransmitter preventing the  central nervous system  from detecting that the  eosophagus  is closed, so that the  upper esophagus sphincter  becomes, randomly, hypertonic."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2855", "text": "The condition can appear as a symptom of the  generalized anxiety disorder . Early signs are other symptoms like difficulty or inability to eat (loss of appetite,  satiety  after swallowing minor quantities),  headache , dry mouth at night, sleeping issues,  tremor , tension in the neck, in the throat, abdominal, stomach or chest pain etc. The sequence can result from a recent  stress ,  panic attack  or  worry ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2856", "text": "The subject heads to cricopharyngeal spasms when, for instance, eating pasty food requiring more throat cleanings, like peanuts, pumpkin seeds and other nuts, becomes painful [ citation needed ] . Continuous swallowing appears with the spasms as the brain interprets the feeling as something stuck."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2857", "text": "The  vagus nerves  seems to play a role in the mother condition through a  neurovegetative hyperactivity  or  dysautonomia . It innerves the  inferior pharyngeal constrictor muscle  where the cricopharyngeal spasms occur."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2858", "text": "Throat spasms can also appear after an accident, a disease, may be caused or worsened by  GERD . There may be hereditary factors."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2859", "text": "In the context of  long covid  psychiatrists envisioned a potential relationship with an immune reaction, involving  cytokines , that would persist quietly. [ 2 ]  However, due the anxiogenic situation, stress was again present when the symptoms started."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2860", "text": "These spasms are frequently misunderstood by the patient to be  cancer  due to the 'lump in the throat' feeling ( Globus pharyngis ) that is symptomatic of this syndrome."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2861", "text": "All the anatomic examinations can appear normal despite the condition. The throat  endoscopy  can objectify that nothing is stuck, that there is no lesion or inflammation. The  barium swallow  can miss that the sphincter is hypertonic if it does not happen during the examination, or if the sphincter still relaxes enough for the food bolus to go through. The  esophageal manometry  cannot detect any abnormal wave."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2862", "text": "The cricopharyngeal spasms (\"feeling that something is stuck\") occur in the cricopharyngeal part of the  inferior pharyngeal constrictor muscle , at the bottom of the throat. They cause muscle tension on the  cricoid cartilage , leading to a  globus feeling . Pharyngeal spasms, a more common source of a  globus feeling , cause tension on the  thyroid cartilage . They move up and down, left and right in the  pharyngeal muscles . Both may be present."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2863", "text": "The patient complains about the signs and symptoms enumerated above. The pain causes dry deglutition and dry deglutition adds to the pain, triggering a vicious circle. The spams start after dry deglutition, after the meals or randomly during the day. They can start (and stop) brutally. Or softly, by the feeling that a small pill is stuck, frictions around it, then the impression that a ball is stuck. When the spasms last long they can give the impression of a knife stabbed in the throat."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2864", "text": "The cricopharyngeal spasms can be, for instance, formally diagnosed as part of the more general condition. For instance, did the patient recently encounter other symptoms of the  generalized anxiety disorder ? Does the patient have  neurovegetative symptoms ? Are there symptoms of  dysautonomia ? Is there evidence of a lack of serotonin, like no sleep ( melatonin  is generated from serotonin)? Is there any other  psychiatric  condition?"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2865", "text": "Cricopharyngeal spasms remain a rare symptom. Difficulties for the patient to describe an unusual symptom and for the practitioners to figure out the condition can entail a prompt diagnosis."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2866", "text": "The condition is known to be temporary. In some individuals it can disappear by itself without medication. For others, it can stagnate or worsen until appropriate medical care is given."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2867", "text": "Since the problem can last, medical specialists are not readily available and potential treatments act slowly, patience is required. During that time, finding distractions and support is a first help. Attention should be paid to not increase the levels of stress and anxiety, or fall into  depression  because of the symptom or its root cause."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2868", "text": "The medical specialists to consult are  ENT specialist  and  psychiatrist :"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2869", "text": "A cure for the condition exists and number of treatments may provide a relief."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2870", "text": "Treatments based on medicines"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2871", "text": "A typical treatment that can be prescribed starts, for instance, with nidefipine (as long as it brings a relief), a benzodiazepine (one month maximum) that has a myorelaxant effect and that can be chosen to simultaneously address other faces of the problem (anxiety, sleeping issue) and a well-tolerated anti-depressant like escitalopram (long enough so that the problem does not come back)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2872", "text": "Treatments based on other factors"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2873", "text": "Other therapies"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2874", "text": "Diastasis recti ,  or  rectus abdominis diastasis , is an  increased gap  between the right and left  rectus abdominis muscles . [ 1 ]  The increased distance between the muscles is created by the stretching of the  linea alba , a connective collagen sheath created by the  aponeurosis  insertions of the  transverse abdominis ,  internal oblique , and  external oblique . [ 2 ]  This condition has no associated morbidity or mortality. Physical therapy is often required to repair this separation and surgery is an option for more severe cases. Standard exercise rarely results in complete healing of the separated muscles. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2875", "text": "Diastasis of the rectus abdominis muscle most frequently occurs in  newborns  and  pregnant women ; however, it may occur in any adult woman or man. In the newborn, the rectus abdominis is not fully developed and may not be sealed together at midline. Diastasis recti is more common in  premature  newborns. In pregnant or  postpartum  women, the condition is caused by the stretching of the rectus abdominis by the growing uterus. It is more common in  multiparous  women (women who have had multiple pregnancies) owing to repeated episodes of stretching. When the defect occurs during pregnancy, the uterus can sometimes be seen bulging through the abdominal wall beneath the skin. Non-pregnant women are more susceptible to develop diastasis recti when over the age of 35 or with high birth weight of child, multiple birth pregnancy, or multiple pregnancies. Additional causes can be attributed to excessive abdominal exercises after the first trimester of pregnancy. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2876", "text": "Strength training of all the core muscles, including the abdominis recti muscle, may reduce the size of the gap in pregnant or postpartum women.  Crunches  may increase the diastasis recti separation. All corrective exercises should be in the form of pulling in the abdominal muscles rather than pushing them outwards. In extreme cases diastasis recti is corrected with a  cosmetic surgery  procedure known as an  abdominoplasty  by creating a plication, or folding, of the linea alba and suturing it together, which results in a tighter abdominal wall."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2877", "text": "A diastasis recti may appear as a ridge running down the midline of the abdomen, anywhere from the  xiphoid process  to the  umbilicus . It becomes more prominent with straining and may disappear when the abdominal muscles are relaxed. The medial borders of the right and left halves of the muscle may be palpated during contraction of the rectus abdominis. [ 5 ]  The condition can be diagnosed by physical exam, and must be differentiated from an  epigastric hernia  or  incisional hernia , if the patient has had abdominal surgery. [ 3 ]  Hernias may be ruled out using ultrasound. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2878", "text": "In infants, they typically result from a minor defect of the linea alba between the rectus abdominis muscles. This allows tissue from inside the abdomen to herniate anteriorly. On infants, this may manifest as an apparent 'bubble' under the skin of the belly between the  umbilicus  and  xiphisternum  (bottom of the breastbone). [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2879", "text": "Examination is performed with the subject lying on the back, knees bent at 90\u00b0 with feet flat, head slightly lifted placing chin on chest. With muscles tense, the examiner then places fingers in the ridge that is presented. Measurement of the width of separation is determined by the number of fingertips that can fit within the space between the left and right  rectus abdominis  muscles. Separation consisting of a width of 2\u00a0fingertips (approximately 1\u00a01/2\u00a0centimeters) or more is the determining factor for diagnosing diastasis recti. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2880", "text": "Diastasis recti can be diagnosed by  physical examination , which may include measuring the distance between the  rectus abdominis muscles  at rest and during contraction at several levels along the  linea alba . [ 9 ]  Diastasis recti is defined as a gap of about 2.7\u00a0cm or greater between the two sides of the  rectus abdominis muscle . [ 1 ]   Abdominal ultrasonography  provides objective evidence for the diagnosis, and also confirms that the bulge is not a  hernia . [ 9 ]  An  abdominal CT scan  may also visualise diastasis recti. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2881", "text": "A 2014 systematic review found that the width of the gap in diastasis recti may be reduced by exercising during and after pregnancy. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2882", "text": "A 2018 review mentions other techniques in addition to strengthening exercises: postural training; education and training for proper lifting mechanisms; manual therapy (which includes soft tissue mobilization);  myofascial release ; Noble technique (i.e., manual approximation of abdominal muscles during partial sit-up); and abdominal bracing and taping. Other techniques to strengthen abdominal muscles are using  Pilates  and functional training. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2883", "text": "In extreme cases, diastasis recti is corrected with a  cosmetic surgery  procedure known as an  abdominoplasty  by creating a plication or folding of the linea alba and suturing together. This creates a tighter abdominal wall. There are two surgical methods: one more common through plication of the anterior rectus sheath; and the other through  hernia repair , considering suture closure of the hernia sac combined with mesh reinforcement. Two studies showed few post-operative complications. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2884", "text": "Distal spinal muscular atrophy type 2  ( DSMA2 ), also known as  Jerash type distal hereditary motor neuropathy  ( HMNJ ), is a very rare childhood-onset genetic disorder characterised by progressive muscle wasting affecting lower and subsequently upper limbs. The disorder has been described in  Arab  inhabitants of  Jerash  region in  Jordan [ 1 ] [ 2 ]  as well as in a Chinese family. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2885", "text": "The condition is linked to a genetic  mutation  in the  SIGMAR1  gene on  chromosome 19  ( locus  19p13.3) and is likely inherited in an  autosomal recessive  manner. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2886", "text": "This article about a medical condition affecting the nervous system is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2887", "text": "Dynapenia  (pronounced dahy-nuh-p\u0113-n\u0113-a,  Greek  translation for poverty of strength, power, or force) is the loss of muscular strength not caused by neurological or muscular disease that typically is associated with older adults. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2888", "text": "Dynapenia is the loss of muscle strength, rather than the loss of muscle mass ( sarcopenia ). The preservation of muscular strength through the aging process has become increasingly significant with increasing life expectancy in the modern world."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2889", "text": "The muscular degeneration that occurs throughout the aging process has been one of the greatest concerns of mankind for thousands of years. Greeks of the 4th and 5th centuries BC viewed aging as a chronic, incurable, and progressive disease. By the 1st century BC and 1st century AD, aging began to be thought of as something that is modifiable and should be resisted. In  Cicero \u2019s \u2018Essay on Old Age\u2019 from 44 BC he states that \u201cit is our duty\u2026 to resist old age, to compensate for its defects, to fight against it as we would fight a disease; to adopt a regimen of health; to practice moderate exercise; and to take just enough food and drink to restore our strength.\u201d [ 2 ]  Cicero also highlights the restrictions aging has forced upon mankind for centuries; restrictions that we are now trying to overcome with today's technology. \u201cOld age,\u201d it seems, \u201cdisqualifies us from taking an active part in the great scenes of business. But in what scenes? let me ask. If in those which require the strength and vivacity of youth, I readily admit the charge.\u201d  [ 2 ]  Although aging has always been perceived as a paradox that plagues humanity, the idea of formulating preventative treatments didn't advance until the latter part of the 20th century. With the rapid advancement of today's technology and the unprecedented growth rate of the world's older population, the drive of the scientific community to delay the aging process has significantly increased. \u201cThe next imputation thrown upon old age is, that it impairs our\nstrength, and it must be acknowledged the charge is not altogether without foundation. But, for my part, I no more regret the want of that vigour which I possessed in my youth, than I lamented in my youth that I was not endowed with the force of a bull or an elephant. It is sufficient if we exert with spirit, upon every proper occasion, that degree of strength which still remains with us.\u201d  [ 2 ]  The aging process remains an inevitable part of the life cycle, but science is now being used to treat the deterioration of the human body so that the aging population can live with independence and comfort. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2890", "text": "Sarcopenia  is defined as loss of muscle tissue as a natural part of the aging process. [ 3 ] \nThis does not include loss of muscle strength, which is defined by dynapenia.  Muscle strength appears to be a critical component in maintaining physical function, mobility, and vitality in old age, which is why it's imperative to identify and study contributing factors of dynapenia. A longitudinal study on the age-related changes in muscle strength, quality, and inter muscular fat showed an increase in  adipose tissue  infiltration of mid thigh skeletal muscle in both men and women ranging between 70 and 79 years-old during a 5-year period. The increase in fatty tissue infiltration occurred regardless of changes in weight or subcutaneous thigh adipose tissue. The study also found that the decrease in muscle strength due to aging was 2-5 times greater than the loss of muscle size. These results demonstrate the age-related progression of muscle weakness and muscular fat infiltration regardless of changes in muscle mass or subcutaneous fat, reinforcing that muscle quality is lost with aging. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2891", "text": "The age-associated deterioration of force-generating properties of skeletal muscles can be directly associated with increased risk of physical disability, [ 5 ] [ 6 ]  functional impairments, [ 7 ] [ 8 ] [ 9 ] [ 10 ] [ 11 ] [ 12 ] [ 13 ]  and increased mortality. [ 14 ] [ 15 ] [ 16 ] [ 17 ]  Dynapenia can contribute to increased risk of falling as well as feeling weak and/or fatigued. With regard to the relation of higher levels of muscular strength to a lower risk of premature death, studies by Newman et al. [ 14 ]  have shown that grip and  knee extensor  muscle strength are strongly correlated with mortality. For women, they observed crude  hazard ratios  of 1.84 for  grip strength  and 1.65 for knee extensor strength. For men, they observed crude hazard ratios of 1.36 for grip strength and 1.51 for knee extensor strength. More recent studies by Xue et al. [ 15 ]  have observed that faster decline in  hip flexor  and grip strengths individually predicted mortality after accounting for potential contributors. Manini et al. [ 18 ]  recently conducted an informal meta-analysis that showed significant correlation between low levels of muscle strength and poor physical performance and/or physical disability in 90% of the studies. Together, these studies provide evidence that dynapenia in older adults is strongly correlated with increased risk of physical disabilities and mortality, and decreased physical function. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2892", "text": "There currently is no agreed upon algorithm to diagnose dynapenia. Lack of consensus upon how to properly diagnose the disease has prevented practitioners from determining if muscle weakness likely plays a role in an individual's disability or poor physical performance. Manini and Clark have proposed a decision algorithm for the diagnosis of dynapenia. [ 18 ]  The algorithm begins by screening individuals aged over 60 years for dynapenia, and those with high risk factors for the development of dynapenia are referred for a knee extension strength assessment. If an individual presents no or low risk factors, it is suggested that they undergo a grip strength test to decide if a lower extremity strength test is needed. Follow-up testing is then recommended based on the results of these tests to determine the etiology of dynapenia. It's important to note that dynapenia is defined based on muscle strength rather than muscle power because both factors perform similarly when identifying individuals with physical disability or poor physical performance. A recent study from Bean and colleagues [ 19 ]  showed that older adults with mobility limitations who participated in a 16-week \u201cpower-training\u201d exercise program were able to raise their leg press power about 10% more than the group that participated in a traditional \u201cstrength-training\u201d exercise program. Both groups exhibited equivalent increases in muscle strength and mobility performance, despite the 10% difference in muscle power. Also, there is a limited amount of data on muscle power from  epidemiological  studies of aging. The equipment to measure muscle strength is also more readily available than equipment used to measure muscle power. [ 18 ]  Together, these factors justify the reasoning behind using muscle strength to define dynapenia rather than muscle power. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2893", "text": "Three principal risk factors stand out when considering preemptive components of dynapenia. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2894", "text": "Possible biological contributors to dynapenia include the  nervous system \u2019s deteriorating control of  voluntary skeletal muscle  activation and a decreased number of functioning  motor units . [ 23 ] [ 24 ]  The nervous system's lowered ability to stimulate a full muscle contraction subsequently leads to loss of muscle strength and power. A study by Harridge et al. [ 21 ]  also showed that all dynapenic subjects had incomplete voluntary activation during a maximum contraction (69-93%), suggesting that loss of voluntary muscle activation plays an important role in the loss of muscle strength. Studies involving the dissection of  cadavers  have uncovered a 43% decrease in the cell body size of  neurons  found in the  premotor cortex  compared to those of younger adults. [ 25 ]  New studies have recently verified this finding in living subjects using high resolution  magnetic resonance imaging  (MRI). [ 26 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2895", "text": "Recent evidence suggests that aging is also related to the loss of  myelinated  nerve fiber length and the mass of  white matter , with individuals losing approximately 45% of total nerve fiber length as they age. [ 27 ] \n [ 28 ]  These changes that develop through the aging process affect the connectivity of the cortex within itself as well as its connectivity to the rest of the central nervous system. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2896", "text": "Another potential contributor to dynapenia is a disruption of the process that converts electrical signal given for muscular activation into an actual contraction. Particularly, impairments in the release of  calcium  (Ca2+) from the  sarcoplasmic reticulum  have been suggested to explain why decreased muscle quality is so prevalent in older adults. [ 29 ] \n [ 30 ] \n [ 31 ] \n [ 32 ] \n [ 33 ] \n [ 34 ] \n [ 35 ] \n [ 36 ] \n [ 37 ] \n [ 38 ] [ 39 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2897", "text": "A systematic review on the literature regarding the relationship between type II muscle fiber loss and aging found that the total number of fibers in the  vastus lateralis  decreases tremendously with age. [ 40 ]  This decline is first observed around 25 years of age and proceeds at an even greater rate throughout the lifespan. The age-related Type II fiber loss highlights the negative effect of aging on muscle power. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2898", "text": "It has also been suggested that nutritional factors may contribute to the onset of dynapenia. It has been proposed that low levels of  Vitamin E , [ 41 ] \n [ 42 ] [ 43 ] carotenoids , [ 41 ] [ 44 ]  and  selenium [ 45 ] \n [ 46 ]  are associated with lower levels of muscle strength. The activity of  Vitamin D  receptors on muscle has been found to decrease with aging. These receptors initiate the nuclear response leading to  de novo synthesis  of proteins. [ 47 ]  However, the results of multiple studies on the relation between Vitamin D and muscle strength have been highly controversial, making the effect of Vitamin D on muscle strength in need of further investigation.  The Recommended Dietary Allowance (RDA) for protein is not very clear for older adults; it may underestimate the amount of protein needed to maintain optimal physical function with age. A study by Houston and colleagues showed how decreased protein intake may increase the risk of developing mobility limitations later on. [ 48 ]  The study revealed that 35.4% out of 43% of participants who consumed a significantly smaller amount of protein (mean: 0.38 g/kg body weight/d) than the RDA (0.8 g/kg body weight/d) developed mobility limitations over the 6 year follow-up. In contrast, participants who consumed more protein (mean: (\u22651.0 g/kg body weight/d) than the RDA had a lower risk of developing mobility limitations over the 6 year follow-up. [ 48 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2899", "text": "Resistance training  has been shown to greatly influence virtually all of the strength related physiological mechanisms of the nervous and skeletal muscle systems - even into very late life. Recent studies by Peterson et al. [ 49 ]  have uncovered two critical aspects of resistance training that must be implemented in the training process to achieve positive results. One factor is the positive correlation between higher intensity resistance training and greater improvements in muscle strength. The other factor is a direct relationship between increased resistance training volume, which is the total number of exercise sets performed in a session, and improvements in lean body mass. [ 50 ]  A meta-analysis on the effect of resistance exercise for multiple strength outcomes in older adults revealed a positive effect for each of the strength outcomes. Specifically, the estimate of mean strength change from baseline to post intervention for the leg press was 31.63\u00a0kg. There was a mean strength change of 9.83\u00a0kg for the chest press, 12.08\u00a0kg for the knee extension, and 10.63\u00a0kg for the lat pull. [ 49 ]  These results demonstrate that resistance training is an effective way to improve the muscular strength capacity of older adults."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2900", "text": "By defining strength cutoff values and establishing a clinical definition of dynapenia, treatment and prevention plans could be developed to decrease the physical limitations of older adults. The creation of an agreed-upon definition of dynapenia could give clinicians the ability to diagnose patients with decreased muscle function and expand research on the subject by providing a universal standard, which in turn could lead to the development of effective interventions and treatment options. [ 1 ]  Gathering a firmer understanding of what causes dynapenia will help determine the degree of variance in the biological contributions of participants, and provide insight into how treatment options may be adapted to fit patients\u2019 unique needs. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2901", "text": "Although they vary in particulars,  polymyositis ,  dermatomyositis  and  inclusion body myositis  are idiopathic inflammatory myopathies (IIM) [ 1 ]  primarily characterized by chronic  inflammation  of human  skeletal muscle  tissue [ 2 ]  that ultimately causes the  necrosis  of muscle cells.  This degeneration leads to muscle tissue wasting, weakness and fatigue among other serious effects.  Until recently, exercise has been avoided as a type of therapy, and even forbidden due to the risk of triggering or amplifying inflammation.  However, several studies have been conducted to test this assumption and have shown that  aerobic exercise  as well as  resistance training  can maintain and even improve quality of life for IIM-affected individuals without increased  inflammatory response . [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2902", "text": "With the main goals of treatment being improved functionality and quality of life, exercise programs should focus on \"functional\" exercises (e.g. walking, walking up/down stairs, sit-to-stand), when applicable. Performing functional exercises increases (a) the efficiency of the exercise program and (b) the likelihood the improvements will be transferred to activities of daily living. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2903", "text": "In 1993,  isometric exercise  training was applied for four weeks resulting in isometric peak power at 60% of maximal voluntary contraction. [ 5 ]  The increase in isometric power was later shown to have no significant effect on serum  creatine kinase  (CK) after two weeks of  strength training . [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2904", "text": "A six-week training program in 1998 that included 30 minutes of  aerobic activity  three times per week set at 60% maximum heart rate (predicted by age) resulted in increased  VO 2  max  (i.e. maximal oxygen consumption or aerobic capacity), diminished pain, reduced muscle impairment, and improved quality of life. [ 7 ] [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2905", "text": "The results produced by aerobic activity were repeated in 1999 [ 9 ]  where for 12 weeks, weight-bearing exercise was added for patients not exhibiting marked physical incapacity as measured by the Functional Index in Myositis [ 10 ]  (see Functional Assessment section). Confirmed by MRI and muscle biopsy, both the 1998 and 1999 studies showed that there were no significant changes in levels of creatine kinase and  aldolase , and no increase in muscle inflammation. In 2001, 22 patients were placed on a three-week physical therapy and exercise program, and found that creatine kinase levels actually dropped in 20 of the patients. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2906", "text": "The longest study to date was a six-month exercise program demonstrating a significant improvement in exercise capacity, VO 2 ,  isokinetic  strength, and the ability to perform daily tasks compared to controls. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2907", "text": "Chest expansion and thoracic extension exercises may offer preventive support to those at risk of  restrictive lung disease  through the effects of IIM, and patients with inclusion body myositis may also be able to prevent contracture and extend functional daily activities through stretching and range of motion exercises. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2908", "text": "It is important to recognize that all described exercise programs were conducted by physicians or physiotherapists during the stable phase of the disease (except Painelli [ 3 ] ). Patients were monitored closely for indicators of deleterious effects, such as increases in serum creatine kinase, inflammation or weakness.  Monitoring of this kind can only be done in conjunction with a medical team who is aware of the risks posed by increased  inflammatory response  in patients with IIM. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2909", "text": "The pathophysiology of IIMs is not well understood. Muscle weakness can be caused by a single or combined effect on muscle tissue by inflammation, inflammatory infiltrates, muscle atrophy, metabolic abnormalities that indicate disordered energy metabolism, [ 2 ]  and possibly neuropathy, [ 13 ]  among others. Therefore, physical exercise has the potential to cause harm."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2910", "text": "However, the results of these exercise studies, at minimum, show that exercise can attenuate muscle damage due to disease, inactivity and steroid use. [ 3 ]   They reflect the benefit of exercise through the strengthening of complement (non-diseased) muscles, and should encourage further studies to confirm whether diseased muscle may experience regeneration. The definition of improvement must be established, [ 2 ]  and reproducible longitudinal studies must be conducted to determine the efficacy of exercise as therapy for IIM. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2911", "text": "Exercise-associated muscle cramps  (EAMC) are defined as  cramping  (painful muscle spasms) during or immediately following exercise. [ 1 ] [ 2 ] [ 3 ]  Muscle cramps during exercise are very common, even in elite athletes. EAMC are a common condition that occurs during or after exercise, often during endurance events such as a triathlon or marathon. [ 1 ] [ 3 ]  Although EAMC are extremely common among athletes, the cause is still not fully understood because muscle cramping can occur as a result of many underlying conditions. Elite athletes experience cramping due to paces at higher intensities. [ 2 ] [ 3 ]  The cause of exercise-associated muscle cramps is hypothesized to be due to altered neuromuscular control,  dehydration , or  electrolyte  depletion. [ 1 ] [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2912", "text": "It is widely believed that excessive sweating due to strenuous exercise can lead to muscle cramps. Deficiency of sodium and other electrolytes may lead to contracted interstitial fluid compartments, which may exacerbate the muscle cramping. According to this theory, the increased blood plasma  osmolality  from sweating sodium losses causes a fluid shift from the interstitial space to the intervascular space, which causes the interstitial fluid compartment to deform and contributes to muscle hyperexcitability and risk of spontaneous muscle activity. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2913", "text": "The second hypothesis is altered neuromuscular control.  In this hypothesis, it is suggested that cramping is due to altered neuromuscular activity.  The proposed underlying cause of the altered neuromuscular control is due to  fatigue . [ 2 ]   There are several disturbances, at various levels of the central and peripheral nervous system, and the skeletal muscle that contribute to cramping. These disturbances can be described by a series of several key events.  First and foremost, repetitive muscle exercise can lead to the development of fatigue due to one or more of the following: inadequate conditioning, hot and or humid environments, increased intensity, increased duration, and decreased supply of energy.  Muscle fatigue itself causes increased excitatory  afferent  activity within the  muscle spindles  and decreased inhibitory afferent activity within the Golgi tendon.  The coupling of these events leads to altered neuromuscular control from the spinal cord. A cascade of events follow the altered neuromuscular control; this includes increased alpha- motor neuron  activity in the spinal cord, which overloads the lower motor neurons, and increased muscle cell membrane activity. [ 2 ]  Thus, the resultant of this cascade is a muscle cramp. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2914", "text": "Medication has not been found to help reduce or prevent muscle cramping. To prevent or treat, athletes are recommended to stretch, stop movement and rest, massaging the area that is cramping, or drink fluids. Stretching helps to calm down spindles by lengthening the muscle fibers and increase firing duration to slow down the firing rate of the muscle. [ 1 ]  Recommended fluids during cramping are water or fluids that are high in electrolytes to replenish the system with sodium. [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2915", "text": "Exertional rhabdomyolysis  ( ER ) is the breakdown of  muscle  from extreme physical exertion. It is one of many types of  rhabdomyolysis  that can occur, and because of this, the exact  prevalence  and incidence are unclear."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2916", "text": "ER is more likely to occur when strenuous exercise is performed under high temperatures and humidity. [ 1 ]  Poor  hydration  levels before, during, and after strenuous bouts of  exercise  have also been reported to lead to ER. [ 2 ]  This condition and its signs and symptoms are not well known amongst the sport and fitness community and because of this it is believed that the incidence is greater but highly underreported. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2917", "text": "Risks that lead to ER include exercise in hot and humid conditions, improper hydration, inadequate recovery between bouts of exercise, intense physical training, and inadequate  fitness  levels for beginning high-intensity workouts. [ 3 ]   Eccentric contraction  of muscles can result in ER more often than  concentric contraction . [ 4 ]   Dehydration is one of the biggest factors that can give almost immediate feedback from the body by producing very dark-colored urine. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2918", "text": "Exertional rhabdomyolysis results from damage to the intercellular proteins inside the  sarcolemma .  Myosin  and  actin  break down in the  sarcomeres  when  ATP  is no longer available due to injury to the  sarcoplasmic reticulum . [ 6 ]  Damage to the sarcolemma and sarcoplasmic reticulum from direct trauma or high force production causes a high influx of  calcium  ions into the muscle fibers increasing calcium permeability. Calcium ions build up in the  mitochondria , impairing cellular respiration. [ 7 ]  The mitochondria are unable to produce enough ATP to power the cell properly. Reduction in ATP production impairs the cells' ability to extract calcium from the muscle cell."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2919", "text": "The ion imbalance causes calcium-dependent enzymes to activate which break down muscle proteins even further. [ 8 ]  A high concentration of calcium activates muscle cells, causing the muscle to contract while inhibiting its ability to relax."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2920", "text": "The increase of sustained muscle contraction leads to oxygen and ATP depletion with prolonged exposure to calcium. The muscle cell membrane pump may become damaged allowing free form myoglobin to leak into the bloodstream. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2921", "text": "Rhabdomyolysis causes the  myosin  and  actin  to degenerate into smaller proteins that travel into the circulatory system. The body reacts by increasing intracellular swelling to the injured tissue to send repair cells to the area. This allows  creatine kinase  and  myoglobin  to be flushed from the tissue where it travels in the blood until reaching the kidneys. [ 10 ]  In addition to the proteins released, large quantities of ions such as intracellular potassium, sodium, and chloride find their way into the circulatory system. Intracellular potassium ion has deleterious effects on the heart's ability to generate action potentials leading to cardiac arrhythmias. [ 11 ]   Consequently, this can affect peripheral and central perfusion which in turn can affect all major organ systems in the body. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2922", "text": "When the protein reaches the kidneys it causes a strain on the anatomical structures reducing its effectiveness as a filter for the body. The protein acts as a dam as it forms into tight aggregates when it enters the renal tubules. [ 11 ]  In addition, the increased intracellular  calcium  has greater time to bind due to the blockage allowing for renal calculi to form. [ 12 ]  As a result this causes urine output to decrease allowing for the uric acid to build up inside the organ. The increased acid concentration allows the iron from the aggregate protein to be released into the surrounding renal tissue. [ 13 ]  Iron then strips away molecular bonds of the surrounding tissue which eventually will lead to kidney failure if the tissue damage is too great. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2923", "text": "Muscle degeneration from rhabdomyolysis destroys the myosin and actin filaments in the affected tissue. This initiates the body's natural reaction to increasing  perfusion  to the area allowing for an influx of specialized cells to repair the injury. However, the swelling increases the intracellular pressure beyond normal limits. As the pressure builds in the muscle tissue, the surrounding tissue is crushed against the underlying tissue and bone. [ 14 ]  This is known as  compartment syndrome  which leads to greater death of the surrounding muscle tissue around the injury. [ 14 ]   As the muscle dies this will cause pain to radiate from the affected area into the compartmentalized tissue. A loss of range of motion from swelling will also be seen in the affected limb. Along with muscle strength weakness associated with the muscles involved from loss of filament interaction. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2924", "text": "Dehydration  is a common risk factor for exertional rhabdomyolysis because it causes a reduction of plasma volume during exertion. This leads to a reduction of blood flow through the vascular system which inhibits blood vessel constriction. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2925", "text": "Exertional rhabdomyolysis, the exercise-induced muscle breakdown that results in muscle pain/soreness, is commonly diagnosed using the urine myoglobin test accompanied by high levels of  creatine kinase  (CK).  Myoglobin  is the protein released into the bloodstream when  skeletal muscle  is broken down. The urine test simply examines whether myoglobin is present or absent. When results are positive the  urine  normally obtains a dark, brown color followed by serum CK level evaluation to determine the severity of muscle damage. Elevated levels of serum CK greater than 5,000 U/L that are not caused by myocardial infarction,  brain injury  or disease, generally indicate serious muscle damage confirming the diagnosis of ER. [ 17 ] \nUrine is often a dark \"cola\" color as a result of the excretion of muscle cell components. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2926", "text": "Military data suggest that the risk of exertional rhabdomyolysis can be lowered by engaging in prolonged lower-intensity  exercise , as opposed to high-intensity exercise over a shorter time period.  In all athletic programs, three features should be present: (1) emphasizing prolonged lower-intensity exercise, as opposed to repetitive max intensity exercises; (2) adequate rest periods and a high- carbohydrate  diet, to replenish  glycogen  stores; and (3) proper hydration, to enhance renal clearance of myoglobin. [ 18 ]  Also, exercise in above-average temperature and  humidity  can increase risk for ER. [ 19 ]  ER can be avoided by gradually increasing intensity during new exercise regimens, properly hydrating,  acclimatization , and avoidance of diuretics during times of strenuous activity. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2927", "text": "After ER is diagnosed, treatment is applied to 1) avoid renal dysfunction and 2) alleviate  symptoms . This should be followed by recommended  rehabilitation  program,  exercise prescription  (ExRx).  Treatment  involves extensive  hydration  normally done through IV fluid replacement with administration of normal saline until CK levels reduce to a maximum of 1,000 U/L. [ 21 ]  Proper treatment will ensure hydration and normalize muscle discomfort (pain), flu-like symptoms, CK levels, and myoglobin levels for patient to begin ExRx. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2928", "text": "Although sufficient evidence is currently lacking, supplementation with a combination of sodium bicarbonate and mannitol is commonly utilized to prevent kidney failure in rhabdomyolysis patients. Sodium bicarbonate alkalizes urine to stop myoglobin from precipitating in renal tubules.  Mannitol  has several effects, including vasodilatation of the renal vasculature, osmotic diuresis, and free-radical scavenging. [ 22 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2929", "text": "Before initiating any form of physical activity, the individual must demonstrate a normal level of functioning with all previous  symptoms  absent. Physical activity should be supervised by a health care professional in case of a recurrence. However, in some low-risk individuals, supervision by a medical professional is not required as long as the individual follows up with weekly checkups. [ 23 ]  Proper hydration prior to performing physical activity and performing  exercise  in cool, dry environments may reduce the chances of developing a reoccurring episode of ER. [ 23 ]   Lastly, it is imperative for  urine  and blood values to be monitored along with careful observation for the redevelopment of any signs or symptoms. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2930", "text": "The recovery program focuses on progressive conditioning/reconditioning the individual and improving  functional  mobility. However, special considerations prior to participating in the rehabilitation program include the individual's 1) extent of muscle injury, if any 2) level of fitness before the incident and 3) weight training experience. [ 19 ]  These special considerations collectively are a form of assessing the individual's capacity to perform physical activity, which is ultimately used to specify the ExRx design. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2931", "text": "The actual cost for this condition is unknown and also dependent on the level of the condition. In some cases ER can lead to  acute kidney failure  and bring medical costs up due to the need for  hemodialysis  for recovery/treatment. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2932", "text": "Fanconi\u2013Bickel syndrome  is a form of  glycogen storage disease  named for  Guido Fanconi  and  Horst Bickel , [ 1 ] [ 2 ]  who first described it in 1949."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2933", "text": "It is associated with  GLUT2 , [ 3 ] [ 4 ]  a glucose transport protein which, when functioning normally, allows glucose to exit several tissues, including the liver, nephrons, and enterocytes of the intestines, and enter the blood. The syndrome results in hepatomegaly secondary to glycogen accumulation, glucose and galactose intolerance, fasting hypoglycaemia, a characteristic proximal tubular nephropathy and severe short stature. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2934", "text": "This article about an endocrine, nutritional, or metabolic disease is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2935", "text": "Fibrodysplasia ossificans progressiva  ( / \u02cc f a\u026a b r o\u028a d \u026a \u02c8 s p l e\u026a \u0292 ( i ) \u0259   \u0252 \u02c8 s \u026a f \u026a k \u00e6 n z   p r \u0259 \u02c8 \u0261 r \u025b s \u026a v \u0259 / ; [ 1 ]   abbr.   FOP ),  also called  M\u00fcnchmeyer disease  or formerly  myositis ossificans progressiva , is an extremely rare  connective tissue disease  in which fibrous  connective tissue  such as  muscle ,  tendons , and  ligaments  turn into  bone  tissue ( ossification ). It is the only known medical condition where one  organ system  changes into another. [ 2 ]  It is a severe, disabling disorder with no cure."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2936", "text": "FOP is caused by a  mutation  of the gene  ACVR1 . The mutation affects the body's repair mechanism, causing  fibrous tissue  including  muscle ,  tendons , and  ligaments  to become  ossified , either spontaneously or when damaged as the result of trauma. In many cases, otherwise minor injuries can cause  joints  to become permanently fused as new bone forms, replacing the damaged muscle tissue. This new bone formation (known as \"heterotopic ossification\") eventually forms a secondary skeleton and progressively restricts the patient's ability to move. Bone formed as a result of this process is identical to \"normal\" bone, simply in improper locations. Circumstantial evidence suggests that the disease can cause joint degradation separate from its characteristic bone growth. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2937", "text": "Surgical removal of the extra bone growth has been shown to cause the body to \"repair\" the affected area with additional bone. Although the rate of bone growth may differ depending on the patient, the condition ultimately leaves sufferers immobilized as new bone replaces musculature and fuses with the existing skeleton. This has earned FOP the nickname \" stone man disease \". [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2938", "text": "For unknown reasons, children born with FOP often have malformed  big toes , sometimes missing a joint or, in other cases, simply presenting with a notable lump at the minor joint. [ 5 ]  The first \"flare-up\" that leads to the formation of FOP bone usually occurs before the age of 10. [ 5 ]  The bone growth generally progresses from the top of the body downward, just as bones grow in fetuses. A child with FOP will typically develop additional bones starting at the neck, then at the shoulders, arms, chest area, and finally at the feet. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2939", "text": "Specifically, ossification is typically first seen in the dorsal, axial, cranial, and proximal regions of the body. Later, the disease progresses in the ventral, appendicular, caudal, and distal regions. [ 5 ]  However, it does not necessarily occur in this order due to injury-caused flare-ups. Often, the tumor-like lumps that characterize a flare-up of the disease appear suddenly."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2940", "text": "Bone growth occurring during flare-ups may result in the loss of mobility to affected joints, including, if the jaw/mandible is involved, the inability to fully open the mouth, limiting speech and eating. A specific occurrence of a flare-up of this condition in the foot/ankle joints can result in the limited ability to put a foot flat on the ground. [ citation needed ]  Bone growth can also result in the immobilization of the hip or knee, affecting the individual's ability to walk. Extra bone formation around the rib cage restricts the expansion of lungs and diaphragm causing respiratory complications. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2941", "text": "Since the disorder is incredibly rare, only occurring in 1 out of 2 million people, the condition may be misdiagnosed as  cancer  or  fibrosis . Misdiagnoses can lead  physicians  to order  biopsies , potentially exacerbating the growth of FOP bone. [ 7 ]  The presence of malformed toes or thumbs in those born with FOP helps distinguish this disorder from other skeletal problems. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2942", "text": "With proper medical management the median age of survival is 40 years. However, delayed diagnosis, trauma, and infections can decrease life expectancy. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2943", "text": "FOP is caused by an  autosomal   dominant allele  on chromosome 2q23-24. [ 10 ]  The allele has variable  expressivity , but complete  penetrance . Most cases are caused by spontaneous mutation in the  gametes ; most people with FOP cannot or choose not to have children.  A similar but less catastrophic disease is  fibrous dysplasia , which is caused by a  post-zygotic mutation ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2944", "text": "A mutation in the gene  ACVR1  (also known as activin-like kinase 2 (ALK2)) is responsible for the disease. [ 10 ]  ACVR1 encodes  activin  receptor type-1, a  BMP  type-1 receptor. The mutation causes substitution of  codon  206 from  arginine  to  histidine  in the ACVR1 protein. [ 11 ] [ 12 ]  This substitution causes abnormal activation of ACVR1, leading to the transformation of connective tissue and muscle tissue into a secondary skeleton. This causes  endothelial cells  to transform to  mesenchymal stem cells  and then to bone. [ 13 ]  \nNormally, the ACVR1 gene encodes the activin receptor type-1 transmembrane  kinase  that bind BMP receptors (Type I BMPR and Type II BMPR) for  chondrogenesis  signaling. BMPs belong to a superfamily of proteins known as Transforming growth factor-beta ( TGF- \u03b2 ) proteins. The binding of ACVR1 protein to BMP receptors start a signaling cascade that is crucial for inducing  endochondral  bone formation during development, as well as, skeletal and tissue  homeostasis . [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2945", "text": "FOP is an  autosomal dominant  disorder. Thus, a child of an affected heterozygous parent and an unaffected parent has a 50% probability of being affected. Two affected individuals can produce unaffected children. Two unaffected individuals can produce an affected offspring as a result of the mutation of the gene. The homozygous dominant form is more severe than the heterozygous form. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2946", "text": "The protein that causes ossification is normally deactivated by an inhibitory protein after a fetus's bones are formed in the womb, but in patients with FOP, the protein keeps working. Aberrant bone formation in patients with FOP occurs when injured connective tissue or muscle cells at the sites of injury or growth incorrectly express an enzyme for bone repair during  apoptosis  (self-regulated cell death), resulting in lymphocytes containing excess  bone morphogenetic protein 4  (BMP4) provided during the immune system response. The bone that results occurs independently of the normal skeleton, forming its own discrete skeletal elements.  These elements, however, can fuse with normal skeletal bone. [ 16 ]  The diaphragm, tongue, and extra-ocular muscles are spared in this process, as well as cardiac and  smooth muscle . [ 5 ]  Since the incorrect enzyme remains unresolved within the immune response, the body continues providing the incorrect BMP4-containing lymphocytes. BMP4 is a product that contributes to the development of the skeleton in the normal embryo. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2947", "text": "The  ACVR1  gene encodes a bone morphogenic protein (BMP) receptor; this gene is mutated in FOP. It is responsible for growth and development of bone and muscles. The typical mutation, R202H, makes the inhibitor  FKBP1A  bind less tightly to the activation GS-loop. [ 18 ]  The result is that ACVR1 is not effectively turned off, and an overgrowth of bone and cartilage and fusion of joints occurs. [ 19 ]  Atypical mutations involving other residues work similarly. In some cases, the receptor can end up signalling that it's active without being bound to its activating ligand. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2948", "text": "Most cases of FOP are the result of a new gene mutation: these people had no history of this particular disorder in their family. There are some cases where the individual has inherited the mutation from one affected parent. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2949", "text": "Generally, FOP can be diagnosed with  radiographs . Early diagnosis of this disorder through radiology is very important to avoid unnecessary invasive investigations like  biopsies . The smallest or trivial trauma or intramuscular injections can amplify progression of the disease through inflammation hence the favorability of radiology. Clinicians should be aware of this rare entity, as it is frequently misdiagnosed as cancer or other benign entities such as infection, resulting in biopsies that can often hasten disease progression. [ 21 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2950", "text": "Outbreaks may be measurable clinically by elevated levels of  alkaline phosphatase  and  bone-specific alkaline phosphatase . [ 22 ]  Another telltale sign of FOP is a shortened great toe with a malformed distal first metatarsal and a missing or abnormal first phalanx and/or interphalangeal joint. [ 23 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2951", "text": "While FOP remains without a cure, a promising breakthrough lies in the approved treatment, Sohonos ( palovarotene ). [ 24 ]  Notably, attempts to surgically remove bone in a FOP patient may result in explosive growth of new bone. [ 25 ]  While undergoing  anesthesia , people with FOP may encounter difficulties with  intubation ,  restrictive pulmonary disease , and changes in the  electrical conduction system of the heart . [ 26 ]  Activities that increase the risk of falling or soft tissue injury should be avoided, as even minor trauma may provoke  heterotopic ossification . [ 27 ]  Intramuscular injections, including immunizations, should likewise be avoided in individuals with FOP, as these can also trigger ossification  [ 28 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2952", "text": "Although there are no effective definitive treatments of the disorder, there are intermittent treatments such as anti-inflammatory drugs to suppress  inflammation  as a result of flare-ups or inflammation from muscle damage. Currently, surgery is not usually recommended for people with FOP as it can incite rapid bone formation at incision sites or where sutures have been applied to muscle or connective tissue. Life-saving surgery may be considered, however developing a surgical plan with input from a FOP specialist may be considered best practice. Surgical release of joint contractures is generally unsuccessful and risks new, trauma-induced heterotopic ossification. [ 29 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2953", "text": "Antisense-mediated therapy, specifically using allele-selective LNA gapmers, has emerged as a promising strategy for FOP [ 30 ] . This approach targets the mutated ACVR1 gene, which causes heterotopic ossification by responding aberrantly to activin A. In recent studies, LNA gapmers effectively reduced the expression of the pathogenic ACVR1R206H transcript while sparing the wild-type ACVR1 gene, thus selectively suppressing osteogenic differentiation associated with FOP. This novel antisense approach offers potential for therapeutic application in FOP, representing a breakthrough in targeted genetic treatment for this and potentially other autosomal dominant disorders"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2954", "text": "As of 2017 [update] , approximately 800 cases of FOP have been confirmed worldwide, making FOP one of the rarest diseases known. [ 31 ]  The estimated  incidence  of FOP is 0.5 cases per million people and affects all ethnicities. [ 31 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2955", "text": "Medical reports describing individuals affected by FOP date back to Dr.  Guy Patin  in 1692. [ 31 ]  FOP was originally called myositis ossificans progressiva and was thought to be caused by muscular inflammation ( myositis ) that caused bone formation. [ 31 ]  The disease was renamed by  Victor A. McKusick  in 1970 following the discovery that soft tissue other than muscles (e.g.  ligaments ) were also affected by the disease process. [ 31 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2956", "text": "The best known FOP case is that of  Harry Eastlack  (1933\u20131973). His condition began to develop at the age of ten, and by the time of his death from pneumonia in November 1973, six days before his 40th birthday, his body had completely ossified, leaving him able to move only his lips. Eastlack never met another person with FOP during his lifetime. [ 32 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2957", "text": "Eastlack donated his body to science and his skeleton is now at the  M\u00fctter Museum  in  Philadelphia , and has proven to be an invaluable source of information in the study of FOP. Another person with FOP,  Carol Orzel  (April 20, 1959 \u2013 February 2018), also donated her body to the museum and her skeleton was placed on exhibit there, adjacent to Eastlack's, in February 2019. [ 33 ] [ 34 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2958", "text": "Clinical trials of  isotretinoin ,  etidronate  with oral  corticosteroids , and  perhexiline  maleate have failed to demonstrate effectiveness, though the variable course of the disease and small prevalence induces uncertainty. [ 22 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2959", "text": "A handful of pharmaceutical companies focused on rare diseases are currently in varying stages of investigation into different therapeutic approaches for FOP."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2960", "text": "In August 2015, the U.S.  Food and Drug Administration  (FDA) Office of Orphan Products Development granted La Jolla Pharmaceuticals  orphan drug  designation for two novel compounds for FOP. The compounds are small-molecule  protein kinase inhibitors  designed to selectively block ACVR1 (ALK2). [ 40 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2961", "text": "In August 2015,  Clementia Pharmaceuticals  also began the enrollment of children (ages 6 and above) into its Phase II clinical trial investigating  palovarotene  for the treatment of FOP. [ 41 ]  Preclinical studies demonstrated that palovarotene, a retinoic acid receptor gamma agonist, blocked abnormal bone formation in animal models by inhibition of secondary messenger systems in the BMP pathway. [ 42 ]  Clementia licensed palovarotene from Roche Pharmaceuticals, which previously evaluated the compound in more than 800 individuals including healthy volunteers and patients with chronic obstructive pulmonary disease. Palovarotene received Fast Track designation from the FDA and orphan designations for the treatment of FOP from both the FDA and the  European Medicines Agency  (EMA). [ 41 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2962", "text": "In September 2015,  Regeneron  announced new insight into the mechanism of disease involving the activation of the ACVR1 receptor by activin A. In 2016, the company initiated a phase 1 study of its activin antibody,  REGN 2477 , in healthy volunteers; a phase 2 trial in FOP patients was conducted in 2017. [ 43 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2963", "text": "Another potential therapeutic approach involves allele-specific  RNA interference  that targets mutated mRNA for degradation while preserving normal ACVR1 gene expression. [ 44 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2964", "text": "Further investigation into the mechanisms of heterotopic bone formation in FOP could aid in the development of treatments for other disorders involving extra-skeletal bone formation."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2965", "text": "Fibro/adipogenic progenitors (FAPs) may be the disease-causing cell type responsible for activin A dependent ectopic bone formation in both the muscles and tendons of mice bearing the FOP causing ACVR1(R206H) mutation. [ 45 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2966", "text": "In December 2019,  Ipsen  issued a partial clinical hold for people under the age of 14, due to reports of early fusion of growth plates."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2967", "text": "Recently, as of 2021 [update] , a potential therapeutic candidate,  saracatinib , is in phase III clinical trials as a potent heterotopic ossification inhibitor in wild-type and ACVR1 mutant mice. [ 46 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2968", "text": "A  glycogen storage disease  ( GSD , also  glycogenosis  and  dextrinosis ) is a  metabolic disorder  caused by a deficiency of an  enzyme  or  transport protein  affecting  glycogen synthesis ,  glycogen breakdown , or  glucose breakdown , typically in  muscles  and/or  liver  cells. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2969", "text": "GSD has two classes of cause: genetic and environmental. Genetic GSD is caused by any  inborn error of carbohydrate metabolism  (genetically defective enzymes or transport proteins) involved in these processes.  In livestock, environmental GSD is caused by  intoxication  with the  alkaloid   castanospermine . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2970", "text": "However, not every inborn error of carbohydrate metabolism has been assigned a GSD number, even if it is known to affect the muscles or liver. For example,  phosphoglycerate kinase deficiency  (gene PGK1) has a myopathic form."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2971", "text": "Also,  Fanconi-Bickel syndrome  (gene SLC2A2) and  Danon disease  (gene LAMP2) were declassed as GSDs due to being defects of  transport proteins  rather than  enzymes ; however,  GSD-1  subtypes b, c, and d are due to defects of transport proteins (genes SLC37A4, SLC17A3) yet are still considered GSDs."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2972", "text": "Phosphoglucomutase deficiency  (gene PGM1) was declassed as a GSD due to it also affecting the formation of N-glycans; however, as it affects both  glycogenolysis  and  glycosylation , it has been suggested that it should re-designated as GSD-XIV. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2973", "text": "(See  inborn errors of carbohydrate metabolism  for a full list of inherited diseases that affect glycogen synthesis, glycogen breakdown, or glucose breakdown.)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2974", "text": "(Lewis' disease) [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2975", "text": "Muscle 0b: No"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2976", "text": "(Muscle 0b) Risk of sudden death in childhood due to cardiac arrest. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2977", "text": "(Liver 0a) Epilepsy [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2978", "text": "(Muscle 0b) Rarely epilepsy, tonic-clonic seizures. [ 7 ]  Arrhythmia, long QT syndrome. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2979", "text": "( GAA )"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2980", "text": "The symptoms of both Pompe and Danon diseases are very similar due to a defect in lysosomes. However, in Danon disease, some show abnormal glycogen accumulation, but not all. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2981", "text": "myogenic  hyperuricemia [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2982", "text": "Exercise-induced muscle cramps, stiffness, pain. [ 28 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2983", "text": "Yes"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2984", "text": "Myopathy (including exercise-related fatigue,  exercise intolerance , muscle weakness).\nMuscle biopsy shows glycogen accumulation. [ 31 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2985", "text": "Second Wind  phenomenon in some [ 32 ]  but not all [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2986", "text": "Methods to diagnose glycogen storage diseases include  history  and  physical examination  for associated symptoms,  blood tests  for associated metabolic disturbances, and  genetic testing  for suspected mutations. [ 16 ] [ 45 ]  It may also include a non-ischemic forearm test,  exercise stress test , or 12-minute walk test (12MWT). [ 45 ]  Advancements in genetic testing are slowly diminishing the need for biopsy; however, in the event of a  VUS  and inconclusive exercise tests, a biopsy would then be necessary to confirm diagnosis. [ 45 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2987", "text": "Glycogen storage diseases that involve skeletal muscle typically have exercise-induced ( dynamic ) symptoms, such as premature  muscle fatigue , rather than fixed  weakness  ( static ) symptoms. [ 46 ]  Differential diagnoses for glycogen storage diseases that involve fixed muscle weakness, particularly of the  proximal  muscles, would be an  inflammatory myopathy  or a  limb-girdle muscular dystrophy . [ 46 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2988", "text": "For those with exercise intolerance and/or proximal muscle weakness, the  endocrinopathies  should be considered. [ 47 ] [ 48 ] [ 49 ]  The timing of the symptoms of exercise intolerance, such as muscle fatigue and cramping, is important in order to help distinguish it from other  metabolic myopathies  such as  fatty acid metabolism disorders . [ 50 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2989", "text": "Problems originating within the circulatory system, rather than the muscle itself, can produce exercise-induced muscle fatigue, pain and cramping that alleviates with rest, resulting from inadequate blood flow ( ischemia ) to the muscles. Ischemia that often produces symptoms in the leg muscles includes  intermittent claudication ,  popliteal artery entrapment syndrome , and  chronic venous insufficiency ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2990", "text": "Diseases disrupting the neuromuscular junction can cause abnormal muscle fatigue, such as  myasthenia gravis , an autoimmune disease. [ 51 ]  Similar, are  Lambert\u2013Eaton myasthenic syndrome  (autoimmune) and the  congenital myasthenic syndromes  (genetic)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_2991", "text": "Diseases can disrupt glycogen metabolism  secondary  to the primary disease. Abnormal thyroid function\u2014hypo- and hyperthyroidism\u2014can manifest as myopathy with symptoms of exercise-induced muscle fatigue, cramping, muscle pain and may include proximal weakness or muscle hypertrophy (particularly of the calves). [ 52 ] [ 48 ]   Hypothyroidism  up-regulates glycogen synthesis and down-regulates glycogenolysis and glycolysis; conversely,  hyperthyroidism  does the reverse, up-regulating glycogenolysis and glycolysis while down-regulating glycogen synthesis. [ 53 ] [ 54 ] [ 55 ] [ 48 ] [ 56 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2992", "text": "Prolonged hypo- and hyperthyroid myopathy leads to atrophy of type II (fast-twitch/glycolytic)  muscle fibres , and a predominance of type I (slow-twitch/oxidative) muscle fibres. [ 54 ] [ 48 ] [ 49 ]  Muscle biopsy shows abnormal muscle glycogen: high accumulation in hypothyroidism and low accumulation in hyperthyroidism. [ 56 ] [ 53 ] [ 54 ]  Hypothyroid myopathy includes  Kocher-Debre-Semelaigne syndrome  (childhood-onset),  Hoffman syndrome  (adult-onset), myasthenic syndrome, and atrophic form. [ 56 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2993", "text": "In patients with increased growth hormone, muscle biopsy includes, among other features, excess glycogen deposition. [ 57 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2994", "text": "EPG5-related  Vici syndrome  is a multisystem disorder, a congenital disorder of  autophagy , with muscle biopsy showing excess glycogen accumulation, among other myopathic features. [ 58 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2995", "text": "It is interesting to note, in comparison to hypothyroid myopathy, that McArdle disease ( GSD-V ), which is by far the most commonly diagnosed of the muscle GSDs and therefore the most studied, [ 59 ] [ 45 ] [ 60 ]  has as its second highest  comorbidity  endocrine disease (chiefly hypothyroidism) [ 61 ] [ 45 ]  and that some patients with McArdle disease also have hypertrophy of the calf muscles. [ 21 ]  Late-onset Pompe disease ( GSD-II ) also has calf hypertrophy and hypothyroidism as comorbidities. [ 14 ] [ 62 ] [ 63 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2996", "text": "Poor diet and  malabsorption  diseases (such as celiac disease) may lead to malnutrition of essential vitamins necessary for glycogen metabolism within the muscle cells. Malnutrition typically presents with systemic symptoms, but in rare instances can be limited to myopathy. [ 64 ]   Vitamin D deficiency  myopathy (also known as  osteomalic  myopathy due to the interplay between vitamin D and calcium) results in muscle weakness, predominantly of the proximal muscles; with muscle biopsy showing abnormal glycogen accumulation, atrophy of type II (fast-twitch/glycolytic) muscle fibres, and diminished calcium uptake by the sarcoplasmic reticulum (needed for muscle contraction). [ 65 ] [ 66 ] [ 67 ]  Although Vitamin D deficiency myopathy typically includes muscle atrophy, [ 65 ]  rarely calf muscle hypertrophy has been reported. [ 68 ] [ 69 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2997", "text": "Exercise-induced, electrically silent, muscle cramping and stiffness (transient muscle contractures or \"pseudomyotonia\") are seen not only in GSD types V, VII, IXd, X, XI, XII, and XIII, but also in  Brody disease ,  Rippling muscle disease  types 1 and 2, and  CAV3 -related hyperCKemia (Elevated serum creatine phosphokinase). [ 26 ]  Unlike the other myopathies, in Brody disease the muscle cramping is painless. [ 70 ] [ 71 ]  Like GSD types II, III, and V, a pseudoathletic appearance of muscle hypertrophy is also seen in some with Brody disease and Rippling muscle disease. [ 70 ] [ 72 ] [ 73 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2998", "text": "Erythrocyte lactate transporter defect (formerly  Lactate transporter defect, myopathy due to ) also includes exercise-induced, electrically silent, painful muscle cramping and transient contractures; as well as exercise-induced muscle fatigue. [ 26 ] [ 74 ]  EMG and muscle biopsy is normal however, as the defect is not in the muscle but in the red blood cells that should clear lactate buildup from exercising muscles. [ 74 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_2999", "text": "Although most muscular dystrophies have fixed muscle weakness rather than exercise-induced muscle fatigue and/or cramping, there are a few exceptions. Limb\u2013girdle muscular dystrophy autosomal recessive 23 (LGMD R23) has calf hypertrophy and exercise-induced cramping. [ 75 ]  Myofibrillar myopathy 10 (MFM10) has exercise-induced muscle fatigue, cramping and stiffness, with hypertrophic neck and shoulder girdle muscles. [ 76 ]  LGMD R28 has calf hypertrophy and exercise-induced muscle fatigue and pain. [ 77 ]  LGMD R8 has calf pseudohypertrophy and exercise-induced weakness (fatigue) and pain. [ 78 ]  LGMD R15 (a.k.a MDDGC3) has muscle hypertrophy, proximal muscle weakness, and muscle fatigue. [ 79 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3000", "text": "DMD-related myopathies of  Duchenne  and  Becker muscular dystrophy  are known for fixed muscle weakness and pseudohypertrophic calf muscles, but they also have secondary  muscular mitochondrial impairment  causing low ATP production; as well as decreasing type II (fast-twitch/glycolytic) muscle fibres, producing a predominance of type I (slow-twitch/oxidative) muscle fibres. [ 80 ]  DMD-related childhood-onset milder phenotypes present with exercise-induced muscle cramping, stiffness, pain, fatigue, and elevated CK. [ 81 ]  Becker muscular dystrophy has adult-onset exercise-induced muscle cramping, pain, and elevated CK. [ 82 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3001", "text": "Tubular aggregate myopathy  (TAM) types 1 and 2 has exercise-induced muscle pain, fatigue, stiffness, with proximal muscle weakness and calf muscle pseudohypertrophy. TAM1 has cramping at rest, while TAM2 has cramping during exercise. [ 83 ] [ 84 ] [ 85 ] [ 86 ]  Stormorken syndrome includes the symptoms of TAM, but is a more severe presentation including short stature and other abnormalities. [ 84 ]   Satoyoshi syndrome  has exercise-induced painful muscle cramps, muscle hypertrophy, and short stature. [ 87 ]  Dimethylglycine dehydrogenase deficiency has muscle fatigue, elevated CK, and fishy body odour. [ 88 ]  Myopathy with myalgia, increased serum creatine kinase, with or without episodic rhabdomyolysis (MMCKR) has exercise-induced muscle cramps, pain, and fatigue; with some exhibiting proximal muscle weakness. [ 89 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3002", "text": "(help wikipedia by contributing to this subsection)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3003", "text": "Glycogenosis-like phenotype of  congenital hyperinsulinism  due to  HNF4A  mutation or  MODY1  (maturity-onset diabetes of the young, type 1). This phenotype of MODY1 has  macrosomia  and infantile-onset hyperinsulinemic hypoglycemia, physiological 3-OH butyrate, increased triglyceride serum levels, increased level of glycogen in liver and erythrocytes, increased liver transaminases, transient  hepatomegaly , renal  Fanconi syndrome , and later develop liver cirrhosis, decreased succinate-dependent respiration (mitochondrial dysfunction), rickets,  nephrocalcinosis , chronic kidney disease, and diabetes. [ 90 ] [ 91 ] [ 92 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3004", "text": "Treatment is dependent on the type of glycogen storage disease. Von Gierke disease ( GSD-I ) is typically treated with frequent small meals of  carbohydrates  and  cornstarch , called  modified cornstarch therapy , to prevent low blood sugar, while other treatments may include  allopurinol  and  human granulocyte colony stimulating factor . [ 93 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3005", "text": "Cori/Forbes disease ( GSD-III ) treatment may use modified cornstarch therapy, a high protein diet with a preference to complex carbohydrates. However, unlike GSD-I,  gluconeogenesis  is functional, so simple sugars (sucrose, fructose, and lactose) are not prohibited. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3006", "text": "A ketogenic diet has demonstrated beneficial for McArdle disease ( GSD-V ) as ketones readily convert to acetyl CoA for oxidative phosphorylation, whereas free fatty acids take a few minutes to convert into acetyl CoA. [ 94 ] [ 95 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3007", "text": "For  phosphoglucomutase deficiency  (formerly GSD-XIV), D-galactose supplements and exercise training has shown favourable improvement of signs and symptoms. [ 30 ]  In terms of exercise training, some patients with phosphoglucomutase deficiency also experience \"second wind.\" [ 30 ] [ 32 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3008", "text": "For McArdle disease (GSD-V), regular aerobic exercise utilizing \" second wind \" to enable the muscles to become aerobically conditioned, as well as anaerobic exercise (strength training) that follows the activity adaptations so as not to cause muscle injury, helps to improve exercise intolerance symptoms and maintain overall health. [ 45 ] [ 60 ] [ 96 ] [ 97 ]  Studies have shown that regular low-moderate aerobic exercise increases peak power output, increases peak oxygen uptake ( V\u0307O 2 peak ), lowers heart rate, and lowers serum CK in individuals with McArdle disease. [ 96 ] [ 97 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3009", "text": "Regardless of whether the patient experiences  symptoms  of muscle pain, muscle fatigue, or cramping, the phenomenon of second wind having been achieved is demonstrable by the  sign  of an increased heart rate dropping while maintaining the same speed on the treadmill. [ 97 ]  Inactive patients experienced second wind, demonstrated through relief of typical symptoms and the sign of an increased heart rate dropping, while performing low-moderate aerobic exercise (walking or brisk walking). [ 97 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3010", "text": "Conversely, patients that were regularly active did not experience the typical symptoms during low-moderate aerobic exercise (walking or brisk walking), but still demonstrated second wind by the sign of an increased heart rate dropping. [ 97 ] [ 98 ]  For the regularly active patients, it took more strenuous exercise (very brisk walking/jogging or bicycling) for them to experience both the typical symptoms and relief thereof, along with the sign of an increased heart rate dropping, demonstrating second wind. [ 97 ] [ 98 ] [ 99 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3011", "text": "In young children (<10 years old) with McArdle disease (GSD-V), it may be more difficult to detect the second wind phenomenon. They may show a normal heart rate, with normal or above normal peak cardio-respiratory capacity ( V\u0307O 2max ). [ 45 ] [ 100 ]  That said, patients with McArdle disease typically experience symptoms of exercise intolerance before the age of 10 years, [ 45 ]  with the median symptomatic age of 3 years. [ 59 ] [ 101 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3012", "text": "Tarui disease ( GSD-VII ) patients do not experience the \"second wind\" phenomenon; instead are said to be \"out-of-wind.\" [ 45 ] [ 60 ] [ 102 ]  However, they can achieve sub-maximal benefit from lipid metabolism of free fatty acids during aerobic activity following a warm-up. [ 45 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3013", "text": "Overall, according to a study in  British Columbia , approximately 2.3 children per 100,000 births (1 in 43,000) have some form of glycogen storage disease. [ 103 ]  In the United States, they are estimated to occur in 1 per 20,000\u201325,000 births. [ 10 ]  Dutch incidence rate is estimated to be 1 per 40,000 births.\nWhile a Mexican incidence showed 6.78:1000 male newborns. [ 12 ] [ 104 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3014", "text": "Within the category of muscle glycogenoses (muscle GSDs), McArdle disease (GSD-V) is by far the most commonly diagnosed. [ 59 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3015", "text": "Glycogen storage disease type V  ( GSD5 ,  GSD-V ), [ 1 ]  also known as  McArdle's disease , [ 2 ]  is a  metabolic disorder , one of the  metabolic myopathies , more specifically a muscle  glycogen storage disease , caused by a deficiency of  myophosphorylase . [ 3 ] [ 4 ]  Its incidence is reported as one in 100,000, roughly the same as  glycogen storage disease type I . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3016", "text": "The disease was first reported in 1951 by British physician  Brian McArdle  of  Guy's Hospital , London. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3017", "text": "In the classic  phenotype , the onset of this disease is usually noticed in childhood, [ 6 ] [ 7 ] [ 8 ]  but often not diagnosed until the third or fourth decade of life, frequently due to misdiagnosis and dismissal of symptoms. [ 6 ] [ 8 ]  The median age of symptom onset is 3 years, with the median diagnostic delay being 29 years. [ 8 ]  Misdiagnosis is overwhelmingly common, with approximately 90% of patients being misdiagnosed, and approximately 62% receiving multiple misdiagnoses before a correct diagnosis. [ 8 ]  The prolonged diagnostic delay, misdiagnosis or multiple misdiagnoses, or being given inappropriate exercise advice (such as ignore pain or avoid exercise) severely impacts quality of life (QoL), physically and mentally. [ 6 ] [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3018", "text": "There is an ultra-rare adult-onset,  limb\u2013girdle  phenotype that presents very late in life (70+ years of age) due to a recessive  homozygous  PYGM mutation (p.\u00a0Lys42Profs*48) resulting in severe upper and lower limb atrophy, with the possibility of ptosis (drooping eyelids) and camptocormia (stooped posture). [ 9 ]  As of 2017, there have been two reported cases of this specific homozygous mutation and phenotype. [ 9 ]  In 1980, a woman also had a limb\u2013girdle phenotype with onset at age 60, histochemical staining showed myophosphorylase deficiency; however the genetic mutation was unknown. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3019", "text": "There is an ultra-rare, fatal infantile-onset phenotype that results in profound muscle weakness (\" floppy baby \") and respiratory failure within weeks of birth (perinatal asphyxia). Post mortem biopsy showed deficiency of myophosphorylase and abnormal glycogen accumulation in skeletal muscle tissue. This phenotype may also include premature birth and joint contractures. [ 11 ] [ 12 ]  Two reported cases, in 1978 and 1989. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3020", "text": "There is an ultra-rare mild phenotype caused by recessive  heterozygous  alleles in the PYGM gene, where one allele is a common  exon  mutation and the other allele is an ultra-rare  intronic  mutation. It can also be caused by recessive homozygous intronic mutations. These intronic mutations result in a milder phenotype compared to the classic phenotype of McArdle disease. There is residual myophosphorylase activity, between 1-2% residual activity compared to unaffected individuals. This results in greater exercise capacity compared to classic phenotype McArdle individuals, particularly for sustained aerobic activity, but the capacity was still below that of unaffected individuals. In this mild phenotype, since their early teens, they did experience cramping and premature muscle fatigue during sudden vigorous exercise and prolonged isometric exercise; however, due to their less diminished capacity for aerobic activity, they were able to keep up with their peers in sports and everyday activities. [ 14 ] [ 15 ]  As of 2009, there have been 3 reported cases of non-related individuals, a reported  Druze  family of  consanguineous  (related) individuals and 9 reported cases in two  Finnish  families. [ 14 ] [ 16 ] [ 15 ] [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3021", "text": "The most prominent symptom is that of  exercise intolerance  which includes:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3022", "text": "Heart rate during exercise is a key indicator as, unlike the symptoms of muscle fatigue and cramping, it is a medical sign (meaning that it is observable and measurable by a third party rather than felt subjectively by the patient). In regularly active individuals with McArdle disease, they may not feel the usual symptoms of muscle fatigue and cramping until they increase their speed to very brisk walking, jogging or cycling; however, they will still show an inappropriate rapid heart rate response to exercise, with a declining heart rate once second wind has been achieved. [ 20 ] [ 21 ] [ 22 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3023", "text": "\"In McArdle's, our heart rate tends to increase in what is called an 'inappropriate' response. That is, after the start of exercise it increases much more quickly than would be expected in someone unaffected by McArdle's.\" [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3024", "text": "Myoglobinuria  (reddish-brown urine) may be seen due to the breakdown of  skeletal muscle  known as  rhabdomyolysis  (a condition in which muscle cells breakdown, sending their contents into the bloodstream). [ 23 ]  In 2020, the largest study to-date of 269 GSD-V patients, 39.4% reported no previous episodes of myoglobinuria and 6.8% had normal CK (including those with fixed muscle weakness); so an absence of myoglobinuria and normal CK should not rule out the possibility of the disease. [ 24 ]  Between 33-51.4% develop fixed  muscle weakness , typically of the trunk and upper body, with the onset of muscle weakness usually occurring later in life (40+ years of age). [ 25 ] [ 24 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3025", "text": "Younger people may display unusual symptoms, such as difficulty in chewing, swallowing or utilizing normal oral motor functions. [ 26 ]  Idiopathic leg pains were common in children, usually occurring at night, often presumed to be \"growing pains\" and not investigated further. [ 27 ]  A number of comorbidities were found in GSD-V individuals at a higher rate than in the general population, including (but not limited to): hypertension (17%), endocrine diseases (15.7%), musculoskeletal/rheumatic disease (12.9%), hyperuricemia/gout (11.6%), gastrointestinal diseases (11.2%), neurological disease (10%), respiratory disease (9.5%), and coronary artery disease (8.3%). [ 24 ]  They may have a  pseudoathletic appearance  of muscle hypertrophy (24%), particularly of the legs, and may have lower bone mineral content and density in the legs. [ 28 ] [ 27 ] [ 29 ] [ 30 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3026", "text": "Besides exercise-induced premature muscle fatigue, GSD-V individuals may also have comorbidities of mental fatigue, general fatigue, reduced motivation, sleep disturbances, anxiety and depression. [ 31 ] [ 27 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3027", "text": "As skeletal muscle relies predominantly on  glycogenolysis  for the first few minutes as it transitions from rest to activity, as well as throughout high-intensity aerobic activity and all anaerobic activity, individuals with GSD-V experience during exercise:  sinus tachycardia ,  tachypnea , muscle fatigue and pain, during the aforementioned activities and time frames. [ 18 ] [ 32 ]  They may exhibit a  \"second wind\" phenomenon , which is characterized by the individual's better tolerance for aerobic exercise such as walking and cycling after approximately 10 minutes. [ 33 ]   This is attributed to the combination of increased blood flow and the ability of the body to find alternative sources of energy, like fatty acids, proteins, and increased blood glucose uptake. [ 6 ] [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3028", "text": "AMP is primarily produced from the  myokinase  (adenylate kinase) reaction, [ 34 ]  which runs when the ATP reservoir is low. The myokinase reaction is one of three reactions in the  phosphagen system (ATP-PCr) , with the myokinase reaction occurring after phosphocreatine (creatine phosphate) has been depleted. In McArdle disease individuals, their muscle cells produce far more AMP than non-affected individuals as the reduced glycolytic flux from impaired glycogenolysis results in a chronically low ATP reservoir during exercise. [ 34 ]  The muscle cells need  ATP  (adenosine triphosphate) as it provides energy for  muscle contraction  by actively transporting calcium ions into the sarcoplasmic reticulum before muscle contraction, and it is used during muscle contraction for the release of myosin heads in the sliding filament model during the cross-bridge cycle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3029", "text": "Along with the myokinase reaction, AMP is also produced by the  purine nucleotide cycle , which also runs when the ATP reservoir in muscle cells is low, and is a part of  protein metabolism . In the purine nucleotide cycle, three nucleotides:  AMP  (adenosine monophosphate),  IMP  (inosine monophosphate), and  S-AMP  (adenylosuccinate) are converted in a circular fashion; the byproducts are fumarate (which goes on to produce ATP via oxidative phosphorylation), ammonia (from the conversion of AMP into IMP), and uric acid (from excess AMP). GSD-V patients may experience myogenic  hyperuricemia  (exercise-induced accelerated breakdown of purine nucleotides in skeletal muscle). [ 35 ] [ 36 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3030", "text": "To avoid health complications, GSD-V patients need to get their ATP primarily from free fatty acids ( lipid metabolism ) rather than  protein metabolism .  Over-reliance on protein metabolism can be best avoided by not depleting their ATP reservoir, such as by not pushing through the pain and by not going too fast, too soon. [ 19 ] [ 22 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3031", "text": "\"Be wary of pushing on when you feel pain start. This pain is a result of damaging muscles, and repeated damage will cause problems in the long term. But also this is counterproductive\u2013it will stop you from getting into second wind. By pressing on despite the pain, you start your protein metabolism which then effectively blocks your glucose and  fat metabolism . If you ever get into this situation, you need to stop completely for 30 minutes or more and then start the whole process again.\" [ 22 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3032", "text": "Patients may present at emergency rooms with a transient  contracture  of the muscles and often severe pain (e.g. \"clawed hand\"). These require urgent assessment for  rhabdomyolysis  as in about 30% of cases this leads to  acute kidney injury , which left untreated can be life-threatening. In a small number of cases  compartment syndrome  has developed, requiring prompt surgical referral. [ 25 ] [ 37 ] [ 38 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3033", "text": "McArdle disease (GSD-V) is inherited in an  autosomal recessive  manner. If both parents are carriers (not having the disease, but each parent having one copy of the mutated allele), then each child of the couple will have a 25% chance of being affected (having McArdle disease), a 50% chance of being a carrier, and a 25% chance of being unaffected (neither a carrier nor diseased). [ 26 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3034", "text": "Two autosomal recessive forms of this disease occur, childhood-onset and adult-onset. The gene for myophosphorylase,  PYGM  (the muscle-type of the glycogen phosphorylase gene), is located on chromosome 11q13. According to the most recent publications, 95 different mutations have been reported.  The forms of the mutations may vary between ethnic groups. For example, the  R50X  (Arg50Stop) mutation (previously referred to as  R49X ) is most common in North America and western Europe, and the  Y84X  mutation is most common among central Europeans. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3035", "text": "The exact method of protein disruption has been elucidated in certain mutations. For example,  R138W  is known to disrupt to pyridoxal phosphate binding site. [ 39 ]  In 2006, another mutation (c.13_14delCT) was discovered which may contribute to increased symptoms in addition to the common Arg50Stop mutation. [ 40 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3036", "text": "The myophosphorylase structure consists of 842 amino acids. Its molecular weight of the unprocessed precursor is 97 kDa. The three-dimensional structure has been determined for this protein. The interactions of several amino acids in myophosphorylase's structure are known. Ser-14 is modified by phosphorylase kinase during activation of the enzyme. Lys-680 is involved in binding the pyridoxal phosphate, which is the active form of  vitamin B 6 , a cofactor required by myophosphorylase. By similarity, other sites have been estimated: Tyr-76 binds AMP, Cys-109 and Cys-143 are involved in subunit association, and Tyr-156 may be involved in allosteric control. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3037", "text": "Myophosphorylase  is the form of the glycogen phosphorylase found in muscle that catalyses the following reaction: [ 41 ] [ 42 ] [ 43 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3038", "text": "((1\u21924)-alpha-D-glucosyl)  (n)  +  phosphate  = ((1\u21924)-alpha-D-glucosyl)  (n-1)  + alpha-D-glucose 1-phosphate"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3039", "text": "During exercise, a deficiency of this enzyme ultimately leads to rapid depletion of phosphocreatine, a decrease in available ATP, and an exaggerated rise of ADP and AMP. [ 44 ] [ 45 ]  McArdle disease individuals also have increased maximum fat oxidation compared to unaffected individuals. [ 46 ]  During exercise, in affected individuals, there is no significant rise in lactic acid production compared to resting levels (it may even fall below resting levels), and plasma  pH levels rise  (become more alkaline) rather than fall (become more acidic). [ 47 ] [ 48 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3040", "text": "Myophosphorylase  is involved in the breakdown of glycogen to glucose-1-phosphate for use in muscle. The enzyme removes 1,4 glycosyl residues from outer branches of glycogen and adds inorganic phosphate to form  glucose-1-phosphate . Ordinarily, the removal of 1,4 glycosyl residues by myophosphorylase leads to the formation of glucose-1-phosphate during glycogen breakdown and the polar, phosphorylated glucose cannot leave the cell membrane and so is marked for intracellular catabolism. In McArdle's disease, deficiency of myophosphorylase leads to accumulation of intramuscular glycogen and a lack of glucose-1-phosphate for cellular fuel. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3041", "text": "Myophosphorylase comes in two forms: form 'a' is phosphorylated by  phosphorylase kinase , form 'b' is not phosphorylated. Form 'a' is de-phosphorylated into form 'b' by the enzyme  phosphoprotein phosphatase , which is activated by elevated insulin. Both forms have two  conformational  states: active (R or relaxed) and inactive (T or tense). When either form 'a' or 'b' are in the active state, then the enzyme converts glycogen into glucose-1-phosphate. Myophosphorylase-b is  allosterically  activated by elevated AMP within the cell, and allosterically inactivated by elevated ATP and/or glucose-6-phosphate. Myophosphorylase-a is active, unless allosterically inactivated by elevated glucose within the cell. In this way, myophosphorylase-a is the more active of the two forms as it will continue to convert glycogen into glucose-1-phosphate even with high levels of glycogen-6-phosphate and ATP.  [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3042", "text": "There are some  laboratory tests  that may aid in diagnosis of GSD-V. A  muscle biopsy  will note the absence of myophosphorylase in muscle fibers. In some cases, abnormal accumulation of glycogen stained by  periodic acid-Schiff  can be seen with microscopy. [ 25 ] [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3043", "text": "Genetic sequencing  of the PYGM gene (which codes for the muscle isoform of  glycogen phosphorylase [ 49 ] [ 50 ] ) may be done to determine the presence of  gene mutations , determining if McArdle's is present. This type of testing is considerably less invasive than a muscle biopsy. [ 26 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3044", "text": "The  physician  can also perform an ischemic forearm exercise test as described below (see  History ). Some findings suggest a nonischemic test could be performed with similar results. [ 51 ]  The nonischemic version of this test would involve not cutting off the blood flow to the exercising arm. Findings consistent with McArdle's disease would include a failure of  lactate  to rise in  venous blood  and exaggerated  ammonia  levels. These findings would indicate a severe muscle glycolytic block."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3045", "text": "Serum lactate may fail to rise in part because of increased uptake via the  monocarboxylate transporter (MCT1) , which is upregulated in  skeletal muscle  in McArdle disease. Lactate may be used as a fuel source once converted to  pyruvate . Ammonia levels may rise given ammonia is a by-product of  AMP deaminase  which follows after the production of AMP by  adenylate kinase , an alternative pathway for ATP production. In this pathway, adenylate kinase combines two ADP molecules to make ATP and AMP; AMP is then  deaminated , producing  inosine monophosphate (IMP)  and  ammonia (NH 3 )  as part of  purine nucleotide cycle . [ 45 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3046", "text": "Physicians may also check resting levels of  creatine kinase , which are moderately increased in 90% of patients. [ 18 ]  In some, the level is increased by multitudes - a person without GSD-V will have a CK between 60 and 400IU/L, while a person with the syndrome may have a level of 5,000 IU/L at rest, and may increase to 35,000 IU/L or more with muscle exertion. This can help distinguish McArdle's syndrome from  carnitine palmitoyltransferase II deficiency  (CPT-II), a lipid-based metabolic disorder which prevents fatty acids from being transported into  mitochondria  for use as an energy source. Also, serum electrolytes and endocrine studies (such as thyroid function, parathyroid function and growth hormone levels) will also be completed. Urine studies are required only if rhabdomyolysis is suspected. Urine volume, urine sediment and myoglobin levels would be ascertained. If rhabdomyolysis is suspected, serum myoglobin, creatine kinase, lactate dehydrogenase, electrolytes and renal function will be checked. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3047", "text": "Physicians may also conduct an  exercise stress test  to test for an inappropriate rapid heart rate ( sinus tachycardia ) in response to exercise. Due to the rare nature of the disease, the inappropriate rapid heart rate in response to exercise may be misdiagnosed as  inappropriate sinus tachycardia  (which is a  diagnosis of exclusion ). The 12 Minute Walk Test (12MWT) can be used to determine \" second wind ,\" which requires a treadmill (no incline), heart rate monitor, stop watch, pain scale, and that the patient has rested for 30 minutes prior to the test to ensure that \"second wind\" has stopped (that is, that increased ATP production primarily from free fatty acids has returned to resting levels). [ 20 ] [ 52 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3048", "text": "Electromyography  (EMG) may show normal or myopathic results (short duration, polyphasic, small amplitude  MUAPs ). [ 9 ] [ 53 ]  Before exercise, a minority of GSD-V patients show myopathic results (5/25 patients); whereas after 5 minutes of high-intensity isometric exercise, the majority showed myopathic results (22/25 patients). The myopathic results were a decrease in  CMAP  amplitude, which was evident immediately after exercise and, after a plateau phase of a few minutes, reached its maximum after 30 minutes. [ 53 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3049", "text": "Dynamic symptoms of exercise intolerance (e.g. muscle fatigue and cramping) with or without fixed proximal muscle weakness:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3050", "text": "Exercise-induced muscle fatigue without cramping:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3051", "text": "Fixed symptom of muscle weakness, predominantly of the proximal muscles:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3052", "text": "Allelic to McArdle disease (GSD-V) is a recently discovered disease that has a pathogenic autosomal dominant mutation in exon 16 of the PYGM gene c.1915G>C (p.Asp639His). Discovered in 2020, it affected 13 members of a family over four generations and has yet to be assigned a GSD number. Unlike McArdle disease (GSD-V), this disease does not have an overall deficiency of myophosphorylase, only a deficiency of functioning myophosphorylase-a with plenty of functioning myophosphorylase-b (similar to  GSD-IXd ). Myophosphorylase-b can be  allosterically  activated to break down glycogen (glycogenolysis) by high levels of AMP, and as the AMP-dependent activity was preserved, the individuals of this family had normal muscle glycogen concentrations as well as lacked exercise intolerance (which are prominent distinguishing features from McArdle disease). The only symptom was adult-onset (40+ years of age) fixed muscle weakness, initially of the proximal muscles of the legs, followed by proximal arms, then distal leg muscles. Muscle biopsy also showed accumulation of the intermediate filament desmin in the myofibres. [ 54 ] [ 55 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3053", "text": "Supervised exercise programs have been shown in small studies to improve exercise capacity by several measures: lowering heart rate, lowering serum creatine kinase (CK), increasing the exercise intensity threshold before symptoms of muscle fatigue and cramping are experienced, and the skeletal muscles becoming  aerobically conditioned . [ 56 ] [ 57 ] [ 30 ] [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3054", "text": "Oral sucrose treatment (for example a sports drink with 75 grams of sucrose in 660 ml.) taken 30 minutes prior to exercise has been shown to help improve exercise tolerance, including a lower heart rate and lower perceived level of exertion compared with placebo. [ 58 ]  This is because the ingestion of a high-carbohydrate meal or drink causes transient hyperglycaemia, with the exercising muscle cells utilizing the high glucose in the blood for the glycolytic pathway. However, the ingestion of a high-carbohydrate meal or drink is problematic as a frequent form of treatment since it will increase the release of  insulin , which inhibits the release of fatty acids [ 59 ]  and subsequently will delay the ability to get into  second wind . [ 19 ]  The frequent ingestion of sucrose (e.g. sugary drinks), in order to avoid premature muscle fatigue and cramping, is also problematic in that it can lead to obesity as insulin will also stimulate triglyceride synthesis (develop body fat), [ 59 ]  and obesity-related ill health (e.g. type II diabetes and heart disease). [ 19 ] [ 60 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3055", "text": "A low dosage treatment with  creatine  showed a significant improvement of muscle problems compared to placebo in a small clinical study, while other studies have shown minimal subjective benefit. [ 61 ] [ 62 ]  High dosage treatment of creatine has been shown to worsen symptoms of myalgia (muscle pain). [ 62 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3056", "text": "A ketogenic diet has demonstrated beneficial for McArdle disease (GSD-V) as ketones readily convert to acetyl CoA for oxidative phosphorylation, whereas free fatty acids take a few minutes to convert into acetyl CoA. [ 63 ] [ 64 ]  Ketones are a part of fat metabolism, [ 59 ]  the ketones can act as the main fuel before fatty acid catabolism takes over (second wind), during which the ketones would act as a supplementary fuel alongside the fatty acids to produce adenosine triphosphate (ATP) by oxidative phosphorylation."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3057", "text": "The deficiency was the first  metabolic myopathy  to be recognized, when the physician  Brian McArdle  described the first case in a 30-year-old man who always experienced pain and weakness after exercise. McArdle noticed this patient's cramps were electrically silent and his venous  lactate  levels failed to increase upon ischemic exercise. (The ischemic exercise consists of the patient squeezing a hand dynamometer at maximal strength for a specific period of time, usually a minute, with a blood pressure cuff, which is placed on the upper arm and set at 250 mmHg, blocking blood flow to the exercising arm.)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3058", "text": "Notably, this is the same phenomenon that occurs when muscle is poisoned in vitro by  iodoacetate , which inhibits the breakdown of glycogen into glucose and prevents the formation of lactate; as well as produces an electronically silent muscle contracture. Knowing what occurs to muscle poisoned by iodoacetate, helped McArdle speculate that a glycogenolytic block might be occurring when he first described the disease. [ 65 ]  McArdle accurately concluded that the patient had a disorder of glycogen breakdown that specifically affected skeletal muscle. The associated enzyme deficiency was discovered in 1959 by  W. F. H. M. Mommaerts  et al. [ 66 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3059", "text": "Naturally-occurring myophosphorylase deficiency (GSD-V; McArdle disease) has been found in  Charolais cattle  and  Merino sheep . [ 67 ]  The cattle were asymptomatic at rest, but when forced to exercise, would become noticeably fatigued and recumbent (having to lie down) for approximately 10 minutes before being able to resume exercise (the second wind phenomenon). [ 68 ] [ 69 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3060", "text": "Artificially-induced myophosphorylase deficiency was created in mice, by altering their embryonic DNA, for use in laboratory experiments. [ 67 ] [ 70 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3061", "text": "Hereditary inclusion body myopathies  ( HIBM ) are a group of rare  genetic disorders  which have different symptoms. Generally, they are  neuromuscular disorders  characterized by muscle weakness developing in young adults.  Hereditary   inclusion body   myopathies  comprise both  autosomal recessive  and  autosomal dominant  muscle disorders that have a variable expression ( phenotype ) in individuals, but all share similar structural features in the muscles."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3062", "text": "HIBMs are a group of  muscle wasting  disorders that are uncommon in the general world population. One autosomal recessive form of HIBM is known as IBM2 or  GNE myopathy , which is a common genetic disorder amongst people of Iranian Jewish descent. [ 1 ]  IBM2 has also been identified in other minorities throughout the world, including those of Asian, European, and South American, and Middle Eastern descent. In Japan and other East Asian countries, this disorder is known as  distal myopathy with rimmed vacuoles  (DMRV)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3063", "text": "IBM2 causes progressive muscle weakness and wasting. Muscle wasting usually starts around the age of 20 \u2013 30 years, although young onset at 17 and old onset at 52 has been recorded. It can progress to marked disability within 10 to 15 years, causing many people with IBM2 to become full-time wheelchair users. The weakness and severity can vary from person to person. In some, weakness in the legs is noticed first. In some others, the hands are weakened more rapidly than the legs. IBM2 does not seem to affect the brain, internal organs or sensation. The  quadriceps  are relatively spared, and remain strong until the late stages of disease, which is the reason IBM2 is often referred to as quadriceps sparing myopathy (QSM)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3064", "text": "Some early signs of HIBMs includes:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3065", "text": "The different forms have different mutations and inheritance patterns. See the detailed descriptions for details"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3066", "text": "The exact mechanisms of these diseases are not well understood.    GNE/MNK  a key enzyme in the  sialic acid biosynthetic pathway , and loss-of-function mutations in GNE/MNK may lead to a lack of sialic acid, which in turn could affect  sialoglycoproteins .  GNE  knockout mice  show problems similar to people with IBM and in people with IBM  dystroglycan  has been found to lack sialic acid.  However, the part of the dystroglycan that is important in muscle function does not seem to be affected.  Another protein,  neural cell adhesion molecule  is under-sialyated in people with IBM, but as of 2016 it had no known role in muscle function. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3067", "text": "The most useful information for accurate diagnosis is the symptoms and weakness pattern. If the quadriceps are spared but the hamstrings and iliopsoas are severely affected in a person between ages of 20 - 40, it is very likely HIBM will be at the top of the differential diagnosis. The doctor may order any or all of the following tests to ascertain if a person has IBM2:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3068", "text": "Types of hereditary inclusion body myopathy:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3069", "text": "The condition now called  Desmin-related myofibrillar myopathy  (also called myofibrillar myopathy-1) was formerly known as inclusion body myopathy 1 (IBM1). [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3070", "text": "More types of HIMBs, linked to other genes, may be identified in the future."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3071", "text": "Treatment is  palliative , not curative (as of 2009). [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3072", "text": "Treatment options for lower limb weakness such as foot drop can be through the use of Ankle Foot Orthoses (AFOs) which can be designed or selected by an Orthotist based upon clinical need of the individual.  Sometimes tuning of rigid AFOs can enhance knee stability."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3073", "text": "A 2009 review noted that muscle weakness usually begins after age 20 and after 20\u201330 years, the person usually requires a wheelchair for mobility. There was no mention of increased mortality. [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3074", "text": "Because lack of sialic acid appears to be part of the pathology of IBM caused by GNE mutations, clinical trials with sialic acid supplements, and with a precursor of sialic acid,  N-Acetylmannosamine ,  have been conducted, and as of 2016 further trials were planned. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3075", "text": "Hereditary inclusion body myopathy (IBM) constitutes a unique group of neuromuscular disorders characterized by adult-onset slowly progressive distal and proximal weakness, and a typical muscle pathology including rimmed vacuoles and filamentous inclusions. Autosomal dominant (IMB3; OMIM 605637  [1] ) and autosomal recessive (IBM2; OMIM 600737  [2] ) forms have been described. The autosomal recessive form, first characterized in Jews of Persian descent, is a myopathy that affects mainly leg muscles, but with an unusual distribution that spares the quadriceps, so-called quadriceps-sparing myopathy (QSM). This disorder was subsequently found in other Middle Eastern families, the gene was mapped to 9p13-p12, and in 104 affected persons from 47 Middle Eastern families the same mutation in homozygous state was found in the GNE gene. [ 15 ]  Affected individuals in families of other ethnic origins were found to be compound heterozygotes for other distinct mutations in the GNE gene. From OMIM 603824. [3]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3076", "text": "Hoffmann syndrome  is a rare form of  hypothyroid   myopathy  and is not to be confused with  Werdnig-Hoffmann disease  (a type of spinal muscular atrophy)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3077", "text": "It was first documented in 1897 by  Johann Hoffmann . [ 1 ]  It has adult-onset symptoms and is comparable to the childhood-onset  Kocher\u2013Debr\u00e9\u2013Semelaigne syndrome . It is caused by low  thyroid hormones  (T3 and T4) with elevated TSH. [ 2 ] [ 3 ] [ 4 ] [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3078", "text": "Signs and symptoms include  exercise intolerance ,  muscle fatigue ,  muscle cramps ,  myalgia , delayed muscle relaxation (pseudo myotonia ), proximal  muscle weakness , delayed deep tendon reflexes ( hyporeflexia ) especially of the ankles, and a  pseudoathletic appearance  of  hypertrophic  calf muscles. There may also be  bradycardia , mild  anemia , dry skin, hoarse voice, and  cold intolerance .  EMG  may be normal, neuropathic, myopathic, or mixed type. Serum  CK  may be normal or raised. The sign of  myoedema  (raised muscle tissue in response to percussive tactile stimulus) may be observed. Treatment is thyroid hormone replacement therapy and  prognosis  is generally good. Hypertrophic calves typically return to normal after approximately 3 months of treatment. [ 2 ] [ 3 ] [ 4 ] [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3079", "text": "It is caused by low  thyroid hormones  (T3 and T4).  [ 2 ] [ 3 ] [ 4 ] [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3080", "text": "Muscle biopsy of hypothyroid myopathy shows atrophy of type II (fast-twitch/glycolytic)  muscle fibres  and a predominance of type I (slow-twitch/oxidative) muscle fibres; as well as abnormally high glycogen accumulation. [ 7 ] [ 8 ] [ 9 ]  The reason for the muscle hypertrophy in Hoffmann syndrome is not clearly established; it may be due to altered  carbohydrate metabolism ,  mucoid  deposits, or  glycosaminoglycan  deposits. [ 3 ] [ 7 ]  In an individual diagnosed with Hoffmann syndrome whose hypertrophy did not improve after thyroid hormone replacement therapy, muscle biopsy showed hypertrophy of muscle fibres with increased nuclei, few necrotic fibres and  mucoid  deposits in places. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3081", "text": "Diseases known to have a  pseudoathletic appearance  of the calves ( hypertrophy  or  pseudohypertrophy ), including exercise intolerance and/or muscle weakness:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3082", "text": "Thyroid metabolism can be disrupted secondary to a primary disease. A common  comorbidity  of the  metabolic myopathy  McArdle disease (Glycogen storage disease type V) is hypothyroidism. [ 14 ] [ 15 ]  It is also a comorbidity of late-onset Pompe disease (Glycogen storage disease type II). [ 16 ] [ 17 ]  As both hyper- and hypothyroidism disrupts muscle glycogen metabolism, it is important to keep in mind differential diagnoses and their comorbidities when trying to determine whether signs and symptoms are either  primary or secondary disease . [ 7 ] [ 8 ] [ 9 ] [ 18 ] [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3083", "text": "\u03b2-Hydroxy \u03b2-methylbutyric acid [ note 1 ]  ( HMB ), otherwise known as its  conjugate base ,  \u03b2-hydroxy   \u03b2-methylbutyrate , is a  naturally produced  substance in humans that is used as a  dietary supplement  and as an ingredient in certain  medical foods  that are intended to promote  wound healing  and provide nutritional support for people with  muscle wasting  due to  cancer  or  HIV/AIDS . [ sources 1 ]  In healthy adults, supplementation with HMB has been shown to increase exercise-induced gains in  muscle  size, muscle strength, and  lean body mass , reduce  skeletal muscle  damage from exercise, improve aerobic exercise performance, and expedite recovery from exercise. [ sources 2 ]   Medical reviews  and  meta-analyses  indicate that HMB supplementation also helps to preserve or increase lean body mass and muscle strength in individuals experiencing  age-related muscle loss . [ note 2 ] [ 11 ] [ 12 ] [ 13 ]  HMB produces these effects in part by stimulating the  production of proteins  and inhibiting the  breakdown of proteins  in muscle tissue. [ 11 ] [ 14 ] [ 15 ]  No  adverse effects  from long-term use as a dietary supplement in adults have been found. [ 16 ] [ 17 ] [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3084", "text": "HMB is sold as a dietary supplement at a cost of about  US$ 30\u201350  per month when taking 3\u00a0grams per day. [ 16 ] [ 19 ] [ 20 ]  HMB is also contained in several nutritional products, including certain formulations of  Ensure  and  Juven . [ 8 ] [ 21 ]  HMB is also present in insignificant quantities in certain foods, such as  alfalfa ,  asparagus ,  avocados ,  cauliflower ,  grapefruit , and  catfish . [ 22 ] [ 23 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3085", "text": "The effects of HMB on human skeletal muscle were first discovered by Steven L. Nissen at  Iowa State University  in the  mid-1990s . [ 8 ] [ 24 ]  As of 2018, [update]  HMB has not been banned by the  National Collegiate Athletic Association ,  World Anti-Doping Agency , or any other prominent national or international athletic organization. [ 25 ] [ 26 ] [ 27 ]  In 2006, only about 2% of college  student athletes  in the United States used HMB as a dietary supplement. [ 19 ] [ 28 ]  As of 2017, HMB has reportedly found widespread use as an  ergogenic supplement  among young athletes. [ 29 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3086", "text": "HMB is sold as an  over-the-counter   dietary supplement  in the  free acid  form,  \u03b2-hydroxy \u03b2-methylbutyric acid  (HMB-FA), and as a  monohydrated  calcium  salt  of the  conjugate base ,  calcium  \u03b2-hydroxy \u03b2-methylbutyrate  monohydrate  (HMB-Ca, CaHMB). [ 19 ] [ 20 ]  Since only a small fraction of HMB's metabolic precursor,  L -leucine , is metabolized into HMB, pharmacologically active concentrations of the compound in  blood plasma  and muscle can only be achieved by supplementing HMB directly. [ 1 ] [ 30 ] [ 31 ]  A healthy adult produces approximately 0.3\u00a0grams per day, while supplemental HMB is usually taken in doses of  3\u20136 \u00a0grams per day. [ 17 ]  HMB is sold at a cost of about  US$ 30\u201350  per month when taken in doses of 3\u00a0grams per day. [ 16 ]  HMB is also contained in several nutritional products and medical foods marketed by  Abbott Laboratories  (e.g., certain formulations of  Ensure  and  Juven ), [ 8 ] [ 21 ]  and is present in insignificant quantities in certain foods, such as  alfalfa ,  asparagus ,  avocados ,  cauliflower ,  grapefruit , and  catfish . [ 22 ] [ 23 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3087", "text": "Supplemental HMB has been used in  clinical trials  as a treatment for preserving lean body mass in muscle wasting conditions, particularly  sarcopenia , and has been studied in clinical trials as an  adjunct therapy  in conjunction with  resistance exercise . [ 11 ] [ 16 ] [ 30 ]  Based upon two medical reviews and a  meta-analysis  of seven  randomized controlled trials , HMB supplementation can preserve or increase lean muscle mass and muscle strength in  sarcopenic  older adults. [ note 2 ] [ 11 ] [ 12 ] [ 13 ]  HMB does not appear to significantly affect fat mass in older adults. [ 11 ] [ 12 ]  Preliminary clinical evidence suggests that HMB supplementation may also prevent  muscle atrophy  during  bed rest . [ 11 ] [ 29 ]  A growing body of evidence supports the efficacy of HMB in nutritional support for reducing, or even reversing, the loss of muscle mass,  muscle function , and  muscle strength  that occurs in  hypercatabolic  disease states such as cancer  cachexia ; [ 16 ] [ 30 ] [ 32 ]  consequently, the authors of two 2016 reviews of the clinical evidence recommended that the prevention and treatment of sarcopenia and muscle wasting in general include supplementation with HMB, regular resistance exercise, and consumption of a  high-protein diet . [ 16 ] [ 30 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3088", "text": "Clinical trials that used HMB for the treatment of muscle wasting have involved the administration of 3\u00a0grams of HMB per day under different dosing regimens. [ 16 ]  According to one review, an optimal dosing regimen is to administer it in one 1\u00a0gram dose, three times a day, since this ensures elevated plasma concentrations of HMB throughout the day; [ 16 ]  however, as of 2016 [update]  the best dosing regimen for muscle wasting conditions is still being investigated. [ 30 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3089", "text": "Some branded products that contain HMB (i.e., certain formulations of Ensure and Juven) are  medical foods  that are intended to be used to provide nutritional support under the care of a doctor in individuals with  muscle wasting  due to  HIV/AIDS  or  cancer , to promote  wound healing  following surgery or injury, or when otherwise recommended by a medical professional. [ sources 3 ]  Juven, a nutrition product which contains 3\u00a0grams of  HMB-Ca , 14\u00a0grams of  L -arginine , and 14\u00a0grams of  L -glutamine  per two servings, [ 2 ]  has been shown to improve  lean body mass  during clinical trials in individuals with AIDS and cancer, but not  rheumatoid cachexia . [ 17 ] [ 33 ] [ 34 ]  Further research involving the treatment of cancer cachexia with Juven over a period of several months is required to adequately determine treatment efficacy. [ 17 ] [ 33 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3090", "text": "With an appropriate exercise program, dietary supplementation with 3\u00a0grams of HMB per day has been shown to increase exercise-induced gains in muscle size, muscle strength and power, and lean body mass, reduce exercise-induced skeletal muscle damage, [ note 3 ]  and expedite recovery from high-intensity exercise. [ sources 2 ]  Based upon limited clinical research, HMB supplementation may also improve aerobic exercise performance and increase gains in  aerobic fitness  when combined with  high-intensity interval training . [ 12 ] [ 14 ]  These effects of HMB are more pronounced in untrained individuals and athletes who perform high intensity resistance or aerobic exercise. [ 1 ] [ 12 ] [ 14 ]  In resistance-trained populations, the effects of HMB on muscle strength and lean body mass are limited. [ 37 ]  HMB affects muscle size, strength, mass, power, and recovery in part by stimulating  myofibrillar  muscle  protein synthesis  and inhibiting muscle  protein breakdown  through various mechanisms, including the activation of  mechanistic target of rapamycin complex 1  (mTORC1) and inhibition of  proteasome -mediated  proteolysis  in skeletal muscles. [ 14 ] [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3091", "text": "The efficacy of HMB supplementation for reducing skeletal muscle damage from prolonged or high-intensity exercise is affected by the time that it is used relative to exercise. [ 1 ] [ 36 ]  The greatest reduction in skeletal muscle damage from a single bout of exercise has been shown to occur when  HMB-Ca  is ingested  1\u20132 \u00a0hours prior to exercise or  HMB-FA  is ingested  30\u201360 \u00a0minutes prior to exercise. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3092", "text": "In 2006, only about 2% of college  student athletes  in the United States used HMB as a dietary supplement. [ 19 ] [ 28 ]  As of 2017, HMB has found widespread use as an  ergogenic supplement  among athletes. [ 29 ]  As of 2018, [update]  HMB has not been banned by the  National Collegiate Athletic Association ,  World Anti-Doping Agency , or any other prominent national or international athletic organization. [ 25 ] [ 26 ] [ 27 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3093", "text": "The  safety profile  of HMB in adult humans is based upon evidence from  clinical trials  in humans and  animal studies . [ 16 ] [ 18 ]  In humans, no  adverse effects  in young adults or older adults have been reported when HMB is taken in doses of 3\u00a0grams per day for up to a year. [ 16 ] [ 17 ] [ 18 ]  Studies on young adults taking 6\u00a0grams of HMB per day for up to 2\u00a0months have also reported no adverse effects. [ 17 ] [ 18 ]  Studies with supplemental HMB on young, growing rats and livestock have reported no adverse effects based upon  clinical chemistry  or observable characteristics; [ 1 ] [ 23 ]  for humans younger than 18, there is limited data on the safety of supplemental HMB. [ 1 ]  The  human equivalent dose  of HMB for the  no-observed-adverse-effect level  (NOAEL) that was identified in a rat model is approximately 0.4\u00a0g/kg of  body weight  per day. [ note 4 ] [ 18 ] [ 23 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3094", "text": "Two animal studies have examined the effects of HMB supplementation in pregnant pigs on the offspring and reported no adverse effects on the fetus. [ 23 ]  No clinical testing with supplemental HMB has been conducted on pregnant women, [ 38 ]  and pregnant and lactating women are advised not to take HMB by  Metabolic Technologies, Inc. , the company that grants licenses to include HMB in dietary supplements, due to a lack of safety studies. [ 38 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3095", "text": "Several components of the  signaling cascade  that mediates the HMB-induced increase in human skeletal muscle protein synthesis have been identified  in vivo . [ 14 ] [ 15 ]  Similar to HMB's  metabolic precursor ,  L -leucine , HMB has been shown to increase protein synthesis in human skeletal muscle via  phosphorylation  of the  mechanistic target of rapamycin  (mTOR) and subsequent activation of  mTORC1 Tooltip mechanistic target of rapamycin complex 1 , which leads to  protein biosynthesis  in cellular  ribosomes  via phosphorylation of mTORC1's immediate targets (i.e., the  p70S6 kinase  and the  translation  repressor protein  4EBP1 ). [ note 5 ] [ 15 ] [ 39 ] [ 41 ]  Supplementation with HMB in several non-human animal species has been shown to increase the  serum  concentration of  growth hormone  and  insulin-like growth factor\u00a01  (IGF-1) via an unknown mechanism, in turn promoting protein synthesis through increased mTOR phosphorylation. [ 1 ] [ 16 ] [ 23 ]  Based upon limited clinical evidence in humans, supplemental HMB appears to increase the secretion of growth hormone and IGF-1 in response to resistance exercise. [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3096", "text": "As of 2016 [update] , the signaling cascade that mediates the HMB-induced reduction in muscle protein breakdown has not been identified in living humans, although it is well-established that it attenuates  proteolysis  in humans  in vivo . [ 11 ] [ 15 ]  Unlike  L -leucine , HMB attenuates muscle protein breakdown in an  insulin -independent manner in humans. [ note 6 ] [ 15 ]  HMB is believed to reduce muscle protein breakdown in humans by inhibiting the  19S  and  20S  subunits of the  ubiquitin\u2013proteasome system  in skeletal muscle and by inhibiting  apoptosis  of  skeletal muscle nuclei  via unidentified mechanisms. [ 15 ] [ 16 ] [ 41 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3097", "text": "Based upon animal studies, HMB appears to be metabolized within skeletal muscle into  cholesterol , which may then be incorporated into the  muscle cell membrane , thereby enhancing membrane integrity and function. [ 34 ] [ 35 ]  The effects of HMB on muscle  protein metabolism  may help stabilize muscle cell structure. [ 23 ]  One review suggested that the observed HMB-induced reduction in the plasma concentration of muscle damage  biomarkers  (i.e., muscle enzymes such as  creatine kinase  and  lactate dehydrogenase ) in humans following intense exercise may be due to a cholesterol-mediated improvement in muscle cell membrane function. [ note 3 ] [ 23 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3098", "text": "HMB has been shown to stimulate the  proliferation ,  differentiation , and  fusion  of human  myosatellite cells   in vitro , which potentially increases the regenerative capacity of skeletal muscle, by increasing the protein expression of certain  myogenic regulatory factors  (e.g.,  myoD  and  myogenin ) and gene  transcription factors  (e.g.,  MEF2 ). [ 1 ] [ 17 ] [ 42 ]  HMB-induced human myosatellite cell proliferation  in vitro  is mediated through the phosphorylation of the  mitogen-activated protein kinases   ERK1  and  ERK2 . [ 17 ] [ 23 ] [ 42 ]  HMB-induced human myosatellite differentiation and accelerated fusion of myosatellite cells into muscle tissue  in vitro  is mediated through the phosphorylation of  Akt , a  serine/threonine-specific protein kinase . [ 17 ] [ 23 ] [ 42 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3099", "text": "The free acid ( HMB-FA ) and monohydrated calcium salt ( HMB-Ca ) forms of HMB have different  pharmacokinetics . [ 1 ] [ 20 ]  HMB-FA is more readily absorbed into the bloodstream and has a longer  elimination half-life  (3\u00a0hours) relative to HMB-Ca (2.5\u00a0hours). [ 1 ] [ 20 ]  Tissue uptake and utilization of HMB-FA is  25\u201340%  higher than for HMB-Ca. [ 1 ] [ 20 ]  The fraction of an ingested dose that is excreted in urine does not differ between the two forms. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3100", "text": "After ingestion,  HMB-Ca  is converted to  \u03b2-hydroxy \u03b2-methylbutyrate  following  dissociation  of the calcium  moiety  in the gut. [ 1 ]  When the HMB-Ca  dosage form  is ingested, the magnitude and time at which the peak plasma concentration of HMB occurs depends on the dose and concurrent food intake. [ 1 ]  Higher HMB-Ca doses increase the rate of  absorption , resulting in a peak plasma HMB level ( C max ) that is disproportionately greater than expected of a linear  dose-response relationship  and which occurs sooner relative to lower doses. [ note 7 ] [ 1 ]  Consumption of HMB-Ca with sugary substances slows the rate of HMB absorption, resulting in a lower peak plasma HMB level that occurs later. [ note 7 ] [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3101", "text": "HMB is eliminated via the  kidneys , with roughly  10\u201340%  of an ingested dose being excreted unchanged in urine. [ 1 ] [ 3 ]  The remaining  60\u201390%  of the dose is retained in tissues or excreted as HMB metabolites. [ 1 ] [ 3 ]  The fraction of a given dose of HMB that is excreted unchanged in urine increases with the dose. [ note 8 ] [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3102", "text": "The metabolism of HMB is catalyzed by an uncharacterized enzyme which converts it to  \u03b2-hydroxy   \u03b2-methylbutyryl-CoA  ( HMB-CoA ). [ 43 ] [ 46 ]  HMB-CoA is metabolized by either  enoyl-CoA hydratase  or another uncharacterized enzyme, producing  \u03b2-methylcrotonyl-CoA  ( MC-CoA ) or  hydroxymethylglutaryl-CoA  ( HMG-CoA ) respectively. [ 3 ] [ 46 ]   MC-CoA  is then converted by the enzyme  methylcrotonyl-CoA carboxylase  to  methylglutaconyl-CoA  ( MG-CoA ), which is subsequently converted to  HMG-CoA  by  methylglutaconyl-CoA hydratase . [ 3 ] [ 46 ] [ 47 ]   HMG-CoA  is then cleaved into  acetyl-CoA  and  acetoacetate  by  HMG-CoA  lyase  or used in the production of cholesterol via the  mevalonate pathway . [ 3 ] [ 46 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3103", "text": "HMB is synthesized in the human body through the  metabolism  of  L -leucine , a  branched-chain amino acid . [ 46 ]  In healthy individuals, approximately\u00a060% of dietary  L -leucine  is metabolized after several hours, with roughly 5% ( 2\u201310% \u00a0range) of dietary  L -leucine  being converted to HMB. [ 3 ] [ 16 ] [ 46 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3104", "text": "The vast majority of  L -leucine  metabolism is initially catalyzed by the  branched-chain amino acid aminotransferase  enzyme, producing  \u03b1-ketoisocaproate  (\u03b1-KIC). [ 3 ] [ 46 ]  \u03b1-KIC is mostly metabolized by the  mitochondrial  enzyme  branched-chain  \u03b1-ketoacid  dehydrogenase , which converts it to  isovaleryl-CoA . [ 3 ] [ 46 ]  Isovaleryl-CoA is subsequently metabolized by  isovaleryl-CoA dehydrogenase  and converted to  MC-CoA , which is used in the synthesis of acetyl-CoA and other compounds. [ 46 ]  During  biotin deficiency , HMB can be synthesized from  MC-CoA  via  enoyl-CoA hydratase  and an unknown  thioesterase  enzyme, [ 43 ] [ 44 ] [ 48 ]  which convert  MC-CoA  into  HMB-CoA  and  HMB-CoA  into HMB respectively. [ 44 ]  A relatively small amount of \u03b1-KIC is metabolized in the  liver  by the  cytosolic  enzyme  4-hydroxyphenylpyruvate dioxygenase  (KIC dioxygenase), which converts \u03b1-KIC to HMB. [ 3 ] [ 46 ] [ 49 ]  In healthy individuals, this minor pathway\u00a0\u2013 which involves the conversion of  L -leucine  to \u03b1-KIC and then HMB\u00a0\u2013 is the predominant route of HMB synthesis. [ 3 ] [ 46 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3105", "text": "\u03b2-Hydroxy   \u03b2-methylbutyric  acid is a  monocarboxylic   \u03b2-hydroxy acid  and  natural product  with the  molecular formula   C 5 H 10 O 3 . [ 50 ] [ 51 ]  At room temperature, pure  \u03b2-hydroxy   \u03b2-methylbutyric  acid occurs as a transparent, colorless to light yellow liquid which is soluble in water. [ 6 ] [ 52 ]   \u03b2-Hydroxy   \u03b2-methylbutyric  acid is a  weak acid  with a  p K a  of 4.4. [ 5 ]  Its  refractive index  ( \n \n \n \n \n \n \n n \n \n \n \n 25\u00b0C \n \n \n \n \u03bb \n = \n 589 \n n \n m \n \n \n \n \n \n {\\displaystyle {\\mathit {n}}_{\\text{25\u00b0C}}^{\\mathrm {\\lambda =589nm} }} \n \n ) is 1.42. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3106", "text": "\u03b2-Hydroxy   \u03b2-methylbutyric  acid is a member of the  carboxylic acid  family of  organic compounds . [ 50 ]  It is a  structural analog  of  butyric acid  with a  hydroxyl   functional group  and a  methyl   substituent  located on its  beta carbon . [ 50 ] [ 53 ]  By extension, other structural analogs include  \u03b2-hydroxybutyric  acid  and  \u03b2-methylbutyric  acid . [ 50 ] [ 53 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3107", "text": "A variety of synthetic routes to  \u03b2-hydroxy   \u03b2-methylbutyric  acid have been developed. The first reported  chemical syntheses  approached HMB by oxidation of  alkene ,  vicinal   diol , and  alcohol  precursors:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3108", "text": "Depending on the experimental conditions,  cycloaddition  of  acetone  and  ketene  produces either  \u03b2-isovalerolactone  or 4,4-dimethyloxetan-2-one, [ 59 ] [ 60 ]  both of which  hydrolyze  under basic conditions to yield the conjugate base of HMB. The  haloform reaction  provides another pathway to HMB involving the exhaustive halogenation of the methyl-ketone region of  diacetone alcohol  with  sodium hypobromite  or  sodium hypochlorite ; [ 5 ] [ 61 ] [ 62 ]  Diacetone alcohol is readily available from the  aldol condensation  of acetone. [ 61 ]  An  organometallic  approach to HMB involves the  carboxylation  of  tert -butyl alcohol  with  carbon monoxide  and  Fenton's reagent  ( hydrogen peroxide  and  ferrous iron ). [ 5 ] [ 63 ]  Alternatively, HMB can be prepared through  microbial oxidation  of  \u03b2-methylbutyric  acid by the fungus  Galactomyces reessii . [ 64 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3109", "text": "The concentration of naturally produced HMB has been measured in several human  body fluids  using  nuclear magnetic resonance spectroscopy ,  liquid chromatography\u2013mass spectrometry , and  gas chromatography\u2013mass spectrometry  methods. [ 65 ] [ 50 ]  In the blood plasma and  cerebrospinal fluid  (CSF) of healthy adults, the average  molar concentration  of HMB has been measured at 4.0\u00a0 micromolar  (\u03bcM). [ 50 ]  The average concentration of HMB in the  intramuscular fluid  of healthy men of ages  21\u201323  has been measured at 7.0\u00a0\u03bcM. [ 15 ]  In the urine of healthy individuals of any age, the excreted urinary concentration of HMB has been measured in a range of  0\u201368 \u00a0 micromoles  per millimole (\u03bcmol/mmol) of  creatinine . [ 50 ]  In the breast milk of healthy lactating women, HMB and  L -leucine  have been measured in ranges of  42\u2013164 \u00a0\u03bcg/L and  2.1\u201388.5 \u00a0mg/L. [ 65 ]  In comparison, HMB has been detected and measured in the milk of healthy cows at a concentration of  <20\u201329 \u00a0\u03bcg/L. [ 66 ]  This concentration is far too low to be an adequate dietary source of HMB for obtaining pharmacologically active concentrations of the compound in blood plasma. [ 66 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3110", "text": "In a study where participants consumed 2.42\u00a0grams of pure  HMB-FA  while fasting, the average plasma HMB concentration increased from a basal level of 5.1\u00a0 \u03bcM  to 408\u00a0\u03bcM after 30\u00a0minutes. [ 15 ]  At 150\u00a0minutes post-ingestion, the average plasma HMB concentration among participants was 275\u00a0\u03bcM. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3111", "text": "Abnormal HMB concentrations in urine and blood plasma have been noted in several disease states where it may serve as a  diagnostic biomarker , particularly in the case of  metabolic disorders . [ 50 ]  The following table lists some of these disorders along with the associated HMB concentrations detected in urine or blood plasma. [ 50 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3112", "text": "The first reported  chemical synthesis  of HMB was published in 1877 by the Russian chemists Michael and  Alexander Zaytsev . [ 54 ]  HMB was isolated from the bark of  Erythrophleum couminga  (a Madagascan tree) in 1941 by  Leopold Ru\u017ei\u010dka . [ 67 ]  The earliest reported isolation of HMB as a human  metabolite  was by Tanaka and coworkers in 1968 from a patient with  isovaleric acidemia . [ 68 ] [ 69 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3113", "text": "The effects of HMB on human skeletal muscle were first discovered by Steven L. Nissen at  Iowa State University  in the  mid-1990s . [ 8 ] [ 24 ]  Nissen founded a company called  Metabolic Technologies, Inc.  (MTI) around the time of his discovery, which later acquired six HMB-related  patents  that the company has used to license the right to manufacture and incorporate HMB into dietary supplements. [ 24 ] [ 70 ] [ 71 ]  When it first became available commercially in the late 1990s, HMB was marketed solely as an exercise supplement to help athletes and bodybuilders build muscle. [ 70 ]  MTI subsequently developed two HMB-containing products, Juven and Revigor, to which  Abbott Nutrition  obtained the market rights in 2003 and 2008 respectively. [ 8 ] [ 70 ]  Since then, Abbott has marketed Juven as a medical food and the Revigor brand of HMB as an active ingredient in food products (e.g., certain formulations of Ensure) and other medical foods (e.g., certain formulations of Juven). [ 8 ] [ 21 ] [ 70 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3114", "text": "Hypertonia  is a term sometimes used synonymously with  spasticity  and  rigidity  in the literature surrounding damage to the  central nervous system , namely  upper motor neuron lesions . [ 1 ]  Impaired ability of damaged  motor neurons  to regulate descending pathways gives rise to disordered  spinal reflexes , increased excitability of  muscle spindles , and decreased  synaptic  inhibition. [ 2 ]  These consequences result in abnormally increased  muscle tone  of symptomatic muscles. [ 3 ]  Some authors suggest that the current definition for spasticity, the velocity-dependent over-activity of the  stretch reflex , is not sufficient as it fails to take into account patients exhibiting increased muscle tone in the absence of stretch reflex over-activity. They instead suggest that \" reversible hypertonia \" is more appropriate and represents a treatable condition that is responsive to various therapy modalities like drug or physical therapy. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3115", "text": "Symptoms associated with central nervous systems disorders are classified into positive and negative categories. Positive symptoms include those that increase muscle activity through hyper-excitability of the stretch reflex (i.e., rigidity and spasticity) where negative symptoms include those of insufficient muscle activity (i.e.  weakness ) and reduced motor function. [ 5 ]  Often the two classifications are thought to be separate entities of a disorder; however, some authors propose that they may be closely related. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3116", "text": "Hypertonia is caused by  upper motor neuron lesions  which may result from injury, disease, or conditions that involve damage to the central nervous system.  The lack of or decrease in upper motor neuron function leads to loss of inhibition with resultant hyperactivity of  lower motor neurons .  Different patterns of muscle weakness or hyperactivity can occur based on the location of the lesion, causing a multitude of neurological symptoms, including  spasticity ,  rigidity , or  dystonia . [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3117", "text": "Spastic hypertonia involves uncontrollable  muscle spasms , stiffening or straightening out of muscles, shock-like contractions of all or part of a group of muscles, and abnormal  muscle tone . It is seen in disorders such as  cerebral palsy ,  stroke , and  spinal cord injury .  Rigidity is a severe state of hypertonia where muscle resistance occurs throughout the entire range of motion of the affected joint independent of velocity. It is frequently associated with lesions of the  basal ganglia . Individuals with rigidity present with stiffness, decreased range of motion and loss of motor control. Rigidity is a nonselective increase in the tone of agonist and antagonist without velocity dependence, and the increased tone remains uniform throughout the range of movement. On the contrary, spasticity is a velocity-dependent increase in tone resulting from the hyper excitability of stretch reflexes. [ 7 ]  It primarily involves the antigravity muscles \u2013 flexors of the upper limb and extensors of the lower limb. During the passive stretch, a brief \u201cfree interval\u201d is appreciated in spasticity but not in rigidity because the resting muscle is electromyographically silent in spasticity. In contrast, in rigidity, the resting muscle shows firing. [ 8 ]   Dystonic  hypertonia refers to muscle resistance to passive stretching (in which a therapist gently stretches the inactive contracted muscle to a comfortable length at very low speeds of movement) and a tendency of a limb to return to a fixed involuntary (and sometimes abnormal) posture following movement. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3118", "text": "Therapeutic interventions are best individualized to particular patients. [ citation needed ]  Basic principles of treatment for hypertonia are to avoid noxious stimuli and provide frequent range of motion exercise. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3119", "text": "Physiotherapy  has been shown to be effective in controlling hypertonia through the use of stretching aimed to reduce  motor neuron  excitability. [ 9 ]  The aim of a physical therapy session could be to inhibit excessive tone as far as possible, give the patient a sensation of normal position and movement, and to facilitate normal movement patterns. While static stretch has been the classical means to increase range of motion,  PNF stretching  has been used in many clinical settings to effectively reduce muscle spasticity. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3120", "text": "Icing and other  topical anesthetics  may decrease the reflexive activity for short period of time in order to facilitate motor function.  Inhibitory pressure (applying firm pressure over muscle tendon) and promoting body heat retention and rhythmic rotation (slow repeated rotation of affected body part to stimulate relaxation) [ 11 ]  have also been proposed as potential methods to decrease hypertonia.  Aside from static stretch casting, splinting techniques are extremely valuable to extend joint range of motion lost to hypertonicity. [ 12 ]   A more unconventional method for limiting tone is to deploy quick repeated passive movements to an involved joint in cyclical fashion; this has also been demonstrated to show results on persons without physical disabilities. [ 9 ]  For a more permanent state of improvement, exercise and patient education is imperative. [ 11 ]   Isokinetic , [ 13 ] [ 14 ] [ 15 ] [ 16 ]   aerobic , [ 17 ] [ 18 ] [ 19 ]  and  strength training [ 20 ] [ 21 ] [ 22 ] [ 23 ]  exercises should be performed as prescribed by a physiotherapist, and stressful situations that may cause increased tone should be minimized or avoided. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3121", "text": "Baclofen ,  diazepam  and  dantrolene  remain the three most commonly used pharmacologic agents in the treatment of spastic hypertonia. Baclofen is generally the drug of choice for spinal cord types of spasticity, while sodium dantrolene is the only agent which acts directly on muscle tissue.  Tizanidine  is also available.  Phenytoin  with  chlorpromazine  may be potentially useful if sedation does not limit their use.  Ketazolam , not yet available in the United States, [ needs update ]  may be a significant addition to the pharmacologic set of options.  Intrathecal  administration of antispastic medications allows for high concentrations of drug near the site of action, which limits side effects. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3122", "text": "Inclusion body myositis  ( IBM ) ( / m a\u026a o\u028a \u02c8 s a\u026a t \u026a s / ) (sometimes called  sporadic inclusion body myositis ,  sIBM ) is the most common  inflammatory muscle disease  in older adults. [ 2 ] [ failed verification ]  The disease is characterized by slowly progressive weakness and wasting of both proximal muscles (located on or close to the  torso ) and distal muscles (close to hands or feet), most apparent in the  finger   flexors  and  knee   extensors . [ 3 ]  IBM is often confused with an entirely different class of diseases, called  hereditary inclusion body myopathies  (hIBM). [ 4 ] [ 5 ]  The \"M\" in hIBM is an abbreviation for \"myopathy\" while the \"M\" in IBM is for \"myositis\". [ 6 ]  In IBM, two processes appear to occur in the muscles in parallel, one autoimmune and the other degenerative. Inflammation is evident from the invasion of muscle fibers by  immune cells . Degeneration is characterized by the appearance of  holes , deposits of  abnormal proteins , and filamentous inclusions in the muscle fibers. [ 7 ]  sIBM is a rare disease, with a prevalence ranging from 1 to 71 individuals per million. [ 8 ] [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3123", "text": "Weakness comes on slowly (over months to years) in an asymmetric manner and progresses steadily, leading to severe weakness and wasting of arm and leg muscles. IBM is more common in men than women. [ 10 ]  Patients may become unable to perform  activities of daily living  and most require assistive devices within 5 to 10 years of symptom onset. [ 11 ]  sIBM does not significantly affect  life expectancy , [ 1 ]  although death related to  malnutrition  and  respiratory  failure can occur. [ 12 ]  The risk of serious injury due to falls is increased. [ 1 ]  There is no effective treatment for the disease as of 2019. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3124", "text": "IBM  stands for \"inclusion body  myositis:  not \"inclusion body  myopathy. \" [ 6 ]  The 'inclusion body' refers to a histological finding of rimmed vacuoles in muscle tissue. [ 6 ]  However, IBM does not refer to the collection of diseases that feature these inclusion bodies. It refers to a specific disease entity. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3125", "text": "Multiple genetic diseases that feature inclusion bodies have been grouped into \" hereditary  inclusion body  myopathies  (hIBM).\" [ 6 ]   Myopathy  is used because inflammation is not a prominent finding. There is inconsistency in what individual disease entities fall under the category of hIBM. [ 6 ]  The term \" sporadic  inclusion body  myositis \" (sIBM) was introduced as a way to refer to IBM to avoid confusion with hIBM. [ 6 ]  However, one author discourages use of sIBM, as it implies that IBM and hIBM differ only in inheritance; they actually have unrelated mechanisms and manifestations of disease. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3126", "text": "sIBM causes progressive muscle weakness. [ 1 ]  How sIBM affects individuals is variable, including the age of onset (which generally varies from the forties upwards) and rate of progression. Because of this variability, there is no \"textbook case\". [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3127", "text": "Common early symptoms include frequent tripping and falling and difficulty going up stairs.  Foot drop  in one or both feet can occur. [ 14 ]  Part of the cause for this dysfunction is the early involvement of the  quadriceps  muscles. [ 1 ]  Weakness of the  tibialis anterior muscle  is responsible for foot drop. Another common early symptom is trouble manipulating the fingers, such as difficulty with tasks such as turning doorknobs or gripping keys. Weakness of finger flexion and ankle dorsiflexion occurs early. [ 1 ]  sIBM also preferentially affects the  wrist flexors ,  biceps , and  triceps . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3128", "text": "During the course of the illness, the patient's mobility is progressively restricted as it becomes difficult to bend down, reach for things, and walk quickly. Many patients say they have balance problems and fall easily, as the muscles cannot compensate for an off-balanced posture. Because sIBM makes the leg muscles weak and unstable, patients are very vulnerable to serious injury from tripping or falling down. Although pain has not been traditionally part of the \"textbook\" description, many patients report severe muscle pain, especially in the thighs. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3129", "text": "Progressive difficulty swallowing ( dysphagia ) is present in 40 to 85% of IBM cases and often leads to death from  aspiration pneumonia . [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3130", "text": "IBM can also result in diminished capacity for aerobic exercise. This decline is most likely a consequence of the sedentary lifestyle leading to disuse  muscle atrophy  that is often associated with the symptoms of IBM (i.e. progressive muscle weakness, decreased mobility, and increased level of fatigue). Therefore, one focus of treatment should be the improvement of aerobic capacity. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3131", "text": "Patients with sIBM usually eventually need to resort to a cane or a walker and in most cases, a wheelchair eventually becomes a necessity."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3132", "text": "\"The progressive course of s-IBM leads slowly to severe disability. Finger functions can become very impaired, such as manipulating pens, keys, buttons, and zippers, pulling handles, and firmly grasping handshakes. Arising from a chair becomes difficult. Walking becomes more precarious. Sudden falls, sometimes resulting in major injury to the skull or other bones, can occur, even from walking on minimally irregular ground or from other minor imbalances outside or in the home, due to weakness of quadriceps and gluteus muscles depriving the patient of automatic posture maintenance. A foot-drop can increase the likelihood of tripping.  Dysphagia  can occur, usually caused by upper esophageal constriction that often can be symptomatically improved, for several months to years, by bougie dilation per a GI or ENT physician. Respiratory muscle weakness can sometimes eventuate.\" [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3133", "text": "The cause of IBM is unknown. IBM likely results from the interaction of a number of genetic and environmental factors. [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3134", "text": "There are two major theories about how sIBM is caused. One hypothesis suggests that the inflammation-immune reaction, caused by an unknown trigger\u00a0\u2013 likely an undiscovered virus or an autoimmune disorder \u2013 is the primary cause of sIBM and that the degeneration of muscle fibers and protein abnormalities are secondary features. [ 19 ]  Despite the arguments \"in favor of an adaptive immune response in sIBM, a purely autoimmune hypothesis for sIBM is untenable because of the disease's resistance to most immunotherapy.\" [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3135", "text": "The second school of thought advocates the theory that sIBM is a degenerative disorder related to aging of the muscle fibers and that abnormal, potentially pathogenic protein accumulations in myofibrils play a key causative role in sIBM (apparently before the immune system comes into play). This hypothesis emphasizes the abnormal intracellular accumulation of many proteins, protein aggregation and misfolding,  proteosome  inhibition, and  endoplasmic reticulum  (ER) stress. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3136", "text": "One review discusses the \"limitations in the beta-amyloid-mediated theory of IBM myofiber injury.\" [ 21 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3137", "text": "Dalakas (2006) suggested that a chain of events causes IBM \u2013 some sort of virus, likely a  retrovirus , triggers the cloning of  T cells . These T cells appear to be driven by specific  antigens  to invade muscle fibers. In people with sIBM, the muscle cells display \"flags\" telling the immune system that they are infected or damaged (the muscles ubiquitously express MHC class I antigens) and this immune process leads to the death of muscle cells. The chronic stimulation of these antigens also causes stress inside the muscle cell in the  endoplasmic reticulum  (ER) and this ER stress may be enough to cause a self-sustaining T cell response (even after a virus has dissipated). In addition, this ER stress may cause the misfolding of protein. The ER is in charge of processing and folding molecules carrying antigens. In IBM, muscle fibers are overloaded with these  major histocompatibility complex  (MHC) molecules that carry the antigen protein pieces, leading to more ER stress and more protein misfolding. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3138", "text": "A self-sustaining T cell response would make sIBM a type of autoimmune disorder. When studied carefully, it has not been possible to detect an ongoing viral infection in the muscles. One theory is that a chronic viral infection might be the initial triggering factor setting IBM in motion. There have been a handful of IBM cases \u2013 approximately 15 \u2013 that have shown clear evidence of a virus called  HTLV-1 . The HTLV-1 virus can cause  leukemia , but in most cases lies dormant and most people end up being lifelong carriers of the virus. One review says that the best evidence points towards a connection with some type of retrovirus and that a retroviral infection combined with immune recognition of the retrovirus is enough to trigger the inflammation process. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3139", "text": "sIBM is not inherited and is not passed on to the children of IBM patients. There are genetic features that do not directly cause IBM but that appear to predispose a person to getting IBM\u00a0\u2013 having this particular combination of genes increases one's susceptibility to getting IBM. Some 67% of IBM patients have a particular combination of  human leukocyte antigen  genes in a section of the 8.1 ancestral haplotype in the center of the MHC class II region. sIBM is not passed on from generation to generation, although the susceptibility region of genes may be. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3140", "text": "There are also several rare forms of hereditary inclusion body myopathy that are linked to specific genetic defects and that are passed on from generation to generation. Since these forms do not show features of muscle inflammation, they are classified as myopathies rather than forms of myositis. Because they do not display inflammation as a primary symptom, they may in fact be similar, but different diseases to sporadic inclusion body myositis. There are several different types, each inherited in different ways. See  hereditary inclusion body myopathy . [ 24 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3141", "text": "A 2007 review concluded there is no indication that the genes responsible for the familial or hereditary conditions are involved in sIBM. [ 25 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3142", "text": "Elevated  creatine kinase  (CK) levels in the blood (at most ~10 times normal) are typical in sIBM but affected individuals can also present with normal CK levels.  Electromyography  (EMG) studies display variable abnormalities such as increased insertional activity, [ 26 ]  increased spontaneous activity (fibrillation potentials and sharp waves), [ 1 ]  and large/broad or short/narrow motor unit potentials. [ 1 ]  On EMG, recruitment patterns can be reduced or increased. Findings can vary even within the same muscle of an affected individual. [ 1 ]  Muscle biopsy may display several common findings including inflammatory cells invading muscle cells, vacuolar degeneration, and  inclusion bodies  of aggregations of multiple proteins. [ 27 ]  sIBM is a challenge to the pathologist and even with a biopsy, diagnosis can be ambiguous. [ 28 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3143", "text": "A diagnosis of inclusion body myositis was historically dependent on muscle biopsy results. Antibodies to cytoplasmic 5'-nucleotidase (cN1A;  NT5C1A ) have been strongly associated with the condition. [ 1 ]  However, other inflammatory conditions, such as lupus, can have a positive anti-NT5C1A. [ 1 ]  As of 2019, it remains to be established whether a positive anti-NT5C1A antibody test can make muscle biopsy unneeded. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3144", "text": "Muscle imaging can help establish the pattern of muscle involvement and selection of a biopsy site. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3145", "text": "IBM is often initially misdiagnosed as  polymyositis . A course of  prednisone  is typically completed with no improvement and eventually, sIBM is confirmed. sIBM weakness comes on over months or years and progresses steadily, whereas polymyositis has an onset of weeks or months.  Muscular dystrophy  (e.g.,  limb girdle muscular dystrophy ) must be considered as well. [ citation needed ]  sIBM can be mistaken for physical deconditioning. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3146", "text": "Hereditary myopathies can mimic sIBM, both in signs and symptoms and in the appearance of muscle biopsies. A small percentage of those initially diagnosed with sIBM are later found to have pathogenic mutations in the genes  VCP  and  SQSTM1 , which are known to cause hIBM. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3147", "text": "IBM has a distinctive pattern of muscle involvement that distinguishes it among inflammatory myopathies. [ 6 ]  Characteristic of IBM is weakness of finger flexion, knee extension, and ankle dorsiflexion. [ 6 ]  Other inflammatory myopathies cause a proximal muscle weakness pattern, such as weakness of hip flexion, abduction, and extension, as well as shoulder abduction. [ 6 ]  IBM and other inflammatory myopathies both cause bicep/tricep weakness. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3148", "text": "There is no standard course of treatment to slow or stop the progression of the disease as of 2019. [ 1 ]  sIBM patients do not reliably respond to  anti-inflammatory ,  immunosuppressant , or   immunomodulatory medications . [ 31 ]  Most of disease management is  supportive care . [ 1 ]  Prevention of falls is an important consideration. [ 1 ]  There is no consensus on  exercise guidelines ; however, physical therapy is recommended to teach the patient a home exercise program, to teach how to compensate during mobility-gait training with an assistive device, transfers and bed mobility. [ 32 ]  An exercise regimen preferentially minimizes a patient's risk of injury and corresponds to the patient's goals. [ 1 ] [ 33 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3149", "text": "When sIBM was originally described, the major feature noted was muscle inflammation. Two other disorders were also known to display muscle inflammation, and sIBM was classified along with them. They are  dermatomyositis  (DM) and  polymyositis  (PM) and all three illnesses were called  idiopathic  (of unknown origin) myositis or inflammatory myopathies. [ 34 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3150", "text": "It appears that sIBM and polymyositis share some features, especially the initial sequence of immune system activation, however, polymyositis comes on over weeks or months, does not display the subsequent muscle degeneration and protein abnormalities as seen in IBM, and as well, polymyositis tends to respond well to treatments, IBM does not. IBM is often confused with (misdiagnosed as) polymyositis. Polymyositis that does not respond to treatment is likely IBM. [ 35 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3151", "text": "Dermatomyositis  shares a number of similar physical symptoms and histopathological traits as polymyositis, but exhibits a skin rash not seen in polymyositis or sIBM. It may have different root causes unrelated to either polymyositis or sIBM. [ 36 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3152", "text": "Mutations in  valosin-containing protein  (VCP) cause  multisystem proteinopathy  (MSP), which can present (among others) as a rare form of inclusion body myopathy. [ 37 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3153", "text": "Prevalence of disease in a rigorous  meta-analysis  in 2017 was 46 patients per million. [ 6 ]  The earliest published prevalence was in 2000 and put at 5 per million. [ 6 ]  A 2017 study in Ireland reported 112 per million. [ 6 ]  It is not believed that the disease prevalence is increasing with time, but rather diagnostics and reporting are improving. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3154", "text": "Estimates of the mean age of onset range from 61 to 68 years old. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3155", "text": "In the biographical drama film  Father Stu , the protagonist, a boxer-turned-Catholic priest, has sIBM. [ 38 ] [ 39 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3156", "text": "Musician  Peter Frampton  was diagnosed with the disease in 2019."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3157", "text": "Kocher\u2013Debr\u00e9\u2013Semelaigne syndrome  ( KDSS ) is  hypothyroidism  in infancy or childhood characterised by lower extremity or generalized muscular hypertrophy ( Herculean appearance [ 1 ] ),  myxoedema ,  short stature , and  cognitive impairment . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3158", "text": "The syndrome is named after  Emil Theodor Kocher ,  Robert Debr\u00e9  and Georges Semelaigne. Also known as Debr\u00e9\u2013Semelaigne syndrome or cretinism-muscular hypertrophy, hypothyroid myopathy, hypothyroidism-large muscle syndrome, hypothyreotic muscular hypertrophy in children, infantile myxoedema-muscular hypertrophy, myopathy-myxoedema syndrome, myxoedema-muscular hypertrophy syndrome, myxoedema-myotonic dystrophy syndrome."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3159", "text": "The adult-onset form of this syndrome is  Hoffmann syndrome . [ 3 ]  Some sources claim that two of the differentiating symptoms between KDSS and Hoffmann syndrome is that Hoffmann syndrome lacks painful spasms and pseudomyotonia; [ 1 ] [ 4 ]  however, this claim is in conflict with other sources that list these symptoms as also being present in Hoffmann syndrome. [ 5 ] [ 6 ] [ 7 ] [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3160", "text": "The age at which a child presents with KDSS may vary from new born to as late as 11 years of age. [ 9 ]  This disease is very rare as only less than 10% of children with hypothyroid myopathy develops this condition. [ citation needed ]  Along with features of  hypothyroidism  (such as lethargy, slow heart rate, cold intolerance, dry skin, and hoarse voice) the main additional feature is muscle hypertrophy. It can happen in any muscle of the limbs, but commonly affects the calf muscles, giving the typical Herculean appearance. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3161", "text": "Other features are pseudo myotonia ,  myokymia , slow tendon reflex, slowed muscle contractions and relaxations, muscle stiffness, proximal muscle weakness and myopathy. The severity of these symptoms are determined by the period of hypothyroidism and the degree of deficiency of thyroid hormones. [ 10 ]  It may also include  macroglossia . [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3162", "text": "EMG is either normal or may show myopathic low amplitude and short duration motor unit action potentials (MUAPS). [ 12 ]  The enzymes creatine kinase is elevated usually."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3163", "text": "The assumed cause of muscle hypertrophy in KDSS is an abnormal metabolism of carbohydrates leading to increased glycogen accumulation and increased  mucopolysaccharide  deposits in the muscles. [ 13 ]  Yet another speculation is an excess intra cellular calcium due to ineffective reuptake into the sarcoplasmic reticulum, which causes a sustained contraction and thereby hypertrophy. [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3164", "text": "In hypothyroidism the fast twitch muscle fiber is converted to slow twitch fiber, causing the slower reflex or hung up reflex. This may occur as a result of reduction in muscle mitochondrial oxidative capacity and beta-adrenergic receptors, as well as the induction of an insulin-resistant state, due to decrease in thyroid hormones. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3165", "text": "The causes for muscle weakness is said to be decrease in muscle  carnitine , decreased muscle oxidation, expression of a slower  ATPase  in myosin chain and decreased transport across the cell membrane. [ 16 ] [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3166", "text": "The rigidity associated with congenital hypothyroidism may be due to abnormal development of basal ganglia. [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3167", "text": "Thyroid metabolism can be disrupted secondary to a primary disease. A common  comorbidity  of the  metabolic myopathy  McArdle disease (Glycogen storage disease type V) is hypothyroidism. [ 23 ] [ 24 ]  It is also a comorbidity of late-onset Pompe disease (Glycogen storage disease type II). [ 25 ] [ 26 ]  As both hyper- and hypothyroidism disrupts muscle glycogen metabolism, it is important to keep in mind differential diagnoses and their comorbidities when trying to determine whether signs and symptoms are either  primary or secondary disease . [ 27 ] [ 28 ] [ 29 ] [ 30 ] [ 31 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3168", "text": "The muscle hypertrophy and other symptoms are reversible on treatment with  levothyroxine . [ 32 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3169", "text": "Laminopathies  ( lamino-  +  -pathy ) are a group of rare  genetic disorders  caused by  mutations  in genes encoding proteins of the  nuclear lamina .  Since the first reports of laminopathies in the late 1990s, increased research efforts have started to uncover the vital role of nuclear envelope proteins in cell and tissue integrity in animals. Laminopathies are a group of degenerative diseases, other disorders associated with  inner nuclear membrane proteins  are known as  nuclear envelopathies . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3170", "text": "Laminopathies and other nuclear envelopathies have a large variety of clinical symptoms including skeletal and/or cardiac  muscular dystrophy ,  lipodystrophy  and  diabetes ,  dysplasia , dermo- or  neuropathy ,  leukodystrophy , and  progeria  (premature aging). Most of these symptoms develop after birth, typically during childhood or adolescence. Some laminopathies however may lead to an early death, and mutations of lamin B1 ( LMNB1  gene) may be lethal before or at birth. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3171", "text": "Patients with classical laminopathy have mutations in the gene coding for  lamin  A/C ( LMNA  gene). [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3172", "text": "Mutations in the gene coding for  lamin B2  (LMNB2 gene) have been linked to Barraquer-Simons syndrome [ 4 ]  and duplication in the gene coding for lamin B1 (LMNB1 gene) cause autosomal dominant leukodystrophy. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3173", "text": "Mutations implicated in other nuclear envelopathies were found in genes coding for lamin-binding proteins such as  lamin B receptor  (LBR gene), [ 6 ] [ 7 ] [ 8 ] [ 9 ] [ 10 ]   emerin  (EMD gene) and  LEM domain-containing protein 3  (LEMD3 gene) and prelamin A-processing enzymes such as the  zinc metalloproteinase STE24  (ZMPSTE24 gene)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3174", "text": "Mutations causing laminopathies include  recessive  as well as  dominant   alleles  with rare  de novo  mutations creating dominant alleles that do not allow their carriers to reproduce before death. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3175", "text": "The nuclear envelopathy with the highest frequency in human populations is  Emery\u2013Dreifuss muscular dystrophy  caused by an  X-linked  mutation in the EMD gene coding for emerin and affecting an estimated 1 in 100,000 people. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3176", "text": "Lamins are  intermediate filament  proteins that form the  nuclear lamina  scaffold underneath the  nuclear envelope  in animal cells. They are attached to the nuclear envelope membrane via farnesyl anchors and interaction with  inner nuclear membrane proteins  such as lamin B receptor and emerin. The nuclear lamina appears to be an adaptation to mobility in animals as sessile organisms such as  plants  or  fungi  do not have lamins [ 11 ]  and the symptoms of many laminopathies include  muscle  defects. Mutations in these genes might lead to defects in filament assembly and/or attachment to the nuclear envelope and thus jeopardize nuclear envelope stability in physically stressed tissues such as  muscle fibers ,  bone ,  skin  and  connective tissue . [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3177", "text": "Messenger RNA  produced from the LMNA gene undergoes  alternative splicing  and is  translated  into lamins A and C. Lamin A undergoes  farnesylation  to attach a membrane anchor to the protein. This version of the protein is also referred to as prelamin A. Farnesylated prelamin A is further  processed  into mature lamin A by a  metalloproteinase  removing the last 15  amino acids  and its farnesylated  cysteine . This allows lamin A to dissociate from the nuclear envelope membrane and fulfill nuclear functions. Mutations causing laminopathies interfere with these processes on different levels. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3178", "text": "Missense mutations  in the lamin A/C rod and tail domains are the cause for a wide array of genetic disorders, suggesting that lamin A/C protein contains distinct functional domains that are essential for the maintenance and integrity of different cell lineages. Interaction between lamin A and the nuclear envelope protein emerin appears to be crucial in muscle cells, with certain mutations in lamin mimicking mutations in emerin and causing  Emery\u2013Dreifuss muscular dystrophy . Different mutations lead to dominant-negative and recessive alleles. Mutations in the lamin rod domain leading to mislocalization of both lamin A and emerin occur in patients with  autosomal dominant  forms of muscular dystrophy and cardiomyopathy. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3179", "text": "Most lamin B mutations appear to be lethal with mutations in lamin B1 causing death at birth in mice. [ 3 ]  In 2006, lamin B2 missense mutations were identified in patients with acquired partial lipodystrophy. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3180", "text": "The most common mutation in the lamin A/C is the homozygous Arg527His (arginine replaced by histidine at position 527) substitution in\nexon 9 of the LMNA gene [ 14 ] \nOther known mutations are Ala529Val and Arg527His/Val440Met. [ 15 ]  Additionally, some mutations such as Arg527Cys, Lys542Asn, Arg471Cys, Thr528Met/Met540Thr, and Arg471Cys/Arg527Cys, Arg527Leu\nresult in  mandibuloacral dysplasia  with  progeria -like features. [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3181", "text": "Mutations causing  progeria  are defective in  splicing  LMNA mRNA, therefore producing abnormal lamin A protein, also known as  progerin . The mutations activate a cryptic splice site within  exon  11 of the gene, thereby causing the deletion of the processing site on prelamin A. [ 17 ]  This results in an accumulation of progerin that is unable to mature into lamin A, leading to misshapen nuclei. Missplicing also leads to the complete or partial loss of exon 11 and results in a truncated prelamin A protein in the neonatal lethal  tight skin contracture syndrome . [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3182", "text": "Since the metalloproteinase STE24 is required to process prelamin A into mature lamin A, mutations in this gene abolishing  protease  activity cause defects similar to laminopathies caused by prelamin A with truncated processing sites. Symptoms in patients with ZMPSTE24 mutation range from mandibuloacral dysplasia, progeroid appearance, and generalized lipodystrophy to infant-lethal  restrictive dermopathy . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3183", "text": "In the case of  autosomal dominant  leukodystrophy, the disease is associated with a duplication of the lamin B gene LMNB1. The exact  dosage  of lamin B in cells appears to be crucial for nuclear integrity as increased expression of lamin B causes a degenerative phenotype in  fruit flies  and leads to abnormal nuclear morphology. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3184", "text": "Antibodies against lamins are detected in the sera of some individuals with  autoimmune diseases . [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3185", "text": "A-type  lamins  promote genetic stability by maintaining the levels of proteins that have key roles in DNA double-strand break repair during the processes of  non-homologous end joining  and  homologous recombination . [ 21 ]   Mutations in lamin A (LMNA) cause Hutchinson\u2013Gilford  progeria  syndrome, a dramatic form of premature aging. [ 17 ]   Mouse cells deficient for maturation of prelamin A show increased DNA damage and  chromosome aberrations  and are more sensitive to DNA damaging agents. [ 22 ]   The inability to adequately repair DNA damages when A-type lamins are defective is likely responsible for some of the aspects of premature aging. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3186", "text": "Currently, there is no cure for laminopathies and treatment is largely symptomatic and supportive.  Physical therapy  and/or corrective  orthopedic surgery  may be helpful for patients with muscular dystrophies. Laminopathies affecting  heart muscle  may cause  heart failure  requiring treatment with medications including  ACE inhibitors ,  beta blockers  and  aldosterone antagonists , while the  abnormal heart rhythms  that frequently occur in these patients may require a  pacemaker  or  implantable defibrillator . [ 40 ]  Treatment for neuropathies may include medication for  seizures  and  spasticity . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3187", "text": "The recent progress in uncovering the molecular mechanisms of toxic progerin formation in laminopathies leading to premature aging has opened up the potential for the development of targeted treatment. The farnesylation of prelamin A and its pathological form progerin is carried out by the enzyme  farnesyl transferase .  Farnesyl transferase inhibitors  (FTIs) can be used effectively to reduce symptoms in two mouse model systems for progeria and to revert the abnormal nuclear morphology in progeroid cell cultures. Two oral FTIs,  lonafarnib  and  tipifarnib , are already in use as anti-tumor medication in humans and may become avenues of treatment for children with laminopathic progeria. Nitrogen-containing bisphosphate drugs used in the treatment of  osteoporosis  reduce  farnesyldiphosphate  production and thus prelamin A farnesylation. Testing of these drugs may prove them to be useful in treating progeria as well. The use of  antisense   oligonucleotides  to inhibit progerin synthesis in affected cells is another avenue of current research into the development of anti-progerin drugs. [ 41 ] [ 42 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3188", "text": "Ankyrin :  Long QT syndrome 4"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3189", "text": "Macrophagic myofasciitis  ( MMF ) is a  histopathological  finding involving inflammatory  microphage  formations with aluminium-containing crystal  inclusions  and associated microscopic muscle  necrosis  in  biopsy  samples of the  deltoid muscle . Based on the presence of aluminium and the common practice of administering vaccines into the deltoid, it has been proposed that the abnormalities are a result of immunisation with aluminium  adjuvant -containing vaccines. The findings were observed in a minority of persons being evaluated for \"diffuse myalgias, arthralgias or muscle weakness\" who underwent deltoid muscle biopsies. The individuals had a history of receiving aluminium-containing vaccines, administered months to several years prior to observation of MMF histopathology, however this link is tenuous and unsustainable.  [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3190", "text": "It has been subsequently proposed that macrophagic myofasciitis is in fact a systemic disorder where various diseases develop in association and as consequence of vaccination with aluminium-containing vaccines in susceptible individuals, however, the  World Health Organization  has concluded that \"[t]here is no evidence to suggest that MMF is a specific illness\", and that \"[t]he current evidence neither establishes nor excludes a generalized disorder affecting other organs.\" [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3191", "text": "MMF was first described in 1998 by a consortium of French myopathologists as an emerging condition of unknown cause characterised by a defining lesion observed upon muscle biopsy. MMF was identified in patients affected by myalgia and fatigue. MMF was judged a consequence of a switch to  intramuscular injection  and the deltoid muscle being the preferred site of both vaccine injection and biopsy in France (while other sites were preferred for biopsy in other countries) and the commencement of  HBV vaccination  in French adults. Similar lesions could be detected in babies and children upon biopsy of the quadriceps as this is the site of vaccine administration in this group. MMF could also be experimentally reproduced in animals, with regression over time. It has been proposed that in a small portion of the population, vaccination results in persistence of aluminium-compound particles in macrophages in association with myalgia, fatigue, and cognitive dysfunction. A MMF disorder has been compared to  autoimmune/inflammatory syndrome induced by adjuvants . [ 3 ] [ 4 ]  A case-controlled study in France found those with MMF were more likely to have received aluminium-containing vaccines. MMF was also associated with fatigue \u201cand related functional limitations\", with fatigue more common in the beginning of the malady that led to the biopsy. However, neither  myalgia ,  arthralgia , nor any other symptoms or risk factors were identified as specific to those with MMF. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3192", "text": "Many of those with MMF had previously been treated for  malaria  with  chloroquine  or  hydroxychloroquine . [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3193", "text": "As of 2009, with few exceptions, MMF had only been reported in France. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3194", "text": "Malignant hyperthermia  ( MH ) is a type of severe reaction that occurs in response to particular medications used during  general anesthesia , among those who are susceptible. [ 1 ]  Symptoms include  muscle rigidity ,  fever , and a  fast heart rate . [ 1 ]  Complications can include  muscle breakdown  and  high blood potassium . [ 1 ] [ 2 ]  Most people who are susceptible to MH are generally unaffected when not exposed to triggering agents. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3195", "text": "Exposure to triggering agents (certain  volatile anesthetic agents  or  succinylcholine ) can lead to the development of MH in those who are susceptible. [ 1 ] [ 3 ]  Susceptibility can occur due to at least six  genetic mutations , with the most common one being of the  RYR1  gene. [ 1 ]  These genetic variations are often inherited in an  autosomal dominant  manner. [ 1 ]  The condition may also occur as a new mutation or be associated with a number of inherited muscle diseases, such as  central core disease . [ 1 ] [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3196", "text": "In susceptible individuals, the medications induce the release of stored  calcium ions  within  muscle cells . [ 1 ]  The resulting increase in calcium concentrations within the cells cause the  muscle fibers  to contract. [ 1 ]  This generates excessive heat and results in  metabolic acidosis . [ 1 ]  Diagnosis is based on symptoms in the appropriate situation. [ 2 ]  Family members may be tested to see if they are susceptible by  muscle biopsy  or  genetic testing . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3197", "text": "Treatment is with  dantrolene  and rapid cooling along with other  supportive measures . [ 2 ] [ 4 ]  The avoidance of potential triggers is recommended in susceptible people. [ 2 ]  The condition affects one in 5,000 to 50,000 cases where people are given anesthetic gases. [ 1 ]  Males are more often affected than females. [ 3 ]  The risk of death with proper treatment is about 5% while without it is around 75%. [ 3 ]  While cases that appear similar to MH have been documented since the early 20th century, the condition was only formally recognized in 1960. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3198", "text": "The typical signs of malignant  hyperthermia  are due to a  hypercatabolic  state, which presents as  a very high temperature ,  an increased heart rate  and  abnormally rapid breathing , increased  carbon dioxide production , increased oxygen consumption, mixed  acidosis ,  rigid muscles , and  rhabdomyolysis . [ 5 ]  These signs can develop any time during the administration of the anesthetic triggering agents. Rarely, signs may develop up to 40 minutes after the end of anaesthesia. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3199", "text": "Malignant hyperthermia is a disorder that can be considered a gene\u2013environment interaction. In most people with malignant hyperthermia susceptibility, they have few or no symptoms unless they are exposed to a triggering agent. The most common triggering agents are volatile anesthetic gases, such as  halothane ,  sevoflurane ,  desflurane ,  isoflurane ,  enflurane  or the depolarizing muscle relaxants  suxamethonium  and  decamethonium  used primarily in general anesthesia. [ 5 ]  In rare cases, the biological stresses of physical exercise or heat may be the trigger. [ 5 ] [ 7 ]  In fact, malignant hyperthermia susceptibility (MHS), predisposed by mutations in the skeletal muscle calcium release channel (RYR1), is one of the most severe heat-related illnesses. The MHS-associated heat susceptibilities predominantly affect children and metabolically active young adults, often leading to life- threatening hypermetabolic responses to heat. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3200", "text": "Other anesthetic drugs do not trigger malignant hyperthermia. Some examples of drugs that don't cause MH include local anesthetics ( lidocaine ,  bupivacaine ,  mepivacaine ), opiates ( morphine ,  fentanyl ),  ketamine ,  barbiturates ,  nitrous oxide ,  propofol ,  etomidate , and  benzodiazepines . The nondepolarizing muscle relaxants  pancuronium ,  cisatracurium ,  atracurium ,  mivacurium ,  vecuronium  and  rocuronium  also do not cause MH. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3201", "text": "There is mounting evidence that some individuals with malignant hyperthermia susceptibility may develop MH with exercise and/or on exposure to hot environments. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3202", "text": "Malignant hyperthermia's inheritance is  autosomal dominant  with variable penetrance. [ 5 ]  The defect is typically located on the long arm of  chromosome 19  (19q13.2 [ 10 ] ) involving the  ryanodine receptor . [ 5 ]  More than 25 different mutations in this gene are linked with malignant hyperthermia. [ 5 ]  These mutations tend to cluster in one of three domains within the protein, designated MH1-3. MH1 and MH2 are located in the N-terminus of the protein, which interacts with L-type calcium channels and  Ca 2+ . MH3 is located in the transmembrane forming C-terminus. This region is important for allowing  Ca 2+  passage through the protein following opening. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3203", "text": "Chromosome 7q and chromosome 17 have also been implicated.  It has also been postulated that MH and  central core disease  may be allelic and thus can be co-inherited. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3204", "text": "In a large proportion (50\u201370%) of cases, the propensity for malignant hyperthermia is due to a  mutation  of the  ryanodine receptor  (type 1), located on the  sarcoplasmic reticulum  (SR), the  organelle  within  skeletal muscle  cells that stores  calcium . [ 11 ] [ 12 ]  RYR1 opens in response to conformational changes in the L-type  calcium channels  following membrane depolarisation, thereby resulting in a drastic increase in intracellular calcium levels and muscle contraction. RYR1 has two sites believed to be important for reacting to changing  Ca 2+  concentrations: the A-site and the I-site. The A-site is a high  affinity   Ca 2+  binding site that mediates RYR1 opening. The I-site is a lower affinity site that mediates the protein's closing.  Caffeine , halothane, and other triggering agents act by drastically increasing the affinity of the A-site for  Ca 2+  and concomitantly decreasing the affinity of the I-site in mutant proteins.  Mg 2+  also affect RYR1 activity, causing the protein to close by acting at either the A- or I-sites. In MH mutant proteins, the affinity for  Mg 2+  at either one of these sites is greatly reduced. The result of these alterations is greatly increased  Ca 2+  release due to a lowered activation and heightened deactivation threshold. [ 13 ] [ 14 ]  The process of sequestering this excess  Ca 2+  consumes large amounts of  adenosine triphosphate  (ATP), the main cellular energy carrier, and generates the excessive heat (hyperthermia) that is the hallmark of the disease. The muscle cell is damaged by the depletion of ATP and possibly the high temperatures, and cellular constituents \"leak\" into the circulation, including  potassium ,  myoglobin ,  creatine ,  phosphate  and  creatine kinase . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3205", "text": "The other known causative gene for MH is  CACNA1S , which encodes an  L-type   voltage-gated calcium channel  \u03b1-subunit. There are two known mutations in this protein, both affecting the same residue, R1086. [ 15 ] [ 16 ]  This residue is located in the large intracellular loop connecting domains 3 and 4, a domain possibly involved in negatively regulating RYR1 activity. When these mutant channels are expressed in human embryonic kidney ( HEK 293 )  cells, the resulting channels are five times more sensitive to activation by caffeine (and presumably halothane) and activate at 5\u201310mV more hyperpolarized. Furthermore, cells expressing these channels have an increased basal cytosolic  Ca 2+  concentration. As these channels interact with and activate RYR1, these alterations result in a drastic increase of intracellular  Ca 2+ , and, thereby, muscle excitability. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3206", "text": "Other mutations causing MH have been identified, although in most cases the relevant gene remains to be identified. [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3207", "text": "Research into malignant hyperthermia was limited until the discovery of \" porcine stress syndrome \" (PSS) in  Danish Landrace  and other  pig  breeds selected for muscling, a condition in which stressed pigs develop  \"pale, soft, exudative\" flesh  (a manifestation of the effects of malignant hyperthermia) rendering their meat less marketable at slaughter. This \"awake triggering\" was not observed in humans, and initially cast doubts on the value of the animal model, but subsequently, susceptible humans were discovered to \"awake trigger\" (develop malignant hyperthermia) in stressful situations. This supported the use of the pig model for research. Pig farmers use  halothane  cones in swine yards to expose piglets to halothane. Those that die were MH-susceptible, thus saving the farmer the expense of raising a pig whose meat he would not be able to market.  This also reduced the use of breeding stock carrying the genes for PSS.  The condition in swine is also due to a defect in ryanodine receptors. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3208", "text": "Gillard  et al.  discovered the causative mutation in humans only after similar mutations had first been described in pigs. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3209", "text": "Horses also develop malignant hyperthermia. A causative mutated  allele , ryanodine receptor 1 gene (RyR1) at nucleotide C7360G, generating a R2454G amino acid substitution. [ 20 ]  has been identified in the  American Quarter Horse  and breeds with Quarter Horse ancestry, inherited as an  autosomal dominant . [ 21 ] [ 22 ]  It can be caused by overwork, anesthesia, or stress. [ 23 ]   In dogs, its inheritance is  autosomal recessive . [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3210", "text": "An MH mouse has been constructed, bearing the R163C mutation prevalent in humans. These mice display signs similar to human MH patients, including sensitivity to halothane (increased respiration, body temperature, and death). Blockade of RYR1 by  dantrolene  prevents adverse reaction to halothane in these mice, as with humans. Muscle from these mice also shows increased  K + -induced depolarization and an increased caffeine sensitivity. [ 24 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3211", "text": "The earliest signs may include:  masseter muscle  contracture following administration of succinylcholine, a rise in  end-tidal carbon dioxide concentration  (despite increased minute ventilation), unexplained tachycardia, and muscle rigidity. [ 5 ]   Despite the name, elevation of body temperature is often a late sign, but may appear early in severe cases. Respiratory acidosis is universally present and many patients have developed metabolic acidosis at the time of diagnosis. A  fast rate of breathing  (in a spontaneously breathing patient),  cyanosis , hypertension,  abnormal heart rhythms , and  high blood potassium  may also be seen. Core body temperatures should be measured in any patient undergoing general anesthesia longer than 30 minutes. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3212", "text": "Malignant hyperthermia is diagnosed on clinical grounds, but various laboratory investigations may prove confirmatory. These include a raised creatine kinase level, elevated potassium, increased phosphate (leading to decreased calcium) and\u2014if determined\u2014raised myoglobin; this is the result of damage to muscle cells. Severe rhabdomyolysis may lead to  acute kidney failure , so  kidney function  is generally measured on a frequent basis.  Patients may also experience  premature ventricular contractions  due to the increased levels of potassium released from the muscles during episodes. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3213", "text": "The main candidates for testing are those with a close relative who has had an episode of MH or have been shown to be susceptible. The standard procedure is the \"caffeine-halothane contracture test\", CHCT. A muscle  biopsy  is carried out at an approved research center, under local anesthesia. The fresh biopsy is bathed in solutions containing caffeine or halothane and observed for contraction; under good conditions, the  sensitivity  is 97% and the  specificity  78%. [ 25 ]  Negative biopsies are  not  definitive, so any patient who is suspected of MH by their medical history or that of blood relatives is generally treated with non-triggering anesthetics, even if the biopsy was negative. Some researchers advocate the use of the \"calcium-induced calcium release\" test in addition to the CHCT to make the test more specific. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3214", "text": "Less invasive diagnostic techniques have been proposed. Intramuscular injection of halothane 6 vol% has been shown to result in higher than normal increases in local  pCO 2  among patients with known malignant hyperthermia susceptibility. The sensitivity was 100% and specificity was 75%. For patients at similar risk to those in this study, this leads to a  positive predictive value  of 80% and  negative predictive value  of 100%. This method may provide a suitable alternative to more invasive techniques. [ 26 ] \nA 2002 study examined another possible metabolic test. In this test, intramuscular injection of caffeine was followed by local measurement of the  pCO 2 ; those with known MH susceptibility had a significantly higher  pCO 2  (63 versus 44 mmHg). The authors propose larger studies to assess the test's suitability for determining MH risk. [ 27 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3215", "text": "Genetic testing  is being performed in a limited fashion to determine susceptibility to MH. [ 5 ]  In people with a family history of MH, analysis for  RYR1  mutations may be useful. [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3216", "text": "A 1994 consensus conference led to the formulation of a set of diagnostic criteria. The higher the score (above 6), the more likely a reaction constituted MH: [ 28 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3217", "text": "In the past, the  prophylactic  use of dantrolene was recommended for MH-susceptible patients undergoing general anesthesia. [ 29 ]  However, multiple retrospective studies have demonstrated the safety of trigger-free general anesthesia in these patients in the absence of prophylactic dantrolene administration. The largest of these studies looked at the charts of 2214 patients who underwent general or  regional anesthesia  for an elective muscle biopsy. About half (1082) of the patients were muscle biopsy positive for MH. Only five of these patients exhibited signs consistent with MH, four of which were treated successfully with  parenteral  dantrolene, and the remaining one recovered with only symptomatic therapy. [ 30 ]  After weighing its questionable benefits against its possible adverse effects (including nausea, vomiting, muscle weakness and prolonged duration of action of nondepolarizing neuromuscular blocking agents [ 31 ] ), experts no longer recommend the use of prophylactic dantrolene prior to trigger-free general anesthesia in MH-susceptible patients. [ 29 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3218", "text": "Anesthesia for people with known MH susceptible requires avoidance of triggering agent concentrations above 5 parts per million (all volatile anesthetic agents and succinylcholine). Most other drugs are safe (including nitrous oxide), as are regional anesthetic techniques. Where general anesthesia is planned, it can be provided safely by either flushing the machine or using charcoal filters. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3219", "text": "To flush the machine, first remove or disable the vaporizers and then flush the machine with 10 L/min or greater fresh gas flow rate for at least 20 minutes. While flushing the machine the ventilator should be set to periodically ventilate a new breathing circuit. The  soda lime  should also be replaced. After machine preparation, anesthesia should be induced and maintained with non-triggering agents. [ 31 ]  The time required to flush a machine varies for different machines and volatile anesthetics. This prevention technique was optimized to prepare older generation anesthesia machines. Modern anesthetic machines have more rubber and plastic components which provide a reservoir for volatile anesthetics, and should be flushed for 60 minutes. [ 32 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3220", "text": "Charcoal filters can be used to prepare an anesthesia machine in less than 60 seconds for people at risk of malignant hyperthermia. These filters prevent residual anesthetic from triggering malignant hyperthermia for up to 12 hours, even at low fresh gas flows. [ 33 ]  Prior to placing the charcoal filters, the machine should be flushed with fresh gas flows greater than 10 L/min for 90 seconds. [ 34 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3221", "text": "The current treatment of choice is the intravenous administration of  dantrolene , the only known antidote, discontinuation of triggering agents, and supportive therapy directed at correcting hyperthermia, acidosis, and organ dysfunction. Treatment must be instituted rapidly on clinical suspicion of the onset of malignant hyperthermia. [ 31 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3222", "text": "Dantrolene is a muscle relaxant that appears to work directly on the ryanodine receptor to prevent the release of calcium. After the widespread introduction of treatment with dantrolene, the mortality of malignant hyperthermia fell from 80% in the 1960s to less than 5%. [ 5 ]  Dantrolene remains the only drug known to be effective in the treatment of MH. [ 29 ]  The recommended dose of dantrolene is 2.5\u00a0mg/kg, repeated as necessary. [ 5 ]  It is recommended that each hospital keeps a minimum stock of 36 dantrolene vials (720\u00a0mg), sufficient for four doses in a 70-kg person. [ 35 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3223", "text": "Fast recognition and treatment of MH utilizes skills and procedures that are utilized with a low-frequency and high-risk. [ 36 ]  Conducting MH crisis training for  perioperative  teams can identify system failures as well as improve response to these events. [ 37 ]   Simulation  techniques to include the use of cognitive aids have also been shown to improve communication in clinical treatment of MH. [ 38 ] [ 39 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3224", "text": "Prognosis is poor if this condition is not aggressively treated. [ 5 ]  In the 1970s, mortality was greater than 80%; however,  with the current management mortality is now less than 5%. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3225", "text": "It occurs in between 1:5,000 and 1:100,000 in procedures involving general anaesthesia. [ 5 ]  This disorder occurs worldwide and affects all racial groups."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3226", "text": "In the  Manawatu  region of New Zealand, up to 1 in 200 people are at high risk of the condition. [ 40 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3227", "text": "The syndrome was first recognized in  Royal Melbourne Hospital , Australia in an affected family by Denborough  et al.  in 1962. [ 41 ] [ 42 ]  Denborough did much of his subsequent work on the condition at the  Royal Canberra Hospital . [ 43 ]  Similar reactions were found in pigs. [ 44 ]  The efficacy of dantrolene as a treatment was discovered by South African anesthesiologist  Gaisford Harrison  and reported in a 1975 article published in the  British Journal of Anaesthesia . [ 45 ]  After further animal studies corroborated the possible benefit from dantrolene, a 1982 study confirmed its usefulness in humans. [ 46 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3228", "text": "In 1981, the Malignant Hyperthermia Association of the United States (MHAUS)  hotline  was established to provide telephone support to clinical teams treating patients with suspected malignant hyperthermia. The hotline became active in 1982 and since that time MHAUS has provided continuous access to board-certified anesthesiologists to assist teams in treatment. [ 47 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3229", "text": "Other animals, including certain pig breeds, dogs, and horses, are susceptible to malignant hyperthermia. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3230", "text": "In dogs its inheritance is  autosomal dominant . [ 48 ]  The syndrome has been reported in  Pointers, Greyhounds, Labrador Retrievers, Saint Bernards, Springer Spaniels, Bichon Frises, Golden Retrievers, and Border Collies. [ 49 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3231", "text": "In pigs its inheritance is  autosomal recessive . [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3232", "text": "In horses its inheritance is  autosomal dominant , and most associated with the  American Quarter Horse  although it can occur in other breeds. [ 50 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3233", "text": "Azumolene  is a 30-fold more water-soluble  analog  of dantrolene that also works to decrease the release of intracellular calcium by its action on the ryanodine receptor. In MH-susceptible swine, azumolene was as potent as dantrolene. [ 51 ]  It has yet to be studied  in vivo  in humans, but may present a suitable alternative to dantrolene in the treatment of MH. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3234", "text": "Metabolic myopathies  are  myopathies  that result from defects in biochemical metabolism that primarily affect muscle. They are generally genetic defects ( inborn errors of metabolism ) that interfere with the ability to create energy, causing a low ATP reservoir within the muscle cell. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3235", "text": "Metabolic myopathies are generally caused by an inherited genetic mutation, an inborn error of metabolism. (In livestock, an acquired environmental GSD is caused by intoxication with the alkaloid  castanospermine .) [ 3 ]  Metabolic myopathies cause the underproduction of adenosine triphosphate (ATP) within the muscle cell. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3236", "text": "The genetic mutation typically has an autosomal recessive  hereditary  pattern making it fairly rare to inherit, and even more rarely it can be caused by a random  de novo  genetic mutation, or autosomal dominant, X-linked, or mitochondrial. [ 1 ]  Metabolic myopathies are categorized by the metabolic pathway to which the deficient enzyme or transport protein belongs. The main categories of metabolic myopathies are listed below: [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3237", "text": "In the event more ATP is needed from the affected pathway, the lack of it becomes an issue and symptoms develop. People with a metabolic myopathy often experience symptoms such as:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3238", "text": "The degree of symptoms varies greatly from person to person and is dependent on the severity of enzymatic or transport protein defect. In extreme cases it can lead to rhabdomyolysis. [ 19 ]  The symptoms experienced also depend on which metabolic pathway is impaired, as different metabolic pathways produce ATP at different time periods during activity and rest, as well as the type of activity ( anaerobic  or  aerobic ) and its  intensity  (level of ATP consumption).  [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3239", "text": "A majority of patients with metabolic myopathies have  dynamic  rather than  static  findings, typically experiencing exercise intolerance, muscle pain, and cramps with exercise rather than fixed muscle weakness. [ 1 ] [ 20 ]  However, a minority of metabolic myopathies have fixed muscular weakness rather than exercise intolerance, imitating an inflammatory myopathy or limb girdle muscular dystrophy. It is uncommon that both static and dynamic signs predominate. [ 1 ] [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3240", "text": "At the cellular level, metabolic myopathies lack some kind of  enzyme  or  transport protein  that prevents the chemical reactions necessary to create  adenosine triphosphate (ATP) . [ 1 ] [ 17 ]  ATP is often referred to as the \"molecular unit of currency\" of intracellular  energy transfer . The lack of ATP prevents the muscle cells from being able to function properly. Some people with a metabolic myopathy never develop symptoms due to the body's ability to produce enough ATP through alternative pathways (e.g. the majority of those with  AMP-deaminase deficiency  are asymptomatic [ 1 ] [ 21 ] )."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3241", "text": "H 2 O + ATP \u2192 H +  + ADP + P i  + energy \u2192 muscle contraction [ 22 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3242", "text": "ATP is needed for  muscle contraction  by two processes:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3243", "text": "ATP is consumed at a high rate by contracting muscles. The need for ATP in muscle cells is illustrated by the phenomenon of  Rigor mortis , which is the muscle rigidity that occurs in dead bodies for a short time after death. In these muscles, all the ATP has been used up and in the absence of further ATP being generated, the calcium transport proteins stop pumping calcium ions into the sarcoplasmic reticulum and the calcium ions gradually leak out. This causes the myosin proteins to grab the actin and pull once, but without further supply of ATP, cannot release and pull again. The muscles therefore remain rigid in the position at death until the binding of myosin to actin begins to break down and they become loose again. [ 23 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3244", "text": "The symptoms of a metabolic myopathy can be easily confused with the symptoms of another disease. As genetic sequencing research progresses, a non-invasive neuromuscular panel DNA test can help make a diagnosis. Whole genome sequencing is required in more complex cases. [ 1 ]  If the DNA test is inconclusive (negative or  VUS ), then a  muscle biopsy  is necessary for an accurate diagnosis. In mitochondrial myopathies involving a single mtDNA deletion, DNA would have to be tested from affected muscle tissue rather than saliva or blood as unaffected tissues would show normal or near normal levels of mtDNA. [ 1 ] [ 24 ] [ 25 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3245", "text": "A  blood test  for  creatine kinase  (CK) can be done under normal circumstances to test for signs of tissue breakdown, or with an added cardio portion that can indicate if muscle breakdown is occurring. In metabolic myopathies, baseline CK is either normal or elevated. [ 8 ]  An  electromyography  (EMG) test is sometimes taken in order to rule out other disorders if the cause of fatigue is unknown. [ 4 ]  In metabolic myopathies, the EMG is either normal or myopathic, but spontaneous activity is usually absent. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3246", "text": "An  exercise stress test  can be used to determine an inappropriate rapid heart rate ( sinus tachycardia ) response to exercise, which is seen in  GSD-V , other glycogenoses, and mitochondrial myopathies. [ 7 ] [ 9 ]  A 12 Minutes Walk Test (12MWT) can also be used to determine \" second wind \" which is also seen in McArdle disease (GSD-V) and  phosphoglucomutase deficiency  (PGM1-CDG/CDG1T/GSD-XIV). [ 7 ] [ 26 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3247", "text": "A  cardiopulmonary exercise test  can measure both heart rate and breathing, to evaluate the oxygen cost (\u2206V'O 2 /\u2206Work-Rate) during incremental exercise. In both glycogenoses and mitochondrial myopathies, patients displayed an increased oxygen cost during exercise compared to control subjects; and therefore, can perform less work for a given  V\u0307O 2  consumption during submaximal daily life exercises. [ 9 ] [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3248", "text": "In fatty acid oxidation disorders (FAOD), while at rest, some exhibit cardiac arrhythmia (commonly various forms of tachycardia, but more rarely, conduction disorders or acute bradycardia); while others have a normal heart rhythm. [ 27 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3249", "text": "Some GSDs and a mitochondrial myopathy are known to have a  pseudoathletic appearance . McArdle disease (GSD-V) and late-onset Pompe disease (GSD-II) are known to have hypertrophy, particularly of the calf muscles. [ 14 ] [ 15 ]  Cori/Forbes disease (GSD-III) is known to have hypertrophy of the sternocleidomastoid, trapezius, quadriceps, and thigh muscles. [ 13 ] [ 28 ] [ 29 ] [ 30 ]  Muscular dystrophy, limb-girdle, type 1H  (which as of 2017 was excluded from LGMD for showing signs on muscle biopsy as being a mitochondrial myopathy, but not yet assigned new nomenclature) [ 31 ]  is also known to have hypertrophy of the calf muscles. [ 32 ]   Hereditary myopathy with lactic acidosis  (HML), another mitochondrial myopathy, also has hypertrophy of the calf muscles in some. [ 16 ] [ 33 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3250", "text": "Blood test may show a disturbance in pH, with  lactic acidosis  (low pH) in mitochondrial myopathies either at rest or exercise-induced. [ 34 ]  Glycogen storage diseases may show transient exercise-induced  alkalosis  (high pH),  hyperammonemia , and myogenic  hyperuricemia . [ 35 ] [ 36 ] [ 37 ] [ 38 ] [ 39 ]  During a non-ischemic forearm exercise test, in GSDs the plasma lactate typically fails to rise (and may fall below resting levels); except for a few GSDs such as phosphoglucomutase deficiency (GSD-XIV), [ 39 ]  deficiency of functioning myophosphorylase-a (autosomal dominant PYGM), [ 40 ]  phosphorylase-b kinase deficiency (GSD-IXd), and Pompe disease (GSD-II) where lactate production is normal. [ 2 ]  In myoadenylate deaminase deficiency (AMPD1 deficiency), there is no rise in ammonia. [ 2 ]  Some fatty acid oxidation disorders show lactic acidosis, hypoketotic  hypoglycaemia  and hyperammonemia, while others are asymptomatic. [ 2 ] [ 41 ] [ 42 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3251", "text": "Differentiating between different types of metabolic myopathies can be difficult due to the similar symptoms of each type such as  myoglobinuria  and  exercise intolerance . It has to be determined whether the patient has fixed (static) or exercise-induced (dynamic) manifestations; and if exercise-related, what kind of exercise, before extensive exercise-related lab testing is done to determine the underlying cause. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3252", "text": "Adequate knowledge is required of the body's  bioenergetic systems , [ 8 ] [ 43 ]  including:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3253", "text": "For example, leisurely-paced walking and fast-paced walking on level ground (no incline) are both aerobic, but fast-paced walking relies on more muscle glycogen because of the higher intensity (which would cause  exercise intolerance  symptoms in those with muscle  glycogenoses  that hadn't yet achieved \" second wind \"). [ 11 ] [ 7 ] [ 18 ] [ 44 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3254", "text": "When walking at a leisurely pace on level ground (no incline), but there is loose gravel or sand, long grass, snow, mud, or walking into a headwind, that added resistance (requiring more effort) makes the activity more reliant on muscle glycogen also. [ 7 ] [ 18 ]  These and other surfaces, such as ice, can make you tense your muscles (which is anearobic requiring muscle glycogen) as you protect yourself from slipping or falling. [ 7 ] [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3255", "text": "Those with muscle glycogenoses can maintain a healthy life of exercise by learning activity adaptations, utilizing the bioenergetic systems that are available to them. Depending on the type of activity and whether they are in second wind, they slow their pace or rest briefly when need be, to make sure not to empty their \"ATP reservoir.\" [ 7 ] [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3256", "text": "signs and symptoms"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3257", "text": "and  low-intensity aerobic  activity"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3258", "text": "(within seconds to minutes),\nby  high-intensity aerobic  activity"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3259", "text": "and all  anaerobic  activity"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3260", "text": "Metabolic myopathies have varying levels of symptoms, being most severe when developed during infancy. Those who do not develop a form of a metabolic myopathy until they are in their young adult or adult life tend to have more treatable symptoms that can be helped with a change in diet and exercise. [ 19 ]  It might be more accurate to say that metabolic myopathies described as adult-onset, it isn't necessarily that they didn't develop in infancy (they are inborn\u2014from birth\u2014errors of metabolism) but that they didn't display severe enough symptoms to warrant the attention of medical professionals until their adult years (severe symptoms such as rhabdomyolysis, fixed muscle weakness due to years of repetitive injury, or the de-conditioning of muscles from a more sedentary adult lifestyle which exacerbated symptoms). [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3261", "text": "Due to the rare nature of these diseases, it is very common to be misdiagnosed, even misdiagnosed multiple times. [ 11 ] [ 47 ] [ 43 ] [ 48 ]  Once a correct diagnosis has been made, in adult years, looking back symptoms were present since childhood, but either brushed-off as growing pains, laziness, or told that they just needed to exercise more. [ 43 ] [ 47 ] [ 11 ]  It is especially difficult to get a diagnosis when symptoms are  dynamic  (exercise-induced), such as in muscle  glycogenoses . [ 11 ] [ 20 ] [ 43 ]  Sitting in a doctor's office (at rest) or doing movements that only last a few seconds (within the time limit of the phosphagen system) the patient wouldn't display any noticeable abnormalities (such as  muscle fatigue , cramping, or breathlessness). [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3262", "text": "A brief or only mildly  elevated heart rate  (heart rate taken while sitting down after recently walking across the room or getting up on the examination table) might be assumed to be due to anxiety or illness rather than exercise-induced inappropriate rapid heart rate due to an ATP shortage in the muscle cells. In the absence of severe symptoms (such as hepatomegaly, cardiomyopathy, hypoglycemia, lactic acidosis, myoglobinuria, rhabdomyolysis, acute compartment syndrome or renal failure), it is understandable that a disease would not be noticed by medical professionals for years, when at rest the patient appears completely normal. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3263", "text": "Depending on what enzyme is affected, a high-protein or low-fat diet may be recommended along with mild exercise. It is important for people with metabolic myopathies to consult with their doctors for a treatment plan in order to prevent acute muscle breakdowns while exercising that lead to the release of muscle proteins into the bloodstream that can cause kidney damage. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3264", "text": "A ketogenic diet has a remarkable effect on CNS-symptoms in  PDH-deficiency  and has also been tried in  complex I deficiency . [ 49 ]  A ketogenic diet has demonstrated beneficial for McArdle disease ( GSD-V ) as ketones readily convert to acetyl CoA for oxidative phosphorylation, whereas free fatty acids take a few minutes to convert into acetyl CoA. [ 46 ]  As of 2022, another study on a ketogenic diet and McArdle disease (GSD-V) is underway. [ 50 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3265", "text": "For McArdle disease (GSD-V), regular aerobic exercise utilizing \" second wind \" to enable the muscles to become aerobically conditioned, as well as anaerobic exercise that follows the activity adaptations so as not to cause muscle injury, helps to improve exercise intolerance symptoms and maintain overall health. [ 7 ] [ 11 ] [ 51 ] [ 52 ]  Studies have shown that regular low-moderate aerobic exercise increases peak power output, increases peak oxygen uptake ( VO 2 peak ), lowers heart rate, and lowers serum CK in individuals with McArdle disease. [ 51 ] [ 52 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3266", "text": "Regardless of whether the patient experiences  symptoms  of muscle pain, muscle fatigue, or cramping, the phenomenon of second wind having been achieved is demonstrable by the  sign  of an increased heart rate dropping while maintaining the same speed on the treadmill. [ 52 ] [ 43 ]  Inactive patients experienced second wind, demonstrated through relief of typical symptoms and the sign of an increased heart rate dropping, while performing low-moderate aerobic exercise (walking or brisk walking). [ 52 ] [ 43 ]  Conversely, patients that were regularly active did not experience the typical symptoms during low-moderate aerobic exercise (walking or brisk walking), but still demonstrated second wind by the sign of an increased heart rate dropping. [ 52 ] [ 43 ]  For the regularly active patients, it took more strenuous exercise (very brisk walking/jogging or bicycling) for them to experience both the typical symptoms and relief thereof, along with the sign of an increased heart rate dropping, demonstrating second wind. [ 52 ] [ 43 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3267", "text": "Muscle atrophy  is the loss of  skeletal muscle  mass. It can be caused by  immobility , aging,  malnutrition , medications, or a wide range of injuries or diseases that impact the musculoskeletal or  nervous system . Muscle atrophy leads to muscle weakness and causes disability."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3268", "text": "Disuse causes rapid muscle atrophy and often occurs during injury or illness that requires immobilization of a limb or bed rest. Depending on the duration of disuse and the health of the individual, this may be fully reversed with activity. Malnutrition first causes fat loss but may progress to muscle atrophy in prolonged starvation and can be reversed with nutritional therapy. In contrast,  cachexia  is a wasting syndrome caused by an underlying disease such as cancer that causes dramatic muscle atrophy and cannot be completely reversed with nutritional therapy.  Sarcopenia  is  age-related  muscle atrophy and can be slowed by exercise. Finally, diseases of the muscles such as  muscular dystrophy  or  myopathies  can cause atrophy, as well as damage to the nervous system such as in  spinal cord injury  or  stroke . Thus, muscle atrophy is usually a finding ( sign or symptom ) in a disease rather than being a disease by itself. However, some  syndromes  of muscular atrophy are classified as disease spectrums or disease entities rather than as clinical syndromes alone, such as the various  spinal muscular atrophies ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3269", "text": "Muscle atrophy results from an imbalance between protein synthesis and protein degradation, although the mechanisms are incompletely understood and are variable depending on the cause. Muscle loss can be quantified with advanced imaging studies but this is not frequently pursued. Treatment depends on the underlying cause but will often include exercise and adequate nutrition.  Anabolic agents  may have some efficacy but are not often used due to side effects. There are multiple treatments and supplements under investigation but there are currently limited treatment options in clinical practice. Given the implications of muscle atrophy and limited treatment options, minimizing immobility is critical in injury or illness."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3270", "text": "The hallmark sign of muscle atrophy is loss of lean muscle mass. This change may be difficult to detect due to obesity, changes in fat mass or edema. Changes in weight, limb or waist circumference are not reliable indicators of muscle mass changes. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3271", "text": "The predominant symptom is increased weakness which may result in difficulty or inability in performing physical tasks depending on what muscles are affected. Atrophy of the core or leg muscles may cause difficulty standing from a seated position, walking or climbing stairs and can cause increased falls. Atrophy of the throat muscles may cause difficulty swallowing and diaphragm atrophy can cause difficulty breathing. Muscle atrophy can be asymptomatic and may go undetected until a significant amount of muscle is lost. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3272", "text": "Skeletal muscle serves as a storage site for  amino acids ,  creatine ,  myoglobin , and  adenosine triphosphate , which can be used for energy production when demands are high or supplies are low. If metabolic demands remain greater than protein synthesis, muscle mass is lost. [ 3 ]  Many diseases and conditions can lead to this imbalance, either through the disease itself or disease associated appetite-changes, such as loss of taste due to  Covid-19 . Causes of muscle  atrophy , include immobility, aging,  malnutrition , certain systemic diseases ( cancer ,  congestive heart failure ;  chronic obstructive pulmonary disease ;  AIDS ,  liver disease , etc.), deinnervation, intrinsic muscle disease or medications (such as  glucocorticoids ). [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3273", "text": "Disuse is a common cause of muscle atrophy and can be local (due to injury or casting) or general (bed-rest). The rate of muscle atrophy from disuse (10\u201342 days) is  approximately 0.5\u20130.6% of total muscle mass per day although there is considerable variation between people. [ 5 ]  The elderly are the most vulnerable to dramatic muscle loss with immobility. Much of the established research has investigated prolonged disuse (>10 days), in which the muscle is compromised primarily by declines in muscle protein synthesis rates rather than changes in muscle protein breakdown. There is evidence to suggest that there may be more active protein breakdown during short term immobility (<10 days). [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3274", "text": "Certain diseases can cause a complex muscle wasting syndrome known as  cachexia . It is commonly seen in cancer,  congestive heart failure ,  chronic obstructive pulmonary disease ,  chronic kidney disease  and  AIDS  although it is associated with many disease processes, usually with a significant inflammatory component. Cachexia causes ongoing muscle loss that is not entirely reversed with nutritional therapy. [ 6 ]  The pathophysiology is incompletely understood but inflammatory  cytokines  are considered to play a central role. In contrast to weight loss from inadequate caloric intake,  cachexia  causes predominantly muscle loss instead of fat loss and it is not as responsive to nutritional intervention. Cachexia can significantly compromise quality of life and functional status and is associated with poor outcomes. [ 7 ] [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3275", "text": "Sarcopenia  is the degenerative loss of skeletal muscle mass, quality, and strength associated with aging. This involves muscle atrophy, reduction in number of muscle fibers and a shift towards \"slow twitch\" or  type I skeletal muscle fibers  over \"fast twitch\" or  type II fibers . [ 3 ]  The rate of muscle loss is dependent on exercise level, co-morbidities, nutrition and other factors. There are many proposed mechanisms of sarcopenia, such as a decreased capacity for oxidative phosphorylation, cellular senescence or an altered signaling of pathways regulating protein synthesis, [ 9 ]  and is considered to be the result of changes in muscle synthesis signalling pathways and gradual failure in the  satellite cells  which help to regenerate skeletal muscle fibers, specifically in \"fast twitch\" myofibers. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3276", "text": "Sarcopenia can lead to reduction in functional status and cause significant disability but is a distinct condition from  cachexia  although they may co-exist. [ 8 ] [ 11 ]  In 2016 an  ICD code  for sarcopenia was released, contributing to its acceptance as a disease entity. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3277", "text": "Muscle diseases, such as  muscular dystrophy ,  amyotrophic lateral sclerosis  (ALS), or  myositis  such as  inclusion body myositis  can cause muscle atrophy. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3278", "text": "Damage to neurons in the brain or spinal cord can cause prominent muscle atrophy. This can be localized muscle atrophy and weakness or paralysis such as in  stroke  or  spinal cord injury . [ 14 ]  More widespread damage such as in  traumatic brain injury  or  cerebral palsy  can cause generalized muscle atrophy. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3279", "text": "Injuries or diseases of peripheral nerves supplying specific muscles can also cause muscle atrophy. This is seen in nerve injury due to trauma or surgical complication, nerve entrapment, or inherited diseases such as  Charcot-Marie-Tooth disease . [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3280", "text": "Some medications are known to cause muscle atrophy, usually due to direct effect on muscles. This includes glucocorticoids causing glucocorticoid myopathy [ 4 ]  or medications toxic to muscle such as  doxorubicin . [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3281", "text": "Disorders of the endocrine system such as  Cushing's disease  or  hypothyroidism  are known to cause muscle atrophy. [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3282", "text": "Muscle atrophy occurs due to an imbalance between the normal balance between protein synthesis and protein degradation. This involves complex cell signalling that is incompletely understood and muscle atrophy is likely the result of multiple contributing mechanisms. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3283", "text": "Mitochondrial function is crucial to skeletal muscle health and detrimental changes at the level of the mitochondria may contribute to muscle atrophy. [ 20 ]  A decline in mitochondrial density as well as quality is consistently seen in muscle atrophy due to disuse. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3284", "text": "The  ATP -dependent  ubiquitin / proteasome  pathway is one mechanism by which proteins are degraded in muscle. This involves specific proteins being tagged for destruction by a small peptide called  ubiquitin  which allows recognition by the  proteasome  to degrade the protein. [ 21 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3285", "text": "Screening for muscle atrophy is limited by a lack of established diagnostic criteria, although many have been proposed. Diagnostic criteria for other conditions such as  sarcopenia  or  cachexia  can be used. [ 3 ]  These syndromes can also be identified with screening questionnaires. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3286", "text": "Muscle mass and changes can be quantified on imaging studies such as  CT scans  or  Magnetic resonance imaging (MRI) . Biomarkers such as urine  urea  can be used to roughly estimate muscle loss during circumstances of rapid muscle loss. [ 22 ]  Other biomarkers are currently under investigation but are not used in clinical practice. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3287", "text": "Muscle atrophy can be delayed, prevented and sometimes reversed with treatment. Treatment approaches include impacting the signaling pathways that induce  muscle hypertrophy  or slow muscle breakdown as well as optimizing nutritional status. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3288", "text": "Physical activity provides a significant anabolic muscle stimulus and is a crucial component to slowing or reversing muscle atrophy. [ 3 ]  It is still unknown regarding the ideal exercise \"dosing.\" Resistance exercise has been shown to be beneficial in reducing muscle atrophy in older adults. [ 23 ] [ 24 ]  In patients who cannot exercise due to physical limitations such as paraplegia,  functional electrical stimulation  can be used to externally stimulate the muscles. [ 25 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3289", "text": "Adequate calories and protein is crucial to prevent muscle atrophy. Protein needs may vary dramatically depending on metabolic factors and disease state, so high-protein supplementation may be beneficial. [ 3 ]  Supplementation of protein or  branched-chain amino acids , especially leucine, can provide a stimulus for muscle synthesis and inhibit protein breakdown and has been studied for muscle atrophy for sarcopenia and cachexia. [ 3 ] [ 26 ]   \u03b2-Hydroxy \u03b2-methylbutyrate  (HMB), a metabolite of  leucine  which is sold as a  dietary supplement , has demonstrated efficacy in preventing the loss of muscle mass in several muscle wasting conditions in humans, particularly  sarcopenia . [ 26 ] [ 27 ] [ 28 ]  Based upon a  meta-analysis  of seven  randomized controlled trials  that was published in 2015, HMB supplementation has efficacy as a treatment for preserving lean muscle mass in older adults. [ 29 ]  More research is needed to determine the precise effects of HMB on muscle strength and function in various populations. [ 29 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3290", "text": "In severe cases of muscular atrophy, the use of an  anabolic steroid  such as  methandrostenolone  may be administered to patients as a potential treatment although use is limited by side effects. A novel class of drugs, called  selective androgen receptor modulators , is being investigated with promising results. They would have fewer  side effects , while still promoting muscle and bone tissue growth and regeneration. These effects have yet to be confirmed in larger clinical trials. [ 30 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3291", "text": "Outcomes of muscle atrophy depend on the underlying cause and the health of the patient. Immobility or bed rest in populations predisposed to muscle atrophy, such as the elderly or those with disease states that commonly cause  cachexia , can cause dramatic muscle atrophy and impact on functional outcomes. In the elderly, this often leads to decreased biological reserve and increased vulnerability to stressors known as the \" frailty syndrome .\" [ 3 ]  Loss of lean body mass is also associated with increased risk of infection, decreased immunity, and poor wound healing. The weakness that accompanies muscle atrophy leads to higher risk of falls, fractures, physical disability, need for institutional care, reduced quality of life, increased mortality, and increased healthcare costs. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3292", "text": "Inactivity and starvation in mammals lead to atrophy of skeletal muscle, accompanied by a smaller number and size of the muscle cells as well as lower protein content. [ 31 ]  In humans, prolonged periods of immobilization, as in the cases of bed rest or astronauts flying in space, are known to result in muscle weakening and atrophy. Such consequences are also noted in small hibernating mammals like the golden-mantled ground squirrels and brown bats. [ 32 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3293", "text": "Bears  are an exception to this rule; species in the family Ursidae are famous for their ability to survive unfavorable environmental conditions of low temperatures and limited nutrition availability during winter by means of  hibernation . During that time, bears go through a series of physiological, morphological, and behavioral changes. [ 33 ]   Their ability to maintain skeletal muscle number and size during disuse is of significant importance. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3294", "text": "During hibernation, bears spend 4\u20137 months of inactivity and anorexia without undergoing muscle atrophy and protein loss. [ 32 ]  A few known factors contribute to the sustaining of muscle tissue. During the summer, bears take advantage of the nutrition availability and accumulate muscle protein. The protein balance at time of dormancy is also maintained by lower levels of protein breakdown during the winter. [ 32 ]   At times of immobility, muscle wasting in bears is also suppressed by a proteolytic inhibitor that is released in circulation. [ 31 ]   Another factor that contributes to the sustaining of muscle strength in hibernating bears is the occurrence of periodic voluntary contractions and involuntary contractions from shivering during  torpor . [ 34 ]   The three to four daily episodes of muscle activity are responsible for the maintenance of muscle strength and responsiveness in bears during hibernation. [ 34 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3295", "text": "Muscle-atrophy can be induced in pre-clinical models (e.g. mice) to study the effects of therapeutic interventions against muscle-atrophy. Restriction of the diet, i.e. caloric restriction, leads to a significant loss of muscle mass within two weeks, and loss of muscle-mass can be rescued by a nutritional intervention. [ 35 ]  Immobilization of one of the hindlegs of mice leads to muscle-atrophy as well, and is hallmarked by loss of both muscle mass and strength. Food restriction and immobilization may be used in mouse models and have been shown to overlap with mechanisms associated to sarcopenia in humans. [ 36 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3296", "text": "Muscle fatigue  is when muscles that were initially generating a normal amount of  force , then experience a declining ability to generate force. It can be a result of vigorous  exercise , but abnormal fatigue may be caused by barriers to or interference with the different stages of  muscle contraction . There are two main causes of muscle fatigue: the limitations of a  nerve \u2019s ability to generate a sustained  signal  (neural fatigue); and the reduced ability of the  muscle fiber  to contract (metabolic fatigue)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3297", "text": "Muscle fatigue is not the same as muscle weakness, though weakness is an initial symptom. Despite a normal amount of force being generated at the start of activity, once muscle fatigue has set in and progressively worsens, if the individual persists in the exercise they will eventually lose their hand grip, or become unable to lift or push with their arms or legs, or become unable to maintain an isometric position (such as  plank ). Other symptoms may accompany such as myalgia (muscle pain), shortness of breath, fasciculations (muscle twitching), myokymia (muscle trembling), and muscle cramps during exercise; muscle soreness may occur afterwards. [ 1 ]  An inappropriate rapid heart rate response to exercise may be seen, such as in the metabolic myopathy of McArdle disease (GSD-V), where the heart tries to compensate for the deficit of ATP in the  skeletal muscle  cells (metabolic fatigue) by increasing heart rate to maximize delivery of oxygen and blood borne fuels to the muscles for oxidative phosphorylation. [ 2 ]  The combination of an inappropriate rapid heart rate response to exercise with heavy or rapid breathing is known as an exaggerated cardiorespiratory response to exercise. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3298", "text": "Due to the confusion between muscle fatigue and muscle weakness, there have been instances of abnormal muscle fatigue being described as exercise-induced muscle weakness. [ 4 ] [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3299", "text": "Muscle cells work by detecting a  flow  of electrical impulses from the  brain  which signals them to  contract  through the release of  calcium  by the  sarcoplasmic reticulum .  Fatigue (reduced ability to generate force) may occur due to the nerve, or within the muscle cells themselves. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3300", "text": "Nerves  are responsible for controlling the contraction of muscles, determining the number, sequence and force of muscular contraction.  Most movements require a force far below what a muscle could potentially generate, and nervous fatigue is seldom an issue. But, during extremely powerful contractions that are close to the upper limit of a muscle's ability to generate force, nervous fatigue (enervation)\u00a0\u2014 in which the nerve signal weakens\u00a0\u2014 can be a limiting factor in untrained individuals. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3301", "text": "In novice  strength trainers , the muscle's ability to generate force is most strongly limited by nerve\u2019s ability to sustain a high-frequency signal.  After a period of maximum contraction, the nerve\u2019s signal reduces in frequency and the force generated by the contraction diminishes.  There is no sensation of pain or discomfort, the muscle appears to simply \u2018stop listening\u2019 and gradually cease to contract, often  going backwards .  Often there is insufficient stress on the muscles and tendons to cause  delayed onset muscle soreness  following the workout. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3302", "text": "Part of the process of strength training is increasing the nerve's ability to generate sustained, high frequency signals which allow a muscle to contract with its greatest force.  This neural training can cause several weeks of rapid gains in strength, which level off once the nerve is generating maximum contractions and the muscle reaches its physiological limit.  Past this point, training effects increase muscular strength through myofibrillar or sarcoplasmic  hypertrophy  and metabolic fatigue becomes the factor limiting contractile force. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3303", "text": "Though not universally used, \u2018metabolic fatigue\u2019 is a common term for the reduction in contractile force due to the direct or indirect effects of two main factors:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3304", "text": "Substrates  within the muscle serve to power muscular contractions. They include molecules such as  adenosine triphosphate  (ATP),  glycogen  and  creatine phosphate . ATP binds to the  myosin  head and causes the \u2018ratchetting\u2019 that results in contraction according to the  sliding filament model . Creatine phosphate stores energy so ATP can be rapidly regenerated within the muscle cells from  adenosine diphosphate  (ADP) and inorganic phosphate ions, allowing for sustained powerful contractions that last between 5\u20137 seconds. Glycogen is the intramuscular storage form of  glucose , used to generate energy quickly as intramuscular phosphocreatine stores become exhausted, producing  lactic acid  as a metabolic byproduct."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3305", "text": "Substrate shortage is one of the causes of metabolic fatigue. Substrates are depleted during exercise or are unable to be metabolized (e.g.  metabolic myopathies ), resulting in a lack of intracellular energy sources to fuel contractions. In essence, the muscle stops contracting because it lacks the energy to do so."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3306", "text": "Metabolites are the substances (generally waste products) produced as a result of muscular contraction.  They include  chloride ,  potassium ,  lactic acid ,  ADP ,  magnesium  (Mg 2+ ),  reactive oxygen species , and  inorganic phosphate .  Accumulation of metabolites can directly or indirectly produce metabolic fatigue within muscle fibers through interference with the release of calcium (Ca 2+ ) from the sarcoplasmic reticulum or reduction of the sensitivity of contractile molecules  actin  and  myosin  to calcium."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3307", "text": "Intracellular  chloride  partially inhibits the contraction of muscles. Namely, it prevents muscles from contracting due to \"false alarms\", small stimuli which may cause them to contract (akin to  myoclonus )."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3308", "text": "High concentrations of  potassium  (K + ) also causes the muscle cells to decrease in efficiency, causing cramping and fatigue. Potassium builds up in the  t-tubule  system and around the muscle fiber as a result of  action potentials . The shift in K +  changes the membrane potential around the muscle fiber. The change in membrane potential causes a decrease in the release of  calcium  (Ca 2+ ) from the  sarcoplasmic reticulum . [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3309", "text": "It was once believed that  lactic acid  build-up was the cause of muscle fatigue. [ 8 ]   The assumption was lactic acid had a \"pickling\" effect on muscles, inhibiting their ability to contract.  Though the impact of lactic acid on performance is now uncertain, it may assist or hinder muscle fatigue."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3310", "text": "Produced as a by-product of  fermentation , lactic acid can increase intracellular acidity of muscles.  This can lower the sensitivity of contractile apparatus to Ca 2+  but also has the effect of increasing  cytoplasmic  Ca 2+  concentration through an inhibition of the  chemical pump  that  actively transports  calcium out of the cell.  This counters inhibiting effects of potassium on muscular action potentials.  Lactic acid also has a negating effect on the chloride ions in the muscles, reducing their inhibition of contraction and leaving potassium ions as the only restricting influence on muscle contractions, though the effects of potassium are much less than if there were no lactic acid to remove the chloride ions.  Ultimately, it is uncertain if lactic acid reduces fatigue through increased intracellular calcium or increases fatigue through reduced sensitivity of contractile proteins to Ca 2+ ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3311", "text": "Lactic acid is now used as a measure of endurance training effectiveness and  VO 2  max . [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3312", "text": "Muscle fatigue may be due to problems with the  nerve supply ,  neuromuscular disease  (such as  myasthenia gravis ),  inborn errors of metabolism  (such as  metabolic myopathies ), or problems with muscle itself. The latter category includes  polymyositis  and other  muscle disorders ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3313", "text": "Muscle fatigue may be due to precise molecular changes that occur  in vivo  with sustained exercise. It has been found that the  ryanodine receptor  present in skeletal muscle undergoes a  conformational change  during exercise, resulting in \"leaky\" channels that are deficient in  calcium  release. These \"leaky\" channels may be a contributor to muscle fatigue and decreased exercise capacity. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3314", "text": "Fatigue has been found to play a big role in limiting performance in just about every individual in every sport.  In research studies, participants were found to show reduced voluntary force production in fatigued muscles (measured with concentric, eccentric, and isometric contractions), vertical jump heights, other field tests of lower body power, reduced throwing velocities, reduced kicking power and velocity, less accuracy in throwing and shooting activities, endurance capacity, anaerobic capacity, anaerobic power, mental concentration, and many other performance parameters when sport specific skills are examined. [ 11 ] [ 12 ] [ 13 ] [ 14 ] [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3315", "text": "Electromyography  is a research technique that allows researchers to look at muscle recruitment in various conditions, by quantifying electrical signals sent to muscle fibers through motor neurons.  In general, fatigue protocols have shown increases in EMG data over the course of a fatiguing protocol, but reduced recruitment of muscle fibers in tests of power in fatigued individuals.  In most studies, this increase in recruitment during exercise correlated with a decrease in performance (as would be expected in a fatiguing individual). [ 16 ] [ 17 ] [ 18 ] [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3316", "text": "Median power frequency is often used as a way to track fatigue using EMG. Using the median power frequency, raw EMG data is filtered to reduce noise and then relevant time windows are Fourier Transformed. In the case of fatigue in a 30-second isometric contraction, the first window may be the first second, the second window might be at second 15, and the third window could be the last second of contraction (at second 30). Each window of data is analyzed and the median power frequency is found. Generally, the median power frequency decreases over time, demonstrating fatigue. Some reasons why fatigue is found are due to action potentials of motor units having a similar pattern of repolarization, fast motor units activating and then quickly deactivating while slower motor units remain, and conduction velocities of the nervous system decreasing over time. [ 20 ] [ 21 ] [ 22 ] [ 23 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3317", "text": "Muscle balance is necessary for muscles to perform their customary roles and move normally;  muscle imbalance  occurs when there is a lack of parity between corresponding  agonist and antagonist  muscles. [ 1 ]  Muscular imbalance can also arise when a muscle performs outside of its normal physiological muscle function. [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3318", "text": "Muscles are considered balanced when the muscles that surround a joint work together harmoniously, i.e. with appropriate opposing force, to keep the bones aligned where they meet at the joint. This permits normal  human movement . [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3319", "text": "Muscles can be categorized as either functional or pathological. Muscle imbalance can be caused either by adaptation of a functional muscle or by dysfunction in a muscle suffering a pathology."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3320", "text": "Classic symptoms of muscle imbalances are usually pain associated with the affected joint. [ 1 ]  Symptoms can vary depending on what stage their muscular imbalance is, functional or pathological, but commonly exhibit small tissue damage or lesions accompanied by a change in muscle movement patterns. [ 1 ]  Symptoms may occur after injury or surgery, where the recuperation of the joint affected is left untreated causing either tension or restriction to flexibility and strength of the prime movers. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3321", "text": "Tennis elbow  is the most common elbow problem among athletes, highly associated with world class tennis players, it is a condition that involves the common wrist extensor origin, in particular the origin of extensor carpi radialis. [ 4 ]   The causes for tennis elbow includes any activity, not only tennis, where the repetitive use of the extensor muscles of the forearm may cause acute or chronic tendonitis of the tensinous insertion of these muscles at the lateral epicondyle of the elbow. [ 5 ]  The condition itself is most common with painters, plumbers, and carpenters. Further studied have shown that auto-workers, butchers and cooks also get tennis elbow more often than the rest of the population. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3322", "text": "Lazy eye , in particular  strabismus  may be the result of coordination between the  extraocular muscles , which prevents a person on directing both eyes in unison towards the same fixation point. [ 6 ]  The main cause of strabismus is usually the muscular imbalance of the six surrounding muscles that allow both eyes to focus on the same object. [ 7 ]  As each eye does not have the same focus, different images are sent to the brain, confusing it, resulting in the brain ignoring the image from the weaker eye and if left untreated will cause a loss of vision in the ignored eye called  amblyopia . [ 7 ]  Further symptoms of strabismus include decreased vision,  double vision ,  headaches ,  asthenopia  and  eye fatigue . [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3323", "text": "Scoliosis , is a medical condition where a person's spine has several irregular curves that are located between the neck and the pelvis. [ 8 ]  Symptoms of scoliosis in mild cases usually exhibit abnormal posture, back pain, tingling or numbness in the legs and in worse cases can exhibit breathing problems, fatigue, permanent deformities and in rare cases heart problems. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3324", "text": "Functional Imbalances are when the muscles adapt in response for detailed muscle movement patterns, including unequal values in strength or flexibility of antagonistic muscle groups, usually apparent in athletes of different sports ranging from soccer to baseball. [ 1 ]  This type of imbalance is the first stage, it is painless, atraumatic (causes minimal tissue injury [ 9 ] ), adaptive to change and activity specific. [ 1 ]  Studies confirm this as they find the link between muscle imbalance and athletes who perform at elite levels, this also relates to injury occurrence is not treated to muscle specific rehabilitation. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3325", "text": "Pathological muscle imbalance occurs when the imbalance of the muscles begin to inhibit function. [ 1 ]  This pathological muscle imbalance may or may not result from a traumatic event, it is usually associated with pain and dysfunction, although there are cases where pain is not apparent, however pathological muscle imbalances ultimately lead to joint dysfunction and changes in normative muscle movement patterns. [ 1 ]  It would be good to note that this imbalance can progress to either tissue damage and pain or altered movement pattern, with the constant being tightness or weakness. [ 1 ]  A study has shown that athletes that exhibit shoulder pain have been linked to have decreased  rotator cuff  muscle strength and have concluded that they are more susceptible to  rotator cuff tears  and type II superior  labrum  anterior and posterior  lesions . [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3326", "text": "Muscle imbalance can be characterized by different factors, namely where the muscle imbalance is on the body, diagnosis varies for these specific areas as each area needs to be handled differently. Other signs include joint pain or muscular pain, abnormal joint movement patterns or in some cases, muscle tears and lesions. [ 11 ]  It can be diagnosed by demonstrating any one of the following:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3327", "text": "Although treatment for tennis elbow prior 2010 was unknown because the etiology remained unclear, tests confirmed that the cause was an imbalance with the agonist-antagonist functional relationship. [ 4 ] [ 13 ]  Treatment now includes anti-inflammatory medicines, rest, equipment check, physical therapy, braces, steroid injections, shock wave therapy and if symptoms persist after 6 to 12 months, doctors may recommend surgery. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3328", "text": "Although treatment varies depending on how bad eye alignment is and also the underlying causes of strabismus. [ 14 ]  Treatment for strabismus may include  orthoptics  a term used for eye muscle training, this treatment can be provided by  orthoptists  and also  optometrists . [ 15 ]  Other treatment may include wearing eye patches aimed at strengthening the weaker eye while inhibiting the stronger eye, an alternative to eye patches is the use of an opaque lens, other treatments may include eye drops to temporarily inhibit the stronger eye and at any age eye muscle surgery can be done to correct the muscular balance of the ocular muscles. [ 7 ] [ 14 ] [ 16 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3329", "text": "Although the cause of scoliosis can sometimes remain unknown ( idiopathic scoliosis ) there is treatment available that targets at strengthening the back muscles, for milder cases usually do not require medical attention, more severe cases require either muscle strengthening exercises aimed at the back muscles and even special back braces or surgery can be recommended if the case is extreme. [ 8 ]  Studies have shown that treatment with a special back brace among children ranging from 10\u201316 years can be successful and using this method of muscle training scoliosis can be cured with non-surgical treatment. [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3330", "text": "In terms of selective muscle weakness or poor flexibility muscular imbalance is frequently regarded as an  etiological  factor in the onset of  musculoskeletal disorders . [ 2 ]  There are a variety of areas that can be affected, each causing different symptoms hence there are also different treatments available, but in general cases muscle strengthening techniques were developed for the use on the weak or tight muscles. [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3331", "text": "For a long time muscular imbalance had many different theories that revolved around it. It wasn't until 1949 when there was a first manual on muscle testing appeared, written by therapists Henry and  Florence Kendall , [ 19 ]  which discusses muscle weakness in polio patients and treatments approaching tight and weak muscles. [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3332", "text": "In the 1960s  Dr. George Goodheart  and  Dr. Vladimir Janda  each took their own paths in treating patients with muscular imbalance, Goodheart focusing on muscle weakness being the primary cause of muscle imbalance, whilst Janda took on the muscle tightness approach, both developed a large following that continues on today. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3333", "text": "There is evidence to support two different approaches to muscular imbalance, the first is a biomechanical approach that believed the cause was due from repeated movements in one direction or sustained postures, this was widespread by Kendall. The second is a neuromuscular imbalance due to certain muscle groups being tight or weak, popularized by Janda this approach is based on movement patterns that evolve from birth. [ 3 ]  Today there are many different types of therapists who treat muscle imbalance, these include chiropractors, osteopaths, physical therapists, medical doctors and massage therapists each assessing tightness or weakness as the primary cause of muscular imbalance. [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3334", "text": "Muscle weakness  is a lack of  muscle  strength. Its causes are many and can be divided into conditions that have either true or perceived muscle weakness.  True muscle weakness is a primary symptom of a variety of skeletal muscle diseases, including  muscular dystrophy  and  inflammatory myopathy . It occurs in  neuromuscular junction  disorders, such as  myasthenia gravis . Muscle weakness can also be caused by low levels of  potassium  and other  electrolytes  within muscle cells. It can be temporary or long-lasting (from seconds or minutes to months or years). The term myasthenia is from my- from Greek \u03bc\u03c5\u03bf meaning \"muscle\" + -asthenia  \u1f00\u03c3\u03b8\u03ad\u03bd\u03b5\u03b9\u03b1 meaning \" weakness \"."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3335", "text": "Neuromuscular fatigue can be classified as either \"central\" or \"peripheral\" depending on its cause. Central muscle fatigue manifests as an overall sense of energy deprivation, while peripheral muscle fatigue manifests as a local, muscle-specific inability to do work. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3336", "text": "Nerves  control the contraction of muscles by determining the number, sequence, and force of muscular contraction. When a nerve experiences  synaptic fatigue  it becomes unable to stimulate the muscle that it innervates. Most movements require a force far below what a muscle could potentially generate, and barring  pathology , neuromuscular fatigue is seldom an issue. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3337", "text": "For extremely powerful contractions that are close to the upper limit of a muscle's ability to generate force, neuromuscular fatigue can become a limiting factor in untrained individuals. In novice  strength trainers , the muscle's ability to generate force is most strongly limited by nerve's ability to sustain a  high-frequency signal . After an extended period of maximum contraction, the nerve's signal reduces in frequency and the force generated by the contraction diminishes. There is no sensation of pain or discomfort, the muscle appears to simply \u2018stop listening\u2019 and gradually cease to move, often  lengthening . As there is insufficient stress on the muscles and tendons, there will often be no  delayed onset muscle soreness  following the workout.  Part of the process of strength training is increasing the nerve's ability to generate sustained, high frequency signals which allow a muscle to contract with their greatest force.  It is this \"neural training\" that causes several weeks worth of rapid gains in strength, which level off once the nerve is generating maximum contractions and the muscle reaches its physiological limit. Past this point, training effects increase muscular strength through myofibrillar or sarcoplasmic  hypertrophy  and metabolic fatigue becomes the factor limiting contractile force. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3338", "text": "Central fatigue  is a reduction in the  neural  drive or nerve-based motor command to working muscles that results in a decline in the force output. [ 3 ] [ 4 ] [ 5 ]   It has been suggested that the reduced neural drive during exercise may be a protective mechanism to prevent organ failure if the work was continued at the same intensity. [ 6 ] [ 7 ]  There has been a great deal of interest in the role of  serotonergic  pathways for several years because its concentration in the brain increases with motor activity. [ 8 ] [ 9 ] [ 10 ]  During motor activity, serotonin released in synapses that contact  motoneurons  promotes muscle contraction. [ 11 ]  During high level of motor activity, the amount of  serotonin  released increases and a spillover occurs. Serotonin binds to extrasynaptic receptors located on the  axon  initial segment of  motoneurons  with the result that nerve impulse initiation and thereby muscle contraction are inhibited. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3339", "text": "Peripheral muscle fatigue during physical work is an inability for the body to supply sufficient energy or other metabolites to the contracting muscles to meet the increased energy demand. This is the most common case of physical fatigue\u2014affecting a national [ where? ]  average of 72% of adults in the work force in 2002. This causes contractile dysfunction that manifests in the eventual reduction or lack of ability of a single muscle or local group of muscles to do work. The insufficiency of energy, i.e. sub-optimal  aerobic metabolism , generally results in the accumulation of  lactic acid  and other  acidic  anaerobic metabolic by-products in the muscle, causing the stereotypical burning sensation of local muscle fatigue, though recent studies have indicated otherwise, actually finding that lactic acid is a source of energy. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3340", "text": "The fundamental difference between the peripheral and central theories of muscle fatigue is that the peripheral model of muscle fatigue assumes failure at one or more sites in the chain that initiates muscle contraction. Peripheral regulation  therefore depends on the localized metabolic chemical conditions of the local muscle affected, whereas the central model of muscle fatigue is an integrated mechanism that works to preserve the integrity of the system by initiating muscle fatigue through muscle derecruitment, based on collective feedback from the periphery, before cellular or organ failure occurs. Therefore, the feedback that is read by this central regulator could include chemical and mechanical as well as cognitive cues. The significance of each of these factors will depend on the nature of the fatigue-inducing work that is being performed. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3341", "text": "Though not universally used, \"metabolic fatigue\" is a common alternative term for peripheral muscle weakness, because of the reduction in contractile force due to the direct or indirect effects of the reduction of substrates or accumulation of metabolites within the  muscle fiber . This can occur through a simple lack of energy to fuel contraction, or through interference with the ability of Ca 2+  to stimulate  actin  and  myosin  to contract. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3342", "text": "It was once believed that  lactic acid  build-up was the cause of muscle fatigue. [ 14 ]   The assumption was lactic acid had a \"pickling\" effect on muscles, inhibiting their ability to contract.  The impact of lactic acid on performance is now uncertain, it may assist or hinder muscle fatigue. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3343", "text": "Produced as a by-product of  fermentation , lactic acid can increase intracellular acidity of muscles.  This can lower the sensitivity of contractile apparatus to  calcium ions  (Ca 2+ ) but also has the effect of increasing  cytoplasmic  Ca 2+  concentration through an inhibition of the  chemical pump  that  actively transports  calcium out of the cell.  This counters inhibiting effects of  potassium ions  (K + ) on muscular action potentials.  Lactic acid also has a negating effect on the chloride ions in the muscles, reducing their inhibition of contraction and leaving K +  as the only restricting influence on muscle contractions, though the effects of potassium are much less than if there were no lactic acid to remove the chloride ions.  Ultimately, it is uncertain if lactic acid reduces fatigue through increased intracellular calcium or increases fatigue through reduced sensitivity of contractile proteins to Ca 2+ . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3344", "text": "Muscle cells work by detecting a  flow  of electrical impulses from the  brain  which signals them to  contract  through the release of  calcium  by the  sarcoplasmic reticulum .  Fatigue (reduced ability to generate force) may occur due to the nerve, or within the muscle cells themselves. New research from scientists at Columbia University suggests that muscle fatigue is caused by calcium leaking out of the muscle cell. This causes there to be less calcium available for the muscle cell. In addition an enzyme is proposed to be activated by this released calcium which eats away at muscle fibers. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3345", "text": "Substrates  within the muscle generally serve to power muscular contractions.  They include molecules such as  adenosine triphosphate  (ATP),  glycogen  and  creatine phosphate .  ATP binds to the  myosin  head and causes the \u2018ratchetting\u2019 that results in contraction according to the  sliding filament model .  Creatine phosphate stores energy so ATP can be rapidly regenerated within the muscle cells from  adenosine diphosphate  (ADP) and inorganic phosphate ions, allowing for sustained powerful contractions that last between 5\u20137 seconds.  Glycogen is the intramuscular storage form of  glucose , used to generate energy quickly once intramuscular creatine stores are exhausted, producing  lactic acid  as a metabolic byproduct. Contrary to common belief, lactic acid accumulation does not actually cause the burning sensation we feel when we exhaust our oxygen and oxidative metabolism, but in actuality, lactic acid in presence of oxygen recycles to produce pyruvate in the liver which is known as the Cori cycle. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3346", "text": "Substrates produce metabolic fatigue by being depleted during exercise, resulting in a lack of intracellular energy sources to fuel contractions.  In essence, the muscle stops contracting because it lacks the energy to do so. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3347", "text": "The severity of muscle weakness can be classified into different \"grades\" based on the following criteria: [ 16 ] [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3348", "text": "Muscle weakness can also be classified as either \" proximal \" or \" distal \" based on the location of the muscles that it affects. Proximal muscle weakness affects muscles closest to the body's midline, while distal muscle weakness affects muscles further out on the  limbs .  Proximal muscle weakness can be seen in  Cushing's syndrome [ 18 ]  and  hyperthyroidism . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3349", "text": "Muscle weakness can be classified as either \"true\" or \"perceived\" based on its cause. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3350", "text": "In some conditions, such as  myasthenia gravis , muscle strength is normal when resting, but  true  weakness occurs after the muscle has been subjected to exercise. This is also true for some cases of chronic fatigue syndrome, where objective post-exertion muscle weakness with delayed recovery time has been measured and is a feature of some of the published definitions. [ 21 ] [ 22 ] [ 23 ] [ 24 ] [ 25 ] [ 26 ] [ excessive citations ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3351", "text": "In  medicine ,  myopathy  is a  disease  of the  muscle [ 1 ]  in which the  muscle fibers  do not function properly.  Myopathy  means  muscle disease  ( Greek \u00a0: myo-  muscle  + patheia  -pathy \u00a0:  suffering ). This meaning implies that the primary defect is within the muscle, as opposed to the nerves (\" neuropathies \" or \" neurogenic \" disorders) or elsewhere (e.g., the brain)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3352", "text": "This muscular defect typically results in  myalgia  (muscle pain),  muscle weakness  (reduced muscle force), or premature  muscle fatigue  (initially normal, but declining muscle force).  Muscle cramps ,  stiffness ,  spasm , and  contracture  can also be associated with myopathy. Myopathy experienced over a long period (chronic) may result in the muscle becoming an abnormal size, such as  muscle atrophy  (abnormally small) or a  pseudoathletic appearance  (abnormally large)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3353", "text": "Capture myopathy can occur in wild or captive animals, such as deer and  kangaroos , and leads to morbidity and mortality. [ 2 ]  It usually occurs as a result of stress and physical exertion during capture and restraint."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3354", "text": "Muscular disease can be classified as  neuromuscular  or  musculoskeletal  in nature. Different myopathies may be inherited, infectious, non-communicable, or idiopathic (cause unknown). The disease may be isolated to affecting only muscle (pure myopathy), or may be part of a systemic disease as is typical in  mitochondrial myopathies ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3355", "text": "Common symptoms include muscle weakness, cramps, stiffness, and  tetany . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3356", "text": "Myopathies in systemic disease results from several different disease processes including  endocrine ,  inflammatory ,  paraneoplastic , infectious, drug- and toxin-induced, critical illness myopathy, metabolic,  collagen  related, [ 3 ]  and myopathies with other systemic disorders. Patients with systemic myopathies often present  acutely  or sub acutely. On the other hand,  familial myopathies  or  dystrophies  generally present in a  chronic  fashion with exceptions of  metabolic myopathies  where symptoms on occasion can be precipitated acutely. Metabolic myopathies, which affect the production of ATP within the muscle cell, typically present with  dynamic  (exercise-induced) rather than static symptoms. [ 4 ]  Most of the  inflammatory myopathies  can have a chance association with malignant lesion; the incidence appears to be specifically increased only in patients with dermatomyositis. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3357", "text": "There are many types of myopathy.  ICD-10  codes are provided here where available."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3358", "text": "The Food and Drug Administration is recommending that physicians restrict prescribing high-dose  Simvastatin  (Zocor, Merck) to patients, given an increased risk of muscle damage. The FDA drug safety communication stated that physicians should limit using the 80-mg dose unless the patient has already been taking the drug for 12 months and there is no evidence of myopathy.\n\"Simvastatin 80 mg should not be started in new patients, including patients already taking lower doses of the drug,\" the agency states."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3359", "text": "[ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3360", "text": "At birth"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3361", "text": "Onset in childhood"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3362", "text": "Onset in adulthood [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3363", "text": "Because different types of myopathies are caused by many different pathways, there is no single treatment for myopathy. Treatments range from treatment of the symptoms to very specific cause-targeting treatments.  Drug therapy ,  physical therapy , bracing for support,  surgery , and massage are all current treatments for a variety of myopathies. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3364", "text": "X-linked myopathy with excessive autophagy  (XMEA) is a rare childhood onset disease characterized by slow progressive vacuolation and atrophy of skeletal muscle. There is no known cardiac or intellectual involvement."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3365", "text": "The incidence of this disease is not precisely known but it is considered to be rare (< 1/10 6  population). It has been reported in 15 families to date mostly from  Canada ,  Finland  and  France . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3366", "text": "This disease usually presents between the ages of 5 and 10 years old. The usual picture is with weakness involving the upper legs and affects activities such as running and climbing stairs. As the condition progresses, patients tend to experience weakness in their lower legs and arms. Some remain able to walk in advanced age, while others require assistance in adulthood. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3367", "text": "This disorder is inherited in a recessive X linked fashion. As a result, males are much more commonly affected than females. It is due to a mutation in  VMA21  gene - the human  homolog  of the  yeast  Vma21p protein. This gene is located on the long arm of  chromosome X  (Xq28). It is an essential assembly  chaperone  of the vacuolar  ATPase  - the principal mammalian proton pump complex. Mutations in this gene increase lysosomal pH. This in turn reduces lysosomal degradative ability and blocks  autophagy . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3368", "text": "The muscle fibers are rarely necrotic but have evidence of excessive autophagic activity and exocytosis of the phagocytosed material. They have increased variation in size and are predominantly composed of round small and hypertrophic fibers. The vacuoles are strongly reactive for  dystrophin  and lysosome associated membrane protein 2 ( LAMP2 ). Membrane bound vacuoles and balls of dense material under the  basal lamina  are present. Deposition of the C5b-9  complement  attack complex, sub sarcolemmal  deposition of calcium and expression of MHC1 complex also occur. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3369", "text": "On  electron microscopy  characteristic balls of dense material are commonly seen. The vacuoles may contain remains of  mitochondria , membrane whorls and  calcium apatite  crystals. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3370", "text": "The diagnosis can be established by muscle biopsy. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3371", "text": "The serum  creatinine  is raised. [ vague ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3372", "text": "This disorder was described in 1988 by Kalimo  et al  in Finland in three brothers. The same condition affected their maternal grandfather and great-uncle. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3373", "text": "Myositis  is a rarely-encountered  medical condition  characterized by  inflammation  affecting the  muscles . [ 2 ]  The manifestations of this condition may include  skin  issues,  muscle weakness , and the potential involvement of other organs. [ 3 ]  Additionally,  systemic symptoms  like weight loss,  fatigue , and  low-grade fever  can manifest in individuals with myositis."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3374", "text": "Myositis can arise from various causes, including  injury , certain  medications ,  infections , inherited muscle disorders, or  autoimmune conditions . In some instances, the origins of myositis remain  idiopathic , without a discernible cause."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3375", "text": "There are various tools that can be used to help diagnose myositis. The most common methods are physical examination,  electromyography  (EMG),  magnetic resonance imaging  (MRI),  muscle biopsy , and  blood tests . The first course of action a doctor will likely take is perform a physical exam. [ 2 ]  The doctor assesses for muscle weakness or rashes."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3376", "text": "Another possible test is  electromyography. This test involves the insertion of small needles into the patient's muscles. [ 4 ]  This allows a physician to look at the muscles' responses to various electrical  nerve stimuli  and evaluate which muscles potentially have myositis. [ 4 ]   Magnetic resonance imaging  can be useful in diagnosis, [ 9 ]  allowing painless,  non-invasive  visualisation of any  muscle wastage . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3377", "text": "Muscle biopsies, however, are the most reliable tests for diagnosing myositis. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3378", "text": "There are also a variety of blood tests available that help in the diagnosis of myositis. The doctor may look for an elevation of  creatine kinase  in the blood, which is indicative of muscle inflammation. [ 4 ]  Certain  autoantibodies  (antibodies that target muscle cells) can also be found in the blood, which can indicate that myositis is caused by an autoimmune disease. [ 3 ]  Some specific examples of autoantibodies are  Anti-Jo-1 , Anti-HMGCR, Anti-TIF1, etc. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3379", "text": "Treatment for myositis depends on the underlying cause. [ 4 ]  For myositis, which is caused by a viral infection, no treatment is typically needed. [ 4 ]  For myositis caused by a bacterial infection, antibiotics can be used. [ 4 ]  For myositis caused by a medication, it is important to stop using that medication. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3380", "text": "There are a variety of treatment options available if myositis is caused by an autoimmune disease.  Glucocorticoids  are often the first choice for treatment. [ 10 ]  This drug works to weaken the immune system so that it is not able to attack the muscles. It is a type of  steroid  and can cause a wide array of side effects, such as mood changes, increased hunger, trouble sleeping, etc. Another treatment option is a steroid-sparing  immunosuppressive  agent. [ 10 ]  This also works to weaken the immune system but does not cause the side effects that  steroids do. Another treatment option is a class of drugs called  biologics . [ 10 ]  Also, intravenous  immunoglobulins  (IVIg) have  been shown to be effective in the treatment of myositis caused by an  autoimmune disease . [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3381", "text": "Myositis Association  https://www.myositis.org"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3382", "text": "Myositis ossificans  comprises two syndromes characterized by  heterotopic ossification  (calcification) of muscle. In 2020, the World Health Organization classified myositis ossificans together with fibro-osseous pseudotumor of digits as a single specific entity in the category of  fibroblastic and myofibroblastic tumors . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3383", "text": "Most (i.e. 80%) ossifications arise in the thigh or arm, and are caused by a premature return to activity after an injury. Other sites include  intercostal spaces ,  erector spinae ,  pectoralis muscles ,  glutei , and the  chest . On planar x-ray, hazy densities are sometimes noted approximately one month after injury, while the denser opacities eventually seen may not be apparent until two months have passed. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3384", "text": "The exact mechanism of myositis ossificans is not clear. Inappropriate response of stem cells in the bone against the injury or inflammation causes inappropriate differentiation of  fibroblasts  into  osteogenic  cells. When a  skeletal muscle  is injured, inflammatory cytokines ( Bone morphogenetic protein 2 ,  Bone morphogenetic protein 4 , and  Transforming growth factor ) are released. These cytokines stimulate the  endothelial  cells of the blood vessels to transform into  mesenchymal stem cells . These mesenchymal stem cells then differentiate into  chondrocytes , and  osteoblasts , resulting in bone formation in soft tissues. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3385", "text": "The process of myositis ossificans can be divided into three stages: early, intermediate, and mature. The early phase occurs in the first four weeks of injury with inflammatory phase of bone formation. This is followed by intermediate phase of bone formation (four to eight weeks following injury) where calcification started to occur and is visible on X-rays. During the maturation phase, mature bone started to form. As the maturation continues, the bone will consolidate in the coming months and subsequently bone regression occurs. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3386", "text": "Calcification is typically depicted 2 weeks earlier by ultrasound (US) when compared to radiographs. [ 6 ]  The lesion develops in two distinct stages with different presentations at US. [ 7 ]  In the early stage, termed immature, it  depicts a non-specific soft tissue mass that ranges from a hypoechoic area with an outer sheet-like hyperechoic peripheral rim to a highly echogenic area with variable shadowing. In the late stage, termed mature, myositis ossificans is depicted as an elongated calcific deposit that is aligned with the long-axis of the muscle, exhibits acoustic shadowing, and has no soft tissue mass associated. US may suggest the diagnosis at early stage, but imaging features need to evolve with successive maturation of the lesion and formation of the characteristic late stage changes before they become pathognomonic. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3387", "text": "The differential diagnosis includes many tumoral and nontumoral pathologies. A main concern is to differentiate early myositis ossificans from malignant soft-tissue tumors, and the latter is suggested by a fast-growing process. If clinical or sonographic findings are dubious and extraosseous sarcoma is suspected, biopsy should be performed. At histology, detection of the typical zonal phenomenon is diagnostic of myositis ossificans, though microscopic findings may be misleading during the early stage. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3388", "text": "The radiological features of myositis ossificans are \u2018faint soft tissue calcification within 2\u20136 weeks, (may have well-defined\nbony margins by 8 weeks) separated from periosteum by lucent zone and on CT, the characteristic feature is peripheral ossification\u2019. [ 10 ] [ 11 ] [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3389", "text": "Since myositis ossificians is more common in those with bleeding disorders, the formation of bone in soft tissue is thought to be associated with  haematoma  formation. As the calcifications will typically resolve after a period of time, non-surgical treatment is encouraged to minimize the unpleasant symptoms and maximize the function of the affected limb. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3390", "text": "Following a skeletal muscle injury, the affected limb should be immobilized with bed rest, ice therapy, compression, and elevation of the affected limb. Crutches can be used for ambulation while providing adequate rest for the affected limb and minimizing the haematoma formation. Ice therapy for 15 to 20 minutes every 30 to 60 minutes is useful to reduce the skeletal muscle blood flow by 50%. Aggressive limb physiotherapy is not recommended at this stage to prevent the worsening of symptoms. After 48 to 72 hours, range of motion exercise can be introduced as long as the range of motion is not painful. If the lesion becomes more mature, active range of motion and resistance strengthening exercises are useful in maintaining joint function. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3391", "text": "Surgical excision is reserved for those who failed the non-surgical treatment, those with intolerable pain, compression of the neurovascular structures, or limitation of the range of motion of the joint which affects the activities of daily living. Surgery is only performed after 6 to 18 months following injury because surgery does not alter the bone maturation process. If a surgery is performed too early, it may predispose to recurrence. However, the optimum timing for surgery and the rate of recurrence following early surgery is controversial because some studies have shown that early surgery does reduce the rate of recurrence. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3392", "text": "For those who had  total hip replacement  or  total hip arthroplasty , postoperative single low-dose radiation with three weeks of oral  indomethacin  regimen will be preventive  for  heterotopic ossification . [ 13 ] [ 14 ]  Radiation therapy is also effective in preventing recurrence in those who had done operative excision of heterotopic ossification of the elbow. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3393", "text": "Myostatin-related muscle hypertrophy  is a rare  genetic condition  characterized by reduced  body fat  and increased  skeletal muscle  size. [ 1 ]  Affected individuals have up to twice the usual amount of muscle mass in their bodies, but increases in muscle strength are not usually congruent. [ 2 ]  Myostatin-related muscle hypertrophy is not known to cause medical problems, and affected individuals are intellectually normal. The prevalence of this condition is unknown."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3394", "text": "Mutations  in the  MSTN   gene  cause myostatin-related muscle hypertrophy. The  MSTN  gene provides instructions for making a  protein  called  myostatin , which is active in muscles used for movement ( skeletal muscles ) both before and after  birth . A 2010 research paper in the Journal of Musculoskeletal & Neuronal Interactions, which was discussed outside of academic circles, [ 3 ]  linked Myostatin to muscle mass and bone structure. [ 4 ]  This protein normally restrains muscle growth, ensuring that muscles do not grow too large. Mutations that reduce the production of functional myostatin lead to an overgrowth of muscle tissue. Myostatin-related muscle hypertrophy has a pattern of inheritance known as incomplete autosomal dominance. People with a mutation in both copies of the gene in each  cell  ( homozygotes ) have significantly increased muscle mass. People with a mutation in one copy of the  MSTN  gene in each cell ( heterozygotes ) also have increased muscle bulk but to a lesser degree."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3395", "text": "The effect of this growth factor was first described in cattle as \u201cbovine muscular hypertrophy\u201d by the British farmer H. Culley in 1807. Cattle that have a myostatin gene deletion look unusually and excessively muscular."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3396", "text": "Researchers at Guangzhou Institutes of Biomedicine and Health in  China  have edited the genome of  beagles  to create double the amount of muscle. [ 5 ]  Of the two beagles that were genetically modified, only one had increased muscle mass. [ 6 ]  The ultimate aim of this project is to be able to better treat genetic neuromuscular diseases (such as  Parkinson's disease )."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3397", "text": "Besides beagles, genetic modification has also been done in pigs [ 7 ]  and fish. [ 8 ] [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3398", "text": "Orofacial myofunctional disorders  (OMD) (sometimes called \u201coral myofunctional disorder\", and \u201ctongue thrust\u201d) are muscle disorders of the face, mouth, lips, or jaw due to chronic  mouth breathing . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3399", "text": "Recent [ timeframe? ]  studies on the incidence and prevalence of  tongue thrust  behaviors are not available. However, according to previous research, 38% of various populations have OMD. The incidence is as high as 81% in children exhibiting speech/articulation problems (Kellum, 1992)."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3400", "text": "OMD refers to the abnormal resting posture of the orofacial musculature, atypical chewing, and swallowing patterns, dental malocclusions, blocked nasal airways, and speech problems. [ 2 ]   OMD are patterns involving oral and/or orofacial musculature that interferes with normal growth, development, or function of structures, or calls attention to itself. OMD are found in both children and adults. OMD that are commonly seen in children include  tongue thrust  that is also known as swallowing with an anterior  tongue posture . OMD also refers to factors such as nonnutritive sucking behaviors, such as thumb sucking, clenching, bruxing, etc. that led to abnormal development of dentition and oral cavity. OMD in adult and geriatric populations are due to various neurological impairments,  oral hygiene , altered functioning of muscles due to aging, systemic diseases, etc."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3401", "text": "Tongue thrusting  is a type of orofacial myofunctional disorder, which is defined as habitual resting or thrusting the tongue forward and/or sideways against or between the teeth while swallowing, chewing, resting, or speaking. Abnormal swallowing patterns push the upper teeth forward and away from the upper alveolar processes and cause open bites. In children, tongue thrusting is common due to immature oral behavior, narrow dental arch, prolonged upper respiratory tract infections, spaces between the teeth (diastema), muscle weakness, malocclusion, abnormal sucking habits, and open mouth posture due to structural abnormalities of genetic origin. Large tonsils and adenoids also contribute to  tongue thrust swallowing ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3402", "text": "From the dental perspective, teeth move in relation to the balance of the soft tissue; the normal relationship of teeth lies in occlusion; and any deviation from the normal occlusion can lead to dental distress. [ 3 ]  Tongue posture plays an important role in swallowing and dentofacial growth.  In case of  tongue thrust  swallowing, the tip of the tongue can come against or between the dentition; the midpoint may be collapsed or extended unilaterally or bilaterally; or the posterior part of the hard palate. In these conditions, there are chances of abnormal dentofacial growth and other concerns regarding the development of the craniofacial complex."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3403", "text": "There are pertinent symptomatic questions that can be considered for the diagnosis of tongue thrust swallow. Some of these questions are geared toward tongue protrusion and an opening of lips when the client is in repose; habitual  mouth breathing ; digit sucking; existence of high and narrow palatal arch;  ankyloglossia  (tongue-tie);  malocclusions , (Class II, III); weak chewing muscles (masseter); weak lip muscles (orbicularis oris); overdeveloped chin muscles (mentalis); muscular imbalance; abnormal dentition."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3404", "text": "Tongue thrusting and speech problems may co-occur. Due to unconventional postures of the tongue and other articulators, interdental and frontal lisping are very common. The alveolar sounds /s/ and /z/ are produced more anteriorly thus leading to interdental fricative like sounds, /th/. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3405", "text": "While identifying the causes of tongue thrust, it is important to remember that the resting posture of the tongue, jaw, and lips are crucial to the normal development of the mouth and its structures. If the tongue rests against the upper front teeth, the teeth may protrude forward, and adverse tongue pressure can restrict the development of the oral cavity. The tongue lies low in the mouth or oral cavity and is typically forwarded between upper and lower teeth. If tongue thrust behavior is not corrected, it may affect the normal dental development. The teeth may be pushed around in different directions during the growth of permanent teeth."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3406", "text": "The adaptation from nasal to mouth breathing takes place when changes such as chronic middle ear infections, sinusitis, allergic rhinitis, upper airway infections, and sleep disturbances (e.g., snoring) take place. In addition, mouth breathing is often associated with a decrease in oxygen intake into the lungs. Mouth breathing can particularly affect the growing face, as the abnormal pull of these muscle groups on facial bones slowly deforms these bones, causing misalignment. The earlier in life these changes take place, the greater the alterations in facial growth, and ultimately an open mouth posture is created where the upper lip is raised and the lower jaw is maintained in an open posture. The tongue, which is normally tucked under the roof of the mouth, drops to the floor of the mouth and protrudes to allow a greater volume of air intake. Consequently, an open mouth posture can lead to malocclusions and problems in swallowing. Other causes of open-mouth posture are the weakness of lip muscles, overall lack of tone in the body or hypotonia, and prolonged/chronic allergies of the respiratory tract."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3407", "text": "An orofacial myofunctional therapist reeducates the movement of muscles including teaching the client how to breathe properly, restore correct swallowing patterns, and establish adequate labial-lingual postures. [ 3 ] [ 5 ] [ 6 ]  An interdisciplinary nature of treatment is always desirable to reach functional goals in terms of swallowing, speech, and other aesthetic factors. A team approach has been shown to be effective in correcting orofacial myofunctional disorders. The teams include an orthodontist, dental hygienist, certified orofacial myologist, general dentist, otorhinolaryngologist, and a speech-language pathologist."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3408", "text": "Perimyositis  is  inflammation  of the connective tissue around a  muscle . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3409", "text": "Pseudohypertrophy , or  false enlargement,  is an increase in the size of an organ due to  infiltration  of a tissue not normally found in that organ. [ 1 ]  It is commonly applied to enlargement of a muscle due to infiltration of fat or connective tissue, [ 2 ]  famously in  Duchenne muscular dystrophy . This is in contrast with typical  muscle hypertrophy , in which the muscle tissue itself increases in size. [ 2 ]  Because pseudohypertrophy is not a result of increased muscle tissue, the muscles look bigger but are actually atrophied and thus weaker. [ 2 ] [ 3 ]  Pseudohypertrophy is typically the result of a disease, which can be a disease of muscle or a disease of the nerve supplying the muscle. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3410", "text": "Causes of pseudohypertrophy include muscle diseases:  dystrophinopathies ,  limb-girdle muscular dystrophies ,  metabolic myopathy ,  Dystrophic myotonias , Non-dystrophic myotonias,  endocrine disorders , parasitic muscle conditions,  amyloid  and  sarcoid myopathy , and granulomatous myositis. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3411", "text": "Neurological causes include  radiculopathy ,  poliomyelitis ,  Charcot-Marie-Tooth disease ,  spinal muscular atrophy . [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3412", "text": "In pseudohypertrophy where the atrophied muscle tissue has been infiltrated by fat tissue, upon palpitation the seemingly large muscles feel doughy. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3413", "text": "Not all muscles infiltrated by fat or other tissue are pseudohypertrophic. In muscular  steatosis , sometimes the muscles may appear a normal or a slender size, even though the atrophied muscle has been infiltrated with fat tissue, such as the calf muscles in  Bethlem myopathy 1 . [ 4 ] [ 5 ] [ 6 ] [ 7 ] [ 8 ]  In  myosclerosis , the muscle is infiltrated with connective tissue and fibrosis, having a firm, \"woody\" feel upon palpitation, with the muscles appearing slender. [ 9 ] [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3414", "text": "Pseudohypertrophy can be broken up into the following  roots, suffixes, and prefixes :"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3415", "text": "The term was used by  Duchenne de Boulogne  in his description of  Duchenne muscular dystrophy  in one of his works \"paralysie musculaire pseudo-hypertrophique.\" [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3416", "text": "As well as being known as 'false enlargement,' when the muscle has been infiltrated by fat tissue, historically it has also been called muscular  steatosis , pseudohypertrophic atrophy,  lipomatous  pseudohypertrophy, interstitial  lipomatosis , lipomatous muscular dystrophy, or atrophia lipomatosa. [ 12 ]  It is also known as  fatty atrophy  of muscle (not to be confused with fat atrophy, which is atrophy of adipose tissue), as muscle tissue is replaced by fat tissue, the actual muscle atrophies while the fat tissue replaces the bulk. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3417", "text": "Psoas abscess  is a collection of  pus  ( abscess ) in the  iliopsoas muscle  compartment. [ 1 ] [ 2 ]  It can be classified into  primary psoas abscess  (caused by  hematogenous  or lymphatic spread of a  pathogen ) and  secondary psoas abscess  (resulting from contiguous spread from an adjacent infectious focus). [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3418", "text": "Psoas abscess may be caused by  lumbar tuberculosis . Owing to the  proximal  attachments of the iliopsoas, such an abscess may drain  inferiorly  into the upper  medial  thigh and present as a swelling in the region. The sheath of the muscle arises from the  lumbar vertebrae  and the  intervertebral discs  between the vertebrae. The disc is more susceptible to infection, from  tuberculosis  and  Salmonella  discitis . The infection can spread into the  psoas muscle  sheath. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3419", "text": "Treatment may involve drainage and  antibiotics . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3420", "text": "Pyomyositis  is a  bacterial   infection  of the  skeletal muscles  which results in an  abscess . Pyomyositis is most common in  tropical  areas but can also occur in  temperate zones ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3421", "text": "Pyomyositis can be classified as primary or secondary. Primary pyomyositis is a skeletal muscle infection arising from hematogenous infection, whereas secondary pyomyositis arises from localized penetrating trauma or contiguous spread to the muscle. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3422", "text": "Diagnosis is done via the following manner: [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3423", "text": "The abscesses within the muscle must be drained  surgically  (not all patients require surgery if there is no abscess).  Antibiotics  are given for a minimum of three weeks to clear the infection. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3424", "text": "Pyomyositis is most often caused by the bacterium  Staphylococcus aureus . [ 3 ]  The infection can affect any skeletal muscle, but most often infects the large muscle groups such as the  quadriceps  or  gluteal muscles . [ 2 ] [ 4 ] [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3425", "text": "Pyomyositis is mainly a disease of children and was first described by Scriba in 1885. Most patients are aged 2 to 5 years, but infection may occur in any age group. [ 6 ] [ 7 ]  Infection often follows minor trauma and is more common in the tropics, where it accounts for 4% of all hospital admissions. In temperate countries such as the US, pyomyositis was a rare condition (accounting for 1 in 3000 pediatric admissions), but has become more common since the appearance of the  USA300  strain of  MRSA . [ 2 ] [ 4 ] [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3426", "text": "Gonococcal pyomyositis is a rare infection caused by  Neisseria gonorrhoeae . [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3427", "text": "Rigid spine syndrome , also known as congenital muscular dystrophy with rigidity of the spine (CMARS), is a rare and often debilitating  neuromuscular disorder . It is characterized by progressive  muscle stiffness  and rigidity, particularly in the spine, which can severely limit mobility and impact quality of life. This condition is typically present from birth or early childhood and tends to worsen over time. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3428", "text": "Despite its rarity, rigid spine syndrome represents a significant challenge for those affected, as well as for their families and healthcare providers."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3429", "text": "Rigid spine syndrome is characterized by a range of symptoms that can vary in severity and presentation. Common symptoms of the condition include:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3430", "text": "Individuals with rigid spine syndrome often experience tightness and inflexibility in their muscles, particularly in the spine. This rigidity can make movement difficult and may progress over time. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3431", "text": "One of the hallmark features of rigid spine syndrome is the development of spinal deformities, such as  kyphosis  (forward curvature of the spine) and  scoliosis  (sideways curvature of the spine). These deformities can cause pain and further restrict movement. [ 2 ] [ 3 ] [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3432", "text": "Contractures , or permanent tightening of the muscles and tendons around a joint, are common in rigid spine syndrome. This can lead to reduced range of motion and joint deformities. [ 4 ] [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3433", "text": "While muscle stiffness is a primary symptom, individuals with rigid spine syndrome may also experience  muscle weakness , particularly in the limbs."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3434", "text": "In severe cases, rigid spine syndrome can lead to respiratory complications due to the restriction of chest movement caused by spinal deformities and muscle rigidity. [ 2 ] [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3435", "text": "The combination of muscle stiffness, joint contractures, and spinal deformities can make walking and other forms of mobility challenging for individuals with rigid spine syndrome. [ 2 ] [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3436", "text": "Depending on the severity of the condition, individuals with rigid spine syndrome may also experience  fatigue ,  pain , and difficulty with activities of daily living. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3437", "text": "Rigid spine syndrome is a genetic disorder, primarily caused by mutations in the  SEPN1 gene . [ 7 ] [ 8 ]  This gene provides instructions for making a protein called selenoprotein N, which plays a role in muscle function and development. Mutations in the SEPN1 gene can lead to abnormal muscle stiffness and rigidity, as well as other characteristic features of rigid spine syndrome. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3438", "text": "The inheritance pattern of rigid spine syndrome is  autosomal recessive , which means that an individual must inherit two copies of the mutated gene (one from each parent) to develop the condition. Individuals who inherit only one copy of the mutated gene are known as carriers and typically do not show any symptoms of the condition. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3439", "text": "In addition to mutations in the SEPN1 gene, other genetic and environmental factors may also play a role in the development of rigid spine syndrome. However, further research is needed to fully understand these factors and their contribution to the condition. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3440", "text": "Diagnosing rigid spine syndrome can be challenging due to its rarity and the variability of symptoms among affected individuals. However, the following approaches are commonly used to diagnose the condition:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3441", "text": "A thorough physical examination is often the first step in diagnosing rigid spine syndrome. The healthcare provider will assess the patient's muscle tone, range of motion, and any signs of spinal deformities or joint contractures. [ 11 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3442", "text": "X-rays ,  CT scans , or  MRI scans  may be used to evaluate the spine for any abnormalities, such as kyphosis, scoliosis, or other spinal deformities. These imaging studies can also help assess the severity of the condition and guide treatment planning. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3443", "text": "Genetic testing is essential for confirming a diagnosis of rigid spine syndrome. Testing typically involves analyzing the SEPN1 gene for mutations. Identifying mutations in this gene can help confirm the diagnosis and provide valuable information about the genetic basis of the condition. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3444", "text": "In some cases, a  muscle biopsy  may be recommended to evaluate the structure and function of the muscles. This can help differentiate rigid spine syndrome from other muscle disorders and provide additional information about the underlying cause of the condition. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3445", "text": "EMG  may be used to assess the electrical activity of the muscles and  nerves . This test can help identify abnormalities in muscle function and may be used to support a diagnosis of rigid spine syndrome. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3446", "text": "A detailed family history can also be helpful in diagnosing rigid spine syndrome, as it is an autosomal recessive condition and often runs in families. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3447", "text": "The  prognosis  of rigid spine syndrome is variable and can be influenced by several factors, including the severity of symptoms, the age of onset, and the effectiveness of treatment. In general, the condition is progressive, meaning that symptoms tend to worsen over time. However, the rate of progression can vary widely among affected individuals."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3448", "text": "The severity of symptoms at the time of diagnosis can have a significant impact on prognosis. Individuals with milder symptoms may experience slower progression of the condition and better overall outcomes compared to those with more severe symptoms. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3449", "text": "The age at which symptoms of rigid spine syndrome first appear can also influence prognosis. Early onset of symptoms, particularly in  infancy  or early childhood, is often associated with a more severe form of the condition and a poorer prognosis. [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3450", "text": "The effectiveness of treatment in managing symptoms and complications of rigid spine syndrome can greatly impact prognosis. Early and aggressive management, including physical therapy, orthopedic interventions, and respiratory support, can help improve quality of life and slow disease progression. [ 10 ] [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3451", "text": "The development of complications, such as respiratory problems or severe joint contractures, can also affect prognosis. Complications may require additional interventions and can further impact mobility and overall health. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3452", "text": "Each individual responds differently to treatment, and the effectiveness of various interventions can vary. Regular monitoring and adjustments to the treatment plan are essential to managing the condition and optimizing outcomes."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3453", "text": "Despite the progressive nature of rigid spine syndrome, many individuals are able to maintain a good quality of life with appropriate care and support. Access to multidisciplinary care and assistive devices can greatly improve mobility and independence."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3454", "text": "Rigid spine syndrome is a rare neuromuscular disorder, and accurate epidemiological data is limited. However, the condition appears to be extremely rare, with only a few dozen cases reported in medical literature."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3455", "text": "The exact prevalence of rigid spine syndrome is unknown, but it is believed to be very low. The condition has been reported in various populations worldwide, suggesting that it is not limited to any specific ethnic or geographic group. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3456", "text": "Similarly, the incidence of rigid spine syndrome is not well-established due to its rarity. The condition is typically diagnosed in infancy or early childhood, but cases of adult onset have also been reported, albeit rarely. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3457", "text": "Rigid spine syndrome can affect individuals of any age or gender, but it is most commonly diagnosed in childhood. The condition does not appear to have a significant gender bias, affecting males and females equally. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3458", "text": "Rigid spine syndrome has been reported in various countries around the world, indicating that it is not limited to any specific geographic region. However, due to its rarity, there may be underreporting in some areas. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3459", "text": "The autosomal recessive inheritance pattern of rigid spine syndrome suggests that individuals with a family history of the condition are at increased risk. Genetic counseling and testing can help identify carriers and inform family planning decisions. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3460", "text": "Research on rigid spine syndrome is ongoing, with a focus on understanding the underlying genetic and molecular mechanisms of the condition, developing new treatment approaches, and improving the quality of life for affected individuals. Some key areas of research include:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3461", "text": "Researchers are conducting genetic studies to identify additional genes that may be involved in the development of rigid spine syndrome. This research may lead to a better understanding of the condition's genetic basis and the development of targeted therapies. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3462", "text": "Studies are underway to investigate the molecular mechanisms underlying muscle stiffness and rigidity in rigid spine syndrome. This research may uncover new targets for therapeutic interventions aimed at improving muscle function. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3463", "text": "Clinical trials are being conducted to evaluate the safety and efficacy of potential treatments for rigid spine syndrome. These trials may involve medications, physical therapies, or surgical interventions aimed at improving mobility and quality of life for affected individuals. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3464", "text": "Some researchers are exploring the use of regenerative medicine approaches, such as stem cell therapy, to repair damaged muscles and improve muscle function in individuals with rigid spine syndrome. This area of research holds promise for future treatment options. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3465", "text": "Patient registries are being established to collect data on individuals with rigid spine syndrome, including information on symptoms, disease progression, and treatment outcomes. These registries are valuable resources for researchers studying the condition."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3466", "text": "Collaborative research efforts among healthcare providers, researchers, and patient advocacy groups are essential for advancing our understanding of rigid spine syndrome. These collaborations can help facilitate the sharing of data and resources, leading to more rapid progress in the field."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3467", "text": "Future research in rigid spine syndrome is likely to focus on personalized medicine approaches, aimed at tailoring treatments to the specific genetic and molecular characteristics of individual patients. Additionally, research may continue to explore the role of environmental factors in the development and progression of the condition. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3468", "text": "The  sarcoglycanopathies  are a collection of diseases resulting from  mutations  in any of the five  sarcoglycan  genes: \u03b1, \u03b2, \u03b3, \u03b4 or \u03b5.\nThe five sarcoglycanopathies are: \u03b1-sarcoglycanopathy,  LGMD2D ; \u03b2-sarcoglycanopathy, LGMD2E; \u03b3-sarcoglycanopathy, LGMD2C; \u03b4-sarcoglycanopathy, LGMD2F and \u03b5-sarcoglycanopathy, myoclonic dystonia. The four different sarcoglycan genes encode proteins that form a  tetrameric  complex at the muscle  cell plasma membrane . This complex stabilizes the association of  dystrophin  with the  dystroglycans  and contributes to the stability of the plasma membrane  cytoskeleton . The four sarcoglycan genes are related to each other structurally and functionally, but each has a distinct  chromosome  location."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3469", "text": "In outbred populations, the relative frequency of mutations in the four genes is alpha >> beta >> gamma >> delta in an 8:4:2:1 ratio. No common mutations have been identified in outbred populations except the R77C mutation, which accounts for up to one-third of the mutated  SGCA   alleles . Founder mutations have been observed in certain populations. [ 1 ]  A 1997 Italian clinical study demonstrated variations in  muscular dystrophy  progression dependent on the sarcoglycan gene affected. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3470", "text": "Sphincter paralysis  is  paralysis  of one of the body's many  sphincters , preventing it from constricting normally."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3471", "text": "Case studies have shown patients may remain  continent  for many years despite being affected by anal sphincter paralysis. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3472", "text": "This article about a  disease , disorder, or medical condition is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3473", "text": "A  strain  is an acute or  chronic   soft tissue injury  that occurs to a  muscle ,  tendon , or both. The equivalent injury to a  ligament  is a  sprain . [ 1 ]  Generally, the muscle or tendon overstretches and partially tears, under more physical stress than it can withstand, often from a sudden increase in duration, intensity, or frequency of an activity. Strains most commonly occur in the foot, leg, or back. Immediate treatment typically used to include four steps abbreviated as  R.I.C.E.  (rest, ice, compression, elevation) before the role of inflammation was found to be helpful."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3474", "text": "Typical  signs  and  symptoms  of a strain include  pain , functional loss of the involved structure,  muscle weakness ,  contusion , and localized  inflammation . [ 2 ]  A strain can range from mild overstretching to severe  tears, depending on the extent of injury. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3475", "text": "A strain can occur as a result of improper body mechanics with any activity (e.g.,  contact sports , lifting heavy objects) that can induce mechanical trauma or injury. Generally, the muscle or tendon overstretches and is placed under more physical stress than it can withstand. [ 1 ]  Strains commonly result in a partial or complete tear of a tendon or muscle, or they can be severe in the form of a complete tendon rupture. Strains most commonly occur in the  foot ,  leg , or  back. [ 3 ]  Acute strains are more closely associated with recent mechanical trauma or injury. Chronic strains typically result from repetitive movement of the muscles and tendons over a long period of time. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3476", "text": "Degrees of Injury (as classified by the  American College of Sports Medicine ): [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3477", "text": "To establish a uniform definition amongst healthcare providers, in 2012 a Consensus Statement on suggested new terminology and classification of muscle injuries was published. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3478", "text": "The classifications suggested were:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3479", "text": "Indirect Muscle Injury\nFUNCTIONAL (Negative MSK US & MRI) [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3480", "text": "\u2022 Type 2: Neuromuscular muscle disorder"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3481", "text": "STRUCTURAL MUSCLE INJURY (Positive MSK US & MRI) [ 6 ] \n\u2022 Type 3: Partial Muscle Tear\n\u2022 Type 4: (Sub) total tear"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3482", "text": "DIRECT MUSCLE INJURY\n\u2022  Bump or Cut: Contact-related"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3483", "text": "Although strains are not restricted to athletes and can happen while doing everyday tasks, people who play sports are more at risk for developing a strain. It is common for an  injury  to develop when there is a sudden increase in duration, intensity, or frequency of an activity. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3484", "text": "The first-line treatment for a muscular strain in the  acute phase  include five steps commonly known as  P.R.I.C.E. [ 7 ] [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3485", "text": "Immediate treatment is usually an adjunctive therapy of  NSAIDs  and  Cold compression therapy . Cold compression therapy acts to reduce swelling and pain by reducing  leukocyte extravasation  into the injured area. [ 9 ] [ 10 ]  NSAIDs such as  Ibuprofen/paracetamol  work to reduce the immediate inflammation by inhibiting  Cox-1  and  Cox-2  enzymes, which are the enzymes responsible for converting  arachidonic acid  into  prostaglandin . However, NSAIDs, including  aspirin  and ibuprofen, affect platelet function (this is why they are known as \"blood thinners\") and should not be taken during the period when tissue is bleeding because they will tend to increase blood flow, inhibit clotting, and thereby increase bleeding and swelling. After the bleeding has stopped, NSAIDs can be used with some effectiveness to reduce inflammation and pain. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3486", "text": "A new treatment for acute strains is the use of  platelet rich plasma  (PRP) injections which have been shown to accelerate recovery from non-surgical muscular injuries. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3487", "text": "It is recommended that the person injured should consult a medical provider if the injury is accompanied by severe pain, if the limb cannot be used, or if there is noticeable tenderness over an isolated spot. These can be signs of a broken or  fractured bone , a  sprain , or a complete muscle tear. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3488", "text": "Thyrotoxic periodic paralysis  ( TPP ) is a rare condition featuring attacks of  muscle weakness  in the presence of  hyperthyroidism  (overactivity of the  thyroid  gland).  Hypokalemia  (a decreased  potassium  level in the blood) is usually present during attacks. The condition may be life-threatening if weakness of the  breathing muscles  leads to  respiratory failure , or if the low potassium levels lead to  abnormal heart rhythms . [ 1 ] [ 2 ]  If untreated, it is typically recurrent in nature. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3489", "text": "The condition has been linked with  genetic mutations  in genes that code for certain  ion channels  that transport  electrolytes  ( sodium  and  potassium ) across  cell membranes . The main ones are the  L-type calcium channel \u03b11-subunit [ 1 ]  and  potassium inward rectifier 2.6 ; [ 3 ]  it is therefore classified as a  channelopathy . [ 3 ]  The abnormality in the channel is thought to lead to shifts of potassium into  cells , under conditions of high  thyroxine  (thyroid hormone) levels, usually with an additional precipitant."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3490", "text": "Treatment of the low levels of potassium in the blood, followed by correction of the hyperthyroidism, leads to complete resolution of the attacks. It occurs predominantly in males of Chinese, Japanese, Vietnamese, Filipino, and Korean descent. [ 1 ]  TPP is one of several conditions that can cause  periodic paralysis . [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3491", "text": "An attack often begins with muscle pain, cramping, and stiffness. [ 5 ]  This is followed by weakness or paralysis that tends to develop rapidly, usually in late evening or the early hours of the morning. The weakness is usually symmetrical; [ 5 ]  the limb muscles closer to the trunk (proximal) are predominantly affected, and weakness tends to start in the legs and spread to the arms. Muscles of the  mouth and throat ,  eyes , and  breathing  are usually not affected, but occasionally weakness of the respiratory muscles can cause life-threatening  respiratory failure . Attacks typically resolve within several hours to several days, even in the absence of treatment. [ 1 ] [ 2 ] [ 5 ]  On  neurological examination  during an attack,  flaccid weakness  of the limbs is noted;  reflexes  are usually diminished, but the  sensory system  is unaffected. [ 1 ] [ 5 ]  Mental status is not affected. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3492", "text": "Attacks may be brought on by  physical exertion , drinking  alcohol , or eating food high in  carbohydrates  or  salt . This may explain why attacks are more common in summer when more people drink sugary drinks and engage in exercise. Exercise-related attacks tend to occur during a period of rest immediately after exercise; exercise may, therefore, be recommended to abort an attack. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3493", "text": "There may be symptoms of thyroid overactivity, such as  weight loss ,  a fast or irregular heart rate ,  tremor , and  perspiration ; [ 1 ] [ 2 ]  but such symptoms occur in only half of all cases. [ 5 ]  The most common type of hyperthyroidism,  Graves' disease , may additionally cause eye problems ( Graves' ophthalmopathy ) and skin changes of the legs ( pretibial myxedema ). [ 6 ]  Thyroid disease may also cause muscle weakness in the form of  thyrotoxic myopathy , but this is constant rather than episodic. [ 5 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3494", "text": "Genetic mutations in the L-type calcium channel \u03b11-subunit (Ca v 1.1) have been described in Southern Chinese with TPP. The mutations are located in a different part of the gene from those described in the related condition  familial periodic paralysis . In TPP, the mutations described are  single-nucleotide polymorphisms  located in the  hormone response element  responsive to thyroid hormone, implying that  transcription  of the gene and production of ion channels may be altered by increased thyroid hormone levels. Furthermore, mutations have been reported in the genes coding for  potassium voltage-gated channel, Shaw-related subfamily, member 4  (K v 3.4) and  sodium channel protein type 4 subunit alpha  (Na 4 1.4). [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3495", "text": "Of people with TPP, 33% from various populations were demonstrated to have mutations in  KCNJ18 , the gene coding for K ir 2.6, an  inward-rectifier potassium ion channel . This gene, too, harbors a thyroid response element. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3496", "text": "Certain forms of  human leukocyte antigen  (HLA)\u2014especially B46, DR9, DQB1*0303, A2, Bw22, AW19, B17, and DRW8\u2014are more common in TPP. Linkage to particular forms of HLA, which plays a central role in the  immune response , might imply an immune system cause, but it is uncertain whether this directly causes TPP or whether it increases the susceptibility to Graves' disease, a known  autoimmune disease . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3497", "text": "The most common underlying form of thyroid disease associated with TPP is Graves' disease, a syndrome due to an  autoimmune reaction  that leads to overproduction of thyroid hormone. [ 6 ]  TPP has also been described in people with other thyroid problems such as  thyroiditis ,  toxic nodular goiter ,  toxic adenoma ,  TSH -producing  pituitary adenoma , excessive ingestion of  thyroxine  or  iodine , [ 1 ]  and  amiodarone -induced hyperthyroidism. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3498", "text": "The muscle weakness and increased risk of irregular heart beat in TPP result from markedly reduced levels of potassium in the bloodstream. Potassium is not in fact lost from the body, but increased  Na + /K + -ATPase  activity (the  enzyme  that moves potassium into cells and keeps  sodium  in the blood) leads to shift of potassium into tissues, and depletes the circulation. In other types of potassium derangement, the  acid-base balance  is usually disturbed, with  metabolic alkalosis  and  metabolic acidosis  often being present. In TPP, these disturbances are generally absent. Hypokalemia leads to  hyperpolarization  of  muscle cells , making the  neuromuscular junction  less responsive to normal nerve impulses and leading to decreased contractility of the muscles. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3499", "text": "It is not clear how the described genetic defects increase the Na + /K + -ATPase activity, but it is suspected that the enzyme becomes more active due to increased thyroid hormone levels. Hyperthyroidism increases the levels of  catecholamines  (such as  adrenaline ) in the blood, increasing Na + /K + -ATPase activity. [ 5 ]  The enzyme activity is then increased further by the precipitating causes. For instance, increased carbohydrate intake leads to increased  insulin  levels; this is known to activate Na + /K + -ATPase. Once the precipitant is removed, the enzyme activity returns to normal levels. [ 1 ]  It has been postulated that  male hormones  increase Na + /K + -ATPase activity, and that this explains why males are at a higher risk of TPP despite thyroid disease being more common in females. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3500", "text": "TPP is regarded as a model for related conditions, known as \"channelopathies\", which have been linked with mutations in ion channels; the majority of these conditions occurs episodically. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3501", "text": "Hypokalemia  (low blood  potassium  levels) commonly occurs during attacks; levels below 3.0\u00a0mmol/L are typically encountered.  Magnesium  and  phosphate  levels are often found to be decreased.  Creatine kinase  levels are elevated in two-thirds of cases, usually due to a degree of muscle injury; severe elevations suggestive of  rhabdomyolysis  (muscle tissue destruction) are rare. [ 1 ] [ 2 ]   Electrocardiography  (ECG/EKG) may show  tachycardia  (a fast heart rate) due to the thyroid disease, abnormalities due to cardiac arrhythmia ( atrial fibrillation ,  ventricular tachycardia ), and conduction changes associated with hypokalemia (U waves, QRS widening, QT prolongation, and T wave flattening). [ 2 ]   Electromyography  shows changes similar to those encountered in  myopathies  (muscle diseases), with a reduced amplitude of the  compound muscle action potentials  (CMAPs); [ 4 ]  they resolve when treatment has commenced. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3502", "text": "TPP is distinguished from other forms of periodic paralysis (especially  hypokalemic periodic paralysis ) with  thyroid function tests  on the blood. These are normal in the other forms, and in  thyrotoxicosis  the levels of  thyroxine  and  triiodothyronine  are elevated, with resultant suppression of TSH production by the  pituitary gland . [ 1 ] [ 6 ]  Various other investigations are usually performed to separate the different causes of  hyperthyroidism . [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3503", "text": "In the acute phase of an attack, administration of  potassium  will quickly restore muscle strength and prevent complications. However, caution is advised as the total amount of potassium in the body is not decreased, and it is possible for potassium levels to overshoot (\"rebound  hyperkalemia \"); slow infusions of potassium chloride are therefore recommended while other treatment is commenced. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3504", "text": "The effects of excess thyroid hormone typically respond to the administration of a non-selective  beta blocker , such as  propranolol  (as most of the symptoms are driven by increased levels of adrenaline and its effect on the  \u03b2-adrenergic receptors ). Subsequent attacks may be prevented by avoiding known precipitants, such as high salt or carbohydrate intake, until the thyroid disease has been adequately treated. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3505", "text": "Treatment of the thyroid disease usually leads to resolution of the paralytic attacks. Depending on the nature of the disease, the treatment may consist of  thyrostatics  (drugs that reduce production of thyroid hormone),  radioiodine , or occasionally thyroid surgery. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3506", "text": "TPP occurs predominantly in  males  of Chinese, Japanese, Vietnamese, Filipino, and Korean descent, [ 1 ]  as well as  Thais , [ 3 ]  with much lower rates in people of other ethnicities. [ 1 ]  In Chinese and Japanese people with hyperthyroidism, 1.8\u20131.9% experience TPP. This is in contrast to North America, where studies report a rate of 0.1\u20130.2%. [ 1 ] [ 2 ]   Native Americans , who share a genetic background with East Asians, are at an increased risk. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3507", "text": "The typical age of onset is 20\u201340. It is unknown why males are predominantly affected, with rates in males being 17- to 70-fold those in females, despite thyroid overactivity being much more common in women. [ 1 ] [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3508", "text": "After several case reports in the 18th and 19th centuries, periodic paralysis was first described in full by the German neurologist  Karl Friedrich Otto Westphal  (1833\u20131890) in 1885. [ 7 ] [ 8 ]  In 1926 the Japanese physician Tetsushiro Shinosaki, from  Fukuoka , observed the high rate of thyroid disease in Japanese people with periodic paralysis. [ 9 ] [ 10 ]  The first English-language report, in 1931, originated from Dunlap and Kepler, physicians at the  Mayo Clinic ; they described the condition in a patient with features of  Graves' disease . [ 2 ] [ 10 ]  In 1937 periodic paralysis was linked with hypokalemia, as well as precipitation of attacks with glucose and insulin. [ 11 ] [ 12 ]  This phenomenon has been used as a diagnostic test. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3509", "text": "In 1974 it was discovered that  propranolol  could prevent attacks. [ 13 ]  The concept of channelopathies and the link with specific ion channel mutations emerged at the end of the 20th century. [ 1 ] [ 3 ] [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3510", "text": "Weakness  is a  symptom  of many different medical conditions. [ 1 ]  The causes are many and can be divided into conditions that have true or perceived muscle weakness. True muscle weakness is a primary symptom of a variety of skeletal muscle diseases, including  muscular dystrophy  and  inflammatory myopathy . It occurs in  neuromuscular junction  disorders, such as  myasthenia gravis . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3511", "text": "Muscle cells work by detecting a  flow  of electrical impulses from the  brain , which signals them to  contract  through the release of  calcium  by the  sarcoplasmic reticulum . Fatigue (reduced ability to generate force) may occur due to the nerve, or within the muscle cells themselves. New research from scientists at Columbia University suggests that muscle fatigue is caused by calcium leaking out of the muscle cell. This makes less calcium available for the muscle cell. In addition, the Columbia researchers propose that an enzyme activated by this released calcium eats away at muscle fibers. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3512", "text": "Substrates  within the muscle generally serve to power muscular contractions. They include molecules such as  adenosine triphosphate  (ATP),  glycogen  and  creatine phosphate . ATP binds to the  myosin  head and causes the 'ratchetting' that results in contraction according to the  sliding filament model . Creatine phosphate stores energy so ATP can be rapidly regenerated within the muscle cells from  adenosine diphosphate  (ADP) and inorganic phosphate ions, allowing for sustained powerful contractions that last between 5\u20137 seconds. Glycogen is the intramuscular storage form of  glucose , used to generate energy quickly once intramuscular creatine stores are exhausted, producing  lactic acid  as a metabolic byproduct. Contrary to common belief, lactic acid accumulation doesn't actually cause the burning sensation felt when people exhaust their oxygen and oxidative metabolism, but in actuality, lactic acid in presence of oxygen recycles to produce  pyruvate  in the liver, which is known as the  Cori cycle . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3513", "text": "Substrates produce metabolic fatigue by being depleted during exercise, resulting in a lack of intracellular energy sources to fuel contractions. In essence, the muscle stops contracting because it lacks the energy to do so. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3514", "text": "In some conditions, such as  myasthenia gravis , muscle strength is normal when resting, but  true weakness  occurs after the muscle has been subjected to exercise. This is also true for some cases of  Myalgic encephalomyelitis/chronic fatigue syndrome , where objective post-exertion muscle weakness with delayed recovery time has been measured and is a feature of some of the published definitions. [ 4 ] [ 5 ] [ 6 ] [ 7 ] [ 8 ] [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3515", "text": "Asthenia  or  asthaenia  ( Greek :  \u1f00\u03c3\u03b8\u03ad\u03bd\u03b5\u03b9\u03b1 , literally  lack of strength  but also  disease ) is a medical term referring to a condition in which the body lacks or has lost strength either as a whole or in any of its parts. It is a poorly defined condition that can include true or primary  muscle weakness  or perceived muscle weakness. [ 10 ]  For perceived muscle weakness, asthenia has been described as the feeling of weak or tired muscles in the absence of muscle weakness, that is the muscle can generate a normal amount of force but it is perceived as requiring more effort. [ 11 ] [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3516", "text": "General asthenia occurs in many chronic wasting diseases (such as tuberculosis and cancer), sleep disorders or chronic disorders of the heart, lungs or kidneys, and is probably most marked in diseases of the adrenal gland. Asthenia may be limited to certain  organs  or systems of organs, as in  asthenopia , characterized by ready fatiguability. Asthenia is also a side effect of some medications and treatments, such as  Ritonavir  (a  protease inhibitor  used in  HIV  treatment).  [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3517", "text": "Differentiating psychogenic (perceived) asthenia and true asthenia from myasthenia is often difficult, and in time apparent psychogenic asthenia accompanying many chronic disorders is seen to progress into a primary weakness. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3518", "text": "Myasthenia or myasthaenia (my- from  Greek :  \u03bc\u03c5\u03bf  meaning \"muscle\" + -asthenia [ \u1f00\u03c3\u03b8\u03ad\u03bd\u03b5\u03b9\u03b1 ] meaning \"weakness\"), or simply muscle weakness, is a lack of muscle strength. The causes are many and can be divided into conditions that have either true or perceived muscle weakness. True muscle weakness is a primary symptom of a variety of skeletal muscle diseases, including muscular dystrophy and inflammatory myopathy. It occurs in  neuromuscular diseases , such as myasthenia gravis. Perceived muscle weakness occurs in diseases such as sleep disorders, and depression. [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3519", "text": "Muscle fatigue can be central, neuromuscular, or peripheral muscular. Central muscle fatigue manifests as an overall sense of energy deprivation, and peripheral muscle weakness manifests as a local, muscle-specific inability to do work. [ 14 ] [ 15 ]  Neuromuscular fatigue can be either central or peripheral. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3520", "text": "The central fatigue is generally described in terms of a reduction in the  neural  drive or nerve-based motor command to working muscles that results in a decline in the force output. [ 16 ] [ 17 ] [ 18 ]   It has been suggested that the reduced neural drive during exercise may be a protective mechanism to prevent organ failure if the work was continued at the same intensity. [ 19 ] [ 20 ]  The exact mechanisms of central fatigue are unknown, though there has been considerable interest in the role of  serotonergic  pathways. [ 21 ] [ 22 ] [ 23 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3521", "text": "For extremely powerful contractions that are close to the upper limit of a muscle's ability to generate force, neuromuscular fatigue can become a limiting factor in untrained individuals. In novice  strength trainers , the muscle's ability to generate force is most strongly limited by nerve's ability to sustain a  high-frequency signal . After an extended period of maximum contraction, the nerve's signal reduces in frequency and the force generated by the contraction diminishes. There is no sensation of pain or discomfort, the muscle appears to simply 'stop listening' and gradually cease to move, often  lengthening . As there is insufficient stress on the muscles and tendons, there will often be no  delayed onset muscle soreness  following the workout.  Part of the process of strength training is increasing the nerve's ability to generate sustained, high frequency signals which allow a muscle to contract with their greatest force.  It is this \"neural training\" that causes several weeks worth of rapid gains in strength, which level off once the nerve is generating maximum contractions and the muscle reaches its physiological limit. Past this point, training effects increase muscular strength through myofibrillar or sarcoplasmic  hypertrophy  and metabolic fatigue becomes the factor limiting contractile force."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3522", "text": "Peripheral muscle fatigue during physical work is considered [ by whom? ]  an inability for the body to supply sufficient energy or other metabolites to the contracting muscles to meet the increased energy demand. This is the most common case of physical fatigue\u2014affecting a national [ where? ]  average of 72% of adults in the work force in 2002. This causes contractile dysfunction that manifests in the eventual reduction or lack of ability of a single muscle or local group of muscles to do work. The insufficiency of energy, i.e. sub-optimal  aerobic metabolism , generally results in the accumulation of  lactic acid  and other  acidic  anaerobic metabolic by-products in the muscle, causing the stereotypical burning sensation of local muscle fatigue, though recent studies have indicated otherwise, actually finding that lactic acid is a source of energy. [ 24 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3523", "text": "Though not universally used, \"metabolic fatigue\" is a common alternative term for peripheral muscle weakness, because of the reduction in contractile force due to the direct or indirect effects of the reduction of substrates or accumulation of metabolites within the  myocytes . This can occur through a simple lack of energy to fuel contraction, or through interference with the ability of Ca 2+  to stimulate  actin  and  myosin  to contract."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3524", "text": "Writer's cramp  or  focal hand dystonia  ( FHD ) is an  idiopathic   movement disorder  of adult onset, characterized by abnormal posturing and movement of the hand and/or forearm during tasks requiring skilled hand use, such as writing. [ 1 ] [ 2 ]  Overcontraction of affected muscles,  cocontraction  of  agonist and antagonist pairs , and activation of muscles inappropriate to a task all impair use of the affected hand. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3525", "text": "Writer's cramp is a task-specific  focal dystonia  of the hand. [ 4 ]  'Focal' refers to the symptoms being limited to one location (the hand in this case), and 'task-specific' means that symptoms first occur only when the individual engages in a particular activity. Writer's cramp first affects an individual by interfering with their ability to write, especially for prolonged periods of time. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3526", "text": "Epidemiologic  studies report a prevalence of 7\u201369 per million population for writer's cramp, [ 5 ]  which explains its recognition as a  rare disease , like all other forms of  dystonia . [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3527", "text": "Onset usually occurs between the ages of 30 and 50 years and often starts with a feeling of tension in fingers and forearms that interferes with writing fluency. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3528", "text": "More specifically, early symptoms may include loss of precision muscle coordination (sometimes first manifested in declining penmanship, frequent small injuries to the hands, dropped items and a noticeable increase in dropped or chipped dishes), cramping pain with sustained use and trembling. Significant muscle pain and cramping may result from very minor exertions like holding a book and turning pages. It may become difficult to find a comfortable position for arms and legs with even the minor exertions associated with holding arms crossed causing significant pain similar to restless leg syndrome. Affected persons may notice trembling in the diaphragm while breathing, or the need to place hands in pockets, under legs while sitting or under pillows while sleeping to keep them still and to reduce pain. Trembling in the jaw may be felt and heard while lying down, and the constant movement to avoid pain may result in the grinding and wearing down of teeth, or symptoms similar to  TMD . The voice may crack frequently or become harsh, triggering frequent throat clearing. Swallowing can become difficult and accompanied by painful cramping. Patients may also present with varying degree of disability and symptoms, such as experiencing more difficulty writing down-stroke as compared to writing upstroke. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3529", "text": "Electrical sensors (EMG) inserted into affected muscle groups, while painful, can provide a definitive diagnosis by showing pulsating nerve signals being transmitted to the muscles even when they are at rest. The brain appears to signal portions of fibers within the affected muscle groups at a firing speed of about 10\u00a0Hz causing them to pulsate, tremble and contort. When called upon to perform an intentional activity, the muscles fatigue very quickly and some portions of the muscle groups do not respond (causing weakness) while other portions over-respond or become rigid (causing micro-tears under load). The symptoms worsen significantly with use, especially in the case of focal dystonia, and a \"mirror effect\" is often observed in other body parts: use of the right hand may cause pain and cramping in that hand as well as in the other hand and legs that were not being used. Stress, anxiety, lack of sleep, sustained use and cold temperatures can worsen symptoms. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3530", "text": "Direct symptoms may be accompanied by secondary effects of the continuous muscle and brain activity, including disturbed sleep patterns, exhaustion, mood swings, mental stress, difficulty concentrating, blurred vision, digestive problems and short temper. People with dystonia may also become depressed and find great difficulty adapting their activities and livelihood to a progressing disability. Side effects from treatment and medications can also present challenges in normal activities."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3531", "text": "In some cases, symptoms may progress and then plateau for years, or stop progressing entirely. The progression may be delayed by treatment or adaptive lifestyle changes, while forced continued use may make symptoms progress more rapidly. In others, the symptoms may progress to total disability, making some of the more risky forms of treatment worth considering in the future. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3532", "text": "Although the cause of writer's cramp is not well known, it was historically believed to be the result of excessive fine motor activity, possibly complicated by a tense or otherwise inappropriate writing technique. [ 8 ]   More recently, Karin Rosenkranz et al. have suggested that this is not necessarily the case. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3533", "text": "Recent studies point out that there appears to be a  genetic  component to focal hand dystonia (FHD). In fact, up to 20% of those with writer's cramp have a family member with some form of dystonia. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3534", "text": "Musician's cramp (a similar focal dystonia which affects less than 1% of instrumentalists [ 10 ] ) has historically been grouped together with writer's cramp because of this and their common task-specificity. Rosenkranz et al. have more recently identified significant differences between the two populations, however. [ 9 ]   No matter exactly how it arises, researchers generally agree that these types of focal dystonia are the result of a  basal ganglia  and/or  sensorimotor cortex  malfunction in the brain. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3535", "text": "Although dystonias may be induced by chemical exposure/ingestion, brain injury, or hereditary/genetic predisposition, the task-specific focal dystonias such as writer's cramp are a unique challenge to diagnose and treat. Some cases may respond to chemical injections - botulinum toxin (botox) is often cited, though it is not helpful in all cases. [ 2 ] [ 11 ]  Behavioral retraining attempts may include writing devices, switching hands, occupational therapy, biofeedback, constraint-induced motion therapy, and others. Some writing instruments allow variations of pressure application for use. None of these are effective in all cases, however. The work of Dr.  Joaquin Farias  has shown that  proprioceptive stimulation can induce  neuroplasticity , making it possible for patients to recover substantial function that was lost from focal dystonia. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3536", "text": "Anticholinergics  such as   Artane  can be prescribed for off-label use, as some patients have had success. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3537", "text": "Creutzfeldt\u2013Jakob disease"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3538", "text": "The  epitrochleoanconeus muscle  ( anconeous epitrochlearis muscle ,  anconeus-epitrochlearis  or  anconeus sextus ) is a small  accessory muscle  of the  arm  which runs from the back of the inner condyle of the  humerus  over the  ulnar nerve  to the  olecranon . The average prevalence of this muscle is 14.2% in healthy individuals. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3539", "text": "The epitrochleoanconeus is a short striated muscle which originates on the posterior surface of the medial epicondyle of the humerus. The muscle runs over the ulnar nerve, forms an arch over the  cubital tunnel  and inserts on the olecranon. It is innervated by the ulnar nerve."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3540", "text": "There are cases where there is no structure at all bridging the space occupied by the epitrochleoanconeus. [ 2 ]  The muscle tends to be hypertrophied when associated with  cubital tunnel syndrome . [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3541", "text": "The presence of the epitrochleoanconeus muscle can lead to ulnar neuropathy, or cubital tunnel syndrome, due to compression of the ulnar nerve. [ 3 ] [ 4 ] [ 5 ]  The absence of epitrochleoanconeus muscle or Osborne's ligament can increase the chances of ulnar nerve dislocation. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3542", "text": "While there were previous identifications of the epitrochleoanconeus in animal studies, under a variety of names, Gruber (1866) seems to offer the first extensive comparative study involving the epitrochleoanconeus in man. [ 6 ]  This was shortly followed by several accounts by Wood describing his identification of the muscle during a series of dissections in humans along with comparative studies in other animals. [ 7 ] [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3543", "text": "In animals with a discrete developed epitrochleoanconeus the muscle acts as an  adductor  of the olecranon and a  supinator  of the forearm. [ 9 ]  A variety of names have been given to this muscle in different species including flexor antebrachii ulnaris, epitrochleo-cubitalis and entepicondylo-ulnaris. The epitrochleoanconius is common amongst  tetrapods  being found in  reptiles ,  amphibians ,  mammals  and  birds . [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3544", "text": "The epitrochleoanconeus is found widely amongst mammals having been characterised in the mid 19th century in a variety of species including  two-toed sloth ,  duck billed platypus  and  echidna . Galton (1874) gave an overview of the several species characterised at that point and noted that at least 15 species had been figured with the muscle in  Cuvier 's \"Anatomie compar\u00e9e\" of 1855 but that the muscle was given a wide variety of aliases and was not shown in many species where it should have been seen. [ 9 ]  The muscle is common in lower primates but has been lost as a discrete muscle in apes, although it has reoccurred in chimpanzees. [ 9 ] [ 11 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3545", "text": "This article incorporates text in the  public domain  from  page 448  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3546", "text": "Extensor digitorum brevis manus  is an extra or  accessory muscle  on the backside (dorsum) of the  hand . It was first described by Albinus in 1758. [ 1 ]  The muscles lies in the fourth extensor compartment of the  wrist , and is relatively rare. [ 2 ]   It has a prevalence of 4% in the general population according to a meta-analysis. [ 3 ]  This muscle is commonly misdiagnosed as a ganglion cyst, synovial nodule or  cyst . [ 4 ] [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3547", "text": "The extensor digitorum brevis manus usually originates from the dorsal aspect (backside) of the wrist, either from the joint capsule, the distal end (the most distant end) of the radius, the metacarpal, or from the  radiocarpal ligament  in the area of the fourth extensor compartment. [ 3 ]  Many variations of the muscle have been described in the literature. It could have up to four tendons with a single tendon inserting to the index or the middle finger being the two most common variations. [ 7 ]  At the insertion the tendon of the extensor digitorum brevis manus often joins the  extensor indicis proprius , [ 3 ]  although it also occurs when the extensor indicis proprius is absent. It was also reported to coexist with the  extensor medii proprius , another anatomical variation in the extensor compartment of the hand. [ 8 ]  The muscle is supplied the  posterior interosseous nerve  and posterior branch of the  anterior interosseous artery ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3548", "text": "The extensor digitorum brevis manus was found to be present in 4% of the population, and there was no correlation between gender, side or ancestry. [ 2 ]  it inserted to the index finger and the middle finger in 77% and 23% of the cases, respectively. [ 2 ]  It occurred bilaterally in 26% the total cases."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3549", "text": "At some point during the  embryonic development , the precursor extensor mass differentiates into three layers: radial, superficial, and deep. [ 9 ]  The extensor digitorum brevis manus may have been originated from the deep layer, a typical location where most of the variations take place. [ 2 ]  Some authors believe that this muscle may represent a failure of proximal migration of ulnocarpal elements of the extensor muscle mass in humans. [ 8 ] [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3550", "text": "It extends the index or the middle finger. It is believed to be a substitute for the extension of the index finger when the extensor indicis proprius is absent."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3551", "text": "Only a few clinical cases have been reported among more than 300 clinical and cadaveric dissections. [ 11 ]  This implies that the presence of this muscle is usually asymptomatic, although the extensor digitorum brevis manus might cause a painful  swelling  which can potentially be misdiagnosed as other  pathology  such as synovial cyst and  lipoma . [ 4 ] [ 5 ] [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3552", "text": "The  rectus sternalis muscle  is an  anatomical variation  that lies in front of the sternal end of the  pectoralis major  parallel to the margin of the  sternum . The sternalis muscle may be a variation of the pectoralis major or of the  rectus abdominis ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3553", "text": "The sternalis is a  muscle  that runs along the anterior aspect of the body of the sternum. It lies superficially and parallel to the sternum. Its origin and insertion are variable. The sternalis muscle often originates from the upper part of the sternum and can display varying insertions such as the  pectoral fascia ,  lower ribs ,  costal cartilages ,  rectus sheath , aponeurosis of the  abdominal external oblique muscle . [ 1 ] [ 2 ] [ 3 ]  There is still a great deal of disagreement about its  innervation  and its embryonic origin. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3554", "text": "In a review, [ 4 ]  it was reported that the muscle was innervated by the external or internal thoracic nerves in 55% of the cases, by the  intercostal nerves  in 43% of the cases, while the remaining cases were supplied by both nerves. [ 4 ]  However, innervation by the pectoral nerves has also been reported. [ 5 ]  This appears to indicate that the sternalis is not always derived from the same embryonic origin. [ 6 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3555", "text": "Cadaveric studies showed that the sternalis muscle has a mean prevalence of around 7.8% in the population, [ 7 ]  with a slightly higher incidence in females. [ 1 ]  The prevalence ranges from 0.5% to 23.5%, depending on the subpopulation [ 8 ] \u2060\u2014 \u2009 it has been proposed that the possible reason for the sizable range could be the fact of the existence of small, ill-defined, or tendinous fibres which may or may not be accepted as being a\nsternalis muscle. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3556", "text": "A 2014 study [ 8 ]  classified the sternalis into three types depending on morphology."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3557", "text": "Type I, the single head and single belly was seen in the majority of reported cases (58.5%), type II in 18.1%, and type III in 23.4%. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3558", "text": "In addition to the above classification, triple-bellied/double-headed sternalis has also been reported. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3559", "text": "There is no apparent physiological function of the sternalis muscle. [ 11 ]  However, there are many theories for a function. It may function as a  proprioceptive  sensor for thoracic wall movements. [ 12 ]  It may also take part in the movement of the  shoulder joint  or have an additional role in elevation of the chest wall. [ 13 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3560", "text": "The presence of the sternalis is asymptomatic [ 1 ]  but aesthetic complaints have been reported as it was reported to cause chest  asymmetry  or deviation of the nipple-areola complex. [ 1 ] [ 14 ]  The presence of the sternalis may cause alterations in the  electrocardiogram [ 15 ]  or confusion in  mammography . [ 16 ]  However, there is a potential benefit of the muscle as it can be used as a flap in a  reconstructive surgery  of the head and neck and the anterior chest wall. [ 14 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3561", "text": "The sternalis was first reported by Carbolius in 1604 and the name was first given by Turner in 1867. [ 17 ]  Different terminologies have been given to the sternalis due to its highly varied morphology and the disagreement on its embryonic origin. The sternalis was referred to as the  rectus sternalis,   sternalis brutorum, musculus sternalis, episternalis, parasternalis, presternalis, rectus sterni, rectus thoracis, rectus thoracicus superficialis, superficial rectus abdominis, japonicas, and thoracicus  depending on studies . [ 7 ] [ 17 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3562", "text": "A  saccade  ( / s \u0259 \u02c8 k \u0251\u02d0 d /   s\u0259- KAHD ;  French:   [sakad] ;  French  for 'jerk') is a quick, simultaneous movement of both  eyes  between two or more phases of focal points in the same direction. [ 1 ]  In contrast, in  smooth-pursuit movements , the eyes move smoothly instead of in jumps; it could be associated with a shift in frequency of an emitted signal [ clarification needed ]  or a movement of a body part or device. [ 2 ]  Controlled cortically by the  frontal eye fields  (FEF), or subcortically by the  superior colliculus , saccades serve as a mechanism for focal points, rapid eye movement, and the fast phase of  optokinetic nystagmus . [ 1 ]  The word appears to have been coined in the 1880s by French ophthalmologist  \u00c9mile Javal , who used a mirror on one side of a page to observe eye movement in  silent reading , and found that it involves a succession of discontinuous individual movements. [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3563", "text": "Humans and many organisms do not look at a scene in steadiness; instead, the eyes move around, locating interesting parts of the scene and building up a three-dimensional 'map' corresponding to the scene (as opposed to the graphical map of  avians , which often relies upon detection of angular movement on the retina). [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3564", "text": "When scanning immediate surroundings or reading, human eyes make saccadic movements and stop several times, moving very quickly between each stop. The speed of movement during each saccade cannot be controlled; the eyes move as fast as they are able. [ 4 ]  One reason for the saccadic movement of the human eye is that the central part of the  retina \u2014known as the  fovea \u2014which provides the high-resolution portion of vision is very small in humans, only about 1\u20132 degrees of vision, but it plays a critical role in resolving objects. [ 5 ]  By moving the eye so that small parts of a scene can be sensed with greater  resolution , body resources can be used more efficiently. [ how? ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3565", "text": "Saccades are one of the fastest movements produced by the human eye ( blinks  may reach even higher peak velocities). The peak  angular speed  of the eye during a saccade reaches up to 700\u00b0/s in humans for great saccades (25\u00b0 of visual angle); in some monkeys, peak speed can reach 1000\u00b0/s. [ 6 ]  Saccades to an unexpected stimulus normally take about 200 milliseconds (ms) to initiate, and then last from about 20\u2013200 ms, depending on their amplitude (20\u201330 ms is typical in language reading). Under certain laboratory circumstances, the latency of, or reaction time to, saccade production can be cut nearly in half (express saccades). These saccades are generated by a neuronal mechanism that bypasses time-consuming circuits and activates the eye muscles more directly. [ 7 ] [ 8 ]   Specific pre-target oscillatory ( alpha rhythms ) and transient activities occurring in posterior-lateral  parietal cortex  and  occipital cortex  also characterize express saccades. [ 9 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3566", "text": "To achieve such high speeds, there are specialized oculomotor burst neurons in the brainstem that wire into the ocular motor neuron. The burst neurons implement  bang-bang control : they are either completely inhibited, or firing at its full rate of ~1000\u00a0Hz. [ 10 ]  Since the motion of the eye is essentially a linear system, bang-bang control minimizes travel time. [ 11 ]  After a saccade, a constant force is required to hold the position against elastic force, thus resulting in a pulse-step control. [ 12 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3567", "text": "The amplitude of a saccade is the angular distance the eye travels during the movement. For amplitudes up to 15 or 20\u00b0, the velocity of a saccade linearly depends on the amplitude (the so-called  saccadic main sequence , [ 13 ]  a term borrowed from  astrophysics ; see Figure). For amplitudes larger than 20\u00b0, the peak velocity starts to plateau [ 13 ]  (nonlinearly) toward the maximum velocity attainable by the eye at around 60\u00b0.  For instance, a 10\u00b0 amplitude is associated with a velocity of 300\u00b0/s, and 30\u00b0 is associated with 500\u00b0/s. [ 14 ]  Therefore, for larger amplitude ranges, the main sequence can best be modeled by an inverse  power law  function. [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3568", "text": "The high peak velocities and the main sequence relationship can also be used to distinguish  micro- /saccades from other  eye movements  (like  ocular tremor ,  ocular drift , and  smooth pursuit ). Velocity-based  algorithms  are a common  approach for saccade detection in  eye tracking . [ 16 ] [ 17 ] [ 18 ]  Although, depending on the demands on timing accuracy, acceleration-based methods are more precise. [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3569", "text": "Saccades may rotate the eyes in any direction to relocate gaze direction (the direction of sight that corresponds to the fovea), but normally saccades do not rotate the eyes torsionally. (Torsion is clockwise or counterclockwise rotation around the line of sight when the eye is at its central primary position; defined this way,  Listing's law  says that, when the head is motionless, torsion is kept at zero.)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3570", "text": "Head-fixed saccades can have amplitudes of up to 90\u00b0 (from one edge of the oculomotor range to the other), but in normal conditions saccades are far smaller, and any shift of gaze larger than about 20\u00b0 is accompanied by a head movement. During such gaze saccades, first, the eye produces a saccade to get gaze on target, whereas the head follows more slowly and the  vestibulo-ocular reflex  (VOR) causes the eyes to roll back in the head to keep gaze on the target. Since the VOR can actually rotate the eyes around the line of sight, combined eye and head movements do not always obey  Listing's law . [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3571", "text": "The rotational inertia of the eye is negligible compared to the elastic and viscous force."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3572", "text": "Saccades can be categorized by intended goal in four ways: [ 21 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3573", "text": "As referenced to above, it is also useful to categorize saccades by latency (time between go-signal and movement onset). In this case the categorization is binary: Either a given saccade is an  express saccade  or it is not. The latency cut-off is approximately ~200\u00a0ms; any longer than this is outside the express saccade range. [ 7 ] [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3574", "text": "Microsaccades  are a related type of  fixational eye movement  that are small, jerk-like, involuntary  eye movements , similar to miniature versions of voluntary saccades. They typically occur during visual  fixation , not only in humans, but also in animals with  foveal  vision (primates, cats, etc.). Microsaccade amplitudes vary from 2 to 120  arcminutes ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3575", "text": "When exploring the visual environment with the gaze, humans make two to three fixations a second. Each fixation involves binocularly coordinated movements of the eyes to acquire the new target in three dimensions: horizontal and vertical, but also in-depth. In literature it has been shown how an upward or a vertical saccade is generally accompanied by a divergence of the eyes, while a downward saccade is accompanied by a convergence. [ 22 ]  The amount of this  intra-saccadic   vergence  has a strong functional significance for the effectiveness of binocular vision. [ 23 ]  When making an upward saccade, the eyes diverged to be aligned with the most probable uncrossed disparity in that part of the visual field. On the other way around, when making a downward saccade, the eyes converged to enable alignment with crossed disparity in that part of the field. The phenomenon can be interpreted as an adaptation of rapid binocular eye movements to the statistics of the 3D environment, in order to minimize the need for corrective vergence movements at the end of saccades."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3576", "text": "Saccadic oscillations not fitting the normal function are a deviation from a healthy or normal condition.  Nystagmus  is characterized by the combination of 'slow phases', which usually take the eye off the point of regard, interspersed with saccade-like \"quick phases\" that serve to bring the eye back on target. Pathological slow phases may be due to either an imbalance in the  vestibular system  or damage to the  brainstem  \"neural integrator\" that normally holds the eyes in place. [ citation needed ]  On the other hand,  opsoclonus  or  ocular flutter  are composed purely of fast-phase saccadic eye movements. Without the use of objective recording techniques, it may be very difficult to distinguish between these conditions. [ medical citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3577", "text": "Eye movement measurements are also used to investigate psychiatric disorders. For example,  ADHD  is characterized by an increase of antisaccade errors and an increase in delays for visually guided saccade. [ 21 ]  Various pathological conditions also alter microsaccades and other  fixational eye movements . [ 24 ] [ 25 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3578", "text": "Paroxysmal eye\u2013head movements, termed aberrant gaze saccades, are an early symptom of  GLUT1 deficiency syndrome  in infancy. [ 26 ] [ non-primary source needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3579", "text": "When the brain is led to believe that the saccades it is generating are too large or too small (by an experimental manipulation in which a saccade-target steps backward or forward contingent on the eye movement made to acquire it), saccade amplitude gradually decreases (or increases), an adaptation (also termed  gain adaptation ) widely seen as a simple form of motor learning, possibly driven by an effort to correct visual error. This effect was first observed in humans with ocular muscle palsy. [ 27 ]  In these cases, it was noticed that the patients would make hypometric (small) saccades with the affected eye, and that they were able to correct these errors over time. This led to the realization that visual or retinal error (the difference between the post-saccadic point of regard and the target position) played a role in the homeostatic regulation of saccade amplitude. Since then, much scientific research has been devoted to various experiments employing saccade adaptation. [ 28 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3580", "text": "Saccadic eye movement allows the mind to read quickly, but it comes with its disadvantages. It can cause the mind to skip over words because it does not see them as important to the sentence, and the mind completely leaves it from the sentence or it replaces it with the wrong word. This can be seen in \" Paris in the the Spring \". This is a common psychological test, where the mind will often skip the second \"the\", especially when there is a line break in between the two."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3581", "text": "When speaking, the mind plans what will be said before it is said. Sometimes the mind is not able to plan in advance and the speech is rushed out. This is why there are errors like mispronunciation, stuttering, and unplanned pauses. The same thing happens when reading. The mind does not always know what will come next. This is another reason that the second \"the\" can be missed. [ 29 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3582", "text": "It is a common but false belief that during the saccade, no information is passed through the optic nerve to the brain. Whereas low spatial frequencies (the 'fuzzier' parts) are attenuated, higher spatial frequencies (an image's fine details) that would otherwise be blurred by the eye movement remain unaffected.  This phenomenon, known as  saccadic masking  or  saccadic suppression , is known to begin prior to saccadic eye movements in every primate species studied, implying neurological reasons for the effect rather than simply the image's motion blur. [ 30 ]   This phenomenon leads to the so-called stopped-clock illusion, or  chronostasis ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3583", "text": "A person may observe the saccadic masking effect by standing in front of a mirror and looking from one eye to the next (and vice versa).  The subject will not experience any movement of the eyes or any evidence that the optic nerve has momentarily ceased transmitting. Due to saccadic masking, the eye/brain system not only hides the eye movements from the individual but also hides the evidence that anything has been hidden. Of course, a second observer watching the experiment will see the subject's eyes moving back and forth. The function's main purpose is to prevent an otherwise significant smearing of the image. [ 14 ]  (You can experience your eye saccade movements by using your cellphone's front-facing camera as a mirror, hold the cellphone screen a couple of inches away from your face as you saccade from one eye to the other\u2014the cellphone's signal processing delay allows you to see the end of the saccade movement.)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3584", "text": "When a visual stimulus is seen before a saccade, subjects are still able to make another saccade back to that image, even if it is no longer visible. This shows that the brain is somehow able to take into account the intervening eye movement. It is thought that the brain does this by temporarily recording a copy of the command for the eye movement, and comparing this to the remembered image of the target. This is called spatial updating. Neurophysiologists, having recorded from cortical areas for saccades during spatial updating, have found that memory-related signals get remapped during each saccade. [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3585", "text": "It is also thought that perceptual memory is updated during saccades so that information gathered across fixations can be compared and synthesized. However, the entire visual image is not updated during each saccade. Some scientists believe that this is the same as visual working memory, but as in spatial updating the eye movement has to be accounted for. The process of retaining information across a saccade is called trans-saccadic memory, and the process of integrating information from more than one fixation is called trans-saccadic integration."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3586", "text": "Saccades are a widespread phenomenon across animals with image-forming visual systems. They have been observed in animals across three  phyla , including animals that do not have a  fovea  (most vertebrates do) and animals that cannot move their eyes independently of their head (such as insects). [ 31 ]  Therefore, while saccades serve in humans and other primates to increase the effective visual resolution of a scene, there must be additional reasons for the behavior. The most frequently suggested of these reasons is to avoid blurring of the image, which would occur if the response time of a  photoreceptor cell  is longer than the time a given portion of the image is stimulating that photoreceptor as the image drifts across the eye."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3587", "text": "In birds, saccadic eye movements serve a further function.  The  avian retina  is highly developed. It is thicker than the  mammalian retina , has a higher metabolic activity, and has less  vasculature  obstruction, for greater visual acuity. [ 32 ]  Because of this, the retinal cells must obtain nutrients via diffusion through the  choroid  and from the  vitreous humor . [ 33 ]  The  pecten  is a specialised structure in the avian retina. It is a highly vascular structure that projects into the vitreous humor. Experiments show that, during saccadic eye oscillations (which occupy up to 12% of avian viewing time), the  pecten oculi  acts as an agitator, propelling perfusate (natural lubricants) toward the retina. Thus, in birds, saccadic eye movements appear to be important in retinal nutrition and  cellular respiration . [ 34 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3588", "text": "The  frontal eye fields  ( FEF ) are a region located in the  frontal cortex , more specifically in  Brodmann area 8  or BA8, [ 1 ]  of the primate  brain . In humans, it can be more accurately said to lie in a region around the intersection of the  middle frontal gyrus  with the  precentral gyrus , consisting of a frontal and parietal portion. [ 2 ]  The FEF is responsible for  saccadic eye movements  for the purpose of visual field perception and awareness, as well as for voluntary eye movement. The FEF communicates with extraocular muscles indirectly via the  paramedian pontine reticular formation . Destruction of the FEF causes deviation of the eyes to the ipsilateral side."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3589", "text": "The cortical area called frontal eye field (FEF) plays an important role in the control of visual attention and eye movements. [ 3 ]  Electrical stimulation in the FEF elicits saccadic eye movements. The FEF have a topographic structure and represents saccade targets in  retinotopic  coordinates. [ 4 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3590", "text": "The frontal eye field is reported to be activated during the initiation of  eye movements , such as voluntary  saccades [ 5 ]  and  pursuit eye movements . [ 6 ]  There is also evidence that it plays a role in purely sensory processing and that it belongs to a \u201cfast brain\u201d system through a  superior colliculus  \u2013  medial dorsal nucleus  \u2013 FEF ascending pathway. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3591", "text": "In humans, its earliest activations in regard to visual stimuli occur at 45 ms with activations related to changes in visual stimuli within 45\u201360 ms (these are comparable with response times in the  primary visual cortex ). [ 7 ] \nThis fast brain pathway also provides auditory input at even shorter times starting at 24 ms and being affected by auditory characteristics at 30\u201360 ms. [ 7 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3592", "text": "The FEF constitutes together with the  supplementary eye fields  (SEF), the  intraparietal sulcus  (IPS) and the   superior colliculus  (SC) one of the most important brain areas involved in the generation and control of eye movements, particularly in the direction contralateral to the frontal eye fields' location. In addition, FEF has an important role in the covert allocation of spatial attention through its reciprocal connectivity with visual cortex. [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3593", "text": "Unilateral irritative stimulation of a FEF, such as a frontal seizure causes  conjugate gaze  contralateral to the stimulation. Conversely, a unilateral destructive lesion of the FEF causes conjugate gaze towards the lesion."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3594", "text": "Paris in the the Spring  is a phrase often used in an informal  psychological test . The phrase \"Paris in the the Spring\" is written with an extra \"the\". A subject is asked to read the text, and will often jump to conclusions and fail to notice the extra \"the\", especially when there is a line break between the two  the s. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3595", "text": "The second \u2018the\u2019 is skipped because of  saccades , jerky movements that eyes make when looking around. The brain counteracts these movements by steadying them and making everything appear smooth. While the brain is using saccadic movements to read, it searches for the most important words and skips over the less important ones, and fills them in using the words around it and what the brain sees when it quickly skips over it. For instance, in \u2018Paris in the \u00a0 the Spring\u2019, the eyes will read Paris and quickly move ahead to Spring, and just glance over \u2018in the \u00a0 the\u2019, leading the mind to completely disregard the second \u2018the\u2019. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3596", "text": "This  psychology -related article is a  stub . You can help Wikipedia by  expanding it ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3597", "text": "Supplementary eye field  ( SEF ) is the name for the anatomical area of the dorsal medial  frontal lobe  of the primate  cerebral cortex  that is indirectly involved in the control of  saccadic   eye movements . Evidence for a supplementary eye field was first shown by Schlag, and Schlag-Rey. [ 1 ]  Current research strives to explore the SEF's contribution to visual search and its role in visual  salience . [ 2 ] [ 3 ]  The SEF constitutes together with the   frontal eye fields (FEF) , the  intraparietal sulcus  (IPS), and the   superior colliculus  (SC) one of the most important brain areas involved in the generation and control of eye movements, particularly in the direction contralateral to their location. [ 2 ] [ 4 ]  Its precise function is not yet fully known. [ 2 ]  Neural recordings in the SEF show signals related to both vision and saccades somewhat like the frontal eye fields and  superior colliculus , but currently most investigators think that the SEF has a special role in high level aspects of saccade control, like complex spatial transformations, [ 5 ]  learned transformations, [ 6 ]  and executive cognitive functions. [ 7 ] [ 8 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3598", "text": "In 1874,  David Ferrier , a Scottish neurologist first described the  frontal eye fields (FEF) . He noted that unilateral electrical stimulation of the frontal lobe of macaque monkeys caused \"turning of the eyes and head to the opposite side\"  (Fig. 2) . [ 9 ]  The brain area allotted to the FEF by Ferrier's original map was actually quite large and also encompassed the area which we now call the SEF. A century's worth of experimental findings following Ferrier's work have led to shrinking the FEF's size. [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3599", "text": "During the 1950s,  surgical treatment of epileptic patients  was being conducted. Neurosurgeons were removing lesions and other parts of the brain thought to be involved in causing the patient's seizures. \nTreatment of these epileptic patients lead to the discovery of many new brain areas by observant neurosurgeons concerned with the post-surgical implications of removing sections of the brain. Through electrical stimulation studies an area called the  supplementary motor area (SMA)  was observed and documented by the neurosurgeon  Wilder Penfield  in 1950. [ 11 ] [ 12 ]  As Penfield had noted the induction of gaze shifts by stimulation of the rostral part of the SMA, another eye field's existence was postulated."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3600", "text": "In 1987, the SEF was finally characterized by Schlag and Schlag-Rey as an area where low intensity electrical stimulation could evoke saccades, similar to the FEF. It was named as such to complement the SMA's name. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3601", "text": "The eye field originally defined by Ferrier's map of the frontal cortex extended medially to the dorsal surface of the brain  (Fig. 2) . [ 9 ]  But the FEF proper has since shrunk into the rostral back of the  arcuate sulcus   (Fig. 1) . [ 10 ]  Experimenters have since established that the FEF and SEF are two separate and distinct brain areas responsible for saccade initiation through cerebral blood flow, and subdural electrode array studies. [ 11 ] [ 13 ] [ 14 ] [ 15 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3602", "text": "In humans, the SEF is located in the rostral  supplementary motor area  (SMA). [ 16 ]  It is located in   Brodmann area 6 (BA6)  which corresponds to  area F7 , the premotor cortex. [ 17 ]  Based on  single unit recording  and  microstimulation  it has been established that the SEF is caudally contiguous with the parts of the SMA which represent orofacial, and forelimb movements. [ 1 ] [ 18 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3603", "text": "The FEF is located in  Brodmann area 8  which is just anterior to the premotor cortex (BA6)  (Fig. 3) . [ 19 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3604", "text": "As opposed to the FEF, the SEF plays an indirect but executive role in saccade initiation. For example, the activity of SEF neurons is not sufficient to control saccade initiation in macaque monkeys performing  stop signal go/no-go tasks . [ 3 ]  In this kind of task a trained monkey is to make a particular response (in this case move its eyes, or produce a saccade) to a stimulus on a screen such as a flashing dot. For the go-task, the monkey is to look at the dot. But for the no-go task, the go signal will appear and be followed by the no-go signal, testing whether the saccade initiation can be inhibited. [ 20 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3605", "text": "In other words, the SEF does not immediately  or directly contribute to saccade initiation. But, the SEF is thought to improve saccade production by using prior knowledge of anticipated task requirements to influence saccadic eye movements. It does so by balancing gaze holding and gaze shifting actions, yielding a modest improvement in performance in stop signal tasks by delaying saccade initiation when necessary. [ 2 ] [ 3 ]  It can be thought that the  FEF  does the driving part of saccade initiation, while the SEF acts as a backseat passenger, advising the driver as to what to do based on past insights. The SEF has recently been found to encode reward prediction error, suggesting that the SEF may actively evaluate decisions based on a value system on an occulomotor basis, independent of other brain regions. [ 21 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3606", "text": "The visual system is sensitive to sudden change. [ 22 ]  If something distracting occurs while a person is performing a task\u2014reading a newspaper, for example\u2014this immediately captures one's attention. [ 23 ] [ 24 ] [ 25 ]  This sudden shift can be a distraction but it has been also thought to be a reflex of great importance as identifying and reacting to environmental changes quickly (when needed) can be imperative to survival. [ 24 ] [ 26 ] [ 27 ] [ 28 ] [ 29 ]  Saccadic latency, the time delay between the appearance of a target and the initiation of a saccade,  is an important parameter for learning which occulomotor neurons and structures of the brain play what specific roles in saccade initiation. [ 30 ] [ 31 ]  There is much research being conducted on the role of SEF in determining visually salient objects and occurrences, using saccadic latency as the parameter of interest. [ 2 ] [ 26 ] [ 32 ] [ 33 ] [ 34 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3607", "text": "SEF activity has been found to govern decisions in smooth pursuit but not the decision itself. [ 35 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3608", "text": "The SEF responds to auditory stimuli as well as visual stimuli. [ 20 ]  Visual responses from the SEF happen later and are much weaker than that observed in the FEF, though. SEF neurons also exhibit non-retinal modulation including anticipation and reward prediction. [ 3 ] [ 36 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3609", "text": "The SEF was defined by the Schlags as a region where low currents (<50\u03bcA) evoke saccades. It is still found using this characterization as well as the known neighboring anatomy  (Fig. 1) . [ 1 ] [ 10 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3610", "text": "SEF research is conducted mainly in monkey models. Typically trained  rhesus macaque  monkeys are used and surgically implanted with recording chambers. In this fashion,  spike  and  local field potential (LFP)  data can be acquired from SEF neurons, using  microelectrodes  in the recording chamber. Eye movements can also be monitored using eye-tracking camera equipment. [ 2 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3611", "text": "Experiments obviously vary, but to give an example: the monkey might be made to partake in a color visual search task, sitting in front of a computer screen. The monkey would look at a point on the screen which would change from filled in to open at the same time which a colored point of \"opposite\" color appears on the screen. The monkey would be rewarded for looking at a new spot\u2014\"for making a single saccade\"\u2014within 2000\u00a0ms and then fixating on the spot for 500\u00a0ms. Varied tasks such as these are used and data is analyzed to determine the SEF's role in saccade initiation, visual saliency, etc. [ 2 ] [ 3 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3612", "text": "The  triangles of the neck  describe the divisions created by the major muscles in the region."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3613", "text": "The side of the  neck  presents a somewhat quadrilateral outline, limited, above, by the lower border of the body of the  mandible , and an imaginary line extending from the angle of the mandible to the  mastoid process ; below, by the upper border of the  clavicle ; in front, by the middle line of the neck; behind, by the anterior margin of the  trapezius ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3614", "text": "This space is subdivided into two large triangles by  sternocleidomastoid , which passes obliquely across the neck, from the  sternum  and  clavicle  below, to the  mastoid process  and  occipital bone  above."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3615", "text": "The triangular space in front of this muscle is called the  anterior triangle of the neck ; and that behind it, the  posterior triangle of the neck ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3616", "text": "The anterior triangle is further divided into  muscular ,  carotid ,  submandibular  and  submental  and the posterior into  occipital  and  subclavian  triangles. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3617", "text": "The use of the divisions described as the triangles of the neck permit the effective communication of the location of palpable masses located in the neck between healthcare professionals."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3618", "text": "The common swellings anterior of the midline are:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3619", "text": "This article incorporates text in the  public domain  from  page 563  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3620", "text": "The  anterior triangle  is a region of the  neck ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3621", "text": "The triangle is inverted with its apex inferior to its base which is under the chin. [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3622", "text": "Investing fascia  covers the roof of the triangle while  visceral fascia  covers the floor."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3623", "text": "Muscles:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3624", "text": "2 Bellies of digastric"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3625", "text": "Stylohyoid: by the facial nerve, by a branch from that to the posterior belly of digastric."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3626", "text": "Mylohyoid: by its own nerve, a branch of the inferior alveolar (from the mandibular division of trigeminal nerve), which arises just before the parent nerve enters the mandibular foramen, pierces the sphenomandibular ligament, and runs forward on the inferior surface of the mylohyoid, supplying it and the anterior belly of the digastric."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3627", "text": "Geniohyoid: by a branch from the hypoglossal nerve consisting of fibres from the C1 nerve."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3628", "text": "Sternohyoid, omohyoid, sternothyroid are supplied by ansa cervicalis."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3629", "text": "Thyrohyoid: by a branch of hypoglossal nerve but the fibres are all 'hitch-hiking' from C1."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3630", "text": "This space is subdivided into four smaller triangles by the  digastricus  above, and the superior belly of the  omohyoideus ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3631", "text": "These smaller triangles are named:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3632", "text": "The  carotid triangle  (or  superior carotid triangle ) is a portion of the  anterior triangle of the neck ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3633", "text": "It is bounded:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3634", "text": "The roof is formed by:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3635", "text": "The floor is formed by (parts of) the:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3636", "text": "Superficial to the  carotid sheath  lies the  hypoglossal nerve , and  ansa cervicalis  of the  cervical plexus ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3637", "text": "The  hypoglossal nerve  crosses both the internal and external carotids, curving around the origin of the  occipital artery ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3638", "text": "Within the sheath, between the artery and vein, and behind both, is the  vagus nerve ; behind the sheath, the  sympathetic trunk ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3639", "text": "On the lateral side of the vessels, the  accessory nerve  runs for a short distance before it pierces the  Sternocleidomastoideus ; and on the medial side of the  external carotid , just below the  hyoid bone , the internal branch of the  superior laryngeal nerve  may be seen; and, still more inferiorly, the external branch of the same nerve."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3640", "text": "The superior portion of the larynx and inferior portion of the pharynx are also found in the anterior portion part of this space."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3641", "text": "This article incorporates text in the  public domain  from  page 564  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3642", "text": "The  inferior carotid triangle  (or  muscular triangle ), is bounded, in front, by the median line of the neck from the  hyoid bone  to the  sternum ; behind, by the anterior margin of the  sternocleidomastoid ; above, by the superior belly of the  omohyoid ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3643", "text": "It is covered by the integument, superficial fascia,  platysma , and deep fascia, ramifying in which are some of the branches of the supraclavicular nerves."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3644", "text": "Beneath these superficial structures are the  sternohyoid  and  sternothyroid , which, together with the anterior margin of the  sternocleidomastoid , conceal the lower part of the  common carotid artery ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3645", "text": "This vessel is enclosed within its sheath, together with the  internal jugular vein  and  vagus nerve ; the vein lies lateral to the artery on the right side of the neck, but overlaps it below on the left side; the nerve lies between the artery and vein, on a plane posterior to both."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3646", "text": "In front of the sheath are a few descending filaments from the  ansa cervicalis ; behind the sheath are the  inferior thyroid artery , the  recurrent nerve , and the  sympathetic trunk ; and on its medial side, the  esophagus , the  trachea , the  thyroid gland , and the lower part of the  larynx ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3647", "text": "By cutting into the upper part of this space, and slightly displacing the sternocleidomastoid, the common carotid artery may be tied below the omohyoid."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3648", "text": "The  occipital triangle , the larger division of the posterior triangle, is bounded, in front, by the  Sternocleidomastoideus ; behind, by the  Trapezius ; below, by the  Omohyoideus ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3649", "text": "Its floor is formed from above downward by the  Splenius capitis ,  Levator scapul\u00e6 , and the  Scalenus medius  and posterior."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3650", "text": "It is covered by the skin, the superficial and deep fasci\u00e6, and by the  Platysma  below."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3651", "text": "The  accessory nerve  is directed obliquely across the space from the  Sternocleidomastoideus , which it pierces, to the under surface of the  Trapezius ; below, the  supraclavicular nerves  and the  transverse cervical vessels  and the upper part of the  brachial plexus  cross the space."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3652", "text": "The roof of this triangle is formed by the cutaneous nerves of cervical plexus and the external jugular vein and platysma muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3653", "text": "A chain of  lymph glands  is also found running along the posterior border of the  Sternocleidomastoideus , from the mastoid process to the root of the  neck ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3654", "text": "This article incorporates text in the  public domain  from  page 565  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3655", "text": "The  posterior triangle  (or  lateral cervical region ) is a region of the  neck ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3656", "text": "The posterior triangle has the following boundaries: [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3657", "text": "Apex:  Union of the  sternocleidomastoid  and the  trapezius  muscles at the  superior nuchal line  of the  occipital bone"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3658", "text": "Anteriorly:  Posterior border of the  sternocleidomastoideus"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3659", "text": "Posteriorly:  Anterior border of the  trapezius"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3660", "text": "Inferiorly:  Middle one third of the  clavicle"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3661", "text": "Roof:  Investing layer of the  deep cervical fascia"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3662", "text": "Floor:  (From superior to inferior)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3663", "text": "1) M. semispinalis capitis"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3664", "text": "2) M. splenius capitis"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3665", "text": "3) M. levator scapulae"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3666", "text": "4) M. scalenus posterior"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3667", "text": "5) M. scalenus medius"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3668", "text": "The posterior triangle is crossed, about 2.5\u00a0cm above the clavicle, by the inferior belly of the  omohyoid muscle , which divides the space into two triangles:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3669", "text": "A) Nerves and plexuses:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3670", "text": "B) Vessels:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3671", "text": "C) Lymph nodes:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3672", "text": "D) Muscles:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3673", "text": "The accessory nerve (CN XI) is particularly vulnerable to damage during lymph node biopsy. Damage results in an inability to shrug the shoulders or raise the arm above the head, particularly due to compromised  trapezius muscle  innervation."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3674", "text": "The  external jugular vein 's superficial location within the posterior triangle also makes it vulnerable to injury."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3675", "text": "The  subclavian triangle  (or  supraclavicular triangle ,  omoclavicular triangle ,  Ho's triangle ), the smaller division of the posterior triangle, is bounded, above, by the inferior belly of the  omohyoideus ; below, by the  clavicle ; its base is formed by the posterior border of the  sternocleidomastoideus ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3676", "text": "Its floor is formed by the first rib with the first digitation of the  serratus anterior ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3677", "text": "The size of the subclavian triangle varies with the extent of attachment of the clavicular portions of the  Sternocleidomastoideus  and  Trapezius , and also with the height at which the  Omohyoideus  crosses the neck."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3678", "text": "Its height also varies according to the position of the arm, being diminished by raising the limb, on account of the ascent of the clavicle, and increased by drawing the arm downward, when that bone is depressed."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3679", "text": "This space is covered by the integument, the superficial and deep fasci\u00e6 and the  platysma , and crossed by the supraclavicular nerves."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3680", "text": "Just above the level of the clavicle, the third portion of the  subclavian artery  curves lateralward and downward from the lateral margin of the  scalenus anterior , across the first  rib , to the  axilla , and this is the situation most commonly chosen for  ligaturing  the vessel."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3681", "text": "Sometimes this vessel rises as high as 4\u00a0cm. above the clavicle; occasionally, it passes in front of the Scalenus anterior, or pierces the fibers of that muscle."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3682", "text": "The subclavian vein lies behind the clavicle, and is not usually seen in this space; but in some cases it rises as high as the artery, and has even been seen to pass with that vessel behind the Scalenus anterior."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3683", "text": "The  brachial plexus  of nerves lies above the artery, and in close contact with it. Passing transversely behind the clavicle are the  transverse scapular vessels ; and traversing its upper angle in the same direction, the  transverse cervical artery  and vein."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3684", "text": "The  external jugular vein  runs vertically downward behind the posterior border of the Sternocleidomastoideus, to terminate in the  subclavian vein ; it receives the transverse cervical and transverse scapular veins, which form a plexus in front of the artery, and occasionally a small vein which crosses the  clavicle  from the  cephalic ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3685", "text": "The small nerve to the subclavius also crosses this triangle about its middle, and some  lymph glands  are usually found in the space."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3686", "text": "Enlarged nodes in this triangle irrespective of size are categorized at N3 in the TNM classification for nasopharyngeal carcinoma."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3687", "text": "The  submandibular triangle  (or  submaxillary   or  digastric triangle ) corresponds to the region of the neck immediately beneath the body of the  mandible ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3688", "text": "It is bounded: [ 1 ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3689", "text": "It is covered by the  integument ,  superficial fascia ,  Platysma , and deep fascia, ramifying in which are branches of the  facial nerve  and ascending filaments of the  cutaneous cervical nerve ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3690", "text": "Its floor is formed by the  Mylohyoideus  anteriorly, and by the  hyoglossus  posteriorly."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3691", "text": "It is divided into an anterior and a posterior part by the  stylomandibular ligament . [ citation needed ]"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3692", "text": "The anterior part contains the  submandibular gland , superficial to which is the  anterior facial vein , while imbedded in the gland is the  facial artery  and its glandular branches."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3693", "text": "Beneath the gland, on the surface of the  Mylohyoideus , are the  submental artery  and the  mylohyoid artery  and nerve."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3694", "text": "The posterior part of this triangle contains the external carotid artery, ascending deeply in the substance of the  parotid gland"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3695", "text": "This vessel lies here in front of, and superficial to, the external carotid, being crossed by the  facial nerve , and gives off in its course the  posterior auricular ,  superficial temporal , and  internal maxillary  branches: more deeply are the  internal carotid , the  internal jugular vein , and the  vagus nerve , separated from the external carotid by the  Styloglossus  and  Stylopharyngeus , and the  hypoglossal nerve"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3696", "text": "The following summarizes the important structures found in the submandibular triangle:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3697", "text": "The  submental triangle  (or  suprahyoid triangle ) is a division of the  anterior triangle of the neck ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3698", "text": "It is limited to:"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3699", "text": "It contains one or two  lymph glands , the  submental lymph nodes  (three or four in number) and Submental veins and commencement of  anterior jugular veins."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3700", "text": "(The contents of the triangle actually lie in the superficial fascia over the roof of submental triangle)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3701", "text": "This article incorporates text in the  public domain  from  page 565  of\u00a0the 20th edition of   Gray's Anatomy   (1918) , Page 88 of Textbook of Anatomy; head, neck and brain by Vishram Singh"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3702", "text": "The  suboccipital triangle  is a region of the  neck  bounded by the following three muscles of the  suboccipital group of muscles :"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3703", "text": "(Rectus capitis posterior minor is also in this region but does not form part of the triangle)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3704", "text": "It is covered by a layer of dense fibro-fatty tissue, situated beneath the  semispinalis capitis ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3705", "text": "The floor is formed by the  posterior atlantooccipital membrane , and the  posterior arch  of the  atlas ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3706", "text": "In the deep groove on the upper surface of the posterior arch of the atlas are the  vertebral artery  and the first cervical or  suboccipital nerve ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3707", "text": "In the past, the vertebral artery was accessed here in order to conduct  angiography  of the  circle of Willis . Presently, formal angiography of the circle of Willis is performed via catheter angiography, with access usually being acquired at the common femoral artery. Alternatively, a computed tomographic angiogram or magnetic resonance angiogram is performed."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3708", "text": "1) Third part of  vertebral artery \n2) Dorsal ramus of nerve C1- suboccipital nerve \n3)  Suboccipital venous plexus"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3709", "text": "The purpose of these muscles is to provide fine motor function in movements of the head. The actions of  trapezius ,  sternocleidomastoid  and other larger muscles that move the head are refined by the relatively small suboccipital triangle muscles."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3710", "text": "This article incorporates text in the  public domain  from  page 402  of\u00a0the 20th edition of   Gray's Anatomy   (1918)"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3711", "text": "The  supraclavicular fossa  is an indentation (fossa) immediately above the  clavicle ."}
{"_id": "WikiPedia_Muscular_system$$$corpus_3712", "text": "In  terminologia anatomica , it is divided into  fossa supraclavicularis major  and  fossa supraclavicularis minor"}
{"_id": "WikiPedia_Muscular_system$$$corpus_3713", "text": "Fullness in the supraclavicular fossa can be a sign of upper extremity  deep venous thrombosis ."}
{"_id": "stanford_medicine_back_clean$$$corpus_1", "text": "Exploration of the spinal cord and meninges in situ\n\t\t\t\t\t\t\t\t\t\t Cauda equina, conus medullaris and filum terminale\n\t\t\t\t\t\t\t\t\t\tThe lumbar part of the spinal cord has been exposed. The conus medullaris ends at the level of the arch of the second lumbar vertebra.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior lateral cutaneous branch of thoracic nerve XII  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intertransverse muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of lumbar vertebra I (cut across)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral intertransverse muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary processs lumbar vertebra II  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch of lumbar nerve I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal iliocostal muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process lumbar vertebra II (partly resected)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of intervertebral articulation  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal root thoracic nerve XII  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Denticulate ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar enlargement  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Cauda equina  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus dorsi muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular surface lumbar vertebra II  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Conus medullaris  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Filum terminale"}
{"_id": "stanford_medicine_back_clean$$$corpus_3", "text": "Exploration of the spinal cord and meninges in situ\n\t\t\t\t\t\t\t\t\t\t Arachnoid membrane covering cauda equina\n\t\t\t\t\t\t\t\t\t\tThe dura has been cut away in such a manner that the arachnoid membrane remains intact. The filum terminale (15) appears as a white strand deep to the arachnoid. An extensive subarachnoid space surrounds nerve roots which form the cauda equina.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process of lumbar vertebra III  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process lumbar vertebra II  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal iliocostal muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of lumbar vertebra IV  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbodorsal fascia  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum flavum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Epidural space and cut margin of dura  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous attachment of dura to sacrum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Cystic enlargement of dura covering roots of second sacral nerve (note resorption of neighboring bone)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process lumbar vertebra II  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch lumbar artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Arachnoid  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Filum terminale (beneath arachnoid)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Root sacral nerve II  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Level at which spinal subarachnoid space terminates  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Filum spinal dura mater"}
{"_id": "stanford_medicine_back_clean$$$corpus_5", "text": "Exploration of the spinal cord and meninges in situ\n\t\t\t\t\t\t\t\t\t\t Lumbar region; dura covering cauda equina\n\t\t\t\t\t\t\t\t\t\tThe arches of the third, fourth and fifth lumbar vertebrae and the upper two sacral segments have been resected. Epidural fat has been removed to expose segmentally arranged veins (15). Several fibrous strands (10) pass from the lower part of the dura to the sacrum.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Postero-lateral cutaneous branch of thoracic nerve XII  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process lumbar vertebra II  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process lumbar vertebra II  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus dorsi muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal iliocostal muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbodorsal fascia  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Multifidus muscle (cut across near origin from mammillary process)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial Fascia  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous strands attaching dura to sacrum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of latissimus dorsi muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of latissimus dorsi muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Layer of fascia beneath lumbodorsal fascia  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal vertebral venous plexus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of lumbar vertebra III (cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of lumbar vertebra IV (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of lumbar vertebra V (cut across)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of sacrum (cut across)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Root sacral nerve I  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Filum of spinal dura mater (coccygeal nerve roots accompany this band)"}
{"_id": "stanford_medicine_back_clean$$$corpus_7", "text": "Exploration of the spinal cord and meninges in situ\n\t\t\t\t\t\t\t\t\t\t Roots and ganglion of 10th thoracic nerve\n\t\t\t\t\t\t\t\t\t\tThe articular processes of the tenth and eleventh thoracic vertebrae have been cut away on the right side to reveal the lateral course of the 10th thoracic spinal roots. Subarachnoid spaces extend only a millimeter or two along the anterior and posterior roots after they pierce the dura mater. A narrow bridge of dura intervenes between the motor and sensory roots. A mass of plexiform veins was removed from the intervertebral foramen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic part spinal cord  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal vertebral venous plexus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular surface thoracic vertebra XI  4\n\t\t\t\t\t\t.\n\t\t\t\t\t External posterior spinal vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Vein within arch of 11th thoracic vertebra  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator costarum muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum flavum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process thoracic vertebra XII  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process thoracic vertebra X  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal root thoracic nerve X  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal branch of intercostal artery (anterior root of nerve lies just above this)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal ganglion thoracic nerve X  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch of thoracic nerve X  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process thoracic vertebra XI  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus dorsi muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum intertransversarium  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process thoracic vertebra XI"}
{"_id": "stanford_medicine_back_clean$$$corpus_9", "text": "Exploration of the spinal cord and meninges in situ\n\t\t\t\t\t\t\t\t\t\t Epidural plexus of veins, upper thoracic region\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle (reflected)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius cervicis muscle (reflected)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal vertebral venous plexus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid major muscle (cut across)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal iliocostal muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior funiculus spinal cord  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal root cervical nerve VII  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of thoracic vertebra I (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior posterior serratus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus dorsi muscle"}
{"_id": "stanford_medicine_back_clean$$$corpus_11", "text": "Exploration of the spinal cord and meninges in situ\n\t\t\t\t\t\t\t\t\t\t Epidural space in thoracic region\n\t\t\t\t\t\t\t\t\t\tThe epidural space lying deep to the 5th, 6th, 7th and 8th thoracic vertebrae has been exposed. A window has been cut through the dura to expose the subdural space with the arachnoid membrane in its depths. The subdural space appears unduly large due to the collapse of the underlying arachnoid.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus dorsi muscle (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous branch of posterior brach of thoracic nerve V  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal iliocostal muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process thoracic vertebrae VI  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator costarum muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertransverse ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal root thoracic nerve VII  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic part spinal cord  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior costotransverse ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of thoracic vertebra VIII  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal semispinalis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of thoracic vertebra V (partly resected)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbodorsal fascia  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Fat within epidural space  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal vertebral venous plexus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus dorsi muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of intercostal artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum flavum (cut across)"}
{"_id": "stanford_medicine_back_clean$$$corpus_13", "text": "Exploration of the spinal cord and meninges in situ\n\t\t\t\t\t\t\t\t\t\t General view of spinal cord; meninges removed\n\t\t\t\t\t\t\t\t\t\tThe vertebral arches have been cut away with the exception of the left half of the second lumbar arch and spine (16). This spine serves as a land-mark in the close-up studies of the lumbar region which follow and is a guide to the location of the termination of the spinal cord.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical part spinal cord  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic part spinal cord  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar part spinal cord (lower pointer on conus medullaris)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal root cervical nerve II  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle (reflected)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis and cervicis muscles (reflected)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Scapular-vertebral margin  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut surface of vertebral arch  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator costarum muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal iliocostal muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus dorsi muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process lumbar vertebra II  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cauda equina  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Parts of longissimus dorsi muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Subarachnoid space (lumbar cistern)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Filum of dura mater"}
{"_id": "stanford_medicine_back_clean$$$corpus_15", "text": "Exploration of the spinal cord and meninges in situ\n\t\t\t\t\t\t\t\t\t\t Orientation view; areas of subsequent close-up views indicated\n\t\t\t\t\t\t\t\t\t\tThe spinal meninges have been exposed in the cervical region (A), thoracic region (B) and lumbosacral region (C). These areas are the subject of separate study in the following views of this series.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebellum and occipital bone (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Arachnoid covering cervical part of spinal cord  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis and cervicis muscles (reflected)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process cervical vertebra VI  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (cut across)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior serratus muscle (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbodorsal fascia (partially removed)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of scapular-vertebral margin  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid major muscle (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater covering thoracic part spinal cord  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process thoracic vertebra VII  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process thoracic vertebra VIII  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus dorsi muscle (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal iliocostal muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process lumbar vertebra II  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbodorsal fascia (partially cut away)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Arachnoid covering cauda equina (dura mater removed)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrum (arches resected)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle"}
{"_id": "stanford_medicine_back_clean$$$corpus_17", "text": "Dissection of anterior aspect of vertebral column\n\t\t\t\t\t\t\t\t\t\t Coccygeal region.\n\t\t\t\t\t\t\t\t\t\tThe lower part of the dissection illustrated in the previous view is shown in this photograph. A plexus formed by the right lateral sacral artery (7) and the middle sacral artery (20) lies anterior to the coccyx. At the level of the endpiece of the coccyx the glomus coccygeum (24) is visible. The sympathetic trunks converge behind the artery slightly below the glomus. No ganglion impar is present, however.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Filum terminale (right coccygeal nerve fused to posterior aspect of filum and not visible in view)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral canal (pointer indicates interior surface of superficial dorsal sacrococcygeal ligament covering sacral hiatus)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve V  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Rami communicantes  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve IV  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to levator ani muscle and coccygeus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus lateral sacral artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sacral nerve V (visible through opening in tendon of coccygeus muscle) Lower pointer: Lateral branch sacral artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anal canal (remnant cut across close to pelvic diaphragm)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal vertebral venous plexus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve V  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeal nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk (a ganglion lies just above pointer)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve IV  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (body partially removed)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve V  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum on anterior surface of coccyx  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Median sacral artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle (cut off)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion of sympathetic trunk  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Glomus coccygeum Lower pointer: Periosteum covering end piece of coccyx (fibers transversely banded)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (endpiece)"}
{"_id": "stanford_medicine_back_clean$$$corpus_19", "text": "Dissection of anterior aspect of vertebral column\n\t\t\t\t\t\t\t\t\t\t Sacral region.\n\t\t\t\t\t\t\t\t\t\tlumbosacral part of vertebral canal,opened and viewed from in front\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. III-IV (pointer on anulus fibrosus)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. III (partly resected)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior internal vertebral venous plexus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. IV - V (pointer on nucleus pulposus)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous attachment of dura to posterior longitudinal ligament (cut off)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic tnmk  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sacrum (body resected) Lower pointer: Remnant of intervertebral disc S. I - II  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral arteries  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral plexus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle (posterior border of pelvic diaphragm)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal vertebral venous plexus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra L. IV  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum flavum  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle (arch of vertebra) L. V (cut across)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Spinal ganglion lumbar nerve V Lower pointer: Spinal branch iliolumbar artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral femoral cutaneus nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part sacrum  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve I (in pelvic sacral foramen)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Dural filum terminale (coccygeal nerves fused with this at lower level)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve II  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral canal (lined by periosteum)  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve III  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve IV  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve V  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  36\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeal nerve  37\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (covered by periosteum)"}
{"_id": "stanford_medicine_back_clean$$$corpus_21", "text": "Dissection of anterior aspect of vertebral column\n\t\t\t\t\t\t\t\t\t\t Sacral region.\n\t\t\t\t\t\t\t\t\t\tThe right hip bone has been removed. The contents of the pelvic cavity have been removed or retracted to expose the pelvic surface of the sacrum, the sacral sympathetic trunks and the blood vessels of the sacrum\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Common iliac artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. V - S. I  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic surface sacrum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface sacrum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral plexus (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion of sympathetic trunk  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic sacral foramen II  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral splanchnic nerve (sympathetic)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve IV  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior diaphragmatic pelvic fascia  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Median sacral vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Median sacral artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior hypogastric plexus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac vein  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter  22\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac vein  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lateral sacral artery Lower pointer: Ramus communicans (gray)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sacral nerve I Lower pointer: Piriform muscle (covered by parietal pelvic fascia)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic splanchnic nerve (from sacral nerve II)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic splanchnic nerve (from sacral nerve III) 30. Vagina"}
{"_id": "stanford_medicine_back_clean$$$corpus_23", "text": "Dissection of anterior aspect of vertebral column\n\t\t\t\t\t\t\t\t\t\t Lumbar region.\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the preceding view has been turned to expose the left lateral aspect of the vertebral column.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Hemiazygos vein  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Rami communicantes  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right crus of diaphragm  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar artery and vein III  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. IV (pointer on anterior longitudinal ligament)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar nerve IV (emerging through intervertebral foramen)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. IV - V  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Left common iliac vein (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle (cut off)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus lumborum muscle (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Iliohypogastric nerve Lower pointer: Ilioinguinal nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra L. II  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar nerve II  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending lumbar vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint capsule  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar nerve III  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process vertebra L. IV  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Accessory process vertebra L. IV Lower pointer: Intertransverse ligament  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra L. IV  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Interspinous ligament  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinous ligament  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous sacroiliac ligament  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk"}
{"_id": "stanford_medicine_back_clean$$$corpus_25", "text": "Dissection of anterior aspect of vertebral column\n\t\t\t\t\t\t\t\t\t\t Lumbar region.\n\t\t\t\t\t\t\t\t\t\tThe left hip bone,the psoas major and the quadratus lumborum muscles have been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar part of diaphragm  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral arcuate ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar vein III  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion of sympathetic trunk  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. III (pointer on anterior longitudinal ligament)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. III - IV  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar artery IV  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vena cava inferior (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliacus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Genitofemoral nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Common left iliac vein  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Median sacral artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Hemiazygos vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending lumbar vein  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus communicans  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra L. III  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar plexus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral femoral cutaneus nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar artery  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part sacrum  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar artery  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk"}
{"_id": "stanford_medicine_back_clean$$$corpus_27", "text": "Dissection of anterior aspect of vertebral column\n\t\t\t\t\t\t\t\t\t\t Lumbar region.\n\t\t\t\t\t\t\t\t\t\tThe left quadratus lumborum muscle (20) has been exposed. The muscle has been dissected to trace incoming branches from the lumbar nerves that supply it. The psoas major has been detached from its spinal origins but has not been deflected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Kidney right  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right diaphragmatic crus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. II - III  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar veins  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk (pointer on lumbar ganglion)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus communicans  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebral IV (pointer on anterior longitudinal ligament)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Abdominal aorta  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of subcostal nerve to quadratus lumborum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcostal nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Iliohypogastric nerve (cut off) Lower pointer: Ilioinguinal nerve (cut off)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of 1st lumbar nerve to quadratus lumborum  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Muscular branch of lumbar artery Lower pointer: Branch of 2nd lumbar nerve to quadratus lumborum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Tip of 12th costal cartilage  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of transverse process of vertebra L. III  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus lumborum muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of 4th lumbar nerve to quadratus lumborum  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral femoral cutaneus nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus lumborum muscle (lowest fascicle)"}
{"_id": "stanford_medicine_back_clean$$$corpus_29", "text": "Dissection of anterior aspect of vertebral column\n\t\t\t\t\t\t\t\t\t\t Lumbar region.\n\t\t\t\t\t\t\t\t\t\tParts of the lumbar vertebrae and the body of the sacrum have been cut away to expose the lower end of the dural sac. The entire iliopsoas muscle has been uncovered by removing surrounding soft tissues.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial diaphragmatic arcuate ligament (medial lumbar arch)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. V (cut in saggital plane)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliacus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter of femur  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Minor trochanter  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament (joined above this level by right crus of diaphragm which has been cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater (lying within vertebral canal)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle"}
{"_id": "stanford_medicine_back_clean$$$corpus_31", "text": "Dissection of anterior aspect of vertebral column\n\t\t\t\t\t\t\t\t\t\t Thoracic region.\n\t\t\t\t\t\t\t\t\t\tanterior longitudinal ligament  sympathetic trunks\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cervical ganglion (unusually large)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial plexus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra Th. I (covered by anterior longitudinal ligament)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Right superior intercostal vein (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament (pointer on body of vertebra Th. IV)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Endothoracic fascia  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc Th. IX - X  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater splanchnic nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Azygos vein Lower pointer: Inferior vena cava  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus colli muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Stellate ganglion  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I (cut off)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib III  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal artery and vein VII  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve VII  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic aorta"}
{"_id": "stanford_medicine_back_clean$$$corpus_33", "text": "Dissection of anterior aspect of vertebral column\n\t\t\t\t\t\t\t\t\t\t Thoracic region.\n\t\t\t\t\t\t\t\t\t\tThe left tenth rib has been removed from the specimen with care to preserve the ligaments, joint capsules and articular surfaces of the costovertebral articulations. The view is directed inward from in front and to the left. Other dissections of the costotransverse joint are shown in views 214-4 and 219-1.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intercostal nerve IX Lower pointer: Spinal ganglion (lying within intervertebral foramen)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Costotransverse ligament (attached posteriorly to transverse process of vertebrae Th. X)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of rib joint (pointers indicate facets on adjacent vertebral bodies, the cleft between being occupied by the delicate intraarticular ligament)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Radiate ligament  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament (pointer also indicates body of vertebra Th. X)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc Th. X - XI  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Hemiazygos vein (note small veins draining vertebral bodies at higher levels).  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal vein VIII  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal artery VIII  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk (cut off, also see 24)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint at head of rib IX (intact)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve VIII  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib IX  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior costotransverse ligament (upper pointer, anterior division; lower pointer, posterior division)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of ninth intercostal nerve to levator costarum muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral costotransverse ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator costarum muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Borders of area occupied by tenth rib  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse costal facet (covered with articular cartilage)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Innermost intercostal muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve X (cut off)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Sympathetic trunk (cut off, also see 1-1) Right pointer: Ramus communicans  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion of sympathetic trunk"}
{"_id": "stanford_medicine_back_clean$$$corpus_35", "text": "Dissection of anterior aspect of vertebral column\n\t\t\t\t\t\t\t\t\t\t Thoracic region.\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the previous view has been turned to expose its left anterolateral aspect in this close-up view of the lower thoracic and upper lumbar part of the spine.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory hemiazygos vein  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Body of vertebra Th. VIII (pointer on anterior longitudinal ligament) Lower pointer: Intervertebral disc Th. VII-IX  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vein draining body of vertebra  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal arteries IX and X  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater splanchnic nerve (lower pointer on splanchnic ganglion)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser splanchnic nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Least splanchnic it  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar part of diaphragm (upper pointer: left crus; lower pointer: right crus)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Hemiazygos vein Right pointer: Posterior intercostal vein VIII  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib VIII  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk (lower pointer on ganglion of sympathetic trunk)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Rami communicantes  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve XI  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of rib XII  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcostal nerve (note large ramus communicans)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Quadratus lumborum muscle Lower pointer: Psoas major muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending lumbar vein  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra L. II  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar nerve I (passing downward to join lumbar plexus)"}
{"_id": "stanford_medicine_back_clean$$$corpus_37", "text": "Dissection of anterior aspect of vertebral column\n\t\t\t\t\t\t\t\t\t\t Thoracic region.\n\t\t\t\t\t\t\t\t\t\tIn this specimen the thoracic viscera have been removed and the azygos system of veins has been dissected to show the relation of its parts to the intercostal arteries and nerves, the sympathetic trunks and the vertebral columns and ribs.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Manubrium of sternum (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic veins  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of aorta  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Trachea Lower pointer: Esophagus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal arteries  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater splanchnic nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior intercostal vein  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory hemiazygos vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Hemiazygos vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior longitudinal ligament Lower pointer: Intervertebral disc Th. X - XI  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve XI  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII"}
{"_id": "stanford_medicine_back_clean$$$corpus_39", "text": "Dissection of anterior aspect of vertebral column\n\t\t\t\t\t\t\t\t\t\t Cervical region.\n\t\t\t\t\t\t\t\t\t\tThe longus coli, rectus capitis anterior, rectus capitis lateralis, and some of the cervical intertransverse muscles have been cut away. In addition, the transverse processes of the atlas, the axis, and the fifth cervical vertebra have been cut so that the course of the vertebral artery (17) is visible. The artery did not pass through the transverse process of the sixth cervical vertebra in this specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal cavity  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of longus capitis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasopharynx  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus colli muscle (transected close to insertion on anterior tubercle of atlas)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cervical ganglion  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Areas of insertion of longus colli muscle on bodies of vertebra C. III - V  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Position of intervertebral disc uniting vertebra C. IV - V Lower pointer: Body of vertebra C. V  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII) (emerging from hypoglossal canal)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlanto-occipital joint  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral branch cervical nerve I (branch communicating with hypoglossal nerve cut away)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral atlantoaxial joint  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral branch cervical nerve II  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rami communicantes (gray)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve III  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior intertransverse muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch cervical nerve IV  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intertransverse muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral branch cervical nerve IV  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus communicans (gray)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tubercle vertebra C. V  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve VI"}
{"_id": "stanford_medicine_back_clean$$$corpus_41", "text": "Dissection of anterior aspect of vertebral column\n\t\t\t\t\t\t\t\t\t\t Cervical region.\n\t\t\t\t\t\t\t\t\t\tThe longus capitis muscle has been divided close to its origins (15) from the transverse processes of the third to the sixth cervical vertebrae and also at its insertion (1) into the occipital bone. The removal of the belly of this muscle has exposed the longus colli muscle (13) and the anterior arch of the atlas (9).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of longus capitis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal cavity  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasopharynx  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Oropharynx  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Larynx  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal carotid artery (within carotid canal, accompanied by internal carotid plexus) Lower pointer: Jugular foramen (opened)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus capitis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Hypoglossal nerve (XII) Lower pointer: Anterior rectus capitis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior atlantooccipital membrane Lower pointer: Anterior arch of atlas (covered by connective tissue)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of atlas  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral atlantoaxial joint (pointer on joint capsule)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral branch cervical nerve II  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus colli muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cervical ganglion  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Origins of longus capitis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral branch cervical nerve III  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior intertransverse muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament (partially covered by prevertebral fascia)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cervical ganglion  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra C. VII"}
{"_id": "stanford_medicine_back_clean$$$corpus_43", "text": "Dissection of anterior aspect of vertebral column\n\t\t\t\t\t\t\t\t\t\t Cervical region.\n\t\t\t\t\t\t\t\t\t\tThe left half of the head has been previously dissected in connection with the anatomy of the head and neck .In this view, in which the tongue has been removed and the wall of the pharynx has been sectioned close to the midline, the cervical sympathetic trunk and the prevertebral muscles are visible in situ. The prevertebral layer of the cervical fascia has been removed to the left of the midline.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Rostrum of sphenoid Lower pointer: Nasopharynx  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Soft palate (cut in midline)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine tonsil  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Uvula  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Oropharynx  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniohyoid muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone (cut in midline)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vagus nerve (X) Lower pointer: Common carotid artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal carotid artery (in carotid canal) Lower pointer: Jugular foramen (opened)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus capitis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior ganglion vagus nerve (nodose ganglion) Lower pointer: Hypoglossal nerve (XII)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cervical ganglion  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cardiac branch of vagus nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus colli muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical prevertebral fascia  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottis  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Origins of anterior scalene muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve VI  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scalene muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve VIII  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Stellate ganglion  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Costocervical trunk"}
{"_id": "stanford_medicine_back_clean$$$corpus_45", "text": "Lumbosacral meninges, spinal cord and nerve roots dissected from behind\n\t\t\t\t\t\t\t\t\t\t Cauda equina, conus medullaris and filum terminale\n\t\t\t\t\t\t\t\t\t\tThe lumbar part of the spinal cord has been exposed. The conus medullaris ends at the level of the arch of the second lumbar vertebra.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous branch of dorsal branch thoracic nerve XII  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial intertransverse muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina (arch of vertebra) L. I (cut across)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral intertransversarius muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process vertebra L. II  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch lumbar nerve I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra L. II (partly resected)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint capsule  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal roots thoracic nerve XII  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Denticulate ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Intumescentia lumbalis  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Cauda equina  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular surface  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Conus medullaris  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Filum terminale"}
{"_id": "stanford_medicine_back_clean$$$corpus_47", "text": "Lumbosacral meninges, spinal cord and nerve roots dissected from behind\n\t\t\t\t\t\t\t\t\t\t Arachnoid membrane covering cauda equina\n\t\t\t\t\t\t\t\t\t\tThe dura has been removed so that the arachnoid membrane remains intact. The filum terminale (15) appears as a white strand deep to the arachnoid. An extensive subarachnoid space surrounds the nerve roots which form the cauda equina.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process vertebra L. III  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process vertebra L. II  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina (arch of vertebra) L. IV  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum flavum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Epidural space and cut margin of dura  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous attachment of dura to sacrum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Cystic enlargement of dura covering roots of second sacral nerve (note resorption of neighboring bone)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra L. II  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of lumbar artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Arachnoid  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Filum terminale (beneath arachnoid)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve II  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Level at which spinal subarachnoid space terminates  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Dural filum terminale"}
{"_id": "stanford_medicine_back_clean$$$corpus_49", "text": "Lumbosacral meninges, spinal cord and nerve roots dissected from behind\n\t\t\t\t\t\t\t\t\t\t Dura mater in lumbar region\n\t\t\t\t\t\t\t\t\t\tThe laminae of the third, fourth and fifth lumbar vertebrae and of the upper two sacral segments have been resected. Epidural fat has been removed to expose segmentally arranges veins (15). Several fibrous strands (10) pass from the lower part of the dura to the sacrum as part of the anchoring mechanism of the meninges.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous branch of dorsal branch thoracic nerve XII  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra L. II  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process vertebra L. II  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Multifidus muscle (cut across near origin from mammillary process)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous strands attaching dura to sacrum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of latissimus dorsi muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of latissimus dorsi muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Layer of fascia beneath thoracolumbar fascia  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior internal vertebral venous plexus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Laminal arch of vertebra L. III (cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Laminal arch of vertebra L. IV (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Laminal arch of vertebra L. V (cut across)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Laminal arch of sacrum (cut across)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve I  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Dural filum terminale (coccygeal nerve roots accompany this band)"}
{"_id": "stanford_medicine_back_clean$$$corpus_51", "text": "Lumbosacral meninges, spinal cord and nerve roots dissected from behind\n\t\t\t\t\t\t\t\t\t\t Contents of sacral canal, posterior view\n\t\t\t\t\t\t\t\t\t\tThe laminae of the fifth lumbar vertebra have been cut away and the entire sacral canal has been opened to expose the meninges, nerve roots and blood vessels within the lower part of the vertebral canal. The paired coccygeal nerves are fused with the filum durae matris spinalis and as a consequence are not clearly visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra L. IV  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina (arch of vertebra) L. IV  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint capsule L. IV - V  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral canal (pointer indicates epidural space from which veins and fat have been removed)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina (arch of vertebra) L. V (cut through)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint capsule L. V - S. I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve III (pointer on dural sheath of nerve roots)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior internal vertebral venous plexus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle (partially cut away medially)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dural filum terminale (paired coccygeal nerve fused with filum and not clearly visible in this specimen)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve V  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Margins of sacral hiatus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (covered by deep dorsal sacrococcygeal ligament)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum flavum  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Erector spinae muscle (cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra L. V  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Dura mater Lower pointer: Spinal ganglion  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch lateral sacral artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina sacrum (cut through)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacroiliac ligament  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch sacral nerve II  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior sacral foramen III  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral border of sacrum  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral cornu (horn)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal superficial sacrococcygeal ligament (partially removed)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeal cornu (horn)"}
{"_id": "stanford_medicine_back_clean$$$corpus_53", "text": "Thoracic meninges, spinal cord and nerve roots dissected in relation to vertebral column\n\t\t\t\t\t\t\t\t\t\t Intrathoracic structures related to vertebral column, posterior view\n\t\t\t\t\t\t\t\t\t\tRibs and vertebral bodies have been resected bilaterally between the second and ninth thoracic levels. The periosteum (6) which covered the inner surfaces of the ribs has been preserved in most areas. The anterior longitudinal ligament (23), with remnants of the intervertebral discs attached,has also been retained in part. The lungs have been inflated and are visible through the intact costal pleura. The proximal parts of the III-VII thoracic nerves have been positioned on the pleura in such a way that their dorsal and ventral roots, dorsal rami and communications with the sympathetic trunk are visible. These components are labeled for the left seventh thoracic nerve (8,9,10). The intercostal arteries and veins have been cut off in various ways.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve II  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib III (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum of sixth rib  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic aorta  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Intercostal. nerve VII Right pointer: Ramus communicans  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch thoracic nerve VII  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Spinal ganglion and dorsal roots Right pointer: Ventral root  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Innermost intercostal muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator costarum brevis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal intercostal membrane  14\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra Th. II  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc Th. II - III  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Veins of third intervertebral foramen (bones removed)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebromediastinal suspensory ligament  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anulus fibrosus intervertebral disc Th. V - VI  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal artery and vein VI  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Radiate ligament (preserved with periosteum of rib)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal cord  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib IX"}
{"_id": "stanford_medicine_back_clean$$$corpus_55", "text": "Thoracic meninges, spinal cord and nerve roots dissected in relation to vertebral column\n\t\t\t\t\t\t\t\t\t\t Transverse section of body of eighth thoracic vertebra illustrating relations of blood vessels, nerves and ligaments\n\t\t\t\t\t\t\t\t\t\tThe thoracic part of the spinal cord has been exposed by a laminectomy. The upper thoracic vertebra have been completely removed for this view, including the upper half of the body of the eighth vertebra. The interrelations of the internal and external vertebral venous plexuses and the basivertebral vein (5) are visible. The specimen is viewed from above.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal roots thoracic nerve IX  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal cord  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater and arachnoid  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle (arch of vertebra) Th. VIIl (partially removed)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior internal vertebral venous plexus Lower pointer: Basivertebral vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra Th. VIII (partly cut away)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion of sympathetic trunk  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater splanchnic nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc Th. VII- VIII (remnant)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Denticulate ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process vertebra Th. IX  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch thoracic nerve VIII  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal ganglion  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral branch thoracic nerve VIII  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramen  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal pleura  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal artery VII  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Hemiazygos vein"}
{"_id": "stanford_medicine_back_clean$$$corpus_57", "text": "Thoracic meninges, spinal cord and nerve roots dissected in relation to vertebral column\n\t\t\t\t\t\t\t\t\t\t Intervertebral course and meningeal branches of left fifth thoracic nerve\n\t\t\t\t\t\t\t\t\t\tThe fifth rib has been removed from the left side. The vertebral canal has been opened by laminectomy and the pedicle of the fifth thoracic vertebra has been cut off on the left to expose the component parts of the corresponding spinal nerve. A plexus of vertebral branches (11) of this nerve, including meningeal filaments, can be seen to extend medially through the intervertebral foramen anterior to the nerve roots which have been elevated somewhat out of their usual position.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic sympathetic ganglion  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint head of rib V (rib removed)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle (arch of vertebra) Th. V (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Dorsal branch thoracic nerve V Lower pointer: Spinal ganglion thoracic nerve V  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Rami communicantes  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal veins  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve V  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal artery V  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Meningeal branch thoracic nerve V  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of rib (superficial crest rib visible above pointer on upper margin of rib)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra Th. VI  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal cord  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Denticulate ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior internal vertebral venous plexus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Ventral root thoracic nerve V Right pointer: Dorsal roots thoracic nerve V  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramen  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular surface"}
{"_id": "stanford_medicine_back_clean$$$corpus_59", "text": "Thoracic meninges, spinal cord and nerve roots dissected in relation to vertebral column\n\t\t\t\t\t\t\t\t\t\t Right tenth thoracic nerve within vertebral canal and intervertebral foramen\n\t\t\t\t\t\t\t\t\t\tThe vertebral canal has been opened by laminectomy and the tenth intervertebral foramen (6) has been opened on the right side by excision of the inferior articular process of the tenth thoracic vertebra. The dorsal and ventral roots of the corresponding nerve have been exposed. The roots penetrate the dura separately in this specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal cord  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Denticulate ligaments  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Dorsal roots thoracic nerve X Lower pointer: Ventral root thoracic nerve X  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal branch posterior intercostal artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Arachnoid and dura mater  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramen (opened venous plexus partially resected)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Protrusion of intervertebral disc  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior internal vertebral venous plexus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle (arch of vertebra) Th. Xl  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular cavity of intervertebral joint  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertransverse thoracis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Longissimus thoracis muscle Right pointer: Iliocostalis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior articular process vertebra Th. IX Lower pointer: Superior articular process vertebra Th. IX  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Tranverse process vertebra Th. X Right pointer: Levator costarum brevis muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal ganglion thoracic nerve X  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior costotransverse ligament  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ramus communicans Lower pointer: Dorsal branch thoracic nerve X  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertransverse ligament  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle (tendon of insertion)"}
{"_id": "stanford_medicine_back_clean$$$corpus_61", "text": "Thoracic meninges, spinal cord and nerve roots dissected in relation to vertebral column\n\t\t\t\t\t\t\t\t\t\t Epidural space, dura mater and spinal cord in upper thoracic region\n\t\t\t\t\t\t\t\t\t\tA laminectomy has been performed and the epidural space has been cleared of adipose tissue to reveal the posterior part of the internal vertebral venous plexus lying against the dura mater. The area included in this close-up photograph may be visualized in relation to the entire back by reference to view 217-2 wherein such muscles as the semispinalis capitis and splenius cervicis (1 and 3 in the present view) may also be seen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle (reflected)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius cervicis muscle (reflected)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior internal vertebral venous plexus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid major muscle (cut across)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior funiculus of spinal cord  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal roots cervical nerve VII  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina (arch of vertebra) Th. I (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus posterior superior muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle"}
{"_id": "stanford_medicine_back_clean$$$corpus_63", "text": "Atlantooccipital  joint, atlantoaxial joint and cervical vertebrae dissected from behind\n\t\t\t\t\t\t\t\t\t\t Hypoglossal, accessory and vagus nerves; ventral rami of cervical nerves; internal carotid artery; internal jugular vein\n\t\t\t\t\t\t\t\t\t\tThe bodies of the first five cervical vertebrae have been sectioned in the median plane and their left halves removed. The cervical nerves have been retained approximately in their normal positions with the exception of the first nerve (16), which has been displaced superiorly. The anterior internal vertebral venous plexus (18) and the longus colli and longus capitis muscles has been preserved.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior ganglion vagus nerve (X)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of cervical nerves I - II to longus capitis and anterior rectus capitis muscles  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly digastric muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior ganglion vagus nerve (X)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior root ansa cervicalis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lesser occipital nerve Lower pointer: Unnamed cutaneous nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical fascia (deep layer of superficial lamina)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI) (note communicating branches from second and third cervical nerves)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraclavicular nerves  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral branch cervical nerve I  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion cervical nerve II (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior rectus capitis muscle Lower pointer: Anterior external vertebral venous plexus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion of cervical nerve III  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intervertebral disc C. II- llI Lower pointer: Body of vertebra C. III  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion cervical nerve IV  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion cervical nerve V (displaced slightly inferiorly)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular surface vertebra C. VI  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal cord"}
{"_id": "stanford_medicine_back_clean$$$corpus_65", "text": "Atlantooccipital  joint, atlantoaxial joint and cervical vertebrae dissected from behind\n\t\t\t\t\t\t\t\t\t\t Relations of left sternocleidomastoid muscle, internal jugular vein, cervical plexus and cervical vertebrae, viewed from behind\n\t\t\t\t\t\t\t\t\t\tThe cervical fascia has been removed from the deep surface of the upper part of the sternocleidomastoid muscle and the muscle has been retracted slightly laterally. The levator scapulae (29) has been cut from its origins and retracted medially. Parts of the cervical plexus (19,24) and some of its branches (11,12) have been exposed by removing the prevertebral fascia. The carotid sheath has been resected to reveal the internal jugular vein lying anterior to the cervical plexus. The upper cervical vertebrae have been cut and exposed in various ways to demonstrate the relations of ligaments, joint cavities, nerves and blood vessels to these bones.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein (pointer at inferior margin of jugular foramen)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of insertion of longissimus capitis muscle (divided by occipital artery)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle (cut across)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral branch cervical nerve I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly of digastric muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle (cut across a similar, more inferior origin is visible medial to the third cervical nerve (24))  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending cervical artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser occipital nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Greater auricular nerve and superficial transverse nerve Lower pointer: Supraclavicular nerves  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia within posterior cervical triangle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t External jugular vein (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Foramen magnum (anterior margin) Lower pointer: Dens (axis)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Median atlantoaxial joint  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Obliquus capitis inferior muscle (cut across)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve II  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Arch of axis Lower pointer: Roots of cervical nerve III  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Basivertebral vein (cut off at junction with anterior internal vertebral venous plexus) Lower pointer: Body of vertebra C. III  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve III  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint nerve III-IV  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion cervical nerve V  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc C. IV - V  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular surface vertebra C. VI  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle (also see 8 above)"}
{"_id": "stanford_medicine_back_clean$$$corpus_67", "text": "Atlantooccipital joint, atlantoaxial joint and cervical vertebrae dissected from behind\n\t\t\t\t\t\t\t\t\t\t Median atlantoaxial joint opened from behind\n\t\t\t\t\t\t\t\t\t\tThe left half of the transverse ligament (21) has been divided to permit the cruciform ligament to be reflected posteriorly and to the right. The joint cavity between the dens and the cruciform ligament was thus opened. The considerable thickness of the transverse ligament and of the alar ligaments(18) is evident in the sectioned ends of these structures.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Clivus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XII)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Hypoglossal canal (opened) Lower pointer: Hypoglossal nerve (XII)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlantooccipital joint cavity  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral branch cervical nerve I  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral atlantoaxial joint cavity  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion cervical nerve II  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots of hypoglossal nerve (XII)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tectorial membrane (cut edge)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cruciform ligament of atlas (divided, lower part retracted)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous tissue and blood vessels in anterior part of foramen magnum (ligamentum apicis dentis not well defined)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar ligament (divided on left)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens (axis) (joint cavity between dens and transverse ligament opened)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Tectorial membrane (cut across)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse ligament of atlas (divided)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral atlanto axial joint capsule (opened)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of axis"}
{"_id": "stanford_medicine_back_clean$$$corpus_69", "text": "Atlantooccipital joint, atlantoaxial joint and cervical vertebrae dissected from behind\n\t\t\t\t\t\t\t\t\t\t Atlantooccipital and lateral atlantoaxial joints opened\n\t\t\t\t\t\t\t\t\t\tThe capsule of the lateral atlantoaxial joint (22) has been partially resected. The opposing articular surfaces of this joint are incongruous as compared to those of the atlantooccipital joint above (6). The capsule of the latter joint has been cut off at the margin of the sectioned occipital bone. In addition, the articular cartilage on the upper surface of the atlas has been partly removed to permit a sectional view of the component parts of this joint. Near the midline a dense plexus of veins (16) occupies the area between the dens and the margin of the foramen magnum. An apical ligament of the dens was well defined in this specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII) (within hypoglossal canal the nerve is obscured by fibrous tissue and veins)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital condyle (cut across)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlantooccipital joint (opened)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular facet of atlas (articular cartilage removed)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of atlas  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ventral branch cervical nerve I Lower pointer: Groove in atlas for vertebral artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal ganglion cervical nerve II  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral branch cervical nerve II  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch cervical nerve II  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cruciform ligament of atlas (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Plexus of veins (ligamentum apicis dentis absent)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens (axis) (covered by ligaments)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar ligament (cut across)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse ligament of atlas (part of cruciform ligament)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Tectorial membrane (cut across)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint cavity  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule lateralis (together 21 and 22 form lateral atlanto-occipital joint)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of axis (cut across)"}
{"_id": "stanford_medicine_back_clean$$$corpus_71", "text": "Atlantooccipital joint, atlantoaxial joint and cervical vertebrae dissected from behind\n\t\t\t\t\t\t\t\t\t\t Median atlantoaxial joint; cruciform ligament; alar ligaments\n\t\t\t\t\t\t\t\t\t\tThe posterior longitudinal ligament and the tectorial membrane have been resected to reveal the cruciform ligament (22,26) and the alar ligaments (23). The anterior internal vertebral venous plexus has been partially removed from the left side of the dissection. The left half of the occipital bone had been cut back anteriorly to a plane that passes across the occipital condyle and opens into the hypoglossal canal (5) and the jugular foramen (3,4). Lower in the dissection the course of the first and second cervical nerves (10,12) is shown in relation to to the vertebral artery (9).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior semicircular canal  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior petrosal sinus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Glossopharyngeal nerve (IX) Lower pointer: Vagus nerve (X)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior jugular venous bulb (jugular foramen opened, vein emptied of latex, and its anterior wall dissected to show artery to superior ganglion of vagus nerve)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots of hypoglossal nerve (XII) (hypoglossal canal opened to reveal veins and fibrous tissue enclosing nerve)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital bone (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical prevertebral fascia (exposed by removal of lateral rectus capitis muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlantooccipital joint cavity  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ventral branch cervical nerve I Lower pointer: Groove for vertebral artery of atlas  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique capitis muscle (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal ganglion cervical nerve II  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous slip of longissimus cervicis muscle (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of axis (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch cervical nerve III  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VIII)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Clivus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater (cut edge)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior longitudinal ligament Lower pointer: Cruciform ligament of atlas (longitudinal fasciculi)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar ligament (cut across on left)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of dens (axis)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of tectorial membrane  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse ligament of atlas (part of cruciform ligament)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater"}
{"_id": "stanford_medicine_back_clean$$$corpus_73", "text": "Atlantooccipital joint, atlantoaxial joint and cervical vertebrae dissected from behind\n\t\t\t\t\t\t\t\t\t\t Tectorial membrane; atlantooccipital joint\n\t\t\t\t\t\t\t\t\t\tThe brain and spinal cord have been removed and the dura  mater has been cut away from the left half of the specimen. The occipital bone had been cut across on the left side slightly posterior to the occipital condyle. The left atlantooccipital joint (4) has been opened. On the right side a flap of dura (15) has been reflected to expose the posterior longitudinal ligament (18). The latter has been excised to the left of the midline to reveal the tectorial membrane (20).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Posterior semicircular canal (opened) Right pointer: Vestibulocochlear nerve (VIII)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Transverse sinus (sigmoid portion) Right pointer: Internal jugular vein (in jugular foramen)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Condylar emissary vein within condylar canal  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlanto-occipital joint  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlanto-occipital joint capsule  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Obliquus capitis inferior muscle (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior external vertebral venous plexus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch cervical nerve II  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of axis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch cervical nerve III  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus capitis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosal part temporal bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater (reflected)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament (left half resected, cut end visible at upper pointer)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots of hypoglossal nerve (XII)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Tectorial membrane  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots of cervical nerve II  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal branch vertebral artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior internal vertebral venous plexus"}
{"_id": "stanford_medicine_back_clean$$$corpus_75", "text": "Cervical meninges, spinal cord and nerve roots dissected from behind\n\t\t\t\t\t\t\t\t\t\t Cervical spinal cord and nerve roots in relation to meninges, close-up view of fifth cervical nerve\n\t\t\t\t\t\t\t\t\t\tThe spinal cord has been divided between the roots of the fifth and sixth cervical nerves. The arches of the fourth and fifth cervical vertebrae have been cut away to expose the roots, ganglion and dorsal ramus of the fifth cervical nerve. A branch of the right vertebral artery supplies the dura mater (17) and additional branches pass to the spinal cord with the dorsal and ventral roots.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Fasciculus gracilis Lower pointer: Posterior median sulcus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cuneate fasciculus Lower pointer: Posterior intermediate sulcus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral funiculus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior internal vertebral venous plexus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Gray matter column  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior spinal artery Lower pointer: Arachnoid  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal roots cervical nerve V  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral root cervical nerve V  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior internal vertebral venous plexus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots of cervical nerve VI (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Denticulate ligament  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of vertebra C. III (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory filament of dorsal roots  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery within epidural space  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle (arch of vertebra) C. IV  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tubercle vertebra C. IV  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery (within transverse foramen)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tubercle vertebra C. IV  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal ganglion (note that dura fuses to nerve roots medial to the ganglion)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch cervical nerve V  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle (arch of vertebra) C. V  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Synovial fold  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular surface vertebra C. VI"}
{"_id": "stanford_medicine_back_clean$$$corpus_77", "text": "Cervical meninges, spinal cord and nerve roots dissected from behind\n\t\t\t\t\t\t\t\t\t\t Cervical spinal cord and denticulate ligaments\n\t\t\t\t\t\t\t\t\t\tThe arachnoid membrane has been cut away to expose the cervical part of the spinal cord in situ. The small nodules located along the spinal roots of the accessory nerves (19) were identified microscopically as fibromata.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebellar tonsil  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medulla oblongata  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of foramen magnum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior inferior cerebellar artery Lower pointer: Vertebral artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Suboccipital nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal roots cervical nerve II  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Obliquus capitis inferior muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of cervical nerve III  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior median sulcus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intermediate sulcus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior lateral sulcus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal roots cervical nerve VI  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory filament of dorsal root which bifurcates to contribute to two cervical nerves  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal roots accessory nerve (XI)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Major posterior rectus capitis muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior atlanto-occipital membrane (cut across)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior spinal artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle (cut across)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Denticulate ligament  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior internal vertebral venous plexus Lower pointer: Dura mater  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of vertebra C. IV (cut across)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior external vertebral venous plexus  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Multifidus muscle (cut across)"}
{"_id": "stanford_medicine_back_clean$$$corpus_79", "text": "Cervical meninges, spinal cord and nerve roots dissected from behind\n\t\t\t\t\t\t\t\t\t\t Dura mater in cervical region and in posterior cranial fossa\n\t\t\t\t\t\t\t\t\t\tThe dura has been cut away so that the transparent arachnoid membrane is exposed. The subarachnoid space increases in volume above the level of the second cervical dorsal roots forming part of the cerebellomedullary cistern (cisterna magna).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital bone (pointer at margin of foramen magnum)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid emissary vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique capitis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vertebral artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique capitis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of axis (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to semispinalis capitis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior external vertebral venous plexus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital sinus and falx cerebelli  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Arachnoid covering cerebellar tonsil  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebellomedullary cistern  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal roots cervical nerve II  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal roots accessory nerve (XI)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep cervical artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior external vertebral venous plexus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal roots cervical nerve VI  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of vertebra C. VII"}
{"_id": "stanford_medicine_back_clean$$$corpus_81", "text": "Cervical meninges, spinal cord and nerve roots dissected from behind\n\t\t\t\t\t\t\t\t\t\t Dura mater in cervical region and in posterior cranial fossa\n\t\t\t\t\t\t\t\t\t\tThe dura has been exposed by removing part of the occipital bone and the arches of the upper five cervical vertebrae. The cranial dura mater is continuous through the foramen magnum (15) with that which covers the spinal cord. The spinal dura is separated from the wall of the vertebral canal by the epidural space which contains fat and plexiform veins. In the cervical region this space is narrow and the veins are small. Below the foramen magnum the dura is fused with the posterior atlantooccipital membrane (16) so that above the level of the atlas no epidural space is present.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebellum (dura removed, arachnoid intact)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Medulla oblongata visible through cerebellomedullary cistern (arachnoid intact)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery (lying amidst venous plexus)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas (cut across)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle (reflected)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior external vertebral venous plexus (between muscle layers)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle (reflected)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius cervicis muscle (reflected)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis cervicis muscle (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior meningeal artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique capitis muscle (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital bone (pointer at margin of foramen magnum)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior atlanto-occipital membrane (atlas and the occipital bone to which this was attached have been removed)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Rotator muscle (cut near origin)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior external vertebral venous plexus (posterior to vertebral arches)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina (arch of vertebra) C. IV (cut across)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina (arch of vertebra) C. VI with attachment of ligamentum flavum visible along upper margin  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra C. VI  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra C. VII (vertebra prominens)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle"}
{"_id": "stanford_medicine_back_clean$$$corpus_83", "text": "Cervical meninges, spinal cord and nerve roots dissected from behind\n\t\t\t\t\t\t\t\t\t\t General view of spinal cord in situ\n\t\t\t\t\t\t\t\t\t\tThe vertebral arches have been cut away with the exception of the left half of the second lumbar arch and spine (16). This spine serves as a landmark in the close-up studies of the lumbar region which follow (219-5,219-6,219-7)and is a guide to the location of the termination of the spinal cord.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical part spinal cord  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal cord thoracic part  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal cord lumbar part (lower pointer on conus medullaris)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal roots cervical nerve II  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle (reflected)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis and cervicis muscles (reflected)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial margin of scapula  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut surface of vertebral arch  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator costarum muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra L. II  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cauda equina  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Parts of longissimus thoracis muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Subarachnoid space (lumbar cistern)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Filum terminale"}
{"_id": "stanford_medicine_back_clean$$$corpus_85", "text": "Posterior cervical region and suboccipital muscles dissected from behind\n\t\t\t\t\t\t\t\t\t\t Intervertebral joints opened; ligamenta flava\n\t\t\t\t\t\t\t\t\t\tThe arches of the third, fourth and fifth cervical vertebrae have been divided. The cavities of the superior and inferior (12) intervertebral joints of the third cervical vertebra have been opened.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique capitis muscle (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Major posterior rectus capitis muscle (cut across)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Condylar emissary vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlanto-occipital joint capsule  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery and vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of of atlas  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral branch of cervical nerve II (note relation to vertebral artery)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of axis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular cavity  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Minor posterior rectus capitis muscle (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Border of foramen magnum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior tubercle of atlas Lower pointer: Ligamentum flavum  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process axis  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut margins of arch of vertebra C. III (resected)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ligamentum flavum Lower pointer: Interspinalis cervicis muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater spinalis (epidural space absent at this level)"}
{"_id": "stanford_medicine_back_clean$$$corpus_87", "text": "Posterior cervical region and suboccipital muscles dissected from behind\n\t\t\t\t\t\t\t\t\t\t Intervertebral joints; vertebral arches and ligaments\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique capitis muscle (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Major posterior rectus capitis muscle (cut across)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of vertebral artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior atlanto-occipItal membrane  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior arch of atlas Lower pointer: Inferior oblique capitis muscle (cut across)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cervical plexus (deep portion)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique capitis muscle (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum flavum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch cervical nerve V  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint capsule (C. IV - V)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Rotator cervicis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scalene muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Minor posterior rectus capitis muscle (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Major posterior rectus capitis muscle (cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Interspinales cervices muscles  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina (arch of vertebra) C. IV  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra C. VII (vertebra prominens)"}
{"_id": "stanford_medicine_back_clean$$$corpus_89", "text": "Posterior cervical region and suboccipital muscles dissected from behind\n\t\t\t\t\t\t\t\t\t\t Suboccipital muscles; suboccipital triangle, left posterolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique capitis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid cells (dissected)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus capitis muscle (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch occipital artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Digastric muscle (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cervical plexus (of Cruveilhier)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of atlas  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique capitis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intertransverse muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint capsule (C. II- III)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch cervical nerve IV  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital bone  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Minor posterior rectus capitis muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Major posterior rectus capitis muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Nuchal ligament  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Suboccipital nerve (emerging through suboccipital triangle)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process axis  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of axis  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis cervicis muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Multifidus muscle"}
{"_id": "stanford_medicine_back_clean$$$corpus_91", "text": "Posterior cervical region and suboccipital muscles dissected from behind\n\t\t\t\t\t\t\t\t\t\t Suboccipital muscles; semispinalis cervicis muscle; nerve supply to semispinalis capitis muscle\n\t\t\t\t\t\t\t\t\t\tThe semispinalis capitis muscle has been reflected laterally. Dense fibrous connective tissue and fat have been removed from beneath the muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of semispinalis capitis muscle (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of splenius capitis muscle (cut across)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique capitis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch occipital artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle (reflected laterally)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve (reflected with above muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch cervical nerve II (note muscular branches)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Dorsal branch cervical nerve III (note muscular branches) Lower pointer: Third occipital nerve (reflected with muscle)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of dorsal branch cervical nerve IV  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal cutaneous branch cervical nerve IV  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of origin of semispinalis capitis muscle (from transverse process of vertebra Th. II)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: External intercostal muscle Lower pointer: Rib II  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Minor posterior rectus capitis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of suboccipital nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Major posterior rectus capitis muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Nuchal ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process axis  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior external vertebral venous plexus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Interspinales cervices muscles  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis cervicis muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra C. VI  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle"}
{"_id": "stanford_medicine_back_clean$$$corpus_93", "text": "Posterior cervical region and suboccipital muscles dissected from behind\n\t\t\t\t\t\t\t\t\t\t Semispinalis capitis and semispinalis cervicis muscles\n\t\t\t\t\t\t\t\t\t\tThe splenius muscles have been cut away and the fascia has been completely removed from the semispinalis muscles.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of insertion of splenius capitis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process temporal bone (partially cut away laterally)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Nuchal ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus capitis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of origin of levator scapulae muscle (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus cervicis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scalene muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  14\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis cervicis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser occipital nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of origin of splenius capitis muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra C. VI  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Interspinalis cervicis muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis cervicis muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle"}
{"_id": "stanford_medicine_back_clean$$$corpus_95", "text": "Posterior cervical region and suboccipital muscles dissected from behind\n\t\t\t\t\t\t\t\t\t\t Nerve supply to left splenius capitis and splenius cervicis muscles\n\t\t\t\t\t\t\t\t\t\tThe muscles have been cut from their spinal origins (the splenius capitis muscle also cut near its cranial insertion) and reflected laterally. A portion of the fascia which covered the deep surface of the splenius capitis muscle has been preserved. The fascia (15) of the semispinalis capitis muscle (16) has been retained only in a small area.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process temporal bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique capitis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph node  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle (reflected)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Aberrant muscular slip from longissimus capitis muscle to semispinalis capitis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch occipital artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of dorsal branch cervical nerve II  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus capitis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius cervicis muscle (reflected)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of dorsal branch cervical nerve IV  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus cervicis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve right  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of semispinalis capitis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve left  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle right  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Nuchal ligament  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of origin of splenius capitis muscle (cut across)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of dorsal branch cervical nerve III  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal cutaneous branch cervical nerve IV"}
{"_id": "stanford_medicine_back_clean$$$corpus_97", "text": "Posterior cervical region and suboccipital muscles dissected from behind\n\t\t\t\t\t\t\t\t\t\t Left splenius muscles; right trapezius muscle\n\t\t\t\t\t\t\t\t\t\tThe trapezius and rhomboid muscles have been removed from the left side of the body. The left scapula has been pulled laterally. The serratus posterior superior (5) has been reflected to expose underlying parts of the erector spinae and splenius muscles.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Fascia covering semispinalis capitis muscle Lower pointer: Greater occipital nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus posterior superior muscle (reflected laterally)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve supply to serratus posterior superior muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of levator scapulae muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius cervicis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid minor muscle (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis cervicis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinalis thoracis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Nuchal ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Band of thoracolumbar fascia (removed elsewhere)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra Th. II  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Spine of scapula Lower pointer: Deltoid muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle"}
{"_id": "stanford_medicine_back_clean$$$corpus_99", "text": "Posterior cervical region and suboccipital muscles dissected from behind\n\t\t\t\t\t\t\t\t\t\t Superficial structures of back of neck; cervical fascia; trapezius muscle\n\t\t\t\t\t\t\t\t\t\tOn the side of the neck the superficial or investing layer of cervical fascia has been preserved together with the nerves, blood vessels and lymph nodes that lie external to it. On the right the trapezius and sternocleidomastoid muscles have been exposed by removing this fascia\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital belly of occipitofrontal muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser occipital nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Retroauricular lymph node  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital lymph node  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle (covered by cervical fascia)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial branch of dorsal branch cervical nerve IV  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve right  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (pointer near origin from superior nuchal line)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle (pointer near insertion into superior nuchal line)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Aberrant muscular slip  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cervical triangle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (origin from nuchal ligament)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra C. VII  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch cervical nerve VII"}
{"_id": "stanford_medicine_back_clean$$$corpus_101", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Sacroiliac joint opened; interosseous sacroiliac ligament, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe left ilium has been detached to display the auricular surface of the sacrum and the interosseous sacroiliac ligaments.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous sacroiliac ligaments (pointer indicates only a small part of the area occupied by the numerous bands that comprise these ligaments which have been cut at their attachments to the ilium)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface sacrum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral sacroiliac ligament  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra L. V  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinous ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Interspinous ligament L. V - S. I (convex in shape due to compression by extension of vertebra on sacrum)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Median sacral crest  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacroiliac ligament (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac branch of iliolumbar artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of articular surface in which fibrocartilage has been damaged (remainder of auricular surface intact)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule (lined internally by synovial membrane)"}
{"_id": "stanford_medicine_back_clean$$$corpus_103", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Sagittal section of lumbosacral spine; transverse section through sacroiliac joint\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the preceding view (155-7) has been cut in the median plane and the right half subsequently has been cut in a plane transverse to the sacroiliac joint and approximately at right angles to the long axis of the sacrum. The sectioned parts have been separated from each other and are viewed from in front.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intervertebral foramen Lower pointer: Posterior sacral foramen  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous sacroiliac ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacroiliac joint (pointer on cavity and fibrocartilage covering articular surfaces of both bones)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body ilium (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior sacral (pelvic) foramina  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic foramen  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body ischium  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Bony ridge at site of exit of tendon of obturator internus from pelvis (note other parallel ridges)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic foramen  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral sacrococcygeal ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrococcygeal junction (articular cavity present in this specimen)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinous ligament  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine (pointer indicates facet for attachment of coccygeus muscle)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinous ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Interspinous ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra L. IV  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of vertebra L. IV (facing vertebral canal)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum flavum  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anulus fibrosus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. V  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Nucleus pulposus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part sacrum  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior limit of dural sac  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacroiliac joint (reinforced by ventral sacroiliac ligament)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse line sacrum (note remnant of intervertebral disk in cut section)  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sacral hiatus Lower pointer: Dorsal superficial sacrococcygeal ligament"}
{"_id": "stanford_medicine_back_clean$$$corpus_105", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Intervertebral articulations viewed from above and behind\n\t\t\t\t\t\t\t\t\t\tThe third and fourth lumbar vertebrae have been separated by cutting the intervertebral disc and dividing the posterior joint capsules and the various ligaments connecting the two vertebrae.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anulus fibrosus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Nucleus pulposus (both 2 and 3 are part of the intervertebral disc)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral canal (pointer on anterior internal vertebral venous plexus)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle (arch of vertebra) L. IV  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process (upper pointer, cut margin of joint capsule; lower pointer, superior articular surface)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina (arch of vertebra) L. IV  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process vertebra L. IV  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint capsule L. V - S. 1  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacroiliac ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vertebral incisure (note veins forming communications between internal and external vertebral venous plexuses)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum flavum (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Interspinous ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part sacrum  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinous ligament (overlying spinous process vertebra L. IV)"}
{"_id": "stanford_medicine_back_clean$$$corpus_107", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Ligaments of pelvic girdle, anterior view\n\t\t\t\t\t\t\t\t\t\tThe pubic bones have been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part sacrum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineal ligament (ligament of Cooper)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior ramus pubic bone (cut across)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule coxae (pointer overlies head of femur)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiofemoral ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus ischium (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacrococcygeal ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. V  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. V - S. I  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra L. V  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac fossa  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacroiliac joint (covered by ventral sacroiliac ligament)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior sacral (pelvic) foramina  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic foramen  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinous ligament  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic foramen  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator membrane (cut across)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament"}
{"_id": "stanford_medicine_back_clean$$$corpus_109", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Ligaments of pelvic girdle, posterior view\n\t\t\t\t\t\t\t\t\t\tMuscles, blood vessels and nerves have been removed from this specimen of a young adult male.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinous ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process vertebra L. V  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Median sacral crest  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic foramen  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinous ligament (at attachment to ischial spine)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic foramen  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra L. IV  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra L. V  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Wing (ala) of ilium  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacroiliac ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Body ilium  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule coxae  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral comu (horn)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal superficial sacrococcygeal ligament  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacrococcygeal ligament"}
{"_id": "stanford_medicine_back_clean$$$corpus_111", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Ligaments of coccygeal region, close-up posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch coccygeal nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch sacral nerve V  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Connecting ioop between fifth sacral nerve and coccygeal nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (transected)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral border of sacrum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal vein (cut off)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pudendal nerve Lower pointer: Internal pudendal artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine (covered by fibers of coccygeus muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle (overlying sacrospinous ligament)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (pointer on iliococcygeus muscle)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior rectal artery Lower pointer: Perineal artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate fascia (reflected to expose perineal vessels and nerves in pudendal canal)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (pointer on pubococcygeus muscle)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral cornu (horn)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeal cornu (horn)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Aperture for dorsal ramus of fifth sacral nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal superficial sacrococcygeal ligament  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Deep dorsal sacrococcygeal ligament Lower pointer: Sacrotuberous ligament  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (terminal segment)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate fascia  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pelvic diaphragmatic fascia  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  28\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus"}
{"_id": "stanford_medicine_back_clean$$$corpus_113", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Ligaments of sacral region, posterior view\n\t\t\t\t\t\t\t\t\t\tThe central area of the dissection shown in the preceding view is illustrated in this close-up photograph.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinous ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra L. V (periosteum removed)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacral foramina (partially obscured by ligamentous bands note vessels and nerves emerging between bands)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery (cut off)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve (exposed by excision of piriform muscle)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinous ligament (blended with coccygeus m)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra L. V  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint capsule L. V - S. I  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacroiliac ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Median sacral crest  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral cornu (horn)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal superficial sacrococcygeal ligament"}
{"_id": "stanford_medicine_back_clean$$$corpus_115", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Ligaments of lumbosacral region, posterior view\n\t\t\t\t\t\t\t\t\t\tThe erector spinae and gluteus maximus muscles have been removed. On the left the gluteus medius has been cut away.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Erector spinae muscle (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinous ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertransverse ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus lumborum muscle (covered by middle layer of thoracolumbar fascia)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Left kidney (faintly visible through thoracolumbar and renal fascia)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra L. IV  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle (cut edge)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of gluteus medius muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus minimus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve (emerging through greater sciatic foramen)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal pudendal artery Lower pointer: Pudendal nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle (tendon of insertion)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter of femur  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (posterior layer, reflected)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint capsule L. IV-V  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Median sacral crest  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacroiliac ligament  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiorectal fossa  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal superficial sacrococcygeal ligament  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx"}
{"_id": "stanford_medicine_back_clean$$$corpus_117", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Quadratus lumborum muscle, posterior view\n\t\t\t\t\t\t\t\t\t\tThe middle layer of thoracolumbar fascia has been removed from the posterior surface of the quadratus lumborum muscle (7). Small slips of origin join the quadratus lumborum from the transverse processes of the second and third lumbar vertebrae.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbocostal ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcostal nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Dorsal branch lumbar artery II Right pointer: Dorsal branch lumbar nerve II  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra L. III  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (anterior layer)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus lumborum muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra Th. XII  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinous ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertransverse muscles  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch lumbar nerve II  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Erector spinae muscle (covered by thoracolumbar fascia)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint capsule L. III-IV  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina (arch of vertebra) L. V"}
{"_id": "stanford_medicine_back_clean$$$corpus_119", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Rotator, interspinal and intertransverse muscles in lumbar region\n\t\t\t\t\t\t\t\t\t\tThe erector spinae and multifidus muscles have been nearly completely excised from the lumbar region.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial intertransverse muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral intertransverse muscle (several fascicles present)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch thoracic nerve XII  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis transversus abdominis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (upper pointer, middle layer; lower pointer, posterior layer, cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Transversus abdominis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus lumborum muscle (covered by thoracolumbar fascia)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Longissimus muscle Lower pointer: Iliocostalis lumborum muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cluneal nerves  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra L. II  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint capsule  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Interspinalis lumborum muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra L. IV  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (posterior layer)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Rotator muscles  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra L. V  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lamina (arch of vertebra) L. V Lower pointer: Intervertebral joint capsule L. V - S. I  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch sacrum"}
{"_id": "stanford_medicine_back_clean$$$corpus_121", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Ligaments of costotransverse articulations; dorsal rami of spinal nerves, posterior view\n\t\t\t\t\t\t\t\t\t\tThe erector spinae and the transversospinal muscles have been cut away to permit dissection of the ligaments related to several of the costotransverse joints.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle (tendon of insertion)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertransverse ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator costarum brevis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior costotransverse ligament (upper pointer on anterior division, lower pointer on posterior division)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercule of rib VI  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of rib VI (pointer on tendon of insertion of one slip of iliocostalis muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral costotransverse ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch posterior intercostal artery V  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch thoracic nerve V  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Neck of rib Lower pointer: Costotransverse ligament (occupying costotransverse foramen)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint capsule Th. V-VI  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra Th. VI  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina (arch of vertebra) Th. VI  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra Th. V  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to levator costarum brevis muscle (branch of dorsal ramus)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Rotator brevis muscle"}
{"_id": "stanford_medicine_back_clean$$$corpus_123", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Multifidus and rotator muscles in mid-thoracic region\n\t\t\t\t\t\t\t\t\t\tThe transversospinal group of muscles includes the semispinalis, multifidus and rotator muscles that extend obliquely upward from transverse processes to spinous processes of higher vertebrae. The semispinalis muscles, in general spanning five to six vertebrae, are shown in views 213-6, 216-4 and 216-5. Parts of the semispinalis have been cut away in this dissection to expose the more deeply placed multifidus (11) and rotator (13,14) muscles. The former span three or four vertebrae whereas the latter muscles extend across only one or two vertebrae.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus posterior superior muscle (insertions into fourth and fifth ribs)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral costotransverse ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator costarum brevis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis muscle (one muscle slip preserved to illustrate manner in which muscle arises medial to insertion of lower portions of muscle)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle (areas of insertion on rib and transverse process)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib VI  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch thoracic nerve VII  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra Th. III  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis thoracis muscle (cut across and elevated)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cutaneous branch of dorsal branch thoracic nerve III (note muscular branch to multifidus)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Multifidus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Rotator longus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Rotator brevis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t External vertebral venous plexus (posterior)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle (origin, elevated and cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinous ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis and multifidus muscles (cut off)"}
{"_id": "stanford_medicine_back_clean$$$corpus_125", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Deep dissection of iliocostalis lumborum and longissimus thoracic muscles; multifidus muscle\n\t\t\t\t\t\t\t\t\t\tThe upper parts of the iliocostalis and longissimus have been cut away to expose the lower fascicles of these muscles as they pass deeply. The iliocostalis lumborum has strong insertions on the angles of the lower ribs. The longissimus spreads somewhat to insert into ribs, transverse processes, and accessory processes of the lumbar vertebrae.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus posterior inferior muscle (insertions, cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis lumborum muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Transversus abdominis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcostal nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus lumborum muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cluneal nerves  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinalis thoracis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra L. II  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Multifidus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia"}
{"_id": "stanford_medicine_back_clean$$$corpus_127", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Multifidus muscle in lumbar region\n\t\t\t\t\t\t\t\t\t\tThe iliocostalis and longissimus muscles have been retracted laterally and dissected to demonstrate nerves and blood vessels entering the muscles. The multifidus (8) has been exposed in the sacral, lumbar and lower thoracic regions. It should be noted that this muscle is more massive in the lumbosacral region and that its fascicles become progressively more slender in the thoracic area.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib X  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis lumborum muscle (dissected to expose nerve and vascular supply)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle (dissected)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branches of lumbar arteries  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal oblique muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinalis thoracis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Multifidus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (posterior layer)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of posterior superior iliac spine"}
{"_id": "stanford_medicine_back_clean$$$corpus_129", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Components of erector spinae muscle in lower thoracic and lumbar regions\n\t\t\t\t\t\t\t\t\t\tDetails of the lower part of the specimen shown in view 213-5 are illustrated in this photograph. The lumbar part of the mulitfidus muscle (14) is large and has an extensive origin from the deep surface of the aponeurosis of the erector spinae muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib X  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch thoracic nerve XI (muscular and cutaneous branches)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis lumborum muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal oblique muscle (cut across close to origin)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cluneal nerves  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinalis thoracis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra L. II  13\n\t\t\t\t\t\t.\n\t\t\t\t\t External oblique muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Multifidus muscle"}
{"_id": "stanford_medicine_back_clean$$$corpus_131", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Components of erector spinae muscle in relation to semispinalis muscles in upper thoracic region\n\t\t\t\t\t\t\t\t\t\tThis close-up view of the back of the thorax and lower part of the neck shows in more detail the relations of the iliocostalis, longissimus and spinalis muscles illustrated in the previous photograph. In addition, the semispinalis group of muscles (1, 10, 14) has been partially exposed and it can be seen that there is a close interrelation between this group and the longissimus and spinalis muscles.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus capitis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus cervicis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scalene muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis cervicis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus posterior superior muscle (cut off near costal attachments)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib VI  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis cervicis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Interspinalis cervicis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra C. VII (vertebra prominens)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis thoracis muscle (note muscular slips extending to longissimus muscle)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch of posterior intercostal artery V  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cutaneous branch of dorsal branch thoracic nerve V  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinalis thoracis muscle"}
{"_id": "stanford_medicine_back_clean$$$corpus_133", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Components of erector spinae muscle separated, general view\n\t\t\t\t\t\t\t\t\t\tThe heavy aponeurosis of origin of the left erector spinae has been partially removed near the midline. This portion of the aponeurosis, form which the longissimus thoracic part arises, also serves to give attachment to portions of the underlying multifidus muscle (8). The iliocostalis (2, 6), longissimus (4) and spinalis (5) muscles have been separated from each other.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib VI  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinalis thoracis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis lumborum muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal oblique muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Multifidus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra Th. III  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra Th. XII  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (posterior layer)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle"}
{"_id": "stanford_medicine_back_clean$$$corpus_135", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Erector spinae muscle, close-up view of lumbosacral portion\n\t\t\t\t\t\t\t\t\t\tThe posterior layer of thoracolumbar fascia (9)has been cut away on the left to reveal the erector spinae muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis lumborum muscle (insertion)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinalis thoracis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus posterior inferior muscle (cut off near insertion into tenth rib)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous branch of dorsal branch thoracic nerve X  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal oblique muscle (reflected anteriorly)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse abdominis muscle (aponeurosis of origin)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Erector spinae muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cluneal nerves  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (posterior layer)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t External oblique muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar triangle (Petit's)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle"}
{"_id": "stanford_medicine_back_clean$$$corpus_137", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Erector spinae muscle, close-up view of thoracic portion\n\t\t\t\t\t\t\t\t\t\tIn this close-up view of the upper part of the specimen shown in the preceding photograph of the iliocostalis (12), longissimus (13) and spinalis (14) divisions of the erector spinae are more clearly visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib V  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of serratus anterior muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous branch of dorsal branch thoracic nerve IX  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus posterior inferior muscle (insertion into ninth rib)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Scapula  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus posterior superior muscle (reflected laterally)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis cervicis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra Th. II  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cutaneous branch of dorsal branch .thoracic nerve III  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinalis thoracis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi"}
{"_id": "stanford_medicine_back_clean$$$corpus_139", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Erector spinae muscle, general view\n\t\t\t\t\t\t\t\t\t\tThe trapezius and latissimus dorsi muscles have been preserved on the right side. These muscles have been removed on the left side and the left shoulder girdle has been pulled aside. The posterior serratus muscles have been cut away and the thoracolumbar fascia has been removed to display the left erector spinae muscles. The delicate, intrinsic fascia of the erector spinae has also been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Scapula (retracted laterally)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus posterior superior muscle (reflected)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratys anterior muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia related to serratus anterior muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis thoracis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinalis thoracis muscle (together 6, 7 and 8 make up the erector spinae muscle)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch thoracic nerve X (lateral cutaneous branch)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal oblique muscle (reflected anteriorly)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (cut margin of layer which covered erector spinae)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra Th. II  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (intact)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t External oblique muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest"}
{"_id": "stanford_medicine_back_clean$$$corpus_141", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Left serratus posterior inferior muscle\n\t\t\t\t\t\t\t\t\t\tThe field of view extends from the level of the eighth rib downward nearly to the iliac crest. The left latissimus dorsi has been removed. The fascia which covered the serratus posterior inferior has been resected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib VIII  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Erector spinae muscle (covered by thoracolumbar fascia)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus posterior inferior muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XI  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII  7\n\t\t\t\t\t\t.\n\t\t\t\t\t External oblique muscle (cut off)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal oblique muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branches of thoracic nerves VII and VIII (medial cutaneous branches)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branches of thoracic nerves IX and X (lateral cutaneous branches)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra L. II  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia"}
{"_id": "stanford_medicine_back_clean$$$corpus_143", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Nerve supply to serratus posterior superior muscle\n\t\t\t\t\t\t\t\t\t\tThe serratus posterior superior has been reflected laterally to expose branches of the first three intercostal nerves entering the deep surface of the muscle. The fourth intercostal nerve also sends a branch to the muscle, not shown in this view.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse colli artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus posterior superior muscle (reflected)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial margin of scapula  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid minor muscle (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scalene muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of thoracic nerve I, II and III (to serratus posterior superior muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  9\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis muscle"}
{"_id": "stanford_medicine_back_clean$$$corpus_145", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Left serratus posterior superior in relation to splenius and erector spinae muscles\n\t\t\t\t\t\t\t\t\t\tThe left shoulder girdle has been freed by removal of the trapezius, latissimus dorsi and rhomboid muscles and has been pulled away from the thoracic wall. The serratus anterior muscles (10) remains intact. The rather thick, elastic layer of fascia (11) between this muscle and the rib cage has been partially resected to reveal the serratus posterior superior muscle (5).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal scapular nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse colli artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus posterior superior muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib III  7\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial margin of scapula  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid major muscle (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle (elevated)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial layer between serratus anterior and thoracic wall  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia infraspinata  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle"}
{"_id": "stanford_medicine_back_clean$$$corpus_147", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Left levator scapulae and rhomboid muscles; nerve supply to rhomboid major\n\t\t\t\t\t\t\t\t\t\tThe fascia covering the levator scapulae and the rhomboid muscles has been removed. The parallel fascicles of the rhomboideus major have been freed of connective tissue and separated to reveal the course of the dorsal scapular nerve and branches of the transverse cervical artery.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (reflected laterally)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse colli vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse colli artery (divided)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of trapezius on spine of scapula  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial margin of scapula  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus fascia  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid minor muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal scapular nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid major muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia"}
{"_id": "stanford_medicine_back_clean$$$corpus_149", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Fascia of rhomboid muscles; nerve supply to trapezius muscle\n\t\t\t\t\t\t\t\t\t\tThe external layer of muscles of the back and left shoulder has been exposed bilaterally. The left trapezius has been reflected laterally from its spinal origin to reveal the layer of fascia between it and the deeper-lying rhomboid muscles. The accessory nerve has been dissected along the deep surface of the trapezius.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Origins of trapezius muscle (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical surface of superficial fascia  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (reflected laterally)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of transverse colli artery to trapezius (divided in reflecting trapezius)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral brachial cutaneous nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostobrachial nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra C. VII  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid major muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Erector spinae muscle (beneath thoracolumbar fascia)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Triangle of auscultation  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle"}
{"_id": "stanford_medicine_back_clean$$$corpus_151", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Superficial structures and external layer of muscles of lumbosacral region of back\n\t\t\t\t\t\t\t\t\t\tThe lower part of the specimen is shown in view 212-1 is shown in more detail in this close-up photograph.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous branch, intercostal nerve VII (posterior branch)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous branch of dorsal branch thoracic nerve XI  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cluneal nerves  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cluneal nerves  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (covered by ligaments)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cutaneous branch of dorsal branch thoracic nerve X  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (overlying erector spinae muscle)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t External oblique muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar triangle (Petit's triangle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle"}
{"_id": "stanford_medicine_back_clean$$$corpus_153", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Superficial structures and external muscles of thoracic region of back\n\t\t\t\t\t\t\t\t\t\tOn the lower half of the specimen the tela subcutanea has been dissected to expose cutaneous nerves and vessels. To the right of the midline the trapezius and latissimus dorsi muscles have been exposed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical surface of superficial fascia (nuchal fascia)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial dorsal cutaneous branch thoracic nerve III  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostobrachial nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Triangle of auscultation  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia covering latissimus dorsi muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous branch intercostal nerve V (posterior branch)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra C. VII  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Spine of scapula  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia infraspinata  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle"}
{"_id": "stanford_medicine_back_clean$$$corpus_155", "text": "Dissection of thoracic and lumbosacral regions of back from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Superficial structures and external layer of muscles of back, general view\n\t\t\t\t\t\t\t\t\t\tThe skin has been removed form the entire back. On the left half of the body the cutaneous nerves and vessels have been dissected and the deep fascia has been preserved. On the right the external layer of muscles related to the shoulder girdle has been exposed. The following close-up photographs of the thoracic and lumbosacral areas show more details of the cutaneous branches of nerves and arteries.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia cervical surface  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra Th. II  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral brachial cutaneous nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior brachial cutaneous nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial fascia  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal cutaneous branch thoracic nerve V  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch of lateral cutaneous branch intercostal nerve V  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia covering latissimus dorsi muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cluneal nerves  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia infraspinata  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia  17\n\t\t\t\t\t\t.\n\t\t\t\t\t External oblique muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest"}
{"_id": "stanford_medicine_back_clean$$$corpus_157", "text": "Arteries of vertebral column of one\n\t\t\t\t\t\t\t\t\t\t Year-old infant - Arteries of lumbar part of vertibral canal, posterior view\n\t\t\t\t\t\t\t\t\t\tThe pedicles of the lumbar vertebrae have been transformed to permit the removal of the vertebral arches. The ramification of the spinal branches (6) of the lumbar arteries is similar to that in the thoracic region (211-4) in that transversely directed vessels arch across the posterior surface of the vertebral body, sending nutrient branches into the center of ossification and connecting with similar vessels of the opposite side. Ascending and descending communications with neighboring segmental arteries are consistently present. Great variation in the presence and size of radicular arteries is evident in the lumbar region also. The large radicular artery (5) that continues into the anterior spinal artery is the only sizeable vessel of this sort in the field of view.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc Th. XII - L. I  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal branch lumbar artery I (transverse branch)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery to posterior part of epidural space and lamina of vertebra  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramen (opened)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Radicular branch of spinal branch lumbar artery III  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal branch lumbar artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch lumbar artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. II  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Line of junction of ossification centers of body and neural arch  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle (arch of vertebra) L. II"}
{"_id": "stanford_medicine_back_clean$$$corpus_159", "text": "Arteries of vertebral column of one\n\t\t\t\t\t\t\t\t\t\t Year-old infant - Arteries of lumbosacral part of vertebral column, left posterolateral view\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the preceding view has been turned to expose its left posterolateral aspect. Ossified portions of the fifth lumbar vertebra and the sacrum were not sufficiently dry at the time of the photograph to appear as distinctly white as do the centers of ossification elsewhere.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc Th. XII - L. I  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. I  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra L. II  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar artery III  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal branch lumbar artery III  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch lumbar artery III  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of vertebra L. V  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ilium (fragmented)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch lateral sacral artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramen  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra L. 1  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral canal  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior articular process vertebra L. III Lower pointer: Inferior articular process vertebra L. II  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrum (pointer indicates arch of first sacral vertebra)"}
{"_id": "stanford_medicine_back_clean$$$corpus_161", "text": "Arteries of vertebral column of one\n\t\t\t\t\t\t\t\t\t\t Year-old infant - Arteries of lumbosacral part of vertebral column, left anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe abdominal aorta and the middle sacral artery have been cut away. The spinal branch of the iliolumbar artery, the upper lateral sacral artery and the superior gluteal artery arise by a common stem from the internal iliac artery in this specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcostal artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ossification center for body of twelfth thoracic vertebra  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar arteries I (arising from a common stem)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. II- III  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar arteries IV  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ossification center for body of fifth lumbar vertebra  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ilium  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal branch iliolumbar artery (anomalous origin from superior gluteal artery)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramen  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch lumbar artery III  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrum"}
{"_id": "stanford_medicine_back_clean$$$corpus_163", "text": "Arteries of vertebral column of one\n\t\t\t\t\t\t\t\t\t\t Year-old infant - Arteries within cervical part of vertebral canal of mid thoracic region, posterior view\n\t\t\t\t\t\t\t\t\t\tThe pedicles of the thoracic vertebrae have been cut across to open the vertebral canal and the intervertebral foamina. The posterior intercostal arteries (3) give off spinal and dorsal branches opposite the intervertebral foramina. Variations in the manner of origin of those branches from different intercostal arteries are evident. In this preparation the course and distribution  of the spinal branches of several intercostal arteries may be traced except for branches that were distributed to the laminae which have been cut away. The arteries to the bodies of the vertebrae communicate superiorly and inferiorly with neighboring vessels and across the midline with their fellows of the opposite side.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Junction between ossification centers of body and neural arch  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramen (opened)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal artery VI  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch posterior intercostal artery VI  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal branch posterior intercostal artery VI  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Radicular branch of spinal branch posterior intercostal artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of spinal branch to vertebral body  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal branch posterior intercostal artery VII (inferior branch passing downward to communicate with a superior branch from the eighth intercostal artery)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Radicular branch of posterior intercostal artery VIII (note variation in size of this and the radicular branch at level of sixth vertebra)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal branch posterior intercostal artery VIII (branch arching upward to communicate with seventh intercostal artery medial to pedicle of vertebra)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc Th. IV - V  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra Th. V (pointer on nutrient foramen)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Communicating arch between opposite spinal branches of intercostal arteries  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle (arch of vertebra) Th. VI  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior spinal artery"}
{"_id": "stanford_medicine_back_clean$$$corpus_165", "text": "Arteries of vertebral column of one\n\t\t\t\t\t\t\t\t\t\t Year-old infant - Arteries within cervical part of vertebral canal, posterior view\n\t\t\t\t\t\t\t\t\t\tThe vertebral arches have been trimmed away to reveal the vertebral canal in the cervical region. On the right side of the specimen the pedicles of the fourth and fifth vertebrae have been cut across so that the right vertebral artery (10) is visible with three of its segmental spinal branches. The atlas has been entirely removed from the specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens (axis) (two ossification centers visible)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ossification center for body of axis  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of axis  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of fusion of ossification centers for body and neural arch of third cervical vertebra  5\n\t\t\t\t\t\t.\n\t\t\t\t\t External vertebral venous plexus (injected)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular surface vertebra C. V  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal branch vertebral artery (radicular branch which followed roots of seventh cervical nerve)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc C. V - VI  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Unossified cartilage of bodies of vertebra C. V and C. VI  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process vertebra C. III  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal branch vertebral artery (dorsal branch to vertebral arch)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal branch vertebral artery (ventral branch to vertebral body)"}
{"_id": "stanford_medicine_back_clean$$$corpus_167", "text": "Arteries of vertebral column of one\n\t\t\t\t\t\t\t\t\t\t Year-old infant - Arteries of cervicothoracic part of vertebral column, right posterolateral view\n\t\t\t\t\t\t\t\t\t\tThe specimen illustrated in the previous photograph has been rotated to expose its posterolateral aspect. The distribution of the dorsal rami of the deep cervical and intercostal arteries may be traced.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Axis  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra C. VII  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina (arch of vertebra) Th. V  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch occipital artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep cervical artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Supreme intercostal artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch posterior intercostal artery III  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal artery IV  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramen  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra Th. VI"}
{"_id": "stanford_medicine_back_clean$$$corpus_169", "text": "Arteries of vertebral column of one\n\t\t\t\t\t\t\t\t\t\t Year-old infant - Arteries of cervicothoracic part of vertebral column, right anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe arterial system of a one-year-old infant was injected with red acrylic plastic following which the soft tissues were corroded with potassium hydroxide. The specimen has been prepared to illustrate the arteries of the vertebral column and the relation of these vessels to the posterior portions of the ribs. Ossification of the vertebral bodies and neutral arches is incomplete. This preparation was made by Dr. Donald L. Stilwell, who kindly granted permission for those photographs to be recorded. The present view and the succeeding ones of this series illustrate various aspects of the vessels that supply the vertebral column.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of atlas  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep cervical artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch of posterior intercostal artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior intercostal artery II Lower pointer: Collateral branch posterior intercostal artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens (axis)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of axis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery (passing upward into transverse foramen)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra C. VII (pointer on ossification center)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Costocervical trunk  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Supreme intercostal artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal arteries (from aorta)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra Th. VI"}
{"_id": "stanford_medicine_back_clean$$$corpus_171", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Anteroposterior radiograph of female pelvis\n\t\t\t\t\t\t\t\t\t\tThis film was obtained through the courtesy of Dr. Grant Melvin Stevens of the Palo Alto Clinic.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. IV  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacroiliac joint  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ilium  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part sacrum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic sacral foramen  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischium  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis"}
{"_id": "stanford_medicine_back_clean$$$corpus_173", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Radiograph of lumbar part of vertebral column, right lateral view\n\t\t\t\t\t\t\t\t\t\tThe vertebral column is viewed from in front and to the right so that the intervertebral articular cavities (3) of the left side may be seen in profile. Details of the articulations on the right side are obscured by the overlapping shadows of hte spinous processes, pedicles and laminae of the arches. This film was obtained through the courtesy of Dr. Melvin J. Figley.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Overlapping shadows of spinous processes and arches (area indicated extends vertically throughout film)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process vertebra L. III  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral articular cavity  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process vertebra L. II  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate sacral crest  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ilium  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra L. III (in background)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. III  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. IIl-IV  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle (arch of vertebra) L. IV (in background)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part sacrum"}
{"_id": "stanford_medicine_back_clean$$$corpus_175", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Radiograph of lumbar part of vertebral column, right lateral view\n\t\t\t\t\t\t\t\t\t\tThe right iliac crest has not been included in the drawing. It is visible in the foreground of the view parallel to and below the left iliac crest (13). This film was obtained through the courtesy of Dr. Melvin J. Figley.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process vertebra L. II  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process vertebra L. I  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle (arch of vertebra) L. II  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral articular cavity L. Il-III  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra L. III  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramen  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process of sacrum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Median sacral crest  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral canal  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. I  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. II-III  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Residual droplet of radio-opaque material from previous myelographic examination  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest (in background)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine (in background)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory"}
{"_id": "stanford_medicine_back_clean$$$corpus_177", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Radiograph of lumbar part of vertebral column, anteroposterior view\n\t\t\t\t\t\t\t\t\t\tThis film was obtained through the courtesy of Dr. Melvin J. Figley.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra Th. XII (in background)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle (arch of vertebra) L. I (in background)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral articular cavity L. III-IV  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra L. IV  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic notch  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory (indistinct in film)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra Th. XII (pointers indicate upper and lower borders)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Inferior articular process vertebra L. II Right pointer: Superior articular process vertebra L. III  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. III-IV  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle (faint linear shadow of lateral border of muscle)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part sacrum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacroiliac joint"}
{"_id": "stanford_medicine_back_clean$$$corpus_179", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Radiograph of thoracic part of vertebral column, anteroposterior view\n\t\t\t\t\t\t\t\t\t\tThis film was obtained through the courtesy of Dr. Melvin J. Figley.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra Th. I  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra Th. V (located posterior to body of sixth thoracic vertebra)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle (arch of vertebra) Th. VIII  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra Th. XII  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra L. II  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. I - II  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left border of heart  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII"}
{"_id": "stanford_medicine_back_clean$$$corpus_181", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Radiograph of neck, left lateral view\n\t\t\t\t\t\t\t\t\t\tThis film was obtained through the courtesy of Dr. Melvin J. Figley.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior arch of atlas  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens (axis)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse foramen axis  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of axis  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior articular process vertebra C. III Lower pointer: Inferior articular process vertebra C. III  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Transverse foramen vertebra C. V Lower pointer: Transverse process vertebra C. V  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular facet of atlas  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process axis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral foramen (pointers indicate anterior and posterior borders of foramen of vertebra C. IV, outline of vertebral canal visible above and below this level)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina (arch of vertebra) C. V  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra C. VII (vertebra prominens)"}
{"_id": "stanford_medicine_back_clean$$$corpus_183", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Radiograph of head and neck, left oblique view\n\t\t\t\t\t\t\t\t\t\tThe head is turned to the right in this view of a living female subject and as a result the cervical vertebrae lie in various degrees of rotation. The lower vertebrae are more nearly in the anteroposterior position than the upper ones. The respiratory passages and the oral cavity are outlined by their content of air, which produces a dark shadow in the view. Soft tissues are only faintly visible. This film was obtained through the courtesy of Dr. Charles E. Duisenberg.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronal suture  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sella turcica  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior wall of orbit (pointer indicates left orbit)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoidal sinus (in midline)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic bone (margin bordering left temporal fossa indicated by pointer)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary sinus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Hard palate  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Soft palate  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottis (outlined by air in valleculae and in pharynx)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pharyngeal cavity Lower pointer: Ventricle of larynx  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra C. VI  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lambdoid suture  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Petrosal part temporal bone Lower pointer: Mastoid cell  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Neck of mandible Lower pointer: Occipital condyle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens (axis) (crossed by anterior arch of atlas)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavity between articular processes of right second and third cervical vertebrae  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramina (for cervical nerves lV and V)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of overlapping of articular processes of fifth and sixth cervical vertebrae  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle"}
{"_id": "stanford_medicine_back_clean$$$corpus_185", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Anteroposterior radiograph of dens and atlantoaxial joints\n\t\t\t\t\t\t\t\t\t\tThis film was made of an edentulous subject with the mouth opened widely to permit an unobstructed view of the upper cervical vertebrae. The film was obtained through the courtesy of Dr. Melvin J. Figley.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas (pointers indicate upper and lower margins of arch)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of atlas  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of axis (pointer indicates lower border of body)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra C. III (pointers indicate upper and lower borders)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens (axis)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral mass of atlas (upper pointer, superior articular facet; lower pointer, inferior articular facet)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse foramen of atlas  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral atlantoaxial joint  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Transverse foramen of axis Lower pointer: Transverse process of axis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process vertebra C. III  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process of axis"}
{"_id": "stanford_medicine_back_clean$$$corpus_187", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Radiograph of neck, anteroposterior view\n\t\t\t\t\t\t\t\t\t\tThe head has been extended. As a result the superimposed shadow of the base of the skull has obscured the upper three cervical vertebrae. Structural details of the transverse processes and articular processes of the cervical vertebrae are indistinct because of the overlapping of multiple shadows. The cavities of the larynx and trachea are outlined by their content of air. The conus elasticus of the larynx is indicated at 5. This film was obtained through the courtesy of Dr. Melvin J. Figley.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of mandible  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of overlapping shadows of articular processes and transverse processes  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra C. V (pointers indicate upper and lower borders of body)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea (pointer indicates wall of air-filled conus elasticus)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse foramen  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Spinous process vertebra C. Vll Lower pointer: Lamina (arch of vertebra) C. VII  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process vertebra T. I  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Rib II Right pointer: Clavicle (in foreground)"}
{"_id": "stanford_medicine_back_clean$$$corpus_189", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Representative thoracic and lumbar vertebrae viewed from below\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina (arch of vertebra)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle (arch of vertebra)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral foramen  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse costal facet  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior costal facet  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory process  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process"}
{"_id": "stanford_medicine_back_clean$$$corpus_191", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Representative thoracic and lumbar vertebrae viewed from above\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina (arch of vertebra)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle (arch of vertebra)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral foramen  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse costal facet  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior costal facet  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory process  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process"}
{"_id": "stanford_medicine_back_clean$$$corpus_193", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Representative thoracic and lumbar vertebrae, left posterolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process (pointer on articular surface)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral foramen  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina (arch of vertebra)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Area for attachment of ligamentum flavum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior costal facet  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse costal facet  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vertebral incisure  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vertebral incisure  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory process  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process"}
{"_id": "stanford_medicine_back_clean$$$corpus_195", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Representative thoracic and lumbar vertebrae, left anterolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process (pointer on articular surface)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior costal facet  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle (arch of vertebra)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse costal facet  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vertebral incisure  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vertebral incisure"}
{"_id": "stanford_medicine_back_clean$$$corpus_197", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated lumbar vertebrae, left posterolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina (arch of vertebra)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory process  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral canal  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of attachment of ligamentum flavum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process"}
{"_id": "stanford_medicine_back_clean$$$corpus_199", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated lumbar vertebrae, left anterolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Space occupied in life by intervertebral disc  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle (arch of vertebra)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vertebral incisure  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vertebral incisure (together 4 and 5 make up the intervertebral foramen)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process (in background)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory process  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process (pointer on articular surface)"}
{"_id": "stanford_medicine_back_clean$$$corpus_201", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated thoracic vertebrae, left posterolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process (pointer on articular surface)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral canal  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina (arch of vertebra)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse costal facet  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior costal facet  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior costal facet  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle (arch of vertebra)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramen  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory process  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process"}
{"_id": "stanford_medicine_back_clean$$$corpus_203", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated thoracic vertebrae, left anterolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse costal facet  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramen  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior costal facet  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process"}
{"_id": "stanford_medicine_back_clean$$$corpus_205", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Fifth cervical vertebra, superior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of vertebra  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral foramen  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular surface  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tubercle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for cervical nerve V  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tubercle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vertebral incisure  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse foramen"}
{"_id": "stanford_medicine_back_clean$$$corpus_207", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Axis, posterolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens (axis)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior articular surface  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular surface  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse foramen  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Body  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral foramen  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process"}
{"_id": "stanford_medicine_back_clean$$$corpus_209", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Axis, superior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral foramen  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for cervical nerve II  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular surface  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior articular surface  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body"}
{"_id": "stanford_medicine_back_clean$$$corpus_211", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Atlas, posteroinferior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tubercle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral foramen  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse foramen  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular facet  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular facet for dens  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior arch  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle for attachment of transverse ligament of atlas  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral mass"}
{"_id": "stanford_medicine_back_clean$$$corpus_213", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Atlas, superior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tubercle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral foramen  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular facet  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral mass  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle for attachment of transverse ligament of atlas  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior arch  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular facet for dens  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tubercle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for vertebral artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse foramen"}
{"_id": "stanford_medicine_back_clean$$$corpus_215", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Occipital bone, external view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lambdoid margin  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Supreme nuchal line  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior nuchal line  4\n\t\t\t\t\t\t.\n\t\t\t\t\t External occipital crest  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nuchal line  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen magnum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Condylar fossa  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular tubercle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle for attachment of alar ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital condyle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal tubercle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar part  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital plane  14\n\t\t\t\t\t\t.\n\t\t\t\t\t External occipital protuberance  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral angle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Nuchal plane  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid margin  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Condylar canal  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular process  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part"}
{"_id": "stanford_medicine_back_clean$$$corpus_217", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated cervical vertebrae, posterolateral view\n\t\t\t\t\t\t\t\t\t\tRoman numerals designate the individual vertebrae in order.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of atlas  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular surface axis  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse foramen  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tubercle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tubercle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebra prominens  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of vertebra  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens (axis)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular facet of atlas  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral canal  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process"}
{"_id": "stanford_medicine_back_clean$$$corpus_219", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated cervical vertebrae, anterolateral view\n\t\t\t\t\t\t\t\t\t\tRoman numerals designate the individual vertebrae in order.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tubercle of atlas  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysis  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid tubercle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramen  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tubercle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tubercle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus of cervical nerve VI  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebra prominens VII"}
{"_id": "stanford_medicine_head_clean$$$corpus_1", "text": "Exploration of the brain from its superior aspect\n\t\t\t\t\t\t\t\t\t\t Relations of insula, internal capsule and lateral fissure\n\t\t\t\t\t\t\t\t\t\tThe specimen is tilted to the right and the relations of the insula, lateral fissure, internal capsule, body of the lateral ventricle and corpus callosum are seen close-up.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior frontal gyrus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal branch of orbitofrontal artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Meninges of frontal lobe  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of insula  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Insula  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior temporal branch of middle cerebral artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior temporal gyrus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Great anastomotic vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of central sulcus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse temporal gyrus (of Heschl)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial temporal gyrus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior parietal artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior parietal artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cerebral artery right  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulum (cut off)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum (cut edge)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavum of septum pellucidum  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Septum pellucidum  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Caudate nucleus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior occipitofrontal fasciculus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal capsule  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tubercle of thalamus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix (body)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus lateral ventricle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina affixa  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus circularis  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital part internal capsule  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior longitudinal fasciculus (cut off)"}
{"_id": "stanford_medicine_head_clean$$$corpus_2", "text": "Exploration of the brain from its superior aspect\n\t\t\t\t\t\t\t\t\t\t Caudate nucleus; lamina affixa; medullary substance of insula\n\t\t\t\t\t\t\t\t\t\tThe cortex of the upper half of the insula has been scraped away to reveal the underlying medullary substance. The ependymal layer which covered the caudate nucleus has been removed. Much of the choroid plexus in the central part of the lateral ventricle has been cut away to expose its attachment to the lips (taeniae) of the choroidal fissure (cleft between fornix and lamina affixa). Note the choroidal artery (a branch of the a. cerebri posterior) passing anteriorly in this region.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance projecting into superior frontal gyrus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of caudate nucleus (ependyma removed)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of insula  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal capsule  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tubercle of thalamus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Great anastomotic vein (cut end)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina affixa  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroidal fissure (cleft between taenia chorioidea and head of fornix)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix (crus)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut end of superior longitudinal fasciculus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcar avis  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital part radiations of corpus callosum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual gyrus (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulum (divided)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Precentral gyrus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Central sulcus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of posterior cerebral artery in parieto-occipital fissure  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Interparietal sulcus"}
{"_id": "stanford_medicine_head_clean$$$corpus_3", "text": "Exploration of the brain from its superior aspect\n\t\t\t\t\t\t\t\t\t\t Close-up view; relations of posterior horn of lateral ventricle\n\t\t\t\t\t\t\t\t\t\tDetailed relationships in the region of the splenium of the corpus callosum, the junction of the body and posterior horn of the lateral ventricle and the occipital lobe are illustrated. Boundaries of the opened ventricle are clearly visible in the upper central part of the view. The line of Gennari appears in the cut section of the lingual gyrus (29).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior parietal branch of middle cerebral artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior parietal branch of middle cerebral artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus circularis  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior longitudinal fasciculus (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of corpus callosum lateral to splenium  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbus posterior horn of lateral ventricle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tapetum (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of superior temporal gyrus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipitothalamic radiations (Gratiolet) (Note: This stratum includes not only the geniculocalcarine tract but also a system of fibers, the inferior occipitofrontal fasciculus, which can be traced forward toward the frontal lobe in a path lateral to the lentiform nucleus)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut section of the forward continuation of the lingual gyrus which becomes continuous in this region with the hippocampal gyrus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Gray matter lying in the deepest part of the calcarine fissure  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dissected portion of angular gyrus of inferior parietal lobule  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of superior occipital gyrus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal capsule  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Stria terminalis  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina affixa  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus lateral ventricle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix (crus)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Subparietal sulcus (continuous anteriorly with cingulate sulcus)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial longitudinal stria  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral longitudinal stria  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulum (cut across)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Limbic lobe (downward continuation around splenium of cingulate gyrus previously seen)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery in depths of calcarine fissure  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior surface of cerebellum facing transverse cerebral fissure (meninges and branches of superior cerebellar artery are visible on surface)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcarine fissure  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Convolution of lower part of lingual gyrus exposed in depths of a minor sulcus  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Parieto-occipital fissure right  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut section of visual cortex in lingual gyrus (note line of Gennari, hence the name striate cortex often applied to the visual cortex)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Surface of lingual gyrus in depths of calcarine fissure"}
{"_id": "stanford_medicine_head_clean$$$corpus_4", "text": "Exploration of the brain from its superior aspect\n\t\t\t\t\t\t\t\t\t\t Close-up view of anterior part of lateral ventricle and interventricular foramen\n\t\t\t\t\t\t\t\t\t\tClose-up view of central area of preceding stage of dissection seen from a more lateral angle. Details of the medial wall of the lateral ventricle and of the interventricular foramen are now evident. Note the small cavity of the septum pellucidum which has been cut open just beneath the corpus callosum. The ependymal lining of the ventricle is intact.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of superior frontal gyrus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of inferior frontal gyrus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Junction of fibers from internal capsule and corpus callosum to form corona radiata (seen in cross section)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior horn lateral ventricle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior occipitofrontal fasciculus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of caudate nucleus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal branch of middle cerebral artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of fibers derived from medullary substance of insula, external capsule and internal capsule (fibers course in various directions)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Emerging fibers of internal capsule  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Insula  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of precentral sulcus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of central sulcus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse temporal gyrus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulate gyrus (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of cingulate gyrus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Genu corpus callosum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulum (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of corpus callosum  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavum septum pellucidum  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulate sulcus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Septum pellucidum  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Interventricular foramen (of Monro)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus in lateral ventricle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior thalamic tubercle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina affixa  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Caudate nucleus (tail)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Stria terminalis"}
{"_id": "stanford_medicine_head_clean$$$corpus_5", "text": "Exploration of the brain from its superior aspect\n\t\t\t\t\t\t\t\t\t\t Lateral ventricle\n\t\t\t\t\t\t\t\t\t\tA large window has been cut in the corpus callosum to provide a view of the lateral ventricle. The contours and boundaries of the anterior horn, body and atrium of the lateral ventricle are shown in relation to structures seen in earlier stages of the dissection.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of superior frontal gyrus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut ends of superior longitudinal fasciculus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior horn lateral ventricle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal part of operculum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of caudate nucleus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Insula  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal capsule emerging to join corona radiate  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Caudate nucleus (tail)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of central sulcus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse temporal gyrus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina affixa overlying thalamus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus lying in atrium of lateral ventricle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of tapetum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital part radiations of corpus callosum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular gyrus (dissected)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Meninges and vessels in depths of parieto-occipital fissure  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual gyrus (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcarine fissure  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of cuneus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal pole  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fissure (cerebral vein displaced downward in this area)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulate gyrus (cut across)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of frontal part radiations of corpus callosum  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventricular surface of rostral corpus callosum  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Central sulcus  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of interventricular foramen (not visible in view)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior thalamic tubercle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum (trunk)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus lateral ventricle  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper surface of fornix (body)  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of corpus callosum  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulum (cut across)  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior surface of cerebellum (in transverse cerebral fissure)  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Parieto-occipital fissure"}
{"_id": "stanford_medicine_head_clean$$$corpus_6", "text": "Exploration of the brain from its superior aspect\n\t\t\t\t\t\t\t\t\t\t Close-up view of lateral fissure and insula\n\t\t\t\t\t\t\t\t\t\tFurther details in the region of the lateral fissure are shown in this close-up of the central area of the previous view. Note the several transverse temporal gyri, of which the anterior one (11) (Heschl's gyrus) is the most prominent. The superior longitudinal fasciculus which lies directly above the insula was of necessity cut away extensively to expose the underlying structures. The medial and lateral longitudinal striae (fiber tracts of the olfactory system) are clearly visible for most of their course across the upper surface of the corpus callosum.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Surface of medial frontal gyrus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Meninges and vessels of inferior frontal sulcus projecting from dissected margins of medial frontal gyrus and inferior frontal gyrus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of inferior frontal gyrus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus circularis in depths of lateral fissure  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal branch of middle cerebral artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Short insular gyrus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior temporal branch of middle cerebral artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of precentral sulcus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut end of great anastomotic vein (in edge of meninges)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of central sulcus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse temporal gyrus (Heschl)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse temporal sulcus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior and posterior parietal branches of middle cerebral artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of angular gyrus (terminal branch of middle cerebral artery)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Most posterior of transverse temporal gyri  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulate gyrus (cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulum (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal part corona radiata  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior longitudinal fasciculus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulate sulcus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral longitudinal stria  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial longitudinal stria  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum (trunk)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal part corona radiata  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus circularis"}
{"_id": "stanford_medicine_head_clean$$$corpus_7", "text": "Exploration of the brain from its superior aspect\n\t\t\t\t\t\t\t\t\t\t Lateral fissure and insula\n\t\t\t\t\t\t\t\t\t\tThe lateral fissure has now been extensively exposed from above by the removal of the frontal and parietal opercula. The superior longitudinal fasciculus (4) has been cut away to reveal the insula. The principal cortical branches of the middle cerebral artery lie within the lateral fissure. The portion of the temporal lobe facing the fissure displays transversely oriented gyri (of Heschl) wherein the fibers of the central auditory pathway terminate.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of superior frontal gyrus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebral vein is in superior frontal sulcus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulum (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior continuation of superior longitudinal fasciculus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal branches of orbitofrontal artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Insula  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of precentral sulcus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of central sulcus (Note cut end of great anastomotic vein in meninges close to cut end of this artery)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse temporal gyrus (of Heschl)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus circularis Note: this sulcus surrounds the insula in the depths of the lateral fissure  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior and posterior parietal arteries  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior portion of superior longitudinal fasciculus (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniculocalcarine tract and inferior longitudinal fasciculus joining occipital part internal capsule  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital part internal capsule and occipital part of radiations of corpus callosum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of posterior cerebral artery in depths of parieto-occipital fissure  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of posterior cerebral artery in calcarine fissure (exposed by removing cuneus)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of cuneus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal pole  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior frontal gyrus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulate gyrus (cut across)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Central sulcus (Rolandic)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Corona radiata  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial and lateral longitudinal striae"}
{"_id": "stanford_medicine_head_clean$$$corpus_8", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Relation of left facial nerve to parotid gland\n\t\t\t\t\t\t\t\t\t\tThe sternocleidomastoid muscle (3) has been cut off close to its insertion and its tendon reflected laterally from the mastoid process (4) of the temporal bone. The posterior facial vein (7) has been cut off and the parotid gland dissected to expose the facial nerve as it passes between the deep (9) and superficial (10) lobes of the gland.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylomastoid foramen (opened)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid incisure  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle (tendon of insertion stripped from mastoid process)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior (temporofacial) division of facial nerve (VII)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior facial vein  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior (cervicofacial) division of facial nerve (VII)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid gland (deep lobe)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid gland (superficial lobe)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylohyoid ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylohyoid muscle (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Hypoglossal nerve (XII) (cut across) Lower pointer: External maxillary artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia (external layer)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular gland  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t External pterygoid muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process temporal bone  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Salpingopharyngeus muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ascending palatine artery Lower pointer: Stylomandibular ligament  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal constrictor muscle (pointer near origins of muscle from pterygomandibular raphe)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloglossus muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylopharyngeus muscle (cut across)"}
{"_id": "stanford_medicine_head_clean$$$corpus_9", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Musculature of soft palate\n\t\t\t\t\t\t\t\t\t\tThe mucous membrane has been removed from the left half of the soft palate and pharyngeal wall.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending pharyngeal artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cartilaginous auditory tube  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator veli palatini muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending palatine artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor veli palatini muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid hamulus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal constrictor muscle (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid gland  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatopharyngeus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylopharyngeus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylohyoid ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylohyoid muscle (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Digastric muscle (cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater horn hyoid bone  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral thyrohyoid ligament  22\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal septum  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal concha  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Torus tubarius  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Salpingopharyngeal fold  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Velum of palate  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Uvular muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Uvula  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of tongue  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Vallate papilla  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sulcus terminalis Lower pointer: Foramen caecum  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual tonsil  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Oral part pharynx  36\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Epiglottic vallecula Lower pointer: Median glossoepiglottic fold  37\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottis"}
{"_id": "stanford_medicine_head_clean$$$corpus_10", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Glossopharyngeal and vagus nerves in jugular foramen; origin of tympanic nerve; posterior wall of pharynx\n\t\t\t\t\t\t\t\t\t\tThe temporal bone has been dissected to expose the tympanic canaliculus (canal of Jacobson) (2) and the facial canal (1). Veins and fibrous tissue have been removed to reveal the glossopharyngeal nerve (4) in the anterior part of the jugular foramen. The apex of the petrous part of the temporal bone, the left half of the occipital bone and part of the body of the sphenoid bone have been ground away. This was done without disturbing the soft tissues of the carotid canal (14), petrooccipital fissure (15) or the thick fibrous tissue which underlies the base of the skull (17). The longus capitis and rectus capitis anterior muscles have been partially resected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Facial nerve (VII) within facial canal Lower pointer: Stapedius muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic nerve within tympanic canaliculus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricular branch vagus nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Styloid process temporal bone (covered by periosteum) Lower pointer: Internal jugular vein (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly of digastric muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery left  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery left (cut across in cavernous sinus)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus (opened)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteal lining of carotid canal  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Veins and connective tissue of petro-occipital fissure (bone removed)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Basal part occipital bone (sectioned in midline)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum (reinforced by anterior atlanto-occipital membrane and pharyngobasilar fascia)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular ganglion of vagus nerve (X)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (Xl)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior rectus capitis muscle (cut across)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle (cut across)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens (axis)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal[ constrictor muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Nodose ganglion of vagus nerve (X)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle pharyngeal constrictor muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_11", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Joint cavity between transverse ligament and dens\n\t\t\t\t\t\t\t\t\t\tThe left half of the transverse ligament (21) has been divided and the cruciate ligament (15) has been reflected to the right.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Clivus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Hypoglossal canal (opened) Lower pointer: Hypoglossal nerve (Xll)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlanto-occipital joint cavity  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of cervical nerve I  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlantoaxial joint cavity  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion cervical nerve II  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots of hypoglossal nerve (XII)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tectorial membrane (cut edge)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cruciate ligament atlas (divided, lower part retracted)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous tissue and blood vessels in anterior part of foramen magnum (ligamentum apicis dentis not well defined)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar ligament (divided on left)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens axis (joint cavity between dens and transverse ligament opened)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Tectorial membrane (cut across)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse ligament atlas (divided)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlantoaxial joint capsule (opened)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of axis"}
{"_id": "stanford_medicine_head_clean$$$corpus_12", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Relations of internal jugular vein, hypoglossal, accessory and vagus nerves to atlantooccipital joint; atlantoepistrophic joint\n\t\t\t\t\t\t\t\t\t\tThe contents of the jugular foramen (1,3,4) and hypoglossal canal (2) have been partially exposed without disturbing their relations. The capsule of the atlantoepistrophic joint (22) has been partially resected. The opposing articular surfaces of this joint are incongruous as compared to those of the atlantooccipital joint (6). A dense plexus of blood vessels (16) occupies the area between the dens and the margin of the foramen magnum. The apical ligament of the dens was not well defined.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII) (within hypoglossal canal the nerve is obscured by fibrous tissue and veins)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital condyle (cut across)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlanto-occipital articulation (opened)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular facet atlas (articular cartilage removed)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process atlas  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior branch of cervical nerve I Lower pointer: Groove in atlas for vertebral artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal ganglion cervical nerve II  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of cervical nerve II  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch cervical nerve II  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cruciate ligament atlas (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Plexus of veins (ligamentum apicis dentis absent)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens axis (covered by ligaments)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar ligament (cut across)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse ligament atlas (part of cruciate ligament)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Tectorial membrane (cut across)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlanto-occipital joint cavity  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlantoepistrophical joint capsule  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of axis (cut across)"}
{"_id": "stanford_medicine_head_clean$$$corpus_13", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Cruciate ligament; alar ligaments\n\t\t\t\t\t\t\t\t\t\tThe posterior longitudinal ligament and tectorial membrane have been resected. The posterior vertebral venous plexus has been removed from the left side of the dissection. The jugular foramen (4) and the hypoglossal canal (5) have been cut open.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior semicircular canal  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior petrosal sinus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Glossopharyngeal nerve (IX) Lower pointer: Vagus nerve (X)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior jugular venous bulb (jugular foramen opened, vein emptied of latex, and its anterior wall dissected to show artery to jugular ganglion of vagus nerve)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots of hypoglossal nerve (XII) (hypoglossal canal opened to reveal veins and fibrous tissue enclosing nerve)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital bone (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia (exposed by removal of rectus capitis lateralis muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlantooccipital cavity of articulation  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior branch of cervical nerve I Lower pointer: Groove in atlas for vertebral artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique capitis muscle (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal ganglion cervical nerve II  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous slip of longissimus cervicis muscle (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of axis (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch cervical nerve III  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VIII)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Clivus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater encephali (cut edge)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior longitudinal ligament Lower pointer: Cruciate ligament atias  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar ligament (cut across on left)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of dens (axis)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of tectorial membrane  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse ligament atlas (part of cruciate ligament)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater"}
{"_id": "stanford_medicine_head_clean$$$corpus_14", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Tectorial membrane; atlantooccipital joint\n\t\t\t\t\t\t\t\t\t\tMore of the occipital bone has been removed and the suboccipital muscles have been almost completely cut away on the left side. The capsule of the left atlantooccipital joint has been opened. Synovial folds extend into the joint cavity (4). The dura mater (15) has been reflected laterally. The part of the posterior longitudinal ligament (18) to the right of the midline has been preserved. On the left side this ligament has been cut away to expose the tectorial membrane (20).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Posterior semicircular canal (opened) Right pointer: Vestibulocochlear nerve (VIII)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Transverse sinus (sigmoid portion) Right pointer: Internal jugular vein (in jugular foramen)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Condyloid emissary within condyloid canal  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlanto-occipital articulation  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlanto-occipital joint capsule  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique capitis muscle (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior vertebral venous plexus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch cervical nerve II  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of axis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch cervical nerve III  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosal part of temporal bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater (reflected)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament (left half resected, cut end visible at upper pointer)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots of hypoglossal nerve (XII)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Tectorial membrane  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots of cervical nerve II  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal branch vertebral artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal vertebral sinus"}
{"_id": "stanford_medicine_head_clean$$$corpus_15", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Posterior longitudinal ligament\n\t\t\t\t\t\t\t\t\t\tThe posterior part of the occipital bone has been cut away to open the foramen magnum and the arches of the cervical vertebrae have been resected. The brain and spinal cord have been removed. The dura mater has been retained in the right half of the posterior cranial fossa and vertebral canal. Details of the relations of meninges and central nervous system in this area are to be found in Section I, reel 32-4 ff.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vestibulocochlear nerve (VIII) Lower pointer: Inferior petrosal sinus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus. nerve (X)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI) (spinal root)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse sinus (sigmoid portion)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior vertebral venous plexus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique capitis muscle (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch occipital artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique capitis muscle (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of axis (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater (over clivus)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots of hypoglossal nerve (XII)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior longitudinal ligament Lower pointer: Position of dens (axis)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of foramen magnum (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery and ventral roots of cervical nerve I  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch cervical nerve I  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas (cut across)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior vertebral venous plexus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal vertebral sinus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Roots cervical nerve II Lower pointer: Roots cervical nerve III  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of cervical vertebra III (cut across)"}
{"_id": "stanford_medicine_head_clean$$$corpus_16", "text": "Exploration of the brain from its superior aspect\n\t\t\t\t\t\t\t\t\t\t Superior longitudinal fasciculus\n\t\t\t\t\t\t\t\t\t\tParts of the left hemisphere adjacent to the central sulcus are further resected nearly to the lateral fissure. The arched course of the superior longitudinal fasciculus (9) can be seen lateral to the corona radiata (7). Posteriorly, as this fasciculus curves sharply downward into the temporal lobe, another wide band of fibers emerges (11) from under its cover and courses toward the occipital lobe. This latter consists in part of the visual radiation (geniculocalcarine tract) and in part of fibers of the inferior occipitofrontal fasciculus. These systems of fibers join the occipital radiations of the internal capsule and corpus callosum.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Cortical branch of anterior cerebral artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of superior frontal gyrus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal branch of middle cerebral artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulate gyrus (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulum (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of precentral sulcus within precentral sulcus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Corona radiata (area of junction of radiations of corpus callosum and internal capsule)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of central sulcus in lower part of central sulcus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior longitudinal fasciculus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral and medial longitudinal striae  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Parts of geniculocalcarine tract (optic radiations), inferior occipitofrontal fasciculus, occipital part internal capsule and occipital part of radiations of corpus callosum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of posterior cerebral artery lying within parieto-occipital fissure  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of posterior cerebral artery lying within calcarine fissure  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Cortical veins ramifying in transverse occipital sulcus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal pole  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fissure (at this point a large cerebral vein is displaced downward in the specimen)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial frontal gyrus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Precentral gyrus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Central sulcus (Rolandic)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum (splenium)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Parieto-occipital fissure right"}
{"_id": "stanford_medicine_head_clean$$$corpus_17", "text": "Exploration of the brain from its superior aspect\n\t\t\t\t\t\t\t\t\t\t Corpus callosum and corona radiata\n\t\t\t\t\t\t\t\t\t\tThe area of the dissection has been generally widened. The cingulum (3) has been divided and its central portion taken away. Between the cut ends of the cingulum the upper surface of the corpus callosum is exposed and the continuity of its fibers into the corona radiata (6) clearly seen. The medial and lateral longitudinal striae, portions of the olfactory system, are visible as small longitudinal bands lying on the corpus callosum. In the occipital region the cuneus, which lies above the calcarine fissure, has been partly removed so that the calcarine fissure and branches of the posterior cerebral artery are exposed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal branch of middle cerebral artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulate gyrus (cut across)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulum (central portion removed from field)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Great anastomotic vein overlying central sulcus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Central sulcus in depths of dissected area  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Radiations corpus callosum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral longitudinal stria  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial longitudinal stria  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulate gyrus (cut across approximately at the region where it becomes continuous with the Limbic lobe, which leads in turn to the hippocampal gyrus)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of posterior cerebral artery in calcarine fissure  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance extending into cuneus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior frontal sulcus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Central sulcus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Postcentral gyrus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Interparietal sulcus"}
{"_id": "stanford_medicine_head_clean$$$corpus_18", "text": "Exploration of the brain from its superior aspect\n\t\t\t\t\t\t\t\t\t\t Cingulum\n\t\t\t\t\t\t\t\t\t\tThe cortex of the gyrus cinguli has now been scraped away to display the medullary substance which includes the cingulum, a large bundle of association fibers running longitudinally. The upper surface of the corpus callosum is partly exposed, its vessels and meninges remaining intact. Portions of the corona radiata are visible as cut ends of fibers projecting upward.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of superior frontal gyrus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Surface of cingulate gyrus facing cingulate sulcus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebral vein overlying central sulcus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Central sulcus in depths of dissection  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of corona radiata  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior parietal branch of middle cerebral artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Parieto-occipital branch of posterior cerebral artery (enclosed within the meninges of the parieto-occipital fissure)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebral vein within longitudinal fissure  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior frontal sulcus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulate gyrus (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Precentral gyrus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Central sulcus (Rolandic)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Postcentral gyrus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior parietal lobule  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Interparietal sulcus"}
{"_id": "stanford_medicine_head_clean$$$corpus_19", "text": "Exploration of the brain from its superior aspect\n\t\t\t\t\t\t\t\t\t\t Gyrus cinguli; medullary substance of superior frontal gyrus\n\t\t\t\t\t\t\t\t\t\tMedial portions of the left hemisphere have been removed to reveal systems of fibers in the medullary substance. In addition to short association fibers (arcuate fibers) the broken ends of longer association fibers and projection fibers are seen extending upward into the field of dissection. The sulcus cinguli (6), which contains a branch of the anterior cerebral artery, has been exposed to its depth by the removal of part of the left superior frontal gyrus, the medial portions of the precentral and postcentral gyri and the paracentral lobule (of the medial aspect of the hemisphere). The upper surface of the gyrus cinguli is thus exposed. Further posteriorly resection of the superior parietal lobule and precuneus has exposed the depths of the left parieto-occipital fissure and its contained branches of the posterior cerebral artery. The dissected area extends laterally to the interparietal sulcus and superior frontal sulcus. Comparison should be made with the intact right hemisphere.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch anterior cerebral artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch middle cerebral artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Projection fibers extending into superior frontal gyrus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior frontal sulcus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper surface of cingulate gyrus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep margin of cingulate sulcus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Great anastomotic vein of Trolard continuing into one of the superior cerebral veins which follows the central sulcus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Postcentral gyrus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Central sulcus (in depths of dissection on left side)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Broken fibers forming part of corona radiata  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Interparietal sulcus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Surface of cingulate gyrus in depths of subparietal sulcus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Surface of cuneus in depths of parieto-occipital fissure  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch posterior cerebral artery (in depths of parieto-occipital fissure)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch posterior cerebral artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital pole  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal pole  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior frontal gyrus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Callosomarginal branch of anterior cerebral artery (in depths of cingulate sulcus)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Marginal part of cingulate sulcus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior parietal lobule  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Parieto-occipital fissure  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior occipital gyri"}
{"_id": "stanford_medicine_head_clean$$$corpus_20", "text": "Exploration of the brain from its superior aspect\n\t\t\t\t\t\t\t\t\t\t General surface view\n\t\t\t\t\t\t\t\t\t\tThe meninges and vessels have been removed from the right hemisphere to demonstrate the configuration of cortical gyri and sulci to better advantage. On the left side the arachnoid membrane is intact except near the midline. Many branches of the middle cerebral artery  ramify over the lateral surface of the left hemisphere and those of the posterior cerebral artery are seen posteriorly. Several branches of the anterior cerebral artery are visible medially and anteriorly (2). The larger superior cerebral veins which have been cut off at points of entry into venous lacunae of the dura were filled with blue latex by retrograde injection.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal pole  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch anterior cerebral artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Great anastomotic vein of Trolard (passing downward across lateral aspect of hemisphere)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebral vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch middle cerebral artery (posterior parietal artery)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch posterior cerebral artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fissure (cerebral)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial frontal gyrus (superior part)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior frontal sulcus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior frontal gyrus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Precentral sulcus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Precentral gyrus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Central sulcus (of Rolando)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Postcentral gyrus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Postcentral sulcus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Supramarginal gyrus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cerebral fissure (Sylvian)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Interparietal sulcus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior parietal lobule  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior parietal lobule  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Parieto-occipital fissure (extending downward on medial side of hemisphere)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior occipital gyri  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital pole"}
{"_id": "stanford_medicine_head_clean$$$corpus_21", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Course of anterior cerebral arteries around genu of corpus callosum\n\t\t\t\t\t\t\t\t\t\tThe corpus callosum has been cut away to expose its genu. The cingulum and gyrus cinguli have been dissected so that the course of the anterior cerebral arteries may be followed in the longitudinal fissure.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of anterior cerebral artery within cingulate sulcus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulate gyrus (cut across)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal part corona radiata  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulum (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Genu of corpus callosum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Broken ends of fibers of the superior occipitofrontal fasciculus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal part internal capsule (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Septum pellucidum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fibers within septum pellucidum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial surface frontal lobe  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cerebral artery right  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Straight gyrus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Rostral lamina of corpus callosum (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tract  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina terminalis  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior communicating artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior commissure (cut across)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypothalamus"}
{"_id": "stanford_medicine_head_clean$$$corpus_22", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Corpus callosum\n\t\t\t\t\t\t\t\t\t\tThe radiating fibers of the corpus callosum have been exposed by removal of the ependymal lining of the roof of the lateral ventricle. The junction of callosal fibers with those of the internal capsule (4) to form the corona radiata is seen from below.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of inferior frontal gyrus (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal part of operculum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Radiations of corpus callosum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibers of internal capsule at junction with corona radiata  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior longitudinal fasciculus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Central sulcus (Rolandic)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior temporal gyrus (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior horn lateral ventricle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral fissure  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Fusiform gyrus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Straight gyrus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Rostral lamina of corpus callosum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina terminalis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Septum pellucidum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Interventricular foramen  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypothalamus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Thalamus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Left body of fornix (inferior surface)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle (cut across)"}
{"_id": "stanford_medicine_head_clean$$$corpus_23", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Left splenius capitis and cervicis muscles; origin of levator scapulae muscle\n\t\t\t\t\t\t\t\t\t\tThe left rhomboid muscles have been removed and the serratus posterior superior muscle (5) reflected laterally. The left scapula has been pulled laterally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Fascia covering semispinalis capitis muscle Lower pointer: Greater occipital nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior serratus muscle (reflected laterally)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve supply to posterior superior serratus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of levator scapulae muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius cervicis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid minor muscle (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis cervicis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus capitis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsalis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Nuchal ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Band of lumbodorsal fascia (removed elsewhere)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process thoracic vertebrae II  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Spine of scapula Lower pointer: Deltoid muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_24", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Splenius capitis and levator scapulae muscles\n\t\t\t\t\t\t\t\t\t\tThe left trapezius and sternocleidomastoid muscles have been removed. The rhomboideus major and minor muscles have been divided. The fascia of the splenius capitis muscle has been cut away with the exception of a band (6) which has been retained across the inferior part of the muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of origin of trapezius muscle left  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Nuchal ligament  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of splenius capitis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid minor muscle (cut across near origin)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus fascia  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior serratus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid major muscle (aponeurosis of origin)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of insertion of trapezius muscle into spine of scapula  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid minor muscle (cut across near insertion)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid major muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process cervical vertebra VII  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Spine of scapula"}
{"_id": "stanford_medicine_head_clean$$$corpus_25", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Fascia colli; cervical part of trapezius muscle\n\t\t\t\t\t\t\t\t\t\tThe dissected area to the left of the midline has not been altered from the previous view. On the right side the skin and tela subcutanea have been removed and the fascia cut away from the trapezius and sternocleidomastoid muscles.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipitalis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser occipital nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular lymph nodes  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital lymph nodes  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle (covered by superficial fascia)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial branches of posterior rami of cervical nerve IV  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve right  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (pointer near origin from superior nuchal line)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle (pointer near insertion into superior nuchal line)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Aberrant muscular slip (unidentified)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cervical triangle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (origin from nuchal ligament)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process cervical vertebra VII  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneus branches of posterior branches cervical nerve VII"}
{"_id": "stanford_medicine_head_clean$$$corpus_26", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Prevertebral muscles (continued), left anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe longus capitis muscle has been resected close to its origins (15) from the transverse processes of the third to the sixth cervical vertebrae and also close to its insertion (1) into the occipital bone.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of longus capitis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal cavity (for details refer to reel 78-4)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal part pharynx  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Oral part pharynx  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Larynx  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal carotid artery (within carotid canal) Lower pointer: Jugular foramen (opened)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus capitis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Hypoglossal nerve (XII) Lower pointer: Anterior rectus capitis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior atlanto-occipital membrane Lower pointer: Anterior arch atlas (covered by connective tissue)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process atlas  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Articulation of atlas and axis (pointers on capsule)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of cervical nerve II  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus colli muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cervical ganglion  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Origins of longus capitis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of cervical nerve III  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior intertransverse muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament (partially covered by prevertebral fascia)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cervical ganglion  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process cervical vertebra VII"}
{"_id": "stanford_medicine_head_clean$$$corpus_27", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Cervical sympathetic trunk; vagus nerve; prevertebral muscles, anterior view\n\t\t\t\t\t\t\t\t\t\tThe tongue has been removed and the pharynx and palate have been sectioned near the midline. The prevertebral fascia has been cut away to the left of the midline.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sphenoid ridge Lower pointer: Nasal part pharynx  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Soft palate (cut in midline)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine tonsil  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Uvula  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Oral part pharynx  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniohyoid muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone (cut in midline)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vagus nerve (X) Lower pointer: Common carotid artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal carotid artery (in carotid canal) Lower pointer: Jugular foramen (opened)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus capitis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Nodose ganglion Lower pointer: Hypoglossal nerve (XII)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cervical ganglion  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cardiac branch vagus nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus colli muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottis  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Origins of anterior scalene muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve VI  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scalene muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve VIII  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cervical ganglion  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Costocervical trunk"}
{"_id": "stanford_medicine_head_clean$$$corpus_28", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Larynx; relation to oral cavity, oral and laryngeal parts of pharynx, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe left wall of the pharynx has been resected in such a way that the soft palate and left pharyngopalatine arch (20) are preserved. The left glossopalatine arch (15) has been divided and the ends separated. The lateral (attached) surface of the left palatine tonsil (23) is exposed. The hyoid bone has been resected to the midline and the epiglottic cartilage exposed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior longitudinal muscle of tongue  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Genioglossus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior longitudinal muscle of tongue  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid muscle (cut across at midline raphe)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniohyoid muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual tonsil (surface)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vallecula epiglottica left  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadrangular membrane  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Vocal cord and arytenoid cartilage  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricoid cartilage  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Levator veli palatini muscle (cut off) Lower pointer: Styloid process  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatoglossal arch (divided) containing fibers of glossopalatine muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal constrictor muscle (cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cervical ganglion  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Supratonsillar fossa Right pointer: Pharyngopalatine muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatopharyngeal arch (mucosal surface)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Uvula  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine tonsil right in tonsillar fossa  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine tonsil left  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Oral part pharynx  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Epiglottis Lower pointer: Aryepiglottic fold  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Laryngeal part of pharynx  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle (cut across)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus (opened)"}
{"_id": "stanford_medicine_head_clean$$$corpus_29", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Larynx; relation to tongue, pharynx and hyoid bone, left anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe external part of the thyroarytenoid muscle has been cut away to expose the vocal muscle (8) and the vocal cord (7). The wall of the appendix of the ventricle, which was opened in the previous view, has been removed. The intrinsic and extrinsic muscles of the tongue have been dissected and are considered in detail in reel 70-3.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum of tongue  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible (cut across)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Genioglossus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniohyoid muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Quadrangular membrane Lower pointer: Ventricular fold  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Laryngeal ventricle Lower pointer: Vocal cord  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Thyroid cartilage Lower pointer: Vocalis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Conus elasticus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal constrictor muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Hyoglossus muscle (cut off)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle pharyngeal constrictor muscle (chondropharyngeus)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Greater horn hyoid bone Lower pointer: Triticeal cartilage  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior horn thyroid cartilage  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser horn hyoid bone  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform recess (opened)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Arytenoid cartilage  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cricoarytenoid muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricoid cartilage"}
{"_id": "stanford_medicine_head_clean$$$corpus_30", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Superficial nerves and blood vessels; platysma, anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe skin and subcutaneous connective tissue have been removed except for a narrow vertical band which remains in the midline.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ocular orbicular muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal apex  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial quadratic muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Rima oris  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Triangular muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior labial quadratic muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Transversus menti muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of skin  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricula  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid-masseteric fascia  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory parotid gland  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle (covered by fascia colli)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII) (buccal branch)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous nerve filaments  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Risorius muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricularis magnus nerve (covered by fascia)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t External jugular vein (covered by fascia)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcutaneous veins  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia colli covering posterior cervical triangle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of cutaneous colli nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Platysma  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial supraclavicular nerve  *\n\t\t\t\t\t\t.\n\t\t\t\t\t [Legend above restored translation from Latin]"}
{"_id": "stanford_medicine_head_clean$$$corpus_31", "text": "Dissection of nasal fossae, nasal pharynx, and palate\n\t\t\t\t\t\t\t\t\t\t Nasal septum and left nasal fossa; branches of sphenopalatine ganglion, left superolateral view\n\t\t\t\t\t\t\t\t\t\tThe left orbit has been removed except for the remnant of the medial orbital margin (frontal process of maxilla) which has been preserved for purposes of orientation. The nasolacrimal duct (9) has been opened. The left maxillary sinus has been resected except for its floor (14). The mucosa of the lateral wall of the left nasal fossa (4) and the nasal conchae (13,19) have been partially removed to expose the nasal fossa. Part of the mucosa of the septum and floor of the nasal fossa has been removed. A window has been cut through the hard palate and the anterior palatine nerve and major palatine artery dissected. The left ethmoidal air cells have been removed and the left sphenoid sinus opened.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista galli  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior ethmoidal artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Edge of nasal mucosal membrane (of lateral wall)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Perpendicular lamina of ethmoid bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal mucosal membrane (of septum; epithelium removed to expose underlying venous plexus)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal septal cartilage  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of septum in which cartilage and bone were deficient, probably as a result of surgery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Infraorbital margo Lower pointer: Nasolacrimal duct (opened)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal vestibule  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Incisive canal  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Nasopalatine nerve and posterior septal nasal artery Lower pointer: Cut edge of palatum durum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Communicating nasal meatus Lower pointer: Inferior nasal concha  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary sinus [Highmore]  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cribrosal lamina of ethmoid bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Right optical nerve (II)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ethmoid artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Left sphenoidal sinus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Medial nasal concha Right pointer: Posterior nasal septal artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Rami nasales posteriores superiores [laterales] ganglii sphenopalatini  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve (turned postero-inferiorly to expose sphenopalatine ganglion)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal branch of sphenopalatine ganglion  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Sphenopalatine ganglion Right pointer: Pterygopalatine canal nerve [Vidius]  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenopalatine nerves  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior lateral nasal artery Lower pointer: Sphenopalatine artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior palatine nerve  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine levator veli muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine tensor veli muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Major palatine artery (bony pterygopalatine canal removed)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior alveolar nerves  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior palatine nerve  *\n\t\t\t\t\t\t.\n\t\t\t\t\t [Legend above restored translation from Latin]"}
{"_id": "stanford_medicine_head_clean$$$corpus_32", "text": "Dissection of nasal fossae, nasal pharynx, and palate\n\t\t\t\t\t\t\t\t\t\t Right lateral wall of nasal fossa and nasal pharynx dissected; relations of palatine tonsil\n\t\t\t\t\t\t\t\t\t\tPortions of the conchae have been cut away to expose the openings of the paranasal sinuses and nasolacrimal duct. The pterygopalatine canal (20) has been opened and the cartilage of the auditory tube exposed. The muscles of the palate have been dissected and the palatine tonsil removed. Structures which lie lateral and anterior to the tonsil have been dissected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Ethmoidal cell (opened) Right pointer: Olfactory bulb left  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior nasal concha (partially resected)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal septum (cut edge)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal infundibulum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Hiatus semilunaris  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal bulla  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal concha (partially resected)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal meatus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lacrimal fold Lower pointer: Ostium of nasolacrimal duct  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule nasi and vibrissae (hair)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal concha (partially resected)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Hard palate Lower pointer: Anterior palatine nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Gingiva  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Optic nerve (II) left Lower pointer: Hypophysis  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus left  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus right (pointer on ostium)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Openings of ethmoidal cells (posterior)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior superior nasal branch of sphenopalatine ganglion Lower pointer: Posterior nasal septal artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sphenopalatine foramen Lower pointer: Window cut in bone to expose pterygopalatine canal  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Tunica mucosa pharynx  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal branch of sphenopalatine ganglion  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior lateral nasal artery Lower pointer: Posterior inferior (lateral) nasal branch of sphenopalatine ganglion  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater palatine artery in the pterygopalatine canal  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cartilaginous auditory tube Lower pointer: Mucosa  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine tensor veli muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine levator veli muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Salpingopharyngeal muscle (note palatine branch of ascending palatine artery passing downward near pointer)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior constrictor pharyngis muscle  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Uvula  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Glossopalatine muscle Lower pointer: Site of palatine tonsilla (resected)  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pterygoid muscle  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloglossus muscle (cut across)  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Submaxillary gland  36\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal muscle (IX)  37\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossus nerve (XII)  38\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Lingual nerve Right pointer: Submaxillary ganglion  *\n\t\t\t\t\t\t.\n\t\t\t\t\t [Legend above restored translation from Latin]"}
{"_id": "stanford_medicine_head_clean$$$corpus_33", "text": "Dissection of nasal fossae, nasal pharynx, and palate\n\t\t\t\t\t\t\t\t\t\t Right lateral wall of nasal fossa, nasal pharynx and mouth\n\t\t\t\t\t\t\t\t\t\tThe nasal septum has been removed and the right sphenoid sinus (15) opened. The view is from the left.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior ethmoidal foramen  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory bulb  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sphenoethmoidal recess Lower pointer: Olfactory sulcus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal ridge  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Atrium middle nasal meatus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior nasal concha and superior nasal meatus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal concha and middle nasal meatus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Rim of vestibule  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule nasi and vibrissae (hair)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal concha and inferior nasal meatus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasopalatine nerve (cut off)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ostium of parotid duct  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Submandibular duct Left pointer: Sublingual gland  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypophysis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Aperture of sphenoid sinus right  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Supreme nasal concha and supreme nasal meatus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sphenoid sinus left Lower pointer: Vidian nerve (of pterygoid canal)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasopharyngeal meatus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosa pharynx and pharyngeal tonsil (sectioned)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pharyngeal recess Lower pointer: Torus tubarius  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Bony pharyngeal auditory tube  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior lip bony pharyngeal auditory tube Lower pointer: Levator cushion (prominence overlying levator veli palatini muscle)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior lip bony pharyngeal auditory tube Lower pointer: Salpingopharyngeal fold  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal part pharynx  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine velum (fibers of levator veli palatini muscle visible on cut edge)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of posterior palatine nerve  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Anterior palatine nerve Right pointer: Hard palate  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Uvula  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatopharyngeal arch  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual nerve  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)"}
{"_id": "stanford_medicine_head_clean$$$corpus_34", "text": "Dissection of nasal fossae, nasal pharynx, and palate\n\t\t\t\t\t\t\t\t\t\t Relation of nasal septum to sphenoid sinus and hypophysis; right palatine nerves; palatine arches, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe cartilage and bones of the nasal septum have been cut away so that the mucous membrane which covered the right side of the septum is exposed. The sphenoid sinus has been widely opened and a window cut in its bony roof to expose the hypophysis. The left internal carotid artery has been retracted posteriorly.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Medial wall of orbit Lower pointer: Anterior ethmoidal foramen  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Bony roof of ethmoidal cell  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory bulb (visible through window in ethmoidal air cell)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory nerve (I) (enclosed in fibrous sheaths; upper pointer indicates filaments which pass to left lateral wall, lower pointer those which pass to right side of septum)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of septal cartilage  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosal membrane septi (attached surface)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasopalatine nerve left (cut away centrally)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Terminal branches of nasopalatine nerve and sphenopalatine artery (posterior septal artery) entering incisive canal  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Incisive canal  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior palatine nerve emerging from greater palatine foramen  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ostium of parotid duct  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II) (cut off in optic canal)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery (retracted posteriorly)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypophysis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rostrum of sphenoid  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior nasal septal arteries right  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasopalatine nerve right  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal tonsil  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal septum  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Torus tubarius Lower pointer: Pharyngeal recess  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior palatine nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle palatine nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Soft palate (pointer on fibers of uvular muscle)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngopalatine muscle (in palatopharyngeal arch)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Palatine tonsil Lower pointer: Glossopalatine muscle (in palatoglossal arch)"}
{"_id": "stanford_medicine_head_clean$$$corpus_35", "text": "Dissection of nasal fossae, nasal pharynx, and palate\n\t\t\t\t\t\t\t\t\t\t Blood vessels and nerves of nasal septum, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe lateral wall of the nasal fossa has been resected and the palate cut to the left of the midline. The septal mucous membrane has been dissected to reveal the olfactory nerves (1) and branches of the sphenopalatine and ethmoidal nerves and blood vessels. The tongue has been pulled to the left and inferiorly. The relation of the lingual nerve to the submaxillary duct (9) is shown.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior ethmoidal nerve and artery entering anterior ethmoidal foramen from orbit Lower pointer: Olfactory nerve (I) in respiratory region  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior ethmoidal nerve (companion artery uninjected)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal cartilage  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior septal arteries  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Hard palate  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Papilla and ostium of parotid duct  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Oral mucosa  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual gland  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular duct  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tongue (retracted inferiorly and to the left)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II) (cut off in optic canal)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenopalatine artery (cut off at sphenopalatine foramen)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of sphenopalatine foramen  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Torus tubarius  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasopalatine nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal part pharynx  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Uvula (palatine)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cervical ganglion  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine tonsil  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottis"}
{"_id": "stanford_medicine_head_clean$$$corpus_36", "text": "Dissection of nasal fossae, nasal pharynx, and palate\n\t\t\t\t\t\t\t\t\t\t Blood vessels and nerves of lateral wall of left nasal fossa, lateral view\n\t\t\t\t\t\t\t\t\t\tThe inferior nasal meatus has been opened and the mucosa removed from the lateral surface of the inferior concha. The oral part of the pharynx has been cut open but the nasal part remains unopened medial to the pharyngopalatine muscle (20).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial wall of orbit  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal concha (mucosal surface at anterior tip)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary sinus (unusually small)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal concha (mucosa removed to reveal artery)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosal membrane nasal septum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior nasal spine maxilla  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar process of maxilla  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Genioglossus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior nasal septal artery (passing medially through sphenopalatine foramen) Lower pointer: Sphenopalatine artery (cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pterygoid canal (Vidian) Lower pointer: Pharyngeal branch of sphenopalatine artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Outer surface of mucosa of middle nasal meatus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Cartilaginous part auditory tube  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior inferior nasal branches of sphenopalatine ganglion  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior lateral nasal artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Bony pharyngeal auditory tube  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator veli palatini muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior palatine nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Tendon of tensor veli palatini muscle (cut off) Lower pointer: Pterygoid hamulus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngopalatine muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopalatine muscle (cut through)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine tonsil  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottis  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Laryngeal part of pharynx"}
{"_id": "stanford_medicine_head_clean$$$corpus_37", "text": "Dissection of nasal fossae, nasal pharynx, and palate\n\t\t\t\t\t\t\t\t\t\t Relations of nasal passages, maxillary sinus, palate and sphenopalatine ganglion, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe zygomatic bone has been completely removed and the lateral bony walls of the maxillary sinus (20) and inferior nasal meatus (21) have been cut away. The sinus is unusually small. The connections of the sphenopalatine ganglion (17) have been dissected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of lateral rectus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital nerve and artery within infraorbital canal (note branch of artery to inferior oblique muscle)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal concha  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosa of nasal septum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital margin  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal concha (anterior tip resected)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Hard palate  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior nasal spine maxillae  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscles of upper lip (sectioned in midline)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar process of maxilla (edentulous)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator palpebrae superioris muscle and superior rectus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of optic nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic nerve (V)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectus muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sphenoid sinus (cut open) Lower pointer: Vidian nerve of pterygoid canal (bony canal opened)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenopalatine ganglion  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Terminal portion of internal maxillary artery (cut off)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior posterior alveolar nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosal membrane maxillary sinus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior posterior alveolar artery and mucosal membrane inferior nasal meatus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of anterior palatine nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater palatine artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of lateral plate of pterygoid process  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Tunica palatine mucosa  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Tongue"}
{"_id": "stanford_medicine_head_clean$$$corpus_38", "text": "Dissection of nose\n\t\t\t\t\t\t\t\t\t\t Cartilage of nasal septum\n\t\t\t\t\t\t\t\t\t\tThe mucous membrane which lines the lateral wall of the nasal fossa has been exposed by removal of the nasal bone and much of the frontal process of the maxilla. The original margin of these bones are still evident at 6. The nasal bone overlapped the lateral nasal cartilage (3) to a considerable extent. The bony nasolacrimal canal (21) has been opened.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut margin of bony nasal wall  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of lateral nasal cartilage beneath nasal bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t External nasal branches of anterior ethmoidal nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal mucosal membrane (periosteal surface)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Line of bony nasal margin prior to dissection  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal branches of anterior ethmoidal nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal cartilage  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosal membrane of nasal septum (dissected)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal concha (area of articulation with lateral bony wall)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater alar cartilage (lateral crus cut off)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial crus of greater alar cartilage  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior nasal spine maxilla  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of nasal septum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Depressor septi nasi muscle (cut off)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial branches of infraorbital nerve and orbicularis oris muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior tarsus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Eyeball  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligament of eye  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum lining nasolacrimal canal  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticomaxillary suture  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital foramen  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic bone (cut across)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior alveolar artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal incisure (maxilla)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal nasal branch of infraorbital nerve  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_39", "text": "Dissection of nose\n\t\t\t\t\t\t\t\t\t\t Vestibule\n\t\t\t\t\t\t\t\t\t\tThe lateral wall of the nose has been cut away.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External nasal branch of anterior ethmoidal nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral nasal cartilage (cut away)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal septum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater alar cartilage (lateral crus cut away)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal mucosal membrane  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex nasi  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Hair  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule (of nose)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of skin of mobile nasal septum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of nasal septum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Depressor septi nasi muscle (lateral fibers form alar part nasalis muscle, not a separate muscle in this case)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial branches infraorbital nerve (cut ofl)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Labial gland  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oris muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal process of maxilla  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital margin  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticomaxillary suture  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital head of levator labii superioris muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of infraorbital nerve emerging from infraorbital foramen  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse part of nasalis muscle (cut off)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine fossa  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of angular head of levator labii superioris muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal nasal branch infraorbital nerve (cut off)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Depressor anguli oris muscle (cut off)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_40", "text": "Dissection of nose\n\t\t\t\t\t\t\t\t\t\t Nasal exoskeleton, anterolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasomaxillary suture  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse part of nasalis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t External nasal branch of anterior ethmoidal nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral nasal cartilage  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal cartilage (covered by membrane)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep vein  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser alar cartilage and membranous portion of nasal wall  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral crus of greater alar cartilage  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of nose  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala nasi  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Naris  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnants of levator labii superioris muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of nasal septum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial palpebral ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal process of maxilla  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of periosteum  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital septum  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior palpebral branches of infraorbital nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital head of levator labii superioris muscle (cut off)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t External nasal branch of infraorbital nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal nasal branch of infraorbital nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal branch of facial nerve (joining infraorbital plexus)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial branches infraorbital nerve"}
{"_id": "stanford_medicine_head_clean$$$corpus_41", "text": "Dissection of nose\n\t\t\t\t\t\t\t\t\t\t External nasal nerve; arteries of nose, left anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe transverse part of the nasal muscle has been removed. Two branches (6,8) of the external nasal nerve are visible. These emerge through the membrane which covers the junction of the nasal bone and lateral nasal cartilage. A filament of the external nasal branch (10) of the infraorbital nerve crosses the external nasal nerves superficially. No communication was found between the nerves.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch infratrochlear nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Procerus muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal nasal artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum of nasal bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular head of levator labii superioris muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t External nasal branch of anterior ethmoidal nerve (medial branch)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse part of nasalis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t External nasal branch of anterior ethmoidal nerve (lateral branch)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Perichondrium of lateral nasal cartilage  10\n\t\t\t\t\t\t.\n\t\t\t\t\t External nasal branch of infraorbital nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of nose  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Naris  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala nasi  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratrochlear nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle palpebral artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oculi muscle (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial palpebral ligament  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Palpebral part of orbicularis oculi muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Angularis artery and vein  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital part orbicularis oculi muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal branch of angular artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar branch of angular artery  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital head of levator labii superioris muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_42", "text": "Dissection of nose\n\t\t\t\t\t\t\t\t\t\t Superficial nerves and blood vessels; transverse nasal muscle, left anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe skin and subcutaneous connective tissue have been removed. The external nasal nerve is obscured by the transverse nasal muscle and a fascial plane which extends from this muscle toward the apex of the nose.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of supratrochlear nerve left  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch supratrochlear nerve right  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Procerus muscle and base of nose  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular head of levator labii superioris muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse part of nasalis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t External nasal branch infraorbital nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal insertion of angular head of levator labii superioris muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital part orbicularis oculi muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Palpebral part of orbicularis oculi muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of supratrochlear nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of infratrochlear nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Skin of margin of eyelid  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal branch of angular artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of infraorbital nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital head of levator labii superioris muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_43", "text": "Oral cavity\n\t\t\t\t\t\t\t\t\t\t Roof of oral cavity, inferior view\n\t\t\t\t\t\t\t\t\t\tThe palatine arches (13,14) have been cut across and the tongue, mandible and associated structures have been removed. The left upper lip and buccal wall have been cut away. The teeth are numbered in the drawing in the conventional fashion. The third molar teeth were not present.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial incisor  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral incisor  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar I  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar II  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar II  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lip  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of mouth  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle (at labial commissure)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Hard palate  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Gingiva  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Glossopalatine muscle (cut off) Lower pointer: Palatoglossal arch  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Palatopharyngeal arch Lower pointer: Palatopharyngeal muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Incisive papilla  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse palatine fold  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine raphe  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine fovea  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Soft palate  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Uvula  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine tonsil (atrophic)"}
{"_id": "stanford_medicine_head_clean$$$corpus_44", "text": "Oral cavity\n\t\t\t\t\t\t\t\t\t\t Faucial isthmus and soft palate, anterior view\n\t\t\t\t\t\t\t\t\t\tThe subject is a young, adult male.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Velum palatinum (soft palate)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Papilla and ostium of parotid duct  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Tonsillar sinus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Oral part pharynx  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Uvula  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum of tongue  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Median sulcus of tongue  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fungiform papilla  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of tongue  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial incisor (superior)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatopharyngeal arch (lateral boundary of faucial isthmus)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Palatoglossal arch (lateral boundary of faucial isthmus) Lower pointer: Palatine tonsil  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vallate papilla  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral margin of tongue"}
{"_id": "stanford_medicine_head_clean$$$corpus_45", "text": "Oral cavity\n\t\t\t\t\t\t\t\t\t\t Inferior surface of tongue and floor of mouth\n\t\t\t\t\t\t\t\t\t\tThe subject is young, adult male. The mouth has been opened widely and the tongue elevated. The entire inferior dental arch is visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of tongue (above pointer)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral margin of tongue  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior surface of tongue  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Frenulum of tongue  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fimbriated fold (of tongue)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual vein (visible beneath mucosa)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower lip  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual caruncle (openings of submandibular duct)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual fold  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Gingiva  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Openings of minor sublingual duct"}
{"_id": "stanford_medicine_head_clean$$$corpus_46", "text": "Dissection of oral region\n\t\t\t\t\t\t\t\t\t\t Intrinsic muscles of tongue; deep lingual artery, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe tongue has been dissected and elevated.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal mucosal membrane and hard palate  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum of tongue  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse palatine fold  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Gingiva  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of tongue  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of lingual nerve (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Genioglossus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental spine (genial tubercle)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniohyoid muscle right  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid muscle (cut across at raphe)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater palatine artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator veli palatini muscle (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of tensor veli palatini muscle (cut off)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tunica of lingual mucosa  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal constrictor muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior longitudinal muscle of tongue  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Hyoglossus muscle (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior longitudinal muscle of tongue  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep lingual artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle pharyngeal constrictor muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of hypoglossal nerve (cut off)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser horn hyoid bone  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater horn hyoid bone"}
{"_id": "stanford_medicine_head_clean$$$corpus_47", "text": "Dissection of oral region\n\t\t\t\t\t\t\t\t\t\t Genoglossus muscle; lingual artery; glossopharyngeal nerve, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe lingual and hypoglossal nerves have been partially removed and the hyoglossus muscle cut through to expose the lingual artery (22) and its major branches. Periosteum has been stripped from the hyoid bone and the left lamina of the thyroid cartilage has been resected. The styloglossus muscle has been divided to expose the stylopharyngeus muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal mucosal membrane (periosteal surface)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial incisor  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fimbriated fold (of tongue)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut ends of lingual nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Genioglossus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Hyoglossus muscle (partially resected) and deep lingual artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual artery (cut off)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of hypoglossal nerve (cut off)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniohyoid muscle (fibers separated)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of epiglottal cartilage (beneath membrane)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina right thyroid cartilage  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine nerves anterior and medial  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator veli palatini muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor veli palatini muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymphatic vessel draining soft palate  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal constrictor muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending palatine artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylopharyngeus muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloglossus muscle (cut across, fibers separated to expose branch of hypoglossal nerve entering inferior part of muscle)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII) (cut off)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lingual artery Lower pointer: Hyoid branch of lingual artery (cut off)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid artery (pointer opposite origin of superior laryngeal artery)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointers: Branches of dorsal tongue lingual artery Lower pointer: Lesser horn hyoid bone  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater horn hyoid bone  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior laryngeal artery Lower pointer: Superior laryngeal nerve  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform recess (outer surface of mucosa)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial laryngeal gland"}
{"_id": "stanford_medicine_head_clean$$$corpus_48", "text": "Dissection of oral region\n\t\t\t\t\t\t\t\t\t\t Nerve supply to geniohyoid and hyoglossus muscles, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe lingual and hypoglossal nerves have been elevated.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosa of hard palate  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse palatine fold  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Tongue  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial incisor  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Genioglossus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniohyoid muscle (fascicles separated to expose nerves)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Hyoid bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior palatine nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccopharyngeal fascia  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloglossus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending palatine artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior facial vein Lower pointer: External maxillary artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: External carotid artery Lower pointer: Lingual artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Hyoglossus muscle Lower pointer: Muscular branches of hypoglossal nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior laryngeal nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior thyroid artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cut end of stylohyoid muscle Lower pointer: Piriform recess (outer surface of mucosa)"}
{"_id": "stanford_medicine_head_clean$$$corpus_49", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Lamina terminalis\n\t\t\t\t\t\t\t\t\t\tThe rostral lamina (8) of the corpus callosum has been cut back to the midline and medial parts of the hemisphere removed to expose the lamina terminalis (9). The lamina terminalis is easily separated from the callosal fibers and it can be seen to extend anteriorly within the septum pellucidum. The longitudinal fibers seen in the previous stage can also be followed forward. The column of the fornix is removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal part internal capsule  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior occipitofrontal fasciculus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fiber bundles within septum pellucidum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcallosal gyrus (pedunculus corporis callosi)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Interventricular foramen (of Monro)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum (ventricular surface)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Rostral lamina of corpus callosum (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina terminalis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cerebral artery right  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior communicating artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior commissure (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuber cinereum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Thalamus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of Fornix (column)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary body  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)"}
{"_id": "stanford_medicine_head_clean$$$corpus_50", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Longitudinal fibers within septum pellucidum\n\t\t\t\t\t\t\t\t\t\tThe body and crus of the fornix have been removed from the specimen and the column of the fornix (12) turned out from its normal position. A system of fibers is exposed which courses longitudinally above the fornix in the septum pellucidum. By dissecting the septum pellucidum (8) anteriorly these can be traced into the region of the lamina terminalis. Posteriorly the fibers appear to blend with the occipital radiation of the corpus callosum. No connection with the hippocampal structures could be found.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Corona radiata  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Septum pellucidum (ependymal membrane removed)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Dentate fascia  5\n\t\t\t\t\t\t.\n\t\t\t\t\t \"Alveus\"  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tapetum viewed through posterior horn of lateral ventricle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral fissure  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Septum pellucidum (thick portion in paraterminal area dissected free and lifted up)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Radiation of rostral lamina of corpus callosum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior commissure (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix (column) (cut across and turned laterally)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary body  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Thalamus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibers within septum pellucidum (described above)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Stria medullaris thalami  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum (splenium)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Arachnoid (within transverse fissure which is now opened widely)"}
{"_id": "stanford_medicine_head_clean$$$corpus_51", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Cavity of third ventricle; continuity of choroid plexus of third and lateral ventricles\n\t\t\t\t\t\t\t\t\t\tThe cavity of the third ventricle has been exposed from the right side by the resection fo the remaining thalamic structures. No massa intermedia is present in this specimen. The brain is tilted somewhat so that the view is toward the midline from below. The choroid plexus of the third ventricle is pulled away from its attachement along the left thalamus. The left interventricular foramen is visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Septum pellucidum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum (ventricular surface)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior occipitofrontal fasciculus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Corona radiata (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus third ventricle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix (body)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus lateral ventricle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of hippocampal commissure  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroidal branch of posterior cerebral artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix (crus) (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior commissure (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Parolfactory area (dissected)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Interventricular foramen right (exposed by removal of the thalamus)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Interventricular foramen left  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix (column)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypothalamus (medial surface)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary body  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Thalamus (medial surface)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypothalamic sulcus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Stria medullaris thalami  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse cerebral fissure (exposed by separation of choroid plexus of third ventricle from thalamus)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar artery  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery (cut across)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV) (displaced)"}
{"_id": "stanford_medicine_head_clean$$$corpus_52", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Interventricular foramen and column of fornix\n\t\t\t\t\t\t\t\t\t\tThe mammillothalamic tract is cut back and the column of the fornix exposed in its course around the interventricular foramen (3) and down to the mammillary body.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Septum pellucidum (ventricular surface)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum (ventricular surface)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Interventricular foramen  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial nucleus of thalamus (dissected)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix (body)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroidal vessels and meninges along roof of third ventricle (exposed in next view)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum (splenium)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Radiation of rostral lamina of corpus callosum (medial to position of head of caudate nucleus)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior communicating artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Free part of column of fornix  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior commissure (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tectal part of column of fornix  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillothalamic tract (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary body  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Interpeduncular fossa  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Habenular nucleus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Substantia nigra (cut across)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons"}
{"_id": "stanford_medicine_head_clean$$$corpus_53", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Relations of hippocampal structures near splenium of corpus callosum\n\t\t\t\t\t\t\t\t\t\tThe meninges have been removed from the inferior surfaces of the fornix, dentate fascia, hippocampal commissure and splenium of the corpus callosum nearly to the midline. The relations of structures in this transitional area are visualized. In this region the fornix and hippocampal commissure remain inferior to the corpus callosum, whereas the dentate fascia passes around behind the splenium, as the fasciola cinerea, to be continuous on the superior surface of the corpus callosum with the induseum griseum and longitudinal striae.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum (ventricular surface)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior occipitofrontal fasciculus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Corona radiata (dissected)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus lateral ventricle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix (body)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior thick portion of septum pellucidum (area occupied by hippocampal commissure)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix (crus) (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Dentate fascia  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampus (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior horn lateral ventricle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral fissure  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Fusiform gyrus (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillothalamic tract  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial nucleus of thalamus (dissected)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Meninges and choroidal vessels in region of roof of third ventricle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Substantia nigra (cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum (splenium)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery (cut across)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Limbic lobe  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampal gyrus(separated from Limbic lobe by anterior extension of calcarine fissure)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebellum (cut across)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial surface of opposite hemisphere visible through widely opened transverse fissure"}
{"_id": "stanford_medicine_head_clean$$$corpus_54", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Relations of choroid plexus and fornix to transverse fissure\n\t\t\t\t\t\t\t\t\t\tThe stria terminalis, lamina affixa and ependymal surface of the caudate nucleus have been cut away. All of the structures which form the floor of the central part of the lateral ventricle are thus removed. The cerebral peduncle is further cut back.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior nucleus of thalamus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior occipitofrontal fasciculus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal capsule (cut across at junction with corona radiata)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum forming roof of lateral ventricle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus lateral ventricle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix (body) (choroid plexus attaches to head of fornix along lateral margin of fornix)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroidal vein (uninjected)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroidal branch of posterior cerebral artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix (crus)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dentate fascia (hippocampus)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampal gyrus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior commissure  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillothalamic tract  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary body  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial nucleus of thalamus (dissected)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut surface of thalamus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Substantia nigra  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle (cut across)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons"}
{"_id": "stanford_medicine_head_clean$$$corpus_55", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Transverse fissure and lateral ventricle exposed by removal of thalamus\n\t\t\t\t\t\t\t\t\t\tThe thalamus has now been cut away so that only its most medial and anterior portions remain. The lamina affixa (6), which covered the upper lateral part of the thalamus, is partially removed so that in effect the choroidal fissure (8) is opened from below and one looks directly into the medial part of the body of the lateral ventricle which is collapsed. The roof of the ventricle, formed by the corpus callosum, is seen at (7).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal part corona radiata  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ependymal membrane of superior surface of caudate nucleus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior occipitofrontal fasciculus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal capsule (cut across at junction with corona radiata)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior longitudinal fasciculus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina affixa (partially cut away)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum (inferior surface visible through body of lateral ventricle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus lateral ventricle (attached to head of fornix)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus inferior horn of lateral ventricle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fissure (cerebral)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior communicating artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior commissure  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Stria terminalis (note continuity with parolfactory area)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillothalamic tract (Vicq d'Azyr)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary body  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix (body)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Dentate fascia (hippocampus)"}
{"_id": "stanford_medicine_head_clean$$$corpus_56", "text": "Dissection of oral region\n\t\t\t\t\t\t\t\t\t\t Lingual and hypoglossal nerves; submaxillary duct, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe internal pterygoid, mylohyoid and anterior belly of the digastric muscles have been removed. The alveolar process of the maxilla has also been cut away, and nerves and vessels exposed in the palate. The sublingual gland has been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Hard palate  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Greater palatine artery and mucosa of palate Lower pointer: Transverse palatine fold (sectioned)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral lingual margin  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of tongue  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Genioglossus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniohyoid muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Platysma  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Digastric muscle right  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid muscle left (transected at raphe and along attachment to hyoid bone)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Body of hyoid bone Lower pointer: Thyroglossal duct (fibrous remnant)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior palatine nerve within pterygopalatine canal  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor veli palatini muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of buccinator muscle near pterygomandibular raphe  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum of tongue  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal constrictor muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending palatine artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Minor sublingual duct  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloglossus muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery (note plexus of nerves derived from superior cervical ganglion)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular duct  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylohyoid muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lingual artery Lower pointer: Hyoglossus muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior laryngeal nerve and superior laryngeal artery (in this case the artery arises from the external carotid rather than the superior thyroid artery)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior belly digastric muscle (cut off)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior horn thyroid cartilage  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform recess (outer aspect of mucosa)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lamina thyroid cartilage"}
{"_id": "stanford_medicine_head_clean$$$corpus_57", "text": "Dissection of oral region\n\t\t\t\t\t\t\t\t\t\t Relation of sublingual gland to tongue, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe mylohyoid and digastric muscles have been reflected inferiorly to demonstrate the relations of the tongue, sublingual gland, lingual and hypoglossal nerves, and geniohyoid muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial artery (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum linguae  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fimbriated fold (of tongue)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual fold  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual gland  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual lymph nodes and lymphatic vessels  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniohyoid muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Submental artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior belly digastric muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pterygoid muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylohyoid ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular ganglion  17\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery (cut off)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of digastric muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular duct  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_58", "text": "Dissection of oral region\n\t\t\t\t\t\t\t\t\t\t Oral cavity opened; nerves to mylohyoid and digastric muscles, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe left half of the mandible has been removed, and the lower lip and much of the cheek resected. The mylohyoid muscle lies approximately in its normal position. The anterior belly of the digastric muscle has been turned inferiorly and opened to expose its nerve and arterial supply.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Labial glands  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial incisor (sectioned vertically, pointer on pulp cavity)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Plica fimbriata  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oris muscle (sectioned)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual fold  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual gland  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of geniohyoid muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior belly digastric muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct (at entrance to oral cavity)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal mucosa  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual nerve (note close relation to buccal wall and tongue)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tongue  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Submental artery Lower pointer: Mylohyoid nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrohyoid muscle (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage"}
{"_id": "stanford_medicine_head_clean$$$corpus_59", "text": "Dissection of oral region\n\t\t\t\t\t\t\t\t\t\t Lingual nerve; submaxillary ganglion and plexus, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe mylohyoid muscle has been retracted inferiorly and the lingual nerve freed of its connective tissue.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle and gingiva  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual gland  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual nerve (plexiform)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular gland (deep lobule)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of digastric muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid muscle (retracted inferiorly)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior belly digastric muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of lingual nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal pterygoid muscle (pointer on area of insertion on angle of mandible) Lower pointer: Muscular branch of external maxillary artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular ganglion  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular duct  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylohyoid muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Submental artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior laryngeal nerve"}
{"_id": "stanford_medicine_head_clean$$$corpus_60", "text": "Dissection of oral region\n\t\t\t\t\t\t\t\t\t\t Mylohyoid muscle and nerve; internal pterygoid muscle, left anterolateral view\n\t\t\t\t\t\t\t\t\t\tPart of the mandible has been removed. A remnant of the angle (18) and ramus of the mandible has been retracted laterally. The buccinator muscle remains intact. This part of the jaw was edentulous so that the gingival tissue (6) appears intact.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Body maxilla  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pterygoid muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of buccal nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Gingiva  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid muscle (detached from mylohyoid line mandible)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Submental artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Mental nerve (approaching mental foramen) Lower pointer: Mandible (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior belly digastric muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External pterygoid muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior alveolar artery (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior alveolar nerve (cut off)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenomandibular ligament (two distinct bands in this specimen)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid nerve (note relation to lingula of mandible near upper pointer)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly of digastric muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of mandible (retracted laterally)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery (cut off)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular duct  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular lymph node  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Bifurcation of common carotid artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_61", "text": "Dissection of oral region\n\t\t\t\t\t\t\t\t\t\t Nerves and blood vessels to upper teeth, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe soft tissues have been removed from the maxilla, which in turn has been cut away to reveal the roots of the upper teeth. The buccal wall (24) and a portion of the masseter muscle (23) have been retained. The orbital contents have been removed and the mucosa of the maxillary sinus exposed. The superior alveolar nerves and arteries have been dissected. The course of some of the nerve filaments is indicated by interrupted lines in the drawing. These filaments are not clearly visible in the view but their position has been verified in the dissection. A dense network of venules was present in each peridental membrane. This has been preserved only over the root of the second premolar tooth (8).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital margin  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior alveolar branches infraorbital nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior alveolar arteries  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior dental plexus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Naris  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Root of canine  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Septal branch of superior labial artery Lower pointer: Alveolar periosteum (dense plexus of venules injected)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar process of maxilla (bone surface intact in stippled area)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Gingiva  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lip  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital sulcus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygopalatine fossa (internal maxillary artery and pterygoid plexus of veins visible but not drawn)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosa of maxillary sinus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior posterior alveolar nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratemporal surface of maxilla  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal branch of superior posterior alveolar nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior posterior alveolar artery Lower pointer: Buccal branch of above artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum (detached from maxilla)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior dental branches of superior dental plexus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gingival artery and nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseter muscle (partially resected)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle (cut across)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper molar I (below normal position see note with previous view)"}
{"_id": "stanford_medicine_head_clean$$$corpus_62", "text": "Dissection of oral region\n\t\t\t\t\t\t\t\t\t\t Nerves and blood vessels to lower teeth, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe soft tissues have been cut away to expose the left half of the body of the mandible. The bone has been ground away to reveal the dental roots together with their nerves and vessels. Nearly all of the numerous veins which accompanied the inferior alveolar artery in the mandibular canal has been cut away. The late results of dental extraction are of interest in this specimen in which the lower first molar had been removed at some time during life. Complete healing of the alveolar bone and some hollowing of the alveolar margin has occurred. The upper first-molar (7) has descended into the gap created by the extraction, and the lower second molar (10) has become tilted anteriorly. Two nerve filaments and small blood vessels extended into the area of the extraction.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Gingiva  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vascular plexus in alveolar periosteum (injected with blue latex)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut section of lower lip near midline  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior dental branches inferior dental plexus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental nerve and artery emerging from mental foramen (cut open)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper molar I (protruding below normal position see note above)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Masseter muscle (central portion) Lower pointer: Buccinator muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens molaris inferior II (tilted anteriorly as result of extraction of first molar)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior alveolar nerve within mandibular canal  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Gingiva and alveolar part of mandible (at former site of molar I)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior alveolar artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of dissected area of mandible (note thickness of compact bone)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior facial vein (cut off)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery (covered by plexus of small veins; cut end obscured by fat)"}
{"_id": "stanford_medicine_head_clean$$$corpus_63", "text": "Dissection of oral region\n\t\t\t\t\t\t\t\t\t\t Left mandibular canal; inferior alveolar nerve and artery, lateral view\n\t\t\t\t\t\t\t\t\t\tThe muscles of expression have been completely removed from the left half of the face. The lips, mucosa of the oral cavity with its associated glands, and the buccinator muscle (20) have been preserved. The ramus of the mandible, masseter and temporal muscles, and zygomatic arch have been cut away. The contents of the infratemporal and pterygopalatine fossae are visible. The body of the mandible has been partially cut away (22) in order to demonstrate the course of the inferior alveolar vessels and nerve (21). Numerous small veins filled with blue latex surrounded the inferior alveolar artery and nerve and were removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Infraorbital margin Lower pointer: Infraorbital foramen  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal mucosal membrane (lateral wall)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal cartilage  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal nasal branch of infraorbital nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oris muscle (cut ends of fibers)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial branch of infraorbital nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lip  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Labial glands  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis muscle (fibers of origin in temporal fossa)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve (in pterygopalatine fossa)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t External pterygoid muscle (superior fascicle)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Deep anterior temporal artery Lower pointer: Superior posterior alveolar artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t External pterygoid muscle (inferior fascicle)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pterygoid muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sphenomandibular ligament Middle pointer: Inferior alveolar artery (course within mandibular canal obscured by inferior alveolar nerve) Lower pointer: Inferior alveolaris nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior alveolar nerve within mandibular canal  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible (lateral portion cut away to display contents of mandibular canal)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery (cut off)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph node"}
{"_id": "stanford_medicine_head_clean$$$corpus_64", "text": "Left infraorbital, labial and buccal regions\n\t\t\t\t\t\t\t\t\t\t Mental nerve; marginal mandibular branches of facial nerve; labial glands, anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe quadratus labii inferioris, the inferior part of the orbicularis oris and part of the mental muscle have been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Labial gland Lower pointer: Oral mucosa (lamina propria)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Labial commissure  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower lip  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Labial glands  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior labial artery (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Midline section through muscles of mental region  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Mentalis muscle (area of origin from mandible)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior labial branches of mental nerve Lower pointer: Mentalis branch of mental nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Mentum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticus muscle (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior labial artery and buccinator muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Filaments of marginal mandibular branch of facial nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental foramen  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of depressor labii inferioris muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Digastric muscle and hyoid bone"}
{"_id": "stanford_medicine_head_clean$$$corpus_65", "text": "Left infraorbital, labial and buccal regions\n\t\t\t\t\t\t\t\t\t\t Orbicularis oris muscle; labial arteries, anterior view\n\t\t\t\t\t\t\t\t\t\tThe quadratus labii superioris, zygomaticus, risorius and triangularis muscles have been resected. The labial arteries(3,18) have been exposed by removal of portions of the deeper muscle tissue.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibers of depressor septi nasi muscle (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oris muscle (superior portion)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oris muscle (inferior portion)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Mentalis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal nasal branch of infraorbital nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal branch facial nerve (cut off)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Buccal fat pad Lower pointer: Buccinator muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct (cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial branches infraorbital nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of buccinator nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle (inferior part)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Labial commissure  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Labial gland  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior labial artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Marginal mandibular branch facial nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Depressor labii inferioris muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_66", "text": "Left infraorbital, labial and buccal regions\n\t\t\t\t\t\t\t\t\t\t Branches of infraorbital nerve, anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe quadratus labii superioris muscle has been almost completely removed and the periosteum has been scraped from exposed bony surfaces.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t External nasal branch anterior ethmoidal nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasomaxillary suture  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal process of maxilla  4\n\t\t\t\t\t\t.\n\t\t\t\t\t External nasal branch anterior ethmoidal nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral nasal cartilage  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater alar cartilage  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser alar cartilage  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular head of levator labii superioris muscle (cut off)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala nasi  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Naris  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External nasal branches infraorbital nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of nasal septum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Skin of philtrum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Depressor septi nasi muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oris muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial branches Infraorbital nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior palpebra  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oculi muscle (cut off)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital branch of angular artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital septum  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery which was situated in periosteum  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior palpebral branches of infraorbital nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital head of levator labii superioris muscle (cut off)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital artery  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal nasal branch of infraorbital nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomosis of buccal branches of facial nerve (cut off) with infraorbital nerve  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Caninus muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_67", "text": "Left infraorbital, labial and buccal regions\n\t\t\t\t\t\t\t\t\t\t Relation of infraorbital plexus of nerves to quadratus labii superioris muscle, anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe orbicularis oculi muscle has been reflected superiorly. The zygomatic head (16) of the quadratus labii superioris muscle has been cut off and its infraorbital head turned superomedially (5). The zygomatic muscle has been removed. The angular artery has been transected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oculi muscle (reflected superiorly)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular head of levator labii superioris muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior palpebral branches of infraorbital nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of facial nerve to angular head of levator labii superioris muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital head of levator labii superioris muscle (reflected)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial branches Infraorbital nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of angular artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Depressor anguli oris muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oris muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lip  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut fibers of zygomaticus muscle and infraorbital head of levator labii superioris muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital margin  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital branch of angular artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of facial nerve to orbicularis oculi muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticomaxillary suture  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic head of levator labii superioris muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal branches of facial nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseter muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct (cut off)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior facial vein  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular artery (cut off)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_68", "text": "Left infraorbital, labial and buccal regions\n\t\t\t\t\t\t\t\t\t\t Nerves and muscles of upper lip\n\t\t\t\t\t\t\t\t\t\tA portion of the quadratus labii superioris muscle has been reflected superiorly (12).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular head of levator labii superioris muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Naris  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala nasi  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal branch of angular artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Filament of internal nasal branch of infraorbital nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of nasal septum (branch of superior labial artery)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oris muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lip  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial branches infraorbital nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital head of levator labii superioris muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Part of levator labii superioris muscle which inserted into skin of upper lip (reflected superiorly)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Depressor anguli oris muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial artery and labial glands  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of mouth"}
{"_id": "stanford_medicine_head_clean$$$corpus_69", "text": "Left infraorbital, labial and buccal regions\n\t\t\t\t\t\t\t\t\t\t Superficial nerves, blood vessels and muscles, anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe skin and subcutaneous connective tissue have been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Filament of inferior palpebral branch of infraorbital nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular head of levator labii superioris muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar branch of angular artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital part orbicularis oculi muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital head of levator labii superioris muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic head of levator labii superioris muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Communication between facial and infraorbital nerves  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Depressor anguli oris muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous nerve filaments from infraorbital plexus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial branch of infraorbital nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Labial glands  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oris muscle (superior part)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lip  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower lip  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oris muscle (inferior part)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Risorius muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic branches of facial nerve (several cutaneous filaments appear to be branches of the facial nerve although these are presumed to contain sensory fibers which reach the central nervous system through the trigeminal nerve)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory parotid gland  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid-rnasseteric fascia  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseter muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal branch facial nerve (VII)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct (enclosed by sheath of connective tissue and plexus of veins)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticus muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior facial vein (incompletely filled with latex)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Filament of cutaneous colli nerve  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Platysma"}
{"_id": "stanford_medicine_head_clean$$$corpus_70", "text": "Dissection of pharynx from left lateral approach\n\t\t\t\t\t\t\t\t\t\t Interior of auditory tube\n\t\t\t\t\t\t\t\t\t\tThe levator veli palatini muscle has been partially resected and the auditory tube opened.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectus muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve (V)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenopalatine ganglion  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary artery (cut across near termination)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary sinus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosa of inferior nasal meatus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending palatine artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of tensor veli palatini muscle (cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Bursa tensor veli palatini muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum of tongue  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal constrictor muscle (upper pointer, pterygopharyngeus muscle; lower pointer, buccopharyngeus muscle)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal carotid artery Lower pointer: Oculomotor nerve (III)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tegmen tympani  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Chorda tympani  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontorium tympani and tympanic plexus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor tympani muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Bony part auditory tube (dark area on medial wall indicates position of carotid canal) Lower pointer: Isthmus auditory tube  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plate I cartilaginous auditory tube  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Scaphoid fossa sphenoid bone (site of origin of tensor veli palatini muscle)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cartilaginous part auditory tube Lower pointer: Bony pharyngeal auditory tube  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal branch ascending pharyngeal artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Alar fascia Lower pointer: Internal carotid artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pharyngobasilar fascia Lower pointer: Cut end of levator veli palatini muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)"}
{"_id": "stanford_medicine_head_clean$$$corpus_71", "text": "Dissection of pharynx from left lateral approach\n\t\t\t\t\t\t\t\t\t\t Auditory tube; levator veli palatini muscle, lateral view\n\t\t\t\t\t\t\t\t\t\tThe tensor veli palatini muscle (8) has been reflected anteriorly to expose the levator veli palatini muscle (20) as well as the cartilaginous and membranous parts of the auditory tube(5,6). The bursa between the tendon of the tensor veli palatini muscle and the pterygoid hamulus is visible at 9.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve (V) (wall of foramen rotundum cut away)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenopalatine ganglion  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid fossa  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Cartilaginous part auditory tube (lateral plate)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Membranous plate of auditory tube  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending palatine artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor veli palatini muscle (reflected anteriorly)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Bursa tensor veli palatini muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloglossus muscle (cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Major superficial petrosal nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic cavity  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular nerve (V) and foramen ovale  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Otic ganglion  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Chorda tympani  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of tensor veli palatini muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII) (facial canal opened)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar fascia  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator veli palatini muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending palatine artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylopharyngeus muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal constrictor muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery and hypoglossal nerve (XII)"}
{"_id": "stanford_medicine_head_clean$$$corpus_72", "text": "Dissection of left infratemporal and pterygopalatine fossae\n\t\t\t\t\t\t\t\t\t\t Nerve supply to internal pterygoid muscle; mandibular division of trigeminal nerve, lateral view\n\t\t\t\t\t\t\t\t\t\tIn an earlier dissection (65-6) a small branch appeared which passed from the lingual nerve into the internal pterygoid muscle. The major nerve supply (10) to this muscle has now been exposed. Bone has been cut away to show the semilunar ganglion and the mandibular nerve as it passes through the foramen ovale (13).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve (V) passing through foramen rotundum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosa of sphenoid sinus exposed by grinding away sphenoid bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygopalatine fossa (pointer indicates general area of fossa)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior posterior alveolar artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior deep temporal nerve (the anterior deep temporal nerve leaves the buccinator nerve slightly to the left of the pointer but is displaced downward and not clearly visible)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plate of pterygoid process (partially resected)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of origin of external pterygoid muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pterygoid nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pterygoid muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal mucosa (cross section)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Semilunar ganglion (trigeminal) Lower pointer: Mandibular nerve in foramen ovale  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrotympanic fissure  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery (foramen spinosum cut open at upper pointer)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseteric nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor veli palatini muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior alveolar nerve Lower pointer: Lingual nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of sympathetic plexus on external carotid artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly of digastric muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Styloglossus muscle Lower pointer: Stylomandibular ligament  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylohyoid muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_73", "text": "Dissection of left infratemporal and pterygopalatine fossae\n\t\t\t\t\t\t\t\t\t\t Cavity of temporomandibular articulation, inferolateral view\n\t\t\t\t\t\t\t\t\t\tThe inferior cavity of the temporomandibular joint has been fully exposed by removal of mandible. The joint cavity on the inferior surface of the articular disk is indicated by stipple in the drawing (3) but is not clearly visible in the view. It is not coextensive with the superior joint space which overlaps the lower cavity anteriorly but does not descend as far as posterior to the condyle of the mandible. The relation of the masseteric nerve (4) to the joint capsule is shown.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Mandibular fossa (superior articular cavity) Left pointer: Tubercle of articulation  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular disc of mandible  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cavity of temporomandibular joint  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseteric nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater wing of sphenoid (cut through)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior deep temporal nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve (note communications between this nerve and the internal maxillary plexus)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of pterygoid venous plexus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t External pterygoid nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep posterior temporal artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary nerve plexus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior alveolar nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of internal pterygoid muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Cartilaginous acoustic meatus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ceruminous gland  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid cells  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricular branch vagus nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of mandible  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep auricular artery  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylomastoid artery  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse facial artery and superior deep cervical lymph node  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of sternocleidomastoid muscle  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenomandibular ligament  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular artery  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly of digastric muscle  34\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_74", "text": "Dissection of left infratemporal and pterygopalatine fossae\n\t\t\t\t\t\t\t\t\t\t Internal pterygoid muscle, lateral view\n\t\t\t\t\t\t\t\t\t\tThe pterygoid plexus of veins and origins of the external pterygoid muscle have been removed, and the bony wall of the cranial vault resected. Branches of the mandibular nerve have been exposed in their course through the infratemporal fossa. The maxillary nerve (1) is visible as it passes through the foramen rotundum into the pterygopalatine fossa.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Maxillary nerve (V) within cavernous sinus Lower pointer: Maxillary nerve (V) within Pterygopalatine fossa  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid bone (cut across at junction of great wing and body)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Buccal nerve Lower pointer: External pterygoid nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Deep anterior temporal artery Lower pointer: Internal maxillary artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior posterior alveolar nerves Lower pointer: Superior posterior alveolar artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plate of pterygoid process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary nerve plexus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Middle meningeal artery Lower pointer: Anterior tympanic artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pterygoid nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pterygoid muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tongue  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process of temporal bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular disc of mandible  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cartilaginous acoustic meatus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of mandible  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Auriculotemporal nerve Lower pointer: Sphenomandibular ligament (cut off)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII) at exit from stylomastoid foramen  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid cells  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Digastric branch of facial nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid artery  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly of digastric muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior alveolar nerve Lower pointer: Mylohyoid nerve  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle (cut off)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein"}
{"_id": "stanford_medicine_head_clean$$$corpus_75", "text": "Dissection of left infratemporal and pterygopalatine fossae\n\t\t\t\t\t\t\t\t\t\t Internal maxillary artery and plexus of nerves; deep part of pterygoid plexus of veins, lateral view\n\t\t\t\t\t\t\t\t\t\tThe external pterygoid muscle has been removed except for short remnants of its origins (4,13). The mandible has been removed although its articular disk has been retained.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery in middle cranial fossa (also see 12)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior deep temporal nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior deep temporal nerve Lower pointer: Masseteric nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper area of origin of external pterygoid muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep anterior temporal artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Buccal artery Lower pointer: Buccal nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Buccal branch of superior posterior alveolar nerve Lower pointer: Superior posterior alveolar artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid venous plexus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary nerve plexus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower area of origin of external pterygoid muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid branch of internal maxillary artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process of temporal bone  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper cavity of temporomandibular joint (pointer on articular disc)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Joint capsule of mandible Lower pointer: Lower cavity of temporomandibular joint  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Styloid process of temporal bone Lower pointer: Deep auricular artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomotic branch of auriculotemporal nerve with facial nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superficial temporal artery Lower pointer: Transverse facial artery  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly of digastric muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Deep posterior temporal artery Lower pointer: Inferior alveolar artery  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior alveolar nerve  28\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid artery  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid nerve  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of internal pterygoid muscle on medial aspect of angle of mandible"}
{"_id": "stanford_medicine_head_clean$$$corpus_76", "text": "Dissection of left infratemporal and pterygopalatine fossae\n\t\t\t\t\t\t\t\t\t\t Nerve supply to external pterygoid muscle; temporomandibular articulation, anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe superior fascicle of the external pterygoid muscle has been divided at its origin and lifted to expose the nerve supply to both parts of the muscle. The temporomandibular joint has been opened and the head of the mandible pulled inferiorly to expose the articular disk. The bony walls of the orbit and middle cranial fossa have been resected. More of the mandible has been removed. The mylohyoid branch (36) of the inferior alveolar nerve is shown in relation to the lingula (17) of the mandible and the sphenomandibular ligament.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of bony wall of middle cranial fossa  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Periorbita  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater and middle meningeal artery (anterior branch)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t External pterygoid muscle (superior fascicle, retracted)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygopalatine fossa  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseteric nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital artery and maxillary nerve (in background)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior posterior alveolar nerves  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep anterior temporal artery (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of buccinator nerve to temporalis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxilla  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of pterygoid venous plexus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of buccinator nerve to external pterygoid muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t External pterygoid muscle (inferior fascicle)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar glands  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingula of mandible  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pterygoid muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal fossa  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process temporal bone  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cavity of temporomandibular joint  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Ext acoustic meatus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular disc  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cavity of temporomandibular joint and capitulum (condyloid process) of mandible  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process temporal bone (in background)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular artery  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep cervical lymph node (superior)  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck (condyloid process) of mandible (cut across)  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior alveolar artery (cut off)  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior facial vein  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenomandibular ligament (the two bands were separated by veins and areolar connective tissue)  36\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid nerve (inferior alveolar nerve cut away)  37\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly of digastric muscle  38\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of mandible"}
{"_id": "stanford_medicine_head_clean$$$corpus_77", "text": "Dissection of left infratemporal and pterygopalatine fossae\n\t\t\t\t\t\t\t\t\t\t External pterygoid muscle, lateral view\n\t\t\t\t\t\t\t\t\t\tThe pterygoid plexus of veins has been resected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of temporalis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior deep temporal nerve (cut across)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve (V) in depths of pterygopalatine fossa  5\n\t\t\t\t\t\t.\n\t\t\t\t\t External pterygoid muscle (superior fascicle)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep anterior temporal artery (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior posterior alveolar nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior posterior alveolar artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External pterygoid muscle (inferior fascicle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pterygoid muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of temporalis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior deep temporal nerve (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Zygomatic process (cut across) Lower pointer: Joint capsule of mandible  19\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseteric nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep posterior temporal artery (cut off)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomotic branch auriculotemporal nerve with facial nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporofacial division of facial nerve (VII)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery (cut across)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervicofacial division of facial nerve (VII)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid branches of transverse facial artery  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior facial vein (cut across)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenomandibular ligament  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior alveolar artery  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior alveolar nerve  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual nerve  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Compact bone surrounding mandibular canal  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly of digastric muscle  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior deep cervical lymph nodes"}
{"_id": "stanford_medicine_head_clean$$$corpus_78", "text": "Dissection of left infratemporal and pterygopalatine fossae\n\t\t\t\t\t\t\t\t\t\t Blood vessels and nerves related to external pterygoid muscle, lateral view\n\t\t\t\t\t\t\t\t\t\tMost of the temporal muscle has been cut away but short strands in the area of its origin (14) and a remnant of its tendon of insertion (13) remain. In addition, the ramus of the mandible has been partially cut away to reveal the inferior alveolar vessels and nerve as well as the pterygoid plexus of veins.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticotemporal branch zygomatic nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External pterygoid muscle (superior fascicle)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticofacial branch of zygomatic nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Maxillary nerve (V) in depths of pterygopalatine fossa Lower pointer: Infraorbital artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep anterior temporal artery (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior posterior alveolar artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal nerve and buccal artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal branch of superior posterior alveolar artery (uninjected)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal filament from plexus of nerves surrounding alveolar artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine fossa  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar glands  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of temporalis muscle (cut off)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal fossa  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior deep temporal nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior deep temporal nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process temporal bone (cut off)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Auriculotemporal nerve Lower pointer: Temporomandibular ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseteric nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t External pterygoid muscle (inferior fascicle)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse facial artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid venous plexus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenomandibular ligament  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior alveolar artery Lower pointer: Inferior alveolar nerve  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly of digastric muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular canal (cortical bone which forms wall of canal intact in area indicated by pointer)"}
{"_id": "stanford_medicine_head_clean$$$corpus_79", "text": "Dissection of left temporal region\n\t\t\t\t\t\t\t\t\t\t Posterior deep temporal nerve and artery; capsule of temporomandibular joint, lateral view\n\t\t\t\t\t\t\t\t\t\tThe temporal muscle (1) has been reflected anteriorly. Its tendon of insertion (7) remains in situ, although the coronoid process to which it attached has been cut away (20).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior border of temporalis muscle turned anteriorly  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch posterior deep temporal nerve (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior deep temporal nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseteric nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Masseteric artery Lower pointer: Deep posterior temporal artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic arch (divided)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of temporalis muscle (note impression produced by coronoid process of mandible)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal fossa  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle temporal artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Cartilaginous external acoustic meatus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic arch (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery (cut off)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Joint capsule of mandible Lower pointer: Temporomandibular ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of auriculotemporal nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid gland (deep lobe)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse facial artery (cut off)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior facial vein  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ramus of mandible Lower pointer: Coronoid process (cut across)"}
{"_id": "stanford_medicine_head_clean$$$corpus_80", "text": "Dissection of left temporal region\n\t\t\t\t\t\t\t\t\t\t Distribution of nerves and blood vessels to temporal muscle, anterolateral view\n\t\t\t\t\t\t\t\t\t\tMore of the zygomatic arch has been cut away. The temporal muscle (19) has been detached from its extensive origin (11) and reflected laterally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticotemporal branches of zygomatic nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital margin  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut surface of zygomatic bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep anterior temporal artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticofacial branch zygomatic nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior deep temporal nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Filaments from buccinator nerve anastomosing with branches of anterior deep temporal nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar glands  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of temporalis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratemporal crest and masseteric nerve (emerging beneath ligamentous band along bone)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle temporal artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process temporal bone (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of mandible  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve and superficial temporal artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep posterior temporal artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis muscle (reflected laterally)"}
{"_id": "stanford_medicine_head_clean$$$corpus_81", "text": "Dissection of left temporal region\n\t\t\t\t\t\t\t\t\t\t Anterior deep temporal artery, anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe coronoid process of the mandible (17) has been cut away. The temporal muscle has been detached from its origin and reflected posterolaterally. Fat within the anterior part of the temporal fossa has been removed. The buccal fat pad seen previously was continuous with this fat.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticotemporal branch zygomatic nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior deep temporal nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia covering inferior oblique muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery and nerve emerging from zygomaticofacial foramen  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic branch of deep anterior temporal artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep anterior temporal artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior posterior alveolar artery Lower pointer: Communication between above two arteries  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital head of levator labii superioris muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pterygoid muscle (covered by fascia)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of deep anterior temporal artery to superior posterior alveolar artery and buccal artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar glands  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis muscle (area of origin)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis muscle (reflected)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch anterior deep temporal nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of mandible  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut surface of coronoid process of mandible  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Band of fascia continuous from deep surface of temporalis muscle inferiorly into fascia which covers buccinator muscle Lower pointer: Buccal nerve"}
{"_id": "stanford_medicine_head_clean$$$corpus_82", "text": "Dissection of left temporal region\n\t\t\t\t\t\t\t\t\t\t Tendon of temporal muscle, lateral view\n\t\t\t\t\t\t\t\t\t\tA branch of the masseteric nerve (6) is visible as it passes into the unnamed layer of muscle (4) described previously (64-4). Fatty connective tissue has been removed from the space between this muscle and the tendon of the temporal muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch anterior deep temporal nerve supplying superficial parts of temporalis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve and artery in zygomaticofacial foramen  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut surface of zygomatic bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of temporal fascia  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch masseteric artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseteric nerve and artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of masseter muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid process of mandible  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of temporalis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle temporal artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic arch (partially removed)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of mandible  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of facial nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid gland (reflected)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of mandible"}
{"_id": "stanford_medicine_head_clean$$$corpus_83", "text": "Dissection of left temporal region\n\t\t\t\t\t\t\t\t\t\t Temporal muscle, lateral view\n\t\t\t\t\t\t\t\t\t\tThe zygomatic arch has been resected to reveal a separate layer of muscle (8) which arises from the inner surface of the arch and inserts on the coronoid process of the mandible. This muscle fascicle is supplied by a branch of masseteric nerve (12). A delicate sheet of muscle fibres related to the temporal fascia covers the main mass of the temporal muscle and is supplied by a branch (6) of the anterior deep temporal nerve.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronal suture  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal line  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticotemporal branches of zygomatic nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve filament to superficial fascicle of temporalis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of temporal fascia which was attached to zygomatic arch  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscle origin from zygomatic arch (bone resected)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticofacial branch zygomatic nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Malar surface zygomatic bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of coronoid process of mandible  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseteric nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of masseter muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of facial nerve (reflected with parotid gland)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipitalis muscle (cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process temporal bone (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of posterior auricular muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital branch of posterior auricular nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Middle temporal artery Lower pointer: Superficial temporal artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve (cut across)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser occipital nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid gland (reflected posteriorly)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle and great auricular nerve"}
{"_id": "stanford_medicine_head_clean$$$corpus_84", "text": "Dissection of left temporal region\n\t\t\t\t\t\t\t\t\t\t Deep relations of temporal fascia, lateral view\n\t\t\t\t\t\t\t\t\t\tThe temporal fascia (4), except at the borders of the temporal fossa, has been removed. The fascia consists of several distinct laminae with intervening fatty and vascular tissue above the zygomatic arch (at lower edge of view). These laminae blend as they pass up over the temporal muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of supraorbital nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontalis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal branch of superficial temporal artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal fascia (cut edge)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital margin  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatico-orbital artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Fat beneath orbicularis oculi muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticotemporal branches of zygomatic nerve (note communications with branches of facial nerve)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal branches of facial nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior temporal line  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Galea aponeurotica (cut edge)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of coronal suture  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep lamina of temporal fascia  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle temporal vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery (cut off)"}
{"_id": "stanford_medicine_head_clean$$$corpus_85", "text": "Dissection of left temporal region\n\t\t\t\t\t\t\t\t\t\t Temporal fascia, lateral view\n\t\t\t\t\t\t\t\t\t\tThe anterior and superior auricular muscles have been cut away, and the galea aponeurotica and other parts of the frontal and occipital muscles also removed. The superficial temporal vessels and auriculotemporal nerve have been severed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of supraorbital nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal branch of superficial temporal artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontalis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Layer of fascia beneath galea aponeurotica  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal and zygomatic branches of facial nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatico-orbital artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oculi muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Galea aponeurotica  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal fascia (covering temporalis muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipitalis muscle (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_86", "text": "Dissection of left buccal region\n\t\t\t\t\t\t\t\t\t\t Relations of buccinator muscle and nerve, lateral view\n\t\t\t\t\t\t\t\t\t\tThe masseter muscle, coronoid process of the mandible and buccal fat pad has been removed so that the buccinator muscle and associated structures are visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic bone (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital nerve (cut off near infraorbital foramen)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Depressor anguli oris (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum covering alveolar process of maxilla  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle (superior part)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Labial commissure  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Labial glands  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle (inferior part)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior labial artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Marginal mandibular branches facial nerve (terminal filaments)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Depressor labii inferioris muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior posterior alveolar artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Communicating branch between deep anterior temporal artery and superior posterior alveolar artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse facial artery (cut off)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut surface of mandible (coronoid process removed)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct (cut off)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly of digastric muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior deep cervical lymph nodes  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of mandible  23\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular branches of submandibular ganglion"}
{"_id": "stanford_medicine_head_clean$$$corpus_87", "text": "Dissection of left buccal region\n\t\t\t\t\t\t\t\t\t\t Buccinator muscle; buccal and molar glands; parotid duct; lateral view\n\t\t\t\t\t\t\t\t\t\tThe masseter muscle has been cut away and the buccal fat pad (12) partially removed. Branches of the facial nerve (1,9) which entered the infraorbital plexus have been retracted upward. Other branches (18) which communicated with the buccinator nerve have been cut away. The insertions of canine and zygomatic muscles (6) have been elevated. The lumen of the parotid duct is visible as a small aperture on the cut end of the mass of connective and vascular tissue which surrounds the duct(15).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomosis of infraorbital branches of facial nerve with infraorbital nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Depressor anguli oris muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial branches infraorbital nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oris muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Zygomaticus muscle (cut off) Lower pointer: Inferior labial artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of the mouth  8\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal branch facial nerve (retracted upward)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of masseter muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of temporalis muscle inserting on coronoid process of mandible  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal fat pad  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia enclosing fat pad  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar glands  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct (note that the cut end of the duct itself, which is visible just above the pointer, is small in comparison to its surrounding sheath)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle and buccal glands  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut ends of anastomotic branches of facial nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of masseter muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle (inferior part)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Marginal mandibular branches facial nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep facial lymph node"}
{"_id": "stanford_medicine_head_clean$$$corpus_88", "text": "Dissection of left parotideomasseteric region\n\t\t\t\t\t\t\t\t\t\t Distribution of nerves and blood vessels within masseter muscle, anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe left masseter muscle has been detached both from the origin and insertion, and reflected posteriorly. Branches of the masseteric nerve have been exposed by separation of fascicles of the muscle. Masseteric veins, and arteries are also visible within the depths of the muscle tissue. A layer of muscle (2), which arises from the deep surface of the zygomatic arch, is closely related to the deep part of the masseter muscle (15). This layer is usually described with the temporal muscle although it is supplied by the masseteric nerve.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular fascicle arising from temporal surface of zygomatic arch and inserting on coronoid process of mandible  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic head of levator labii superioris muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of masseter muscle (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid process mandible (cut muscle fibers are of masseter muscle)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseteric nerve (emerging from mandibular incisure)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal fat pad (partially cut away)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of temporalis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia covering buccinator nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct (cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of mandible and external maxillary artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseteric branch of external maxillary artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep portion of masseter muscle (cut across near origin from zygomatic arch)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior margin of masseter muscle (reflected)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of mandible  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep portion of masseter muscle cut away from insertion into ramus of mandible  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial portion of masseter muscle cut away from insertion into body of mandible  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid gland  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior facial vein (cut off)"}
{"_id": "stanford_medicine_head_clean$$$corpus_89", "text": "Dissection of left parotideomasseteric region\n\t\t\t\t\t\t\t\t\t\t Left masseter muscle, lateral view\n\t\t\t\t\t\t\t\t\t\tThe parotid duct (10) has been cut where it passes around the anterior margin of the masseter muscle. Terminal branches of the facial nerve have been severed and retracted anteriorly, and the parotid gland has been retracted posteriorly. The superficial (7) and deep (6) parts of the masseter muscle are clearly distinguishable at their origin from the zygomatic bone and zygomatic arch.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process temporal bone and zygomaticotemporal suture  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticofacial branch zygomatic nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of zygomaticus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Malar surface zygomatic bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic head of levator labii superioris muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep portion of masseter muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial portion of masseter muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Depressor anguli oris muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep facial vein communicating with pterygoid venous plexus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct (note veins and connective tissue surrounding cut end of duct)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior facial vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep facial lymph node  15\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal branches of facial nerve (retracted away from masseter muscle)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tragus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal branches of facial nerve (cut across)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory parotid gland (retracted)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct (retracted)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Veins and fascia along original course of parotid duct  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid gland  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal fat pad  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extremity of parotid gland  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior facial vein"}
{"_id": "stanford_medicine_head_clean$$$corpus_90", "text": "Dissection of left parotideomasseteric region\n\t\t\t\t\t\t\t\t\t\t Deep relations of facial nerve\n\t\t\t\t\t\t\t\t\t\tThe superficial lobe of the parotid gland has been entirely removed and the facial nerved raised slightly away from the deep hole of the gland.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process temporal bone (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular capsule of mandible  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior auricular lymph node  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Zygomatic branches of facial nerve Lower pointer: Temporal branch facial nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior facial vein  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal branches of facial nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid gland (deep lobe)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct (inferior division)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Marginal mandibular branches facial nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch facial nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut section of skin of external acoustic meatus (note ceruminous gland in subcutaneous tissue)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricular branch vagus nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Filament from temporal branch of facial nerve which passed through parotid gland toward occipital region)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of styloid process temporal bone  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomotic branch auriculotemporal nerve with facial nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII) at exit from stylomastoid foramen  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of sternocleidomastoid muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior (temporofacial) division of facial nerve (VII)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior (cervicofacial) division of facial nerve (VII)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep lobe and duct of parotid gland  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior belly of digastric muscle Lower pointer: Superior deep cervical lymph node"}
{"_id": "stanford_medicine_head_clean$$$corpus_91", "text": "Dissection of left parotideomasseteric region\n\t\t\t\t\t\t\t\t\t\t Facial nerve within parotid gland\n\t\t\t\t\t\t\t\t\t\tThe superficial lobe of the parotid gland has been reflected posteriorly. The main parotid duct (of Stenson) is out of view anteriorly. Its two principal branches (6,7) drain various parts of the gland. The superior branch connects with the deep lobe (16), while the inferior branch ramifies within the superficial lobe and also receives a tributary from the deep lobe. The isthmus through which the inferior duct passes was necessarily cut away in reflecting the superficial part of the gland. Cut ends of the inferior duct are visible at 20.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic arch (cut away)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscle fibers which originated from zygomatic arch  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic branches of facial nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal branches of facial nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory parotid gland  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Duct draining deep lobule of parotid gland  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Duct from superficial lobe of parotid gland  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseter muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior facial vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch facial nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery (cut off)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal branches of facial nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep lobe of parotid gland (retromandibular process)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial lobe of parotid gland (reflected)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior (temporofacial) division of facial nerve (VII)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior (cervicofacial) division of facial nerve (VII)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut ends of inferior division of parotid duct (in this area the duct passed through the isthmus which connected the deep and superficial parts of the gland)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Marginal mandibular branch facial nerve (VII)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle (reflected posteriorly)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid branch superficial temporal artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior deep cervical lymph nodes"}
{"_id": "stanford_medicine_head_clean$$$corpus_92", "text": "Dissection of left parotideomasseteric region\n\t\t\t\t\t\t\t\t\t\t Parotid gland and branches of facial nerve, lateral view\n\t\t\t\t\t\t\t\t\t\tThe skin and subcutaneous tissues have been removed and the parotideomasseteric fascia cut away. The orbicularis oculi muscle (2) has been reflected anteriorly from the temporal region and the risorius muscle reflected inferiorly in the masseteric region.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontalis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oculi muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Palpebral branch inferior Infraorbital nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse part of nasalis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular head of levator labii superioris muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal branch of angular artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala nasi (note insertion of fibers of angular head of levator labii superioris muscle)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital head of levator labii superioris muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic head of levator labii superioris muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oris muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery and depressor anguli oris (triangularis) muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Depressor labii inferioris muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis fascia  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticotemporal branch zygomatic nerve and zygomatico-orbital artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal branch facial nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal vein (not injected)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of zygomatic arch  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic branches facial nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid gland  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory parotid gland  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal branch facial nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of parotideomasseteric fascia  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal branch facial nerve  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseter muscle  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior facial vein  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_93", "text": "Ear ossicles\n\t\t\t\t\t\t\t\t\t\t Right malleus, incus and stapes\n\t\t\t\t\t\t\t\t\t\tartery Malleus (posterior aspect) B. Incus (anterior aspect) C. Stapes (superior aspect)\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t A\n\t\t\t\t\t\t.\n\t\t\t\t\t Malleus (posterior aspect)  B\n\t\t\t\t\t\t.\n\t\t\t\t\t Incus (anterior aspect)  C\n\t\t\t\t\t\t.\n\t\t\t\t\t Stapes (superior aspect)  1\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum of malleus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior process of malleus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Manubrium of malleus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for incus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of malleus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral process of malleus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for malleus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Short crus incus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Long crus of incus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lenticular process of incus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum of stapes  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior crus of stapes  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of stapes  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle for insertion of stapedius muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior crus of stapes"}
{"_id": "stanford_medicine_head_clean$$$corpus_94", "text": "Ear ossicles\n\t\t\t\t\t\t\t\t\t\t Right ossicles articulated, lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t A\n\t\t\t\t\t\t.\n\t\t\t\t\t Malleus  B\n\t\t\t\t\t\t.\n\t\t\t\t\t Incus  C\n\t\t\t\t\t\t.\n\t\t\t\t\t Stapes  1\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum of malleus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of malleus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral process of malleus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior process of malleus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Manubrium of malleus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior crus of stapes  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of stapes  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of incus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Short crus of incus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Incus-malleolar articulation  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Long crus of incus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum of stapes"}
{"_id": "stanford_medicine_head_clean$$$corpus_95", "text": "Ear ossicles\n\t\t\t\t\t\t\t\t\t\t Right ossicles articulated, lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t A\n\t\t\t\t\t\t.\n\t\t\t\t\t Malleus  B\n\t\t\t\t\t\t.\n\t\t\t\t\t Incus  C\n\t\t\t\t\t\t.\n\t\t\t\t\t Stapes  1\n\t\t\t\t\t\t.\n\t\t\t\t\t Incus-malleolar articulation  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Body incus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Short crus incus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Long crus of incus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lenticular process of incus (forming, together with the stapes, the Incus-stapes articulation)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum of stapes  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior crus of stapes  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum of malleus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of malleus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior process of malleus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral process of malleus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Manubrium of malleus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior crus of stapes  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of stapes"}
{"_id": "stanford_medicine_head_clean$$$corpus_96", "text": "Dissection of left ear from posterior aspect\n\t\t\t\t\t\t\t\t\t\t Relation of facial nerve and stapedius muscle to tympanic cavity and labyrinth\n\t\t\t\t\t\t\t\t\t\tThe semicircular canals have been cut away and the vestibule opened to show the footplate of the stapes (4) lying in the fenestra vestibuli. The facial nerve (7), together with branches of the stylomastoid artery and veins, is visible within the opened facial canal. The stapedius muscle and its nerve have been dissected and are illustrated to the drawing at 11. The muscle appears light in the view because of tendinous fibres on its surface. The tympanic branch (22) of the glossopharyngeal nerve (25) can be traced into the posterior part of the tympanic cavity.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater superficial petrosal nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniculate ganglion  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of stapes in fenestra vestibuli  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum of malleus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of incus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior crus of stapes Lower pointer: Capitulum of stapes  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramidal eminence  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Manubrium of malleus Lower pointer: Tympanic membrane  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Stapedius nerve and muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic sinus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid cell  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of stylomastoid foramen  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar fascia  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper and lower divisions of vestibulocochlear nerve (VIII) (vestibular part)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VIII) (cochlear part)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal acoustic meatus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of modiolus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Veins surrounding internal carotid artery within carotid canal  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Osseous spiral lamina in basal turn of cochlea  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid cell  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Veins within petro-occipital fissure  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomotic branch glossopharyngeal nerve with auricular brancjes of vagus nerve"}
{"_id": "stanford_medicine_head_clean$$$corpus_97", "text": "Dissection of left ear from posterior aspect\n\t\t\t\t\t\t\t\t\t\t Tympanic cavity and labyrinth, posterosuperior view\n\t\t\t\t\t\t\t\t\t\tThe relationship between the posterior semicircular canal, which was seen in the previous view, and other structures of the inner and middle ear is displayed. The superior semicircular canal is not directly visible but lies in the plane of the ridge of bone (16, upper pointer) which has been left in the dissected area. The tegmen tympani has been cut away to expose the ear ossicles within the tympanic cavity.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniculate ganglion  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Malleus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Incus Lower pointer: Mastoid cells  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral semicircular canal (opened)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior pyramidal surface  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Trochlear nerve (IV) Lower pointer: Oculomotor nerve (III)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Hypophysis Lower pointer: Internal carotid artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Abducens nerve (VI)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of cochlea  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal acoustic meatus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VIII)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Facial nerve (VII) Left pointer: Vestibulocochlear nerve (VIII) (vestibular part)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Bone supporting superior semicircular canal Lower pointer: Posterior semicircular canal (opened)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Glossopharyngeal (IX) nerve Lower pointer: Accessory nerve (XI)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlas articular surface (superior)"}
{"_id": "stanford_medicine_head_clean$$$corpus_98", "text": "Dissection of left ear from posterior aspect\n\t\t\t\t\t\t\t\t\t\t Posterior semicircular canal; jugular foramen\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate eminence  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Attached edge of tentorium cerebelli  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Posterior semicircular canal Right pointer: Opening of crus simplex superior semicircular canal  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Common crus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vestibule (part of membrane of utricle visible within) Lower pointer: Posterior osseous ampulla  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse sinus (sigmoid part)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular ganglion of vagus nerve (X)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse sinus entering jugular foramen  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Condyloid emissary  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VIII) (cochlear part)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VIII) (vestibular part)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibular ganglion (seen through window cut in internal acoustic meatus)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cochlear canaliculus (cut open)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior petrosal sinus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Bony margin of foramen magnum"}
{"_id": "stanford_medicine_head_clean$$$corpus_99", "text": "Dissection of left ear from posterior aspect\n\t\t\t\t\t\t\t\t\t\t Posterior surface of petrous part of temporal bone\n\t\t\t\t\t\t\t\t\t\tThe dura mater has been removed from the posterior surface of the temporal bone except along the venous sinuses. The endolymphatic sac was not identified although fibrous tissue which protrudes from the vestibular aqueduct (6) indicates the usual location of the sac.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery within middle cranial fossa  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate eminence  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior petrosal sinus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal acoustic meatus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse sinus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous tissue protruding from external aperture of vestibular aqueduct  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse sinus (sigmoid portion)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular ganglion of vagus nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid emissary  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar plexus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V) entering Meckel's cave  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Abducens nerve (VI)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Nervous intermedius of (VII)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VIII) (upper pointer, cochlear part; lower pointer, vestibular part)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior petrosal sinus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbar root of accessory nerve (XI)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal root of accessory nerve (XI)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII )  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Occipital sinus Lower pointer: Vertebral artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_100", "text": "Dissection of left ear from superior aspect\n\t\t\t\t\t\t\t\t\t\t Cochlea; ear ossicles in situ, anterosuperior view\n\t\t\t\t\t\t\t\t\t\tThe facial nerve and canal have been cut away. The upper margin of the fenestra vestibuli has been removed so that the entire staples is visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior crus of stapes  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior crus of stapes  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Base of stapes Left pointer: Syndesmosis tympanostapedia  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Scala tympani (middle turn)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VIII) (cochlear part) entering base of modiolus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Basal turn of cochlea  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Scala vestibuli (middle turn)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Osseous spiral lamina  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of helicotrema  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor tympani muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid plexus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to tensor tympani muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Auditory tube (cartilaginous part)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Otic ganglion  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Stapedius muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial canal (opened)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pyramidal eminence Lower pointer: Capitulum of stapes  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Short crus of incus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Long crus of incus Lower pointer: Tympanic membrane  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of incus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Manubrium of malleus Lower pointer: Capitulum of malleus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Cochleariform process Right pointer: Tendon of tensor tympani muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Chorda tympani in petrotympanic fissure  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum (condyloid process) of mandible"}
{"_id": "stanford_medicine_head_clean$$$corpus_101", "text": "Dissection of left ear from superior aspect\n\t\t\t\t\t\t\t\t\t\t Tympanic membrane\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum of stapes  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule (opened)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pyramidal angle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (vestibular part)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (cochlear part)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Osseous spiral lamina  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Modiolus: Upper pointer indicates scala vestibuli of middle turn; lower pointer indicates scala tympani of apical turn)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Tendon of tensor tympani muscle Lower pointer: Manubrium of malleus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Major superficial petrosal nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Minor superficial petrosal nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery within carotid canal  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Outer surface of auditory tube (Eustachian)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery and mandibular nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Incus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Incus-malleolar articulation Lower pointer: Malleus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Flaccid part of tympanic membrane  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior malleolar fold  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Pars tensa tympanic membrane  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Limbus (border) of tympanic membrane Lower pointer: Jugular walls of tympanum  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Chorda tympani  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum condyloid process of mandible"}
{"_id": "stanford_medicine_head_clean$$$corpus_102", "text": "Dissection of left ear from superior aspect\n\t\t\t\t\t\t\t\t\t\t Relations of tympanic cavity, facial canal and vestibule\n\t\t\t\t\t\t\t\t\t\tThe lateral semicircular canal has been cut away and the vestibule widely opened. The facial canal has been opened and it course above the posterior part of the tympanic cavity shown.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Stapedius nerve and muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic sinus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII) (within facial canal)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VIII) (vestibular part) (superior and inferior branches)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal acoustic meatus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VIII) (cochlear part)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Modiolus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Central end of facial nerve (Vll) (cut off) Lower pointer: Geniculate ganglion  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Tendon of tensor tympani muscle Lower pointer: Tympanic membrane  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Major superficial petrosal nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Minor superficial petrosal nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Chorda tympani  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Otic ganglion  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular nerve (V)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic antrum  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Short crus of incus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus (note transition from thick to thin skin at junction of cartilaginous and bony parts of wall of meatus)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Manubrium of malleus Lower pointer: Capitulum of malleus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Veins of external auditory meatus tributary to posterior facial vein  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular disc  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum (condylar process) of mandible  25\n\t\t\t\t\t\t.\n\t\t\t\t\t External pterygoid muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_103", "text": "Dissection of left ear from superior aspect\n\t\t\t\t\t\t\t\t\t\t Tympanic membrane and chorda tympani, anterosuperior view\n\t\t\t\t\t\t\t\t\t\tThe sloping lateral wall of the tympanic cavity has been exposed. The anterior malleolar fold of mucous membrane has been removed to reveal the chorda tympani. The external auditory meatus has been opened and the condyle of the mandible exposed by cutting away the articular cartilage above it. Anteriorly, the floor of the middle cranial fossa has been removed to expose the internal carotid artery, auditory tube and otic ganglion.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VIII) (vestibular part)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cochlea  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Tendon of tensor tympani muscle Lower pointer: Tympanic membrane  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater superficial petrosal nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser superficial petrosal nerve (note connection with otic ganglion)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor tympani muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid plexus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery (within carotid canal)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to tensor tympani muscle (from otic ganglion)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep petrosal nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Otic ganglion (two small separate ganglionic masses present)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Plexus of small nerve filaments covering medial surface of mandibular nerve (connections undetermined)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular nerve (V)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic antrum  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lateral semicircular canal Lower pointer: Vestibule (utricle and saccule removed)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Short crus incus Lower pointer: Capitulum mallei  18\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sensory nerve to skin of meatus (branch of auriculotemporal nerve)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Flaccida part of tympanic membrane  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior process malleus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Chorda tympani  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular disc of mandible (cut through)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum (head) of mandible  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t External pterygoid muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseteric nerve"}
{"_id": "stanford_medicine_head_clean$$$corpus_104", "text": "Dissection of left ear from superior aspect\n\t\t\t\t\t\t\t\t\t\t Relation of ear to temporomandibular joint, anterosuperior view\n\t\t\t\t\t\t\t\t\t\tThe temporal bone has been cut away to expose the external auditory meatus (16), with its periosteal lining intact, and the articular cartilage which lines the mandibular fossa of the temporal bone (19).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Subarcuate fossa (occupied by vein)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior semicircular canal Lower pointer: Utricle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (cochlear part)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Facial nerve (VII) (within facial canal) Lower pointer: Geniculate ganglion  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Cochlea  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Tendon of tensor tympani muscle Right pointer: Capitulum of malleus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior malleolar fold (covering anterior process malleus)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater superficial petrosal nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lessor superficial petrosal nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut bone of floor of skull (greater wing of sphenoid bone)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral semicircular canal  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic antrum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ligament of incus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Flaccid part of tympanic membrane  16\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus (periosteal lining intact)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Scutum of temporal bone (squamous part) which fills notch (of Rivinus) between superior ends of tympanic annulus Lower pointer: Lateral margin of tympanic cavity  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of calvaria  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular cartilage lining mandibular fossa"}
{"_id": "stanford_medicine_head_clean$$$corpus_105", "text": "Dissection of left ear from superior aspect\n\t\t\t\t\t\t\t\t\t\t Tympanic cavity and labyrinth, superolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dissected area on posterior aspect of petrous part of temporal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Common crus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Subarcuate fossa Lower pointer: Vestibule (membrane of utricle visible)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper (utriculoampullar) division of vestibulocochlear nerve (VIII)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Cochlea (pointer on modiolus)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniculate ganglion  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater superficial petrosal nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Tendon of tensor tympani muscle Lower pointer: Position of anterior process of malleus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lessor superficial petrosal nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Communicating branch between above nerve (10) and plexus along middle meningeal artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar ganglion (reflected laterally)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral semicircular canal  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior semicircular canal  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic antrum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ligament of incus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Long crus of incus Lower pointer: Body incus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Fold of incus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum of malleus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral margin of tympanic cavity  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid cells"}
{"_id": "stanford_medicine_head_clean$$$corpus_106", "text": "Dissection of left ear from superior aspect\n\t\t\t\t\t\t\t\t\t\t Tympanic cavity and inner ear in relation to external ear, superolateral view\n\t\t\t\t\t\t\t\t\t\tPart of the petrous portion of the temporal bone has been ground away to demonstrate the internal auditory meatus, cochlea, semicircular canals and tympanic cavity. The posterior semicircular canal is obscured by a thin layer of bone but this has been transilluminated to show its position (15). The superior semicircular canal lies within the vertical edge of bone at 14.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Oculomotor nerve (III) Lower pointer: Trochlear nerve (IV)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Periorbita (bony lateral wall of orbit removed)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar ganglion (trigeminal)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater superficial petrosal nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery (cut off) and Lessor superficial petrosal nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cochlea Lower pointer: Geniculate ganglion facial nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Malleus Lower pointer: Incus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral wall of tympanic cavity above tympanic membrane  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic antrum (opened from above)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior margin of foramen magnum (in background of view)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII) within internal acoustic meatus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ridge of bone supporting superior semicircular canal (not visible)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of posterior semicircular canal (exposed and illuminated posteriorly)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral semicircular canal (note short segment of lateral semicircular duct lying within canal)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricle"}
{"_id": "stanford_medicine_head_clean$$$corpus_107", "text": "Dissection of left ear from superior aspect\n\t\t\t\t\t\t\t\t\t\t Anterior surface of petrous part of temporal bone\n\t\t\t\t\t\t\t\t\t\tThe dura mater has been removed except in areas adjacent to blood vessels. Dark patches visible in the bone are caused by underlying air cells (11).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid part of transverse sinus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edges of tentorium enclosing superior petrosal sinus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Area from which bone has been cut away  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate eminence  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of hiatus facial canal (note branch of middle meningeal artery entering hiatus)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of calvaria  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch of middle meningeal artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tegmen tympani  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of Petrosquamous fissure  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid cell (visible beneath surface of bone)"}
{"_id": "stanford_medicine_head_clean$$$corpus_108", "text": "Contents of left jugular foramen\n\t\t\t\t\t\t\t\t\t\t Superolateral view\n\t\t\t\t\t\t\t\t\t\tThe jugular foramen has been opened by cutting away its lateral wall. The internal jugular vein has been removed and its main tributaries, the sigmoid sinus (23) and the inferior petrosal sinus (12), cut off to expose the glossopharyngeal (13), vagus (24) and accessory (22) nerves which descend through the foramen. The dense fibrous tissue which surrounded these structures has been cleared away. The left cerebellar hemisphere has been partially removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Optic tract Lower pointer: Base of peduncle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Clivus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pons Lower pointer: Trigeminal nerve (V)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Abducens nerve (VI)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid plexus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Geniculate ganglion facial nerve (VII) Lower pointer: Vidian nerve (of pterygoid canal)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep petrosal nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cochlea (cut across) Lower pointer: Rectus capitis anterior muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior petrosal sinus Lower pointer: Internal carotid nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cervical ganglion  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebellum  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Dentate nucleus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebellar tonsil right  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Brachium of pons (cut across) Lower pointer: Medulla oblongata  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VIII)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots of glossopharyngeal and vagus nerves  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse sinus (sigmoid part)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular ganglion of vagus nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial wall of jugular foramen  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid cells  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Auricular branch vagus nerve (note communicating branch from glossopharyngeal nerve) Left pointer: Tympanic nerve  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosal ganglion of glossopharyngeal nerve (superior ganglion absent in this specimen)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Nodose ganglion of vagus nerve  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus capitis lateralis muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_109", "text": "Dissection of ear from lateral aspect\n\t\t\t\t\t\t\t\t\t\t Left lateral semicircular canal; facial canal; stapedius muscle; tympanic and tubal air cells\n\t\t\t\t\t\t\t\t\t\tThe labyrinthine wall of the tympanic cavity has been cut away to show the relations of the facial nerve in its course through the facial canal. The geniculate ganglion has been exposed. The bone of the external auditory meatus has been ground away to reveal the extent of tympanic and tubal air cells along the floor (paries jugularis) of the tympanic cavity.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Semicircular canal (lateral) (note delicate lateral semicircular duct within canal)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII) in facial canal  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniculate ganglion (at geniculum facial nerve)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lessor superficial petrosal nerve (part of the course of this nerve is obscured by the semicanal for the tensor tympani muscle)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Major superficial petrosal nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor tympani muscle and nerve supply from otic ganglion  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar ganglion  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Otic ganglion (most of its connections cut away)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plate (cartilaginous) auditory tube  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plate auditory tube  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending pharyngeal artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic antrum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Stapes  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Stapedius muscle and its nerve supply  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Subiculum of promontory Lower pointer: Fenestrated cochlear fossa  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic plexus (superior and inferior caroticotympanic branches which pass anteriorly to reach carotid canal were not identified)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic cells  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubal branches tympanic plexus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylomastoid foramen (cut open)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Tubal air cells Left pointer: Junction of bony part with cartilaginous part auditory tube  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath for styloid process  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus capitis lateralis muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein"}
{"_id": "stanford_medicine_head_clean$$$corpus_110", "text": "Dissection of ear from lateral aspect\n\t\t\t\t\t\t\t\t\t\t Medial wall of left tympanic cavity\n\t\t\t\t\t\t\t\t\t\tThe malleus and incus have been removed and the lateral walls of the auditory tube opened to illustrate structures related to the medial wall (paries labyrinthica) of the tympanic cavity.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor tympani muscle (within semicircular canal)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Major superficial petrosal nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid wall (dark color due to blue latex within veins in carotid canal)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar ganglion  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Minor portion trigeminal nerve (V) (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Bony part auditory tube (isthmus)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Foramen ovale (opened) Lower pointer: Otic ganglion  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plate (cartilaginous) auditory tube  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosa of auditory tube (cut open)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Cartilaginous part auditory tube (opened)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of origin of Tensor veli palatini muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator veli palatini muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tegmen tympani  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic antrum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory semicircular canal  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Prominence of facial canal Lower pointer: Cochlearform process (with tendon of tensor tympani muscle cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Fenestrated vestibular fossa Lower pointer: Capitulum of stapes  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Tendon of stapedius muscle emerging from pyramidal eminence Lower pointer: Tympanic sinus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Promontory Lower pointer: Fenestrated cochlear fossa  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Chorda tympani  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic plexus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic cells  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubal branch of tympanic plexus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylomastoid artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein"}
{"_id": "stanford_medicine_head_clean$$$corpus_111", "text": "Dissection of ear from lateral aspect\n\t\t\t\t\t\t\t\t\t\t Left tympanic cavity, lateral view\n\t\t\t\t\t\t\t\t\t\tThe tympanic membrane has been removed and more of the mastoid and petrous of the temporal bone resected. The facial nerve (17) and chorda tympani (7,16,18) have been exposed. The continuity of the tympanic antrum (14) with the mastoid air cells is visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of peduncle (in background)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior ligament of malleus Lower pointer: Capitulum of malleus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Process of anterior malleus (covered by anterior malleolar plica) Lower pointer: Lateral process malleus (the superior recess, Prussak's space, is located just above this process and is closed laterally by a thin downward extension of squamous bone known as the scutum)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrotympanic fissure  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Manubrium of malleus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Mandibular nerve (V) Lower pointer: Middle meningeal artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Chorda tympani (passing inferiorly to join lingual nerve)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor veli palatini muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar fascia  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloglossus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate eminence  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Epitympanic recess  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic antrum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Body incus Right pointer: Posterior ligament of incus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Chorda tympani within tympanic cavity Right pointer: Tendon of stapedius muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII) within facial canal  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Chorda tympani within canaliculus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Anterior crus of stapes Right pointer: Tympanic sinus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Fenestrated cochlear fossa (separated from tympanic sinus above by promontory) Lower pointer: Promontory (tympanic plexus visible beneath mucosa)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic cells of jugular wall of tympanic cavity  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of stylomastoid foramen (opened)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process (dissected)"}
{"_id": "stanford_medicine_head_clean$$$corpus_112", "text": "Dissection of ear from lateral aspect\n\t\t\t\t\t\t\t\t\t\t Left tympanic membrane, anteroinferior view\n\t\t\t\t\t\t\t\t\t\tThe anterior wall of the external auditory canal has been removed to reveal the tympanic membrane through which the manubrium of the malleus is visible. Due to the direction of view, however, the manubrium does not present the anterosuperior inclination customarily seen in otoscopic examination.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of bony roof of external auditory canal  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Flaccid part of tympanic membrane  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral process malleus (forming malleolar prominence)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Manubrium of malleus (visible as malleolar stria)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pars tensa tympanic membrane  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrotympanic fissure  7\n\t\t\t\t\t\t.\n\t\t\t\t\t External surface of tympanic annulus seen at 3 in previous view  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal bone (squamous part)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenosquamous suture  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Limbus tympanic membrane  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Annulus fibrocartilaginous tympanic membrane  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of osseous floor of auditory canal  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular spine  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic part temporal bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar fascia  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal bone (squamous part) forming roof of external acoustic meatus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid cells  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Skin lining external acoustic meatus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanomastoid suture  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of tympanic part of temporal bone  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral margin of tympanic part of temporal bone  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)"}
{"_id": "stanford_medicine_head_clean$$$corpus_113", "text": "Dissection of ear from lateral aspect\n\t\t\t\t\t\t\t\t\t\t Petrotympanic fissure; relation of cartilaginous part of left external auditory meatus to tympanic part of temporal bone\n\t\t\t\t\t\t\t\t\t\tThe capsule of the temporomandibular articulation has been removed. The tympanic ring produces a noticeable bulge of the bone lateral to the petrotympanic fissure. The squamous part of the temporal bone has been cut away and the cerebral hemisphere removed. The brain stem is visible in the background.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanosquamous fissure  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrotympanic fissure  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Elevation at site of tympanic annulus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal bone (squamous part)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery within foramen spinosum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenosquamous suture  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular nerve (V) in foramen ovale  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseteric nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Angular spine Lower pointer: Alar fascia  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary nerve plexus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior alveolar nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ceruminous gland  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid cells  17\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cartilaginous acoustic meatus Lower pointer: Incisure of external cartilaginous acoustic meatus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII) at exit from stylomastoid foramen  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular nerve (displaced)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph node  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Digastric muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_114", "text": "Dissection of ear from lateral aspect\n\t\t\t\t\t\t\t\t\t\t Relation of left mastoid air cells to external auditory meatus\n\t\t\t\t\t\t\t\t\t\tThe auricle has been cut away and the mastoid air cells opened. In this specimen pneumatization extended well above the petrosquamous fissure (12).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal fossa  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Auricular cartilage (cut across) Lower pointer: Skin of external acoustic meatus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process temporal bone (cut across)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: External acoustic meatus Lower pointer: Cartilaginous acoustic meatus (covered by membrane)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Masseteric nerve Lower pointer: Articular disc of mandible  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pterygoid venous plexus Lower pointer: Middle meningeal artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle temporal artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater exposed in dissected area of temporal bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosquamous fissure  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid cells (opened)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle (cut away)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricular branch vagus nerve (cut off)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anastomotic branch auriculotemporal nerve with facial nerve Lower pointer: Facial nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Mastoid process Lower pointer: Tendon of sternocleidomastoid muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_115", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Mammillothalamic tract; medial forebrain bundle; substantia nigra\n\t\t\t\t\t\t\t\t\t\tThe major part of the thalamus has been removed and the lateral hypothalamic area exposed. The cerebral peduncle is further cut back in order to expose the substantia nigra. Lateral to the mammillary body a bundle of delicate fibers is seen as it courses longitudinally. These fibers constitute the medial forebrain bundle which arises in basal olfactory structures such as the anterior perforated substance and passes through the hypothalamic region into the tegmentum of the mesencephalon.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillothalamic tract (Vicq d'Azyr)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial forebrain bundle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Thalamus (dissected)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary body  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Substantia nigra (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic chiasm  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Infundibulum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuber cinereum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic tract  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Interpeduncular fossa  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons"}
{"_id": "stanford_medicine_head_clean$$$corpus_116", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Ependymal lining of lateral ventricle; lateral aspect of thalamus\n\t\t\t\t\t\t\t\t\t\tThe caudate nucleus has been scraped away from the ependymal lining of the lateral ventricle which covers its upper and medial aspects. This membrane remains intact and the outlines of small uninjected veins may be traced within it. These are tributaries of the terminal vein. Between the position occupied by the caudate nucleus and the internal capsule is a ridge which consists of fibers of the superior occipitofrontal fasciculus. The cavity of the inferior horn of the lateral ventricle is further exposed. The thalamus has been uncovered by scraping away its external medullary lamina.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior occipitofrontal fasciculus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal capsule (cut across)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior longitudinal fasciculus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Central sulcus (Rolandic)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Thalamic branch of posterior cerebral artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus lateral ventricle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampus (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior horn of lateral ventricle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventricular ependyma covering superior and medial surfaces of caudate nucleus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal stalk of thalamus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic chiasm  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Thalamus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral geniculate body (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampal gyrus"}
{"_id": "stanford_medicine_head_clean$$$corpus_117", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Tail of the caudate nucleus and retrolenticular part of the internal capsule\n\t\t\t\t\t\t\t\t\t\tThose fibers of the internal capsule have been removed which pass from the thalamic region to form the superior occipitofrontal fasciculus (see 6-6). The body and tail of the caudate nucleus have thus been brought into view lying above and medial to the course of the internal capsule. The massive radiation of fibers (9) from the posterior thalamic structures forms the bulk of the retrolenticular part of the internal capsule.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of caudate nucleus (covered by a few fibers of the anterior limb of the internal capsule)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal part of operculum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior longitudinal fasciculus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal capsule (cut across at junction with corona radiata)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Caudate nucleus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t External medullary lamina (thalamus)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Central sulcus (Rolandic)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior stalk of thalamus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t External sagittal stratum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampal gyrus and caudate nucleus (tail)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Radiation of rostral lamina of corpus callosum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cerebral artery (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior commissure  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic tract (cut across and elevated)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachium pontis (middle cerebellar peduncle) (cut across)"}
{"_id": "stanford_medicine_head_clean$$$corpus_118", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Caudate nucleus and lateral border of thalamus\n\t\t\t\t\t\t\t\t\t\tThe internal capsule has been removed to demonstrate the head of the caudate nucleus and the external medullary lamina of the thalamus. The latter consists largely of fibers passing from the thalamic nuclei into the internal capsule. Note\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal part corona radiata  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of caudate nucleus (partially removed)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal capsule (cut across at junction with corona radiata)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal stalk of the thalamus (broken ends of fibers which passed into anterior limb of internal capsule)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior commissure  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ansa lenticularis  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal stalk of thalamus (broken ends of fibers which passed through posterior limb of internal capsule)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral geniculate body  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior horn of lateral ventricle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior temporal gyrus (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal, fissure (cerebral)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital gyrus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Straight gyrus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior communicating artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuber cinereum  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Uncus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachium pontis (middle cerebellar peduncle)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebellum and horizontal cerebellar sulcus"}
{"_id": "stanford_medicine_head_clean$$$corpus_119", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Anterior limb of internal capsule, anterior commissure and parolfactory area\n\t\t\t\t\t\t\t\t\t\tThe head of the caudate nucleus has been scraped away to reveal more clearly the fibers of the anterior limb of the internal capsule. These pass forward in discret bundles through the confluent parts of the caudate nucleus and putamen, the whole being named the \"corpus striatum.\" Relations of the anterior commissure, anterior perforated substance and parolfactory area (now partly exposed by dissection) may also be seen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Radiation of rostral lamina of corpus callosum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Space left by removal of head of caudate nucleus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal part internal capsule  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Parolfactory area (dissected)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcallosal gyrus (dissected from within)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior commissure  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ansa lenticularis  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Straight gyrus left  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital branch of anterior cerebral artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cerebral artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior communicating artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tract  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic chiasm  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Infundibulum  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Interpeduncular fossa"}
{"_id": "stanford_medicine_head_clean$$$corpus_120", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t General view of cerebral peduncle and internal capsule\n\t\t\t\t\t\t\t\t\t\tThis view illustrates the general relations of the internal capsule to surface landmarks visible from the inferior aspect of the brain. The middle cerebral artery is extensively cut away.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of inferior frontal gyrus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of straight gyrus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal part corona radiata  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Radiation of rostral lamina of corpus callosum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal part internal capsule  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior commissure  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance with diagonal band of Broca (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus centralis and artery of central sulcus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic tract (divided)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus lateral ventricle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fissure (cerebral)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Straight gyrus left  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory sulcus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal pole  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cerebral artery (cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic chiasm  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons"}
{"_id": "stanford_medicine_head_clean$$$corpus_121", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Internal capsule\n\t\t\t\t\t\t\t\t\t\tThe entire lentiform nucleus has been resected to expose the lateral surface of the internal capsule together with two small arterial branches which originated from the anterior choroidal artery. Fibers of the cerebral peduncle which connected with the temporal lobe via the sublenticular part of the internal capsule are visible at 5. The main trunk of the middle cerebral artery is retracted laterally. The course of the recurrent branch (7) of the anterior cerebral artery can be followed to the anterior limb of the internal capsule.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior longitudinal fasciculus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External capsule  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior commissure  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal capsule and capsular branch of anterior choroidal artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublenticular part of internal capsule (temporopontine fibers)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t External sagittal stratum (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent artery of Heubner  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cerebral artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Infundibulum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuber cinereum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle (pointer at line of attachment of optic tract)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic tract (retracted) (Note: the small artery seen earlier to perforate the optic tract is now visible passing into the region of the lateral geniculate body)"}
{"_id": "stanford_medicine_head_clean$$$corpus_122", "text": "Dissection of ear from lateral aspect\n\t\t\t\t\t\t\t\t\t\t Right auricular cartilage, lateral surface\n\t\t\t\t\t\t\t\t\t\tThe perichondrium has been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Helix  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Triangular fossa  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Scapha  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Cymba conchae  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anthelix  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavum conchae  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Antitragicus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Antitragicohelical fissure Lower pointer: Tail of helix  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Crura anthelicis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Helical spine  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Helicis minor muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tragicus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus helicis  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tragus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Skin of external acoustic meatus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cartilaginous acoustic meatus Lower pointer: Cartilaginous isthmus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Antitragus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid gland  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater auricular nerve"}
{"_id": "stanford_medicine_head_clean$$$corpus_123", "text": "Dissection of ear from lateral aspect\n\t\t\t\t\t\t\t\t\t\t Right auricular cartilage, medial surface\n\t\t\t\t\t\t\t\t\t\tThe cartilage has been retracted anterolaterally after removal of its perichondrium.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal fascia  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior auricular muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser occipital nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tragal plate  5\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital branch posterior auricular artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cartilaginous acoustic meatus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Terminal incisure (pointer on cartilaginous isthmus)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid gland  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal vein and auriculotemporal nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Eminence of triangular fossa  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus of upper crus of anthelix  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse sulcus of anthelix  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Conchal eminence  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Scaphoid eminence  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular muscle and posterior auricular ligament (cut off)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular branch auricular artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Fossa of anthelix  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse auricular muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Antitragicohelical fissure  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Tail of helix"}
{"_id": "stanford_medicine_head_clean$$$corpus_124", "text": "Dissection of ear from lateral aspect\n\t\t\t\t\t\t\t\t\t\t Relation of right auricular cartilage to external auditory meatus; terminal branches of great auricular nerve\n\t\t\t\t\t\t\t\t\t\tThe posterior auricular muscle has been cut and the auricular cartilage retracted laterally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser occipital nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular muscle (cut across)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricular branch vagus nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Aberrant slip of posterior auricular muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital branch of posterior auricular nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle (superficial fascia reflected)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior auricular muscle Lower pointer: Temporal fascia  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Helix  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tragal plate  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus (opened posteriorly)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Conchal eminence  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch greater auricular nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Cartilaginous acoustic meatus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Communication between posterior auricular nerve and greater auricular nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Antitragicohelical fissure Lower pointer: Tail of helix  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch facial nerve (to intrinsic muscles of auricle)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid gland  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater auricular nerve"}
{"_id": "stanford_medicine_head_clean$$$corpus_125", "text": "Dissection of ear from lateral aspect\n\t\t\t\t\t\t\t\t\t\t Superficial structures of right auricle, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipitalis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcutaneous tissue of scalp  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Aberrant slip of posterior auricular muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular nerve (note branch to muscle (4))  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular lymph nodes  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior auricular muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Helix  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of lesser occipital nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Cornchal eminence  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus of crura of helix  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricular branch of posterior auricular artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricular branch vagus nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lobule"}
{"_id": "stanford_medicine_head_clean$$$corpus_126", "text": "Dissection of ear from lateral aspect\n\t\t\t\t\t\t\t\t\t\t Superficial structures of right auricle, lateral view\n\t\t\t\t\t\t\t\t\t\tThe skin has been removed from the auricle to demonstrate the subcutaneous vessels and nerves. The perichondrium remains intact.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser occipital nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Helix  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Triangular fossa  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Scaphoid fossa  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cymba conchae Lower pointer: Crus of helix  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anthelix  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavum conchae  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular sulcus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Antitragus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tail of helix  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia covering sternocleidomastoid muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior auricular muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Crura of anthelix  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior auricular branch of superficial temporal artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Helicis minor muscle Lower pointer: Anterior incisura  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tragicus muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior auricular nerves  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Tragus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertragic incisure  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior auricular lymph nodes  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater auricular nerve (anterior branch)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Lobule"}
{"_id": "stanford_medicine_head_clean$$$corpus_127", "text": "Dissection of ear from lateral aspect\n\t\t\t\t\t\t\t\t\t\t Surface of right auricle, lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Triangular fossa  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipitalis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Helix (pointer at site of Darwinian tubercle, not present in this specimen)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Scaphoid fossa  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Cymba conchae  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anthelix  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavum conchae  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular sulcus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Crura of anthelix  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of helix  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior incisure  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Supratragic tubercle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tragus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertragic incisure  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Antitragus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lobule"}
{"_id": "stanford_medicine_head_clean$$$corpus_128", "text": "Fundus of left eye\n\t\t\t\t\t\t\t\t\t\t Optic papilla, central retinary artery and vein, anterior view\n\t\t\t\t\t\t\t\t\t\tThe view, which was made with a retinal camera, shows the fundus of the left eye of a young man in light complexion. Retinal arteries appear narrow and paler than corresponding veins and have a longitudinal light streak not found in the veins. (This photograph was obtained through the courtesy of Dr. Homer Brugge.)\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior temporal retinal artery Lower pointer: Superior temporal retinal vein  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior nasal retinal vein Lower pointer: Superior retinal nasal artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial retinal artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic papilla  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior nasal retinal vein Lower pointer: Inferior nasal retinal artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior temporal retinal vein Lower pointer: Inferior temporal retinal artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve fibers visible in retina  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior macular artery Lower pointer: Superior macular vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic disc  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sclera visible as narrow white zone surrounding optic papilla  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Narrow band of stratum pigmentosum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Macula lutea (fovea centralis not visible in this instance; whitish halo around macula is common)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior macular vein Lower pointer: Inferior macular artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_129", "text": "Microradiograph of eye; central optic pathways and related structures\n\t\t\t\t\t\t\t\t\t\t Relations of optic pathways at base of brain.\n\t\t\t\t\t\t\t\t\t\tIn this specimen, selected from a series of brain dissections included in Section I of the Atlas, the brain is photographed from its inferior aspect. The anterior part of the right temporal lobe has been removed so that the middle cerebral artery (6), the anterior choroidal artery (18), the inferior horn of the lateral ventricle (10), and the optic tract (19) life exposed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Meninges related to temporal pole  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbitofrontal branch of middle cerebral artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior temporal artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Insula  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal part of operculum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cerebral artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Striate artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of precentral sulcus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior occipitofrontal fasciculus (cut obliquely)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior horn of lateral ventricle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tapetum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial temporal gyrus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior temporal gyrus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior temporal sulcus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Fusiform gyrus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital branch of anterior cerebral artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tract  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior choroid artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic tract  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary body  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampus (cut across)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral fissure  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar artery  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Olive  *\n\t\t\t\t\t\t.\n\t\t\t\t\t [Legend above restored translation from Latin]"}
{"_id": "stanford_medicine_head_clean$$$corpus_130", "text": "Microradiograph of eye; central optic pathways and related structures\n\t\t\t\t\t\t\t\t\t\t Relations of optic pathways at base of brain.\n\t\t\t\t\t\t\t\t\t\tThe vessels shown in the preceding view have been trimmed away and the left half of the optic chiasm has been removed to reveal the infundibulum of the hypophysis (15) extending downward through the opening in the diaphragm of the sella turcica (3). The recesses of the third ventricle that are closely related to the optic chiasm are indicated at 14 and 16. The tentorium has been cut and reflected to reveal the course of the trochlear nerve as it passes anteriorly around the mesencephalon.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Optic nerve (II) Lower pointer: Anterior clinoid process (covered by dura)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragma sellae  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior communicating artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of sinus cavernosus (covered by dura)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral tentorium (reflected)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V) (beneath arachnoid membrane)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of superior cerebellar artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Right anterior cerebral artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior commissure  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Optic chiasm (cut across in midline) Lower pointer: Optic recess  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Infundibulum Right pointer: Triangular recess  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Infundibular recess  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary body (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Third ventricle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Nucleus ruber  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Arterial branch which entered brain stem through posterior perforated substance in interpeduncular fossa  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of medial lemniscus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachium quadrigeminum inferius (cut across)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior colliculus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Left internal cerebral vein  *\n\t\t\t\t\t\t.\n\t\t\t\t\t [Legend above restored translation from Latin]"}
{"_id": "stanford_medicine_head_clean$$$corpus_131", "text": "Microradiograph of eye; central optic pathways and related structures\n\t\t\t\t\t\t\t\t\t\t Relations of optic pathways at base of brain.\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the preceding photograph has been reoriented for this view so that the left orbit extends above and to the left of the area included in the photograph. The brain stem has been cut across through the rostral part of the mesencephalon. The left optic tract has been removed and the optic chiasm has been lifted slightly out of its normal position. The components of the arterial circle of Willis that are related to the optic pathways (i.e., internal carotid artery (6), anterior cerebral artery (5), anterior communicating artery (between 5 and 19, unlabeled), posterior communicating artery (8) and posterior cerebral artery (11)) remain in position.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tract (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cerebral vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala parva ossis sphenoidalis (covered by dura)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cerebral artery (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Left anterior cerebral artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Chiasmatic cistern  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior choroid artery (cut across) Lower pointer: Posterior communicating artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic tract (cut across and elevated)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Central ramus of posterior cerebral artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tributaries of the basal vein which passed into tip of inferior horn of lateral ventricle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Substantia nigra  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Nucleus ruber  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Basal vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebellar tentorium  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Continuation of main trunk of posterior cerebral artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Right anterior cerebral artery (anterior communicating artery partly obscured by optic chiasm)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Falx cerebri  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulate gyrus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericallosal branch of anterior cerebral artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior commissure  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Pars libera columnae fornicis  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventricular surface of hypothalamus  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary body (cut across)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate mass  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal cerebral veins  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Aditus ad aqueductum cerebri  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior commissure  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenium corporis callosi  *\n\t\t\t\t\t\t.\n\t\t\t\t\t [Legend above restored translation from Latin]"}
{"_id": "stanford_medicine_head_clean$$$corpus_132", "text": "Microradiograph of eye; central optic pathways and related structures\n\t\t\t\t\t\t\t\t\t\t Relations of optic pathways at base of brain.\n\t\t\t\t\t\t\t\t\t\tIn this specimen the left hemisphere has been removed and the upper part of the brain stem has been cut through in such a way that parts of the thalamus, the subthalamus, the hypothalamus and the internal capsule have been preserved in relation to the optic pathways. The anterior cerebral arteries and the anterior communicating artery are shown in situ.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Stratum zonale thalami  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral nucleus of thalamus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal cerebral veins  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial nucleus of thalamus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Massa intermedia (cut through)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Subthalamic nucleus (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Septum pellucidum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Third ventricle (pointer on right hypothalamus)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypothalamus (cut through)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior commissure (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina terminalis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior communicating artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior frontal gyrus (on medial surface of right hemisphere)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lateral ventricular choroid plexus Lower pointer: Ramus choroideus ventriculi lateralis  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral geniculate body  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of temporal lobe  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal capsule (near the point at which it is continuous with the cerebral peduncle)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic tract  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial margin of the cerebral tentorium and bifurcation of internal carotid artery into anterior and middle cerebral arteries (lower pointer)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Medical cranial fossa  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic chiasm  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent branch of anterior cerebral artery (artery of Heubner)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cerebral veins  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tract (cut across)  *\n\t\t\t\t\t\t.\n\t\t\t\t\t [Legend above restored translation from Latin]"}
{"_id": "stanford_medicine_head_clean$$$corpus_133", "text": "Microradiograph of eye; central optic pathways and related structures\n\t\t\t\t\t\t\t\t\t\t Optic nerves, interpedicular cistern, brain stem and tentorium cerebelli, viewed from above\n\t\t\t\t\t\t\t\t\t\tThe cerebral hemispheres have been entirely removed from the specimen shown in the previous view. The optic nerves have been divided anterior to the chiasm. The brain stem has been transected slightly above the level of the tentorial notch.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina cribrosa (pointer indicates fascicles of olfactory nerve)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Falx cerebri (cut across)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior clinoid process Lower pointer: Internal carotid artery (entering subarachnoid space)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Anterior cerebral artery (cut off) Left pointer: Medial cerebral artery (cut off)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior communicating artery Lower pointer: Posterior cerebral artery (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Interpeduncular fossa Lower pointer: Cerebral peduncle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Nucleus ruber Lower pointer: Colliculus inferior  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior petrosal sinus (blue latex visible through dura; note that this sinus and the one on the opposite side indicate the line of attachment of tentorium to upper border of petrous portion of temporal bone)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cerebral veins (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Great cerebral vein (formed by confluence of paired internal cerebral veins)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior sagittal sinus (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebellar tentorium  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lens  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Retina  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Infundibulum (cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Dorsum sellae Lower pointer: Oculomotor nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cranial fossa  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Substantia nigra Lower pointer: Cerebral aqueduct  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosal part of the temporal bone (covered by dura; pointer indicates eminentia arcuata)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of the tentorial incisure  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse sinus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior sagittal sinus (cut across)  *\n\t\t\t\t\t\t.\n\t\t\t\t\t [Legend above restored translation from Latin]"}
{"_id": "stanford_medicine_head_clean$$$corpus_134", "text": "Microradiograph of eye; central optic pathways and related structures\n\t\t\t\t\t\t\t\t\t\t Optic pathways dissected in situ, viewed from above\n\t\t\t\t\t\t\t\t\t\tThe visual pathways have been exposed bilaterally from the eyes to the calcarine cortex. The brain stem has been transected horizontally at the level of the optic tracts. The cerebral hemispheres have been dissected somewhat differently on the two sides. The optic radiation (10) has been preserved on the left side but has been divided on the right to expose the underlying inferior horn of the lateral ventricle. Within the right orbit the sheath of the optic nerve has been opened to expose the optic nerve. The sheath remains intact in the left orbit.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tract  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External vagina of optic nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anulus tendineus communis  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vein cerebri media superficialis  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal carotid artery Lower pointer: Anterior cerebral artery (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cerebral artery (within lateral cerebral sulcus)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Optical tract Lower pointer: Cerebral peduncle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral ventricular choroid plexus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral geniculate body (partially resected on right side)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic radiation  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulvinar  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral ventricle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenium corporis callosi  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique superior trochlear muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ocular bulb  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (exposed within sheath)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic canal (partially opened to expose nerve)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Optic chiasm Lower pointer: Medial cranial fossa (uncus and medial part of temporal lobe removed)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Tertiary ventricle (opened from supraoptic recess at upper pointer to communication with cerebral aqueduct posteriorly)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic tract  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Nucleus ruber  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior sagittal sinus (cut across)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcarine sulcus (exposed by removal of cuneus on left; sectioned horizontally on right)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior sagittal sinus  *\n\t\t\t\t\t\t.\n\t\t\t\t\t [Legend above restored translation from Latin]"}
{"_id": "stanford_medicine_head_clean$$$corpus_135", "text": "Microradiograph of eye; central optic pathways and related structures\n\t\t\t\t\t\t\t\t\t\t Microradiography of limbic region of eye, viewed from in front\n\t\t\t\t\t\t\t\t\t\tThis micrograph was obtained through the courtesy of Dr. H.H. Pattee and Dr. L.K. Garron who prepared and radiographed the specimen. Reference to be made to their article entitled \"Stereomicroradiography of the limbal region of human eye\" in X-Ray Microscopy and Microradiography, Academic Press, 1957. Thorotrast was injected into the canal of Schlemm (1) under low pressure. The thorium filled the canal and passed into the vascular network of the sclera (2) and the superficial vascular network of the corne al margin. The specimen was frozen in liquid nitrogen and lyophilized prior to radiography.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Canal of Schlemm  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sclera  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cornea  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial vascular network of cornea"}
{"_id": "stanford_medicine_head_clean$$$corpus_136", "text": "Dissection of eye\n\t\t\t\t\t\t\t\t\t\t Ciliary body and iris, posterior view\n\t\t\t\t\t\t\t\t\t\tThe lens has been removed to expose the iris and pupil. Remains of the vitreous body are visible at the periphery of the view (posterior to the ora serrata). The delicate hyloid membrane (8) is visible as a thin layer which covers the outer margin of the corona ciliaris but has been cut away medially. The cut edge is indicated by a white line in the drawing and the membrane is drawn only  in a small area at the right (9).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic (visual) part of retina  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ora serrata  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbiculus ciliaris  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Corona ciliaris  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pupil (posterior surface of cornea visible in background)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ciliary process  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Plica ciliaris  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of hyaloid membrane  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Hyaloid membrane (drawn only in area within heavy lines)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior surface of iris"}
{"_id": "stanford_medicine_head_clean$$$corpus_137", "text": "Dissection of eye\n\t\t\t\t\t\t\t\t\t\t Ciliary body, ciliary zonule and lens, posterior view\n\t\t\t\t\t\t\t\t\t\tRemnants of the vitreous body appear in the periphery of the view as transparent gelatinous masses. The iris has been removed and the specimen transilluminated.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbiculus ciliaris  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ciliary processes  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Plica ciliaris  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior surface of lens  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Corona ciliaris  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Zonula ciliaris (note zonular fibers, some of which pass to posterior surface of lens, others to anterior surface)"}
{"_id": "stanford_medicine_head_clean$$$corpus_138", "text": "Dissection of eye\n\t\t\t\t\t\t\t\t\t\t Iris, lens and ciliary zonule, anterior view\n\t\t\t\t\t\t\t\t\t\tThe cornea and anterior part of the sclera have been cut away and the iris reflected to display the anterior surface of the lens (3) and the zonular fibers (5) which attach to the anterior and posterior surface of the lens at its lateral margin. The pectinate ligament is visible along the lower margin of the iris (10). The specimen is transilluminated.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior surface of iris (stratum pigmentum visible)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of sclera  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior surface of lens  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Ciliary process  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Zonular fibers (of zonula ciliaris)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ciliary muscle (meridional fibers)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pupillary-iris margin  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Annulus iris minor  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Annulus iris major  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectinate ligament of iris"}
{"_id": "stanford_medicine_head_clean$$$corpus_139", "text": "Dissection of eye\n\t\t\t\t\t\t\t\t\t\t Right cornea, anterior view\n\t\t\t\t\t\t\t\t\t\tThe eyelids have been widely opened.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tunica bulbar conjunctiva  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Annulus conjunctiva (at limbus of cornea)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior surface of iris (visible through cornea)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pupil (visible through cornea)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Vascular loop at margin of conjunctiva  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Annulus iris minor (visible through cornea)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Annulus iris major (visible through cornea)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pupillary-iris margin (note: ciliary margin of iris obscured by annulus conjunctiva (2))  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior palpebra"}
{"_id": "stanford_medicine_head_clean$$$corpus_140", "text": "Dissection of eye\n\t\t\t\t\t\t\t\t\t\t Ciliary body, ciliary zonule and lens of the left eye, horizontal section\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Cornea  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior chamber of eye  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pupillary sphincter muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior surface of iris  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Zonular space  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Limbus of cornea  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Posterior chamber of eye Left pointer: Angle of iris  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular space of iris  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Scleral spur  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ciliary muscle (circular fibers)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ciliary muscle (circular fibers)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ciliary process  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Zonula ciliaris (pointer on zonular fibers)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbiculus ciliaris  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ora serrata Lower pointer: Optic (visual) part of retina  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Iris-pupillary margin  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Capsule of lens  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Nucleus of lens  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Substantia corticalis of lens"}
{"_id": "stanford_medicine_head_clean$$$corpus_141", "text": "Dissection of eye\n\t\t\t\t\t\t\t\t\t\t Horizontal section of left eye\n\t\t\t\t\t\t\t\t\t\tThe plane of section extends through fovea centralis(12). The vitreous body remains within the eye. Delicate strands visible within its substance are remnants of the hyaloid membrane. The lace-like appearance of the periphery of the retina is the result of microcystoid degeneration of the retina\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Cornea  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior chamber of eye  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Iris  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of iris  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ciliary muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ciliary processes (of corona ciliaris)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbiculus ciliaris  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ora serrata  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sclera  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Retina  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Fovea centralis  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Cribriform plate of sclera  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of optic nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Subarachnoid space  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Iris-pupillary margin  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior chamber of eye  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Zonula ciliaris [Zinn]  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Crystalline lens  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic (visual) part of retina  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic disc  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Central artery of retina  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)"}
{"_id": "stanford_medicine_head_clean$$$corpus_142", "text": "Dissection of eye\n\t\t\t\t\t\t\t\t\t\t Interior of left eye cut in frontal plane\n\t\t\t\t\t\t\t\t\t\tThe eye has been cut across in a plane several millimeters posterior to its equator. The medial margins of the sclera lie in the center of the view with the anterior segment of the eye to the left.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic (visual) part of retina  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbiculus ciliaris  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Corona ciliaris  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral margin of sclera  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Crystalline lens  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ciliary process  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ora serrata  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Retina  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sclera  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Papilla of optic nerve and hollowed area for papilla  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Macula lutea  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Fovea centralis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Vorticose vein passing through sclera"}
{"_id": "stanford_medicine_head_clean$$$corpus_143", "text": "Dissection of eye\n\t\t\t\t\t\t\t\t\t\t Vascular tunic of right eye\n\t\t\t\t\t\t\t\t\t\tThe sclera and cornea have been cut away on the medial side of a right eye to display the anterior chamber (7), iris(6), ciliary body(10) and outer surface of the choroid. Although none of the vessels has been injected, the branches of the superior and inferior medial vorticose veins (13,18) are clearly visible. The long posterior ciliary artery (17) was cut across in the resection of the sclera but its course can be traced nearly to the ciliary body. The distribution of the short posterior ciliary arteries is represented by the vessel at 14.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sclera Lower pointer: Choroid  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of tendon of superior rectus muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbar conjunctiva  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Scleral sulcus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectinate ligament of iridocorneal angle (detached from inner surface of cornea)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior surface of iris  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior chamber of eye  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pupil  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Cornea  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ciliary muscle (meridional fibers)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Corneo-scleral border (rim)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Short diary nerves  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vorticose vein  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ciliary artery (short)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of optic nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ciliary artery (long)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Vorticose vein"}
{"_id": "stanford_medicine_head_clean$$$corpus_144", "text": "Insertion of extraocular muscles\n\t\t\t\t\t\t\t\t\t\t Left eye, posterior view\n\t\t\t\t\t\t\t\t\t\tThe fascia has been removed from the muscles and the eye, and the muscles retracted and stretched.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of superior rectus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sclera  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of optic nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior ciliary artery (long) Lower pointer: Position of macula lutea of retina (marked by *)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of lateral rectus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Short ciliary nerves  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of superior oblique muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vorticose veins  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ciliary arteries (short)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial rectus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vorticose veins  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of Inferior rectus muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_145", "text": "Insertion of extraocular muscles\n\t\t\t\t\t\t\t\t\t\t Left eye, anterior view\n\t\t\t\t\t\t\t\t\t\tThe muscles have been elevated and stretched.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of superior rectus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of superior oblique muscle (portion of tendon which originally passed through trochlea turned upward)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of medial rectus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Cornea  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sclera (conjunctiva and bulbar fascia removed)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of Inferior rectus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior ciliary artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Annulus conjunctivae overlying limbus corneae  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of lateral rectus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_146", "text": "Apex of orbit\n\t\t\t\t\t\t\t\t\t\t Sheath of optic nerve, annular tendon, oculomotor foramen\n\t\t\t\t\t\t\t\t\t\tThe optic nerve and its sheath has been cut across close to the optic foramen. The annular tendon (8) is fused medially and superiorly with the sheath. It is separated from the sheath inferiorly and laterally to form the oculomotor foramen for the entry of the nasociliary branch of the ophthalmic nerve (17), the oculomotor nerve (11,17,23,24) and the abducens nerve (19) into the central part of the orbit from the superior orbital fissure. The opthalmic artery (18), in its passage through the optic canal an foramen, is embedded in the sheath of the optic nerve. The superior ophthalmic vein has been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior rectus muscle Lower pointer: Subarachnoid space  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator palpebrae superioris muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of optic nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Common annular tendon  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor foramen  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Periorbita  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior branch of oculomotor nerve (III) (branch to medial rectus muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial rectus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal cells (mucosa abnormally thickened)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater wing of sphenoid (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent meningeal branch of lacrimal artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior branch of oculomotor nerve (III) Lower pointer: Nasociliary nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Abducens nerve (VI)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ciliary ganglion  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior branch of oculomotor nerve (III) (branch to inferior oblique muscle)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior branch of oculomotor nerve (III) (branch to Inferior rectus muscle)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectus muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital muscle (muscle of M\u00fcller)"}
{"_id": "stanford_medicine_head_clean$$$corpus_147", "text": "Apex of orbit\n\t\t\t\t\t\t\t\t\t\t Relations of nerves, arteries and extraocular muscles, anterior view\n\t\t\t\t\t\t\t\t\t\tThe orbit has been sectioned in a frontal plane posterior to the eye. Fat, areolar connective tissue, nerves and blood vessels have been removed to demonstrate the fascia covering the extraordinary muscles and the eye. The fascia of the rectus muscles is thin posteriorly but becomes thick as the muscles approach the eye. It blends with the fascia of the bulb (Tenon's capsule) and, in addition, forms weblike folds (1) which extend between neighboring rectus muscles. The suspensory ligament of the eye has been described with the previous view.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior wall orbit  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator palpebrae superioris muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasociliary nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic artery (passes inferior to optic nerve in this specimen)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II) (within sheath of optic nerve)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory bulb  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Medial rectus muscle Right pointer: Muscular branch of oculomotor nerve (III)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal cells (mucosa abnormally thickened)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Periorbita  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior rectus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior branch of oculomotor nerve (III)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Abducens nerve (VI)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ciliary artery (long)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ciliary ganglion  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Short ciliary nerves  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of oculomotor nerve (III) to inferior oblique muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of oculomotor nerve to inferior rectus muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectus muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital artery and nerve in infraorbital sulcus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital muscle (muscle of M\u00fcller) within Inferior orbital fissure  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary sinus"}
{"_id": "stanford_medicine_head_clean$$$corpus_148", "text": "Orbital fascia\n\t\t\t\t\t\t\t\t\t\t Fascia related to left eyeball, posterior view\n\t\t\t\t\t\t\t\t\t\tThe orbit has been sectioned in a frontal plane posterior to the eye. Fat, areolar connective tissue, nerves and blood vessels have been removed to demonstrate the fascia covering the extraordinary muscles and the eye. The fascia of the rectus muscles is thin posteriorly but becomes thick as the muscles approach the eye. It blends with the fascia of the bulb (Tenon's capsule) and, in addition, forms weblike folds (1) which extend between neighboring rectus muscles. The suspensory ligament of the eye has been described with the previous view.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior rectus muscle (retracted superiorly) Lower pointer: Weblike fold of fascia between superior and lateral rectus muscles  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus muscle (retracted laterally)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sheath of optic nerve Lower pointer: Optic nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Subarachnoid space (spatium intervaginalium)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbar fascia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectus muscle (retracted inferiorly)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary sinus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator palpebrae superioris muscle (retracted superiorly)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cranial fossa  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior oblique muscle Lower pointer: Infratrochlear nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cribriform plate ethmoid bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial rectus muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal septum (cut through)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial check ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal cell (fossa for lacrimal sac lies anterior to this air cell)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Common nasal meatus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal concha  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal meatus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal concha  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Opening of nasolacrimal duct into Inferior nasal meatus"}
{"_id": "stanford_medicine_head_clean$$$corpus_149", "text": "Orbital fascia\n\t\t\t\t\t\t\t\t\t\t Fascia related to left eyeball, anterior view\n\t\t\t\t\t\t\t\t\t\tThe eyelids have been removed, and the bulbar conjunctiva and underlying bulbar fascia have been cut away except for narrow bands (16). The fascia surrounding the extraocular muscles has been cleared of areolar connective tissue and cut away in places to expose the tendons of the rectus muscles and the belly  of the inferior oblique muscle. This fascia is attached to the walls of the orbit to form the medial (5) and lateral (18) check ligaments. The part of the fascia which passes beneath the eye and merges with the check ligaments is the suspensory ligament of the eye (Lockwood).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Frontal artery Left pointer: Supratrochlear nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratrochlear nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior oblique muscle (covered by fascia) Lower pointer: Superior oblique muscle (in background)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle palpebral artery (cut off)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial check ligament  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of medial rectus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial palpebral ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal duct  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cornea Lower pointer: Sclera  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of inferior rectus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital margin  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital margin  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Fascia above Ievator palpebrae superioris muscle Lower pointer: Aponeurosis of levator palpebrae superioris (cut off)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Fascia between levator palpebrae superioris and rectus superior muscles Lower pointer: Tendon of superior rectus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsalis muscle (muscle of M\u00fcller) (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lacrimal gland Lower pointer: Conjunctiva and bulbar fascia  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of lateral rectus muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral check ligament (attached to orbital tubercle of zygomatic bone)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Annulus conjunctivae overlapping limbus corneae  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior part of muscle fascia which forms suspensory ligament of eye  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_150", "text": "Dissection of left orbit from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Structures related to medial orbital wall; nerve supply to medial and inferior rectus muscles\n\t\t\t\t\t\t\t\t\t\tThe eye and optic nerves have been removed to display the medial rectus muscle, the superior oblique muscle and its trochlea, as well as related blood vessels and nerves. The lacrimal canaliculi(8) are cut across at the point at which they penetrate the lacrimal fascia. Short ends of muscle fibres (9) indicate the attachment of the lacrimal part of the orbicularis oculi muscle (Horner's muscle). The attachment of the medial check ligament (7) to the posterior lacrimal crest is shown, although the relation of this fascial band to the medial rectus muscle has been disturbed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of superior oblique muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Supratrochlear nerve (cut off within orbit but shown here in relation to trochlea and its anastomosis with the infratrochlear nerve)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratrochlear nerve (palpebral branches visible posterior to pointer)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal nasal artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior ethmoidal nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial check ligament (attached to posterior lacrimal crest)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal duct (cut off)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrirnal part orbicularis oculi muscle (attached to lacrimal fascia)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Medial wall of orbit Lower pointer: Inferior wall of orbit  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital sulcus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasociliary nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial rectus muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of common annular tendon (cut through)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III) (branches of inferior division of nerve enter medial and inferior rectus muscles)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ophthalmic nerve (VI) Lower pointer: Semilunar ganglion (trigeminal)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Abducens nerve (VI)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve (V)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep petrosal nerves (usually described as a single nerve, here two filaments join the greater superficial petrosal nerve)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Vidian nerve (of pterygoid canal)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenopalatine ganglion"}
{"_id": "stanford_medicine_head_clean$$$corpus_151", "text": "Dissection of left orbit from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Eye sectioned vertically, optic nerve and papilla\n\t\t\t\t\t\t\t\t\t\tThe eye has been sectioned in a parasagittal plane and the optic sheath partially resected. The inferior division of the oculomotor nerve(17) has been preserved. Other nerves which enter the orbit have been transected. The left internal carotid artery is visible withing the cavernous sinus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial and smooth muscle parts of the insertion of the levator palpebrae superioris muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior rectus muscle (cut off) Lower pointer: Ciliary body (distorted)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Interior surface of sclera Lower pointer: Lens  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Papilla optic nerve Lower pointer: Cornea (distorted)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial rectus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of inferior oblique and inferior rectus muscles which contributes to formation of suspensory ligament of eye  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique muscle (cut off)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital margin  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital nerve (within infraorbital canal)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary sinus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator palpebrae superioris muscle and nasociliary nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve and ophthalmic artery (within optic canal)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavernous sinus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Abducens nerve (VI) (cut off) Left pointer: Inferior branch oculomotor nerve (III)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pterygopalatine fossa Lower pointer: Vidian nerve (of pterygoid canal)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending palatine artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_152", "text": "Dissection of left orbit from a lateral approach\n\t\t\t\t\t\t\t\t\t\t General view of orbit, eye and optic pathway to lateral geniculate body\n\t\t\t\t\t\t\t\t\t\tThe eye has been sectioned in a sagittal plane and the sheath of the optic nerve cut away. The optic nerve (7) and the opthalmic artery(10) are visible passing through the optic canal which has been opened by removal of the anterior clinoid process. The sphenoid sinus extended into this process and has been cut open inferior to the opthalmic artery. The dissection of areas in the lower part of the view is shown in detail elsewhere.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Falx cerebri  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic chiasm  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoidal border  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tracts  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Levator palpebrae superioris muscle Lower pointer: Superior rectus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital margin (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Medial rectus muscle Lower pointer: Optic nerve (II)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sclera (internal surface) Lower pointer: Cornea (somewhat distorted)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Crystalline lens  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior rectus muscle Lower pointer: Inferior oblique muscle (cut off)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary sinus (opened)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery right  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Third ventricle (opened)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior colliculus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral geniculate body  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic tract  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery left  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar ganglion (trigeminal)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Abducens nerve (VI)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Major superficial petrosal nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus (opened)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenopalatine ganglion  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Auditory tube (Eustachian) (opened) Lower pointer: Levator veli palatini muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary artery (pterygopalatine portion, cut off)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve emerging from stylomastoid foramen"}
{"_id": "stanford_medicine_head_clean$$$corpus_153", "text": "Dissection of left orbit from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Eye and sheath of optic nerve; ophthalmic artery and ciliary ganglion\n\t\t\t\t\t\t\t\t\t\tThe superior rectus muscle has been cut from its origin and elevated. More of the annular tendon has been resected and the frontal and trochlear nerves have been severed. The inferior oblique muscle has been cut and turned inferiorly to show its nerve and arterial supply.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of levator palpebrae superioris muscle: Upper pointer: Tarsalis muscle (the aponeurosis of the levator muscle to which this attaches is visible as a thin lamina just above the pointer) Lower pointer: Thick fascial layer extending from inferior surface of levator muscle to fornix of conjunctiva  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of superior rectus muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Eyeball  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasofrontal vein (cut off)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Nasociliary nerve Lower pointer: Ophthalmic artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of lateral rectus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of optic nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of inferior oblique muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of ophthalmic artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of inferior rectus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique muscle (cut and deflected inferiorly)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Muscular branch of Oculomotor nerve Right pointer: Levator palpebrae superioris muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior rectus muscle and muscular branch of oculomotor nerve (III)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Common annular tendon Right pointer: Bony roof of optic canal (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Optic nerve (II) (within cranial cavity) Lower pointer: Sheath of optic nerve (within optic canal)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Long roots of diary ganglion Lower pointer: Ophthalmic nerve (frontal and lacrimal branches cut away)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Abducens nerve (VI) (cut off)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Short branches of ciliary ganglion Left pointer: Central retinal artery (this artery enters optic sheath and is not related to muscular artery (9) which descends medial to the sheath)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve (foramen rotundum cut away)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Branch of inferior division of oculomotor nerve Lower pointer: Inferior rectus muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sphenopalatine nerves Lower pointer: Sphenopalatine artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_154", "text": "Dissection of left orbit from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Nerve supply to a superior rectus and levator palpebrae superioris muscles\n\t\t\t\t\t\t\t\t\t\tThe muscles have been elevated. Branches of the superior division of the oculomotor nerve(16) enter the superior rectus muscle. Branches of the nerve also pass through the muscle or along its medial border to reach the inferior surface of the levator palpebrae superioris muscle(12).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of oculomotor nerve (III) entering levator palpebrae superioris muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior rectus muscle Lower pointer: Fascia extending between borders of superior and lateral rectus muscles  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of optic nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ciliary arteries (long and short)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of inferior oblique muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of lateral rectus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Short ciliary nerves  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of oculomotor nerve to inferior oblique muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucoperiosteum of maxillary sinus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator palpebrae superioris muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tracts  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Optic nerve (ll) Lower pointer: Sheath of optic nerve (in optic canal)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior branch oculomotor nerve (III) Lower pointer: Inferior branch oculomotor nerve (llI)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Frontal nerve Lower pointer: Lacrimal nerve (cut off)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Nasociliary nerve Lower pointer: Abducens nerve (cut off)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Common annular tendon (divided) Left pointer: Ophthalmic artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ciliary ganglion  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of ophthalmic artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenopalatine ganglion  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital sulcus"}
{"_id": "stanford_medicine_head_clean$$$corpus_155", "text": "Dissection of left orbit from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Relation of muscle fascia to Tenon's capsule; insertion of lateral rectus and inferior oblique muscles\n\t\t\t\t\t\t\t\t\t\tThe bone of the orbital margin has been resected and the fascia which covered the insertion of the lateral rectus and inferior oblique muscles cut and reflected. The continuity of the muscle fascia with the bulbar fascia (Tenon's capsule) is visible. The lacrimal gland has been cut away except for  a few lobules of its inferior portion. THe lateral expansion of the aponeurosis of the levator palpebrae superioris muscle crosses this area(4). A few muscle fibres from this muscle appear to end in a the fascia related to the lacrimal gland (4, upper pointer).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Falx cerebri  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator palpebrae superioris muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital nerve and artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior lacrimal gland Lower pointer: Lateral horn of aponeurosis of levator palpebrae superioris muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of blending of fascia of lateral rectus muscle with that of the bulh  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital margin  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tunica conjunctiva bulbar  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sclera  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of lateral rectus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tunica conjunctiva bulbar (elevated together with anterior extension of bulbar fascia)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique muscle and related fascia  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery and nerve to inferior oblique muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital branch of infraorbital artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital nerve within infraorbital canal (cut open)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior anterior alveolar nerve Lower pointer: Mucoperiosteum of maxillary sinus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior ophthalmic vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior rectus muscle Lower pointer: Ophthalmic artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of optic nerve (optic canal opened)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Branch of oculomotor nerve (III) to superior rectus muscle Lower pointer: Nasociliary nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Common annular tendon (cut open to show contents of \"oculomotor foramen\")  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Abducens nerve (VI) entering lateral rectus muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Ciliary ganglion  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Short ciliary nerves (no distinct long ciliary branches of nasociliary nerve were present)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ciliary artery (long)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of optic nerve  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectus muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus and sphenopalatine ganglion  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of pterygoid canal  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital artery (cut off)"}
{"_id": "stanford_medicine_head_clean$$$corpus_156", "text": "Dissection of left orbit from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Lateral rectus muscle reflected; ciliary nerves and ganglion\n\t\t\t\t\t\t\t\t\t\tThe lateral rectus muscle has been cut in its midportion and the ends reflected to display structures located more centrally in the orbit. These have been exposed by removal of lobules of fat and delicate connective tissue.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior lacrimal gland  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital margin  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital fat pad  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus muscle (cut end reflected anteriorly)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Eyeball covered by bulbar fascia  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of optic nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Short ciliary nerves  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ciliary artery (long)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior ophthalmic vein (note large communicating vein between this vessel and the superior ophthalmic vein)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Periorbita  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital artery and vein  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior wall orbit and levator palpebrae superioris muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior rectus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimalis artery and vein and superior ophthalmic vein  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior limit of superior orbital fissure Lower pointer: Recurrent meningeal branch of lacrimal artery (cut off)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Abducens nerve entering lateral rectus muscle Right pointer: Muscular branch of ophthalmic artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus muscle (cut and reflected posteriorly)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ciliary ganglion  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior rectus muscle Lower pointer: Branch of oculomotor nerve (III) to inferior oblique muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve (V)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_157", "text": "Dissection of left orbit from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Relation of orbital structures to brain stem and cranial nerves II-V\n\t\t\t\t\t\t\t\t\t\tThe brain has been removed except for the brain stem, optic chiasm and optic tracts. The tentorium has been cut away and the cavernous sinus opened to show the course of cranial nerves related to the orbit with the exception of the abducens nerve which remains almost completely covered.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tract right (cut off at attachment to olfactory trigone)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic chiasm and internal carotid artery (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Optic nerve (II) Lower pointer: Anterior clinoid process (attachment of tentorium visible)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior rectus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic nerve (V1)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve (V2)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid process sphenoid bone (partially resected)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pterygoid muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior clinoid process  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of peduncle (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lateral geniculate body Lower pointer: Optic tract  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Tentorial nerve (recurrent meningeal branch of ophthalmic nerve, which in this specimen grossly appears to be a branch of the trochlear nerve; the tentorium has been cut away from the nerve)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar ganglion (trigeminal)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Major superficial petrous nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular nerve (V3)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus"}
{"_id": "stanford_medicine_head_clean$$$corpus_158", "text": "Dissection of left orbit from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Relation of orbital contents to structures within pterygopalatine fossa\n\t\t\t\t\t\t\t\t\t\tThe lateral wall and part of the roof (16) of the orbit have been cut away and a narrow rim of bone left at the orbital margin (3) for orientation. The position of the superior and inferior orbital fissures may still be identified posteriorly near the roof and floor of the orbit because of the nerves (22,23,24), blood vessels (20,26), smooth muscle (11) and fascia which have been retained. For the size and shape of the fissures in the bony orbit reference should be made to 37-1.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of superior lacrimal gland  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal artery and vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital margin  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut end of anastomotic branch of lacrimal nerve with zygomatic nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral check ligament  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior musclar branch of ophthalmic artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of blending of fascias of lateral and inferior rectus muscles and inferior oblique muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticofacial branch of zygomatic nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Periorbita of floor of orbit  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital muscle (M\u00fcller's muscle situated within inferior orbital fissure)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucoperiosteum of maxillary sinus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior posterior alveolar nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator palpebrae superioris muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior wall orbit (cut away)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior rectus muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior ophthalmic vein  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent branch of lacrimal artery which communicated through superior orbital fissure with middle meningeal artery)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior clinoid process  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic nerve (VI) entering Superior orbital fissure  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Abducens nerve (VI)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of oculomotor nerve (III) to inferior oblique muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Branch of Inferior ophthalmic vein Lower pointer: Orbital branch of sphenopalatine ganglion  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen rotundum  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Zygomatic nerve Lower pointer: Cut surface of greater wing of sphenoid bone  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve (V2)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal branch of artery of pterygoid canal  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary nerve plexus  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_159", "text": "Dissection of left orbit from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Contents of orbit in relation to cranial cavity, brain stem and cavernous sinus\n\t\t\t\t\t\t\t\t\t\tThe left half of the calvaria has been removed and the cerebral hemispheres cut away to expose the optic chiasm (4, lower pointer) and the left optic tract(19) which passes posteriorly to the lateral geniculate body (17). The cavernous sinus has been opened and the contents of the pterygopalatine fossa dissected. The lacrimal gland (7) has been partially resected and structures within the orbit more fully exposed than in previous views. Details of the dissection of the cavernous sinus are to be found in reels 50-7 and 51-1 ff.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Falx cerebri  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cranial fossa right  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser wing sphenoid bone (covered by dura mater)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal carotid artery right Lower pointer: Optic chiasm  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tracts  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior rectus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior lacrimal gland (partially removed)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III) (branch to inferior oblique muscle)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plate of pterygoid process  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cranial fossa right  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Temporal bone (squamous part) (in background) Lower pointer: Pineal body  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of peduncle (cut across at transition into internal capsule)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral geniculate body left  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Edge of tentorium cerebelli (brain stem protrudes upward through tentorial incisure)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Optic tract Lowerpointer: Mesencephalon (pointer on base of peduncle)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Oculomotor nerve (III) within subarachnoid space Lower pointer: Oculomotor nerve (II) within cavernous sinus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV) within cavernous sinus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic nerve (V) within cavernous sinus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar ganglion (trigeminal)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Maxillary nerve (V) within cavernous sinus Lower pointer: Mandibular nerve (V)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery (cut across)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid cells (dissected)"}
{"_id": "stanford_medicine_head_clean$$$corpus_160", "text": "Dissection of left orbit from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Lateral rectus muscle; communication of lacrimal and zygomatic nerves\n\t\t\t\t\t\t\t\t\t\tThe periorbita has been resected and the bony walls of the orbit cut away more than previously. A thin layer of fat separated the lateral rectus muscle from the periorbita. This fat has been removed from along with that surrounding other structures within the orbit. The fascia of the lateral rectus muscle is intact, but is extremely thin through most of its extent. Anteriorly the fascia thickens rapidly and has a broad attachment to the orbital tubercle of the zygomatic bone to form the lateral check ligament (6).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior lacrimal gland  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomotic branch of lacrimal nerve with zygomatic nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Periorbita (split into two layers to enclose lacrimal gland)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral palpebral raphe  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral check ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tunica conjunctiva  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia forming suspensory ligament for eye  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater of anterior cranial fossa  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior rectus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal artery and nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery (anterior branch)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior ophthalmic vein (lacrimal veins visible as tributaries)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of oculomotor nerve (III) to inferior oblique muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior ophthalmic vein (situated in periorbita which bridges across inferior orbital fissure)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital muscle (of M\u00fcller)"}
{"_id": "stanford_medicine_head_clean$$$corpus_161", "text": "Dissection of left orbit from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Periorbita\n\t\t\t\t\t\t\t\t\t\tThe bony wall of the middle cranial fossa has been removed so that the dura mater (9), which encloses the tip of the temporal lobe, is exposed. The dura has been retracted to reveal the lateral wall of the orbit, from which the bone has been cut. Windows cut in the bone of the anterior cranial fossa expose the dura mater (8) in two locations.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior lacrimal gland  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticofrontal suture  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Conjunctiva  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticofacial branch of zygomatic nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal fossa  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater of anterior cranial fossa  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater indented into middle cranial fossa  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Periorbita Lower pointer: Cut surface of greater wing of sphenoid at anterior limit of middle cranial fossa  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cranial fossa  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticotemporal branch zygomatic nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve within pterygopalatine fossa  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital muscle (M\u00fcller's muscle)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic branch of deep anterior temporal artery (cut oft)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_162", "text": "Dissection of left orbit from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Relation of lacrimal gland to periorbita and zygomatic nerve\n\t\t\t\t\t\t\t\t\t\tThe roof and lateral wall of the orbit have been cut away. The bony orbital margin has been preserved and the anterior wall of the middle cranial fossa (great wing of sphenoid bone) has been left undisturbed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater within anterior cranial fossa  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital margin  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Periorbita (partially cut away to reveal lacrimal gland)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior lacrimal gland  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticofrontal suture  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticotemporal branches zygomatic nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal nerve (terminal branches)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lashes  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Margin of skin Lower pointer: Inferior tarsus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Conjunctiva  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticofacial branches of zygomatic nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal fossa (origin of temporalis muscle)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomotic branch lacrimal nerve with zygomatic nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital fat pad"}
{"_id": "stanford_medicine_head_clean$$$corpus_163", "text": "Arteries of right orbital region of newborn\n\t\t\t\t\t\t\t\t\t\t Lateromedial roentgenogram\n\t\t\t\t\t\t\t\t\t\tAfter thorotrast had been injected into the right common carotid artery the head was section in the midsagittal plane and the brain removed. Near the apex of the orbit numerous muscular and ciliary arteries are visible but the identity of these is difficult to establish except for a few muscular branches which continue as anterior ciliary arteries (5,9). Many of the vessels have been omitted from the drawing.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery (in foreground)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior wall orbit  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal artery (along lateral wall of orbit)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal artery (along roof of orbit)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Arterial branch to medial rectus muscle Lower pointer: Ophthalmic artery (also see 7)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery (in foreground)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic artery (within optic canal)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Region of numerous small arterial branches including posterior ciliary arteries (short) and long and muscular branches (these branches are derived from all major branches of the ophthalmic artery but are not included in the drawing)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Arteries to inferior rectus muscle and inferior oblique muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Deep anterior temporal artery Lower pointer: Deep posterior temporal artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary artery (pterygopalatine portion)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary artery (pterygoid portion)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse facial artery (in foreground)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal bone (anterior margin)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior ethmoidal artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle palpebral artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsal arch (peripheral arcade, in communication with branch of lacrimal artery laterally)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsal arch (marginal arcade, incompletely injected laterally)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal nasal artery (in background)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Communication between lacrimal artery and transverse facial artery (in foreground)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Palpebral rim  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior tarsal arch  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Infraorbital margin Right pointer: Anterior margin of fossa of lacrimal sac (in background)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Infraorbital artery Lower pointer: Superior posterior alveolar artery  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_164", "text": "Dissection of right orbit from a superior approach\n\t\t\t\t\t\t\t\t\t\t Ciliary ganglion and connections; nerve supply to medial, inferior and lateral rectus muscles\n\t\t\t\t\t\t\t\t\t\tThe ophthalmic artery and its branches have been cut away to reveal the ciliary nerves (4) and ganglion (8) as well as the nerves which enter the rectus muscles. A distinct bulge occurs in each of the extraocular muscles just anterior to the point of entry of motor nerves into the muscle substance. A filament from the ophthalmic sympathetic plexus (10) joins the ciliary ganglion.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior ethmoidal artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior wall of orbit  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Short ciliary nerves  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial rectus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of oculomotor nerve (III) to medial rectus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique muscle (cut off)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ciliary ganglion  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasociliary nerve (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Filament from ophthalmic nerve plexus to ciliary ganglion  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV) (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic nerve (cut off)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior clinoid process  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of optic nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Position of macula lutea in interior of eyeball (marked by 4) Lower pointer: Insertion of inferior oblique muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral check ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of oculomotor nerve (III) to inferior oblique muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectus muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of oculomotor nerve (III) to inferior rectus muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Abducens nerve (VI)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of oculomotor nerve (III) to superior rectus muscle (cut off)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cranial fossa"}
{"_id": "stanford_medicine_head_clean$$$corpus_165", "text": "Dissection of right orbit from a superior approach\n\t\t\t\t\t\t\t\t\t\t Branches of ophthalmic artery\n\t\t\t\t\t\t\t\t\t\tThe optic nerve has been cut and the eye turned anteriorly. The central end of the optic nerve has been displaced from the optic canal to illustrate the course of the ophthalmic artery in a separate dural investment inferior to the nerve. Branches of this artery within the orbit presented such a complex pattern that it was necessary to displace the artery medially from its original position to demonstrate their arrangement. Branches to structures in the superior part of the orbit have been cut off. In the accompanying drawing smaller arterial branches have been omitted for the sake of simplicity.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial check ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ciliary artery (long) (within sclera)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior ethmoidal artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial rectus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ciliary artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior muscular branch of ophthalmic artery (branches pass to medial, inferior and lateral rectus muscles and inferior oblique muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ethmoidal artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal artery (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ciliary ganglion  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II) (elevated  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic artery entering optic canal  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of superior oblique muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal gland (inferior)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral check ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ciliary arteries (short)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (ll) within sheath  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Central artery of retina (continuity of artery interrupted in drawing but not in specimen)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ciliary artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of superior rectus muscle (cut off)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerves entering orbit through superior orbital fissure"}
{"_id": "stanford_medicine_head_clean$$$corpus_166", "text": "Dissection of right orbit from a superior approach\n\t\t\t\t\t\t\t\t\t\t Ophthalmic artery; ciliary nerves and arteries; sheath of optic nerve; insertion of superior oblique muscle\n\t\t\t\t\t\t\t\t\t\tThe superior rectus muscle has been cut and reflected to expose underlying structures. The fascia of the bulb (Tenon's capsule) has been partially cut away. Short ends of two vorticose veins (16) protrude from the sclera. In this specimen the ophthalmic artery passes beneath the optic nerve rather than above it. This is a rather common variation.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbar fascia  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sclera  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior ethmoidal artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Infratrochlear nerve Lower pointer: Anterior ethmoidal nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial rectus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of optic nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of oculomotor nerve entering superior rectus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior rectus muscle (cut and reflected)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of levator palpebrae superioris muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior rectus muscle (pointer near junction of muscle with tendon of insertion)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of superior oblique muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Vorticose veins (cut off)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral check ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Short ciliary nerves  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ciliary artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Abducens nerve (VI)"}
{"_id": "stanford_medicine_head_clean$$$corpus_167", "text": "Dissection of right orbit from a superior approach\n\t\t\t\t\t\t\t\t\t\t Superior rectus muscle and related fascia\n\t\t\t\t\t\t\t\t\t\tThe levator palpebrae superioris muscle has been cut and reflected anteriorly. The fascia (18) of the inferior surface of this muscle blends with that of the superior rectus muscle in the region of the eye. In addition, the fascia of the superior rectus muscle spreads medially (5) and laterally (20) to fuse with the fascia from neighboring rectus muscles. The tendon of the superior oblique muscle has been lifted from its trochlea (3). Note that the reflected part of this tendon, which passes under the superior rectus muscle, is encased in dense fascia continuous with that already described.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Corrugator supercilii muscle and frontal artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Supratrochlear nerve (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of superior oblique muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial expansion of fascia of superior rectus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbar fascia  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cribriform plate ethmoid bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial rectus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique muscle and trochlear nerve (IV)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasociliary nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery ethmoidalis posterior  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Common annular tendon  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II) and anterior clinoid process  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic chiasm  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery and optic tract  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator palpebrae superioris muscle (reflected)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia beneath levator muscle (17)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal gland (inferior)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral expansion of fascia of superior rectus muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral check ligament  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior rectus muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_168", "text": "Dissection of right orbit from a superior approach\n\t\t\t\t\t\t\t\t\t\t Insertion of levator palpebrae superioris muscle, anterosuperior view\n\t\t\t\t\t\t\t\t\t\tThe aponeurosis of insertion of the levator palpebrae superioris muscle (6) has been exposed. The superior part of the lacrimal gland has been cut away and the fascia removed from the aponeurosis. The upper eyelid (13) has been dissected to display the extension of this aponeurosis onto the anterior surface of the tarsus (12) as well as its attachment to the skin anterior to the tarsus (14). This insertion is also visible in reel 52-3. The insertion of the lateral \"horn\" of the aponeurosis into the orbital tubercle of the zygoma is visible at 11. The medial \"horn\" of the aponeurosis (23) extends downward toward the medial wall of the orbit. Variation in thickness of the bone of the lateral wall of the orbit is well shown in this view.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cranial fossa  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of optic nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior rectus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis muscle (within temporal fossa)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator palpebrae superioris muscle and its aponeurosis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral check ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Area for lacrimal gland  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontosphenoidal process of zygomatic bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral horn of aponeurosis of levator palpebrae superioris muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of levator palpebrae superioris muscle extending to anterior surface of superior tarsus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior palpebra  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous insertion of fibers of aponeurosis of levator palpebrae superioris muscle (partially cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal cell (medial)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial rectus muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal cell (anterior)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia surrounding reflected part of tendon of superior oblique muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial horn of aponeurosis of Ievator palpebrae superioris muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal artery  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Corrugator supercilii muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_169", "text": "Dissection of right orbit from a superior approach\n\t\t\t\t\t\t\t\t\t\t Relation of aponeurosis of levator palpebrae superioris muscle to tendon of superior oblique muscle and lacrimal gland\n\t\t\t\t\t\t\t\t\t\tThe bone of the orbital margin has been resected and the fascia covering the levator palpebrae muscle removed. Subcutaneous structures of the supraorbital region (13-16) have been preserved along with the thickened rim of periorbita at the margin of the orbit (17). The superior orbital fissure (24) has been opened to display nerves which traverse it. The superior ophthalmic vein has been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Reflected part of tendon of superior oblique muscle (the thick fascia which surrounds the tendon blends with fascia of the levator and superior rectus muscles as well as with the bulbar fascia)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Supratrochlear nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia covering medial rectus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior ethmoidal artery and nerve (entering anterior ethmoidal foramen)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator palpebrae superioris muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ethmoidal artery (posterior ethmoidal nerve absent)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Common annular tendon Lower pointer: Trochlear nerve (IV)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Corrugator supercilii muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital artery (supraorbital branch of ophthalmic artery absent in this specimen)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Communicating branch between supraorbital nerve and facial nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Periorbita at supraorbital margin  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of levator palpebrae superioris muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior lacrimal gland  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior rectus muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Eyeball  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior orbital fissure (opened)"}
{"_id": "stanford_medicine_head_clean$$$corpus_170", "text": "Dissection of right orbit from a superior approach\n\t\t\t\t\t\t\t\t\t\t General relations of structures within orbit; orbital fascia\n\t\t\t\t\t\t\t\t\t\tBone has been cut away from the roof of the orbit and the ethmoidal sinuses opened. The periorbita has been resected and the orbital fat removed. The arrangement of muscle fascia anteriorly in the orbit is of particular interest. The muscles have not yet been stripped of intrinsic fascia, but this is so thin posteriorly that it is barely discernable except over the superior oblique muscle (12). The fascia becomes dense only where the muscles approach the eye. Here it spreads away from the muscle borders into neighboring areas.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus (opened)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of superior oblique muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of frontal nerve which communicates with infratrochlear nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of superior oblique muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory nerve (I)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratrochlear nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior ophthalmic vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory bulb  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior ethmoidal nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal air cell (medial)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior ethmoidal artery Lower pointer: Ethmoidal cell (posterior)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Roof of optic canal (upper root of lesser wing of sphenoid bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater and optic nerve (II)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior clinoid process  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Supratrochlear nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal nerve (supraorbital and frontal branches not separated)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of levator palpebrae superioris muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator palpebrae superioris muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of superior rectus muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Periorbita  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior rectus muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal nerve, artery, and vein  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior ophthalmic vein  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal nerve"}
{"_id": "stanford_medicine_head_clean$$$corpus_171", "text": "Palpebral arteries\n\t\t\t\t\t\t\t\t\t\t Anterior view of right eyelids\n\t\t\t\t\t\t\t\t\t\tThe margins of the lids, the tarsal plates and the conjunctival sac have been exposed. The orbital roof and levator palpebrae superioris muscle have been cut away and the orbital fat removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique muscle (tendon removed)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Ophthalmic artery (in depths of dissection) Left pointer: Sclera  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Conjunctiva (outer surface)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior tarsal arch (peripheral arcade) Lower pointer: Superior tarsus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsal arch (marginal arcade)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Skin of lid margin  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral palpebral branch of lacrimal artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsal branch of zygomatico-orbital artery (this vessel has only minute branches communicating with lacrimal artery (7)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital margin (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral palpebral raphe  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral palpebral branch of zygomatico-orbital artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior tarsal branch of zygomatico-orbital artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior tarsus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Palpebral cunjunctiva (outer surface) Lower pointer: Sclera  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oculi muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital branch of transverse facial artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital margin  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital branch of infraorbital artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital vein  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Small artery which enters osseous canal in frontal process of maxilla  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal nasal artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Middle palpebral artery (superior) Lower pointer: Medial check ligament  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle palpebral artery (inferior)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Arterial branch to lacrimal caruncle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial palpebral ligament  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of orbicularis oculi muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Arterial branch to lacrimal sac  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior tarsal arch (marginal and peripheral arcades are present but not as well defined as in upper eyelid)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Anterior ciliary artery Right pointer: Inferior rectus muscle  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique muscle  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular vein  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_172", "text": "Dissection of left orbit from an anterior approach\n\t\t\t\t\t\t\t\t\t\t Lacrimal sac and nasolacrimal duct opened\n\t\t\t\t\t\t\t\t\t\tValve-like mucosal folds (15) are visible in the nasolacrimal duct. The one which guards the opening of the duct into the inferior nasal meatus (valve of Hasner, 17) extends about 5 mm. below the opening of the bony nasolacrimal canal (16). The tendon of the superior oblique muscle has been exposed within the trochlea (4) and its relation to the insertion of the levator palpebrae superioris muscle displayed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital nerve and vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Supratrochlear nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of superior oblique muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratrochlear nerve and dorsal nasal artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle palpebral artery (inferior)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix lacrimal sac  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal process of maxilla  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Site of entry of lacrimal canaliculi into lacrimal sac (sinus of Maier)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal sac (opened)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital margin  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasolacrimal duct (opened; upper pointer, cavity; lower pointer, outer surface)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal concha and middle nasal meatus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosal folds within nasolacrimal duct  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal concha (cut across to illustrate bony wall of nasolacrimal canal)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Lacrimal folds Right pointer: Opening of nasolacrimal duct  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosa of Inferior nasal concha (note venous plexus)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal meatus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal septum  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsalis muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal puncta and ampulla of superior lacrimal duct  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior Iacrimal punctum  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial ocular angle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior lacrimal duct  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior conjunctival fornix  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteal lining of nasolacrirnal canal  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital foramen  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior anterior alveolar artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_173", "text": "Dissection of left orbit from an anterior approach\n\t\t\t\t\t\t\t\t\t\t Lacrimal sac; bony nasolacrimal canal opened\n\t\t\t\t\t\t\t\t\t\tThe lacrimal sac (6) has been uncovered by removal of the medial palpebral ligament and reflection of the lacrimal fascia (5). The lacrimal canaliculi converge toward a common opening through the lateral wall of the sac. The bony nasolacrimal canal and nasal fossa have been exposed by grinding away part of the maxilla and nasal bone. The periosteal lining of the nasolacrimal canal is undisturbed. A thin edge of the infraorbital margin remains at 13.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratrochlear nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibers of origin of orbicularis oculi muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal process of maxilla  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal fascia (cut away)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal sac  7\n\t\t\t\t\t\t.\n\t\t\t\t\t External nasal branches anterior ethmoidal nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral nasal cartilage  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of maxilla  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum lining nasal fossa  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial bony wall of nasolacrimal canal  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteal lining of nasolacrimal canal  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital margin  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal cavity  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosal lining of nasal septum (dissected)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal cartilage  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosal lining of lateral wall of nose (dissected)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal concha (line of attachment to wall of nasal fossa)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle palpebral artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior lacrimal duct (opened)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal puncta  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lacrimal caruncle Lower pointer: Inferior lacrimal duct (opened)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior conjunctival fornix  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of inferior oblique muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital fat pad  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior alveolar artery  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital artery and nerve"}
{"_id": "stanford_medicine_head_clean$$$corpus_174", "text": "Dissection of left orbit from an anterior approach\n\t\t\t\t\t\t\t\t\t\t Bulbar conjunctiva; lacrimal canaliculi opened\n\t\t\t\t\t\t\t\t\t\tThe palpebral conjunctiva has been removed from both eyelids to expose the conjunctival fornices and bulbar conjunctiva. The tarsal plates, medial and lateral palpebral ligaments and lacrimal canaliculi remain in place. The canaliculi have been opened (5,9) to reveal their ampullae.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Supratrochlear nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle palpebral artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal fascia overlying lacrimal sac (some fibers of origin of the orbicularis oculi muscle remain)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ampulla of superior lacrimal duct (opened)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior lacrimal duct  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial palpebral ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial ocular angle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ampulla inferior lacrimal duct (opened)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital margin  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of levator palpebrae superioris muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of levator palpebrae superioris muscle (cut off)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsalis muscle (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior conjunctival fornix  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbar conjunctiva  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Skin supporting cilia of lower lid  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior tarsus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbar conjunctiva  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia forming suspensory ligament of eye"}
{"_id": "stanford_medicine_head_clean$$$corpus_175", "text": "Dissection of left orbit from an anterior approach\n\t\t\t\t\t\t\t\t\t\t Tarsal plates; lacrimal canaliculi; fascia supporting eye\n\t\t\t\t\t\t\t\t\t\tThe supporting tarsal muscle (16) has been detached from the margin of the tarsus and resected to uncover the conjunctival membrane (17). The orbital septum has been cut away to expose the trochlea encased in dense fascia. The fascia (24) which encloses the inferior oblique muscle (12) extends laterally to the orbital tubercle of the zygoma and medially to the posterior lacrimal crest. It also blends with the fascia of the inferior rectus muscle and with the fascia of the bulb. The sling-like support thus formed for the eye is often referred to as the suspensory ligament (of Lockwood).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Supratrochlear nerve and superior oblique muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratrochlear nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasofrontal vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle palpebral artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital fascia converging toward attachment to posterior lacrimal crest  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of superior part of orbicularis oculi muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior lacrimal duct  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial palpebral ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial ocular angle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior lacrimal duct  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital margin  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of levator palpebrae superioris muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of levator palpebrae superioris muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsalis muscle (cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Conjunctiva  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsus and tarsal (Meibomian) glands  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticofrontal suture  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral palpebral artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior tarsus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Conjunctiva  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Suspensory ligament of eye (see text above) Lower pointer: fat pad of orbit"}
{"_id": "stanford_medicine_head_clean$$$corpus_176", "text": "Dissection of left orbit from an anterior approach\n\t\t\t\t\t\t\t\t\t\t Inferior lacrimal part of orbicularis oculi muscle\n\t\t\t\t\t\t\t\t\t\tThe muscle fibers have been separated to show their inward extension toward the lacrimal fascia. This portion of the orbicularis muscle together with its counterpart in the upper eyelid is known as Horner's muscle. The underlying orbital septum (18) is not as distinctly membranous here as it is in the upper part of the orbit.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratrochlear nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle palpebral artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital septum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of superior part of orbicularis oculi muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial palpebral ligament  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasomaxillary suture  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of inferior part of orbicularis oculi muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery in periosteum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral nasal cartilage  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep vein (unnamed)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial horn of aponeurosis of levator palpebrae superioris muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial part of superior tarsalis muscle (M\u00fcller's muscle, composed here of connective tissue with no evident smooth muscle fibers)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior lacrimal duct Lower pointer: Position of lacrimal puncta  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial ocular angle (medial canthus)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal part orbicularis. oculi muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle palpebral artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital septum  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital margin"}
{"_id": "stanford_medicine_head_clean$$$corpus_177", "text": "Dissection of left orbit from an anterior approach\n\t\t\t\t\t\t\t\t\t\t Relation of orbital septum to aponeurotic and smooth muscle insertions of levator palpebrae superioris muscle\n\t\t\t\t\t\t\t\t\t\tThe aponeurosis of the levator palpebrae superioris muscle has been cut back so that the entire extent of the tarsal muscle is visible. Smooth muscle fibers are less evident in the extreme lateral and medial parts of this layer. The orbital septum does not appear to be a complete membrane in the lateral and inferior parts of the orbit, but rather consists of fibrous bands intermingled with lobules of fat. The layer of connective tissue which extended betweeen the orbicularis oculi muscle and the orbital septum has been completely removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital nerve, artery, and vein  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of origin of corrugator supercilli muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital septum (detached from aponeurosis of levator palpebrae muscle)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Supratrochlear nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Position of trochlea Lower pointer: Infratrochlear nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasofrontal vein emerging from orbit  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of upper part of orbicularis oculi muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle palpebral artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior canaliculus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial palpebral ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibers of orbicularis oculi muscle (cut across near origin)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasomaxillary suture  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal process of maxilla  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Small artery along periosteum  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticomaxillary suture  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital margin of orbit  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of levator palpebrae superioris muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of Ievator palpebrae superioris muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process frontal bone  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsalis muscle (muscle of M\u00fcller)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsus and tarsal (Meibomian) glands  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral palpebral artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior tarsus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital branch (aberrant) from external maxillary artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital septum  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatico-facial branch of zygomatic nerve  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic bone"}
{"_id": "stanford_medicine_head_clean$$$corpus_178", "text": "Dissection of left orbit from an anterior approach\n\t\t\t\t\t\t\t\t\t\t Muscle fibers near medial angle of eyelids\n\t\t\t\t\t\t\t\t\t\tNote that no fibers attach to the anterior surface of the medial palpebral ligament.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratrochlear nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscle fibers which joined frontalis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum covering nasal bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of superior part of orbicularis oculi muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of inferior part of orbicularis oculi muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal part orbicularis oculi muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial palpebral ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular head of levator labii superioris muscle (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Corrugator supercilii muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Supratrochlear nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital septum (note its downward extension deep to the orbicularis muscle toward an attachment on the posterior lacrimal crest)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of levator palpebrae superioris muscle (upper pointer, cutaneous insertion; lower pointer, tarsal insertion)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle palpebral artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior palpebral nerves  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal duct  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal lake  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial ocular angle"}
{"_id": "stanford_medicine_head_clean$$$corpus_179", "text": "Dissection of left orbit from an anterior approach\n\t\t\t\t\t\t\t\t\t\t Orbital septum; tarsal plates; insertion of levator palpebrae superioris muscle\n\t\t\t\t\t\t\t\t\t\tThe aponeurosis of the levator palpebrae superioris muscle has been partially elevated to illustrate its insertion (18) into the anterior surface of the tarsus. Laterally the aponeurosis has been reflected (16) to expose the tarsal muscle (17), a layer of smooth muscle which extends between the superior margin of the tarsal plate and the deep surface of the aponeurosis of the levator palpebrae muscle. This layer is known as M|ller's muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Corrugator supercilii muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Supratrochlear nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratrochlear nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle palpebral artery (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal nasal artery emerging from orbit  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal part of orbicularis oculi muscle (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial palpebral ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Small artery in periosteum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of inferior portion of orbicularis oculi muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular head of levator labii superioris muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of facial nerve which supply above muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital margin and zygomatico-orbital artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital septum  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of levator palpebrae superioris muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsal muscle (muscle of Mu\u0308ller)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of aponeurosis of levator palpebrae superioris muscle into superior tarsus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior palpebral nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsus (Meibomian glands visible)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal nerve and artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior tarsus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Fat beneath orbicularis oculi muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of facial nerve to orbicularis oculi muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of external maxillary artery which enters orbit  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior palpebral branch of infraorbital nerve"}
{"_id": "stanford_medicine_head_clean$$$corpus_180", "text": "Dissection of left orbit from an anterior approach\n\t\t\t\t\t\t\t\t\t\t Branches of trigeminal and facial nerves in orbital and infraorbital regions\n\t\t\t\t\t\t\t\t\t\tPortions of the orbicularis oculi muscle remain over the medial parts of the eyelids but have been reflected in various ways to show underlying structures. The zygomatic muscle (24) and zygomatic head of the quadratus labii superioris muscle (26) have been partially removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Supratrochlear nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratrochlear nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Fascia over superior tarsus Lower pointer: Medial palpebral artery (branch which communicates with supraorbital artery displaced inferiorly)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending branches of dorsal nasal artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal nasal artery emerging from orbit  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomotic branch between infratrochlear nerve and facial nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular vein (divided)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oculi muscle (reflected upward)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular head of levator labii superioris muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior palpebral branches of infraorbital nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External nasal branch infraorbital nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar branch of angular artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital head of levator labii superioris muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Communications between buccal branches of facial nerve and superior labial branches of infraorbital nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial branches of infraorbital nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital septum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticotemporal branch zygomatic nerve and zygomatico-orbital artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsus and lacrimal nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Layer of fat beneath orbicularis oculi muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticofacial branch of zygomatic nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Communication between zygomatic branch facial nerve and inferior palpebral branch of infraorbital nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Malar surface zygomatic bone  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticus muscle (cut across)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatico-maxillary suture  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic head of levator labii superioris muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal branches of facial nerve  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseter muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct (cut across)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_181", "text": "Dissection of left orbit from an anterior approach\n\t\t\t\t\t\t\t\t\t\t Orbital septum; corrugator supercilii muscle\n\t\t\t\t\t\t\t\t\t\tThe orbicularis oculi muscle has been cut away and the connective tissue beneath removed to expose nerves, vessels and fascial structures of the upper lid. The layer of fat (18) originally extended medially between the orbicularis muscle (5) and the orbital septum (16).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontalis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Corrugator supercilii muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Supratrochlear nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratrochlear nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oculi muscle (divided and partially removed)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial palpebral artery (note branch which passes superiorly to communicate with supraorbital artery)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut end of lacrimal part orbicularis oculi muscle (superior portion of Horner's muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial palpebral ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal bone (covered by periosteum)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t External nasal branch anterior ethmoidal nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular artery and vein  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontalis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch supraorbital nerve (communicates in part with temporal branch of facial nerve)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal nerve (note contribution to palpebral nerves)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital margin of orbit (periosteum intact)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital septum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior palpebral branches of frontal, supratrochlear, and infratrochlear nerves  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Layer of fat beneath orbicularis oculi muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of levator palpebrae superioris muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal nerve"}
{"_id": "stanford_medicine_head_clean$$$corpus_182", "text": "Dissection of left orbit from an anterior approach\n\t\t\t\t\t\t\t\t\t\t Insertion of levator palpebrae superioris muscle\n\t\t\t\t\t\t\t\t\t\tThe orbicularis oculi muscle has been incised vertically and retracted to expose deeper structures in the upper eyelid. The insertion of the aponeurosis of the levator palpebrae superioris muscle into the deep surface of the orbicularis oculi muscle is visible at 16. Some of the fibers of this aponeurosis continue to insert into the skin of the eyelid. A thin layer of fascia covers the tarsal plate (18).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending branches of infratrochlear nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontalis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch of infratrochlear nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Procerus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular artery and nasal branch of angular vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle palpebral ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Junction of nasal bone with lateral nasal cartilage  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse part of nasalis muscle (left half reflected)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal branch of angular artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular head of levator labii superioris muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External nasal branch of anterior ethmoidal nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Corrugator supercilii muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Layer of fat between orbicularis oculi muscle and orbital septum (not yet exposed)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital part orbicularis oculi muscle (retracted)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis levator palpebrae superioris muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Palpebral part of orbicularis oculi muscle (retracted)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of skin supporting cilia  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Palpebral part of orbicularis oculi muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital part orbicularis oculi muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticus muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_183", "text": "Dissection of left orbit from an anterior approach\n\t\t\t\t\t\t\t\t\t\t Orbicularis oculi muscle; superficial nerves and blood vessels\n\t\t\t\t\t\t\t\t\t\tThe skin and subcutaneous tissue have been removed except for a narrow margin retained at the edges of the eyelids.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending branches of supratrochlear nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending branches of dorsal nasal artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontalis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending branches of infratrochlear nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branches of infratrochlear nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Procerus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial palpebral ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse part of nasalis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular head of levator Iabii superioris muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal branch of angular artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Corrugator supercilii muscle (insertion cut off by removal of skin of eyebrow)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch supraorbital nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal branch facial nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital part orbicularis oculi muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Palpebral part of orbicularis oculi muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Skin supporting lashes at lid margin  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral palpebral raphe (ligament)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticofacial branch of zygomatic nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior palpebral branch of infraorbital nerve"}
{"_id": "stanford_medicine_head_clean$$$corpus_184", "text": "Eye and eyelids\n\t\t\t\t\t\t\t\t\t\t Surface features, right eye\n\t\t\t\t\t\t\t\t\t\tThe eyelids have been opened more widely than normal to expose the entire extent of the cornea.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lashes  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior palpebral limbus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lirnbus of cornea (annulus conjunctivae located at limbus)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sclera and bulbar sheath  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral palpebral commissure  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral ocular angle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Minor annulus of iris  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Major annulus of iris  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior palpebral limbus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior palpebral limbus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Supercilium  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior orbitopalpebral fold Lower pointer: Superior palpebra  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pupil  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior lacrimal papila and puncta  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal lake  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal caruncle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial palpebral commissure  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial ocular angle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior lacrimal papila (punctum not clearly visible)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior palpebra"}
{"_id": "stanford_medicine_head_clean$$$corpus_185", "text": "Scalp\n\t\t\t\t\t\t\t\t\t\t Superficial nerves and blood vessels of scalp, posterior view\n\t\t\t\t\t\t\t\t\t\tThe superficial layers of the scalp have been dissected to illustrate the distribution of the occipital nerves and artery as well as the underlying musculature. The complex pattern of smaller veins and arteries of the scalp was not demonstrated in this specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Galea aponeurotica  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipitalis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior auricular muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular lymph nodes  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph vessel  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser occipital nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital lymph nodes  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital major nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital branch of occipital artery (lateral branch)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous branches of third occipital nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Scalp  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital branch of occipital artery (medial branch)"}
{"_id": "stanford_medicine_head_clean$$$corpus_186", "text": "Scalp\n\t\t\t\t\t\t\t\t\t\t Superficial nerves and blood vessels of scalp, anterolateral view\n\t\t\t\t\t\t\t\t\t\tArteries, veins and nerves which lie in the tela subcutanea have been exposed. Branches of the supraorbital nerve (1) lie mostly beneath the galea aponeurotica and consequently are exposed only near their terminations.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of supraorbital nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal vein (posterior branch)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal vein (anterior branch)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of temporalis muscle beneath galea aponeurotica and temporal fascia  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal branch superficial temporal artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal branch superficial temporal artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Galea aponeurotica  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontalis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal artery (supraorbital artery faintly visible beneath frontalis muscle in a parallel, more lateral position)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital vein  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomosis of superficial veins with middle temporal vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsus and orbicularis oculi muscle (cut away)"}
{"_id": "stanford_medicine_head_clean$$$corpus_187", "text": "Floor of cranial cavity\n\t\t\t\t\t\t\t\t\t\t Structures inferior to left middle cranial fossa (continued); maxillary and mandibular nerves\n\t\t\t\t\t\t\t\t\t\tStructures lying within the pterygopalatine, infratemporal and temporal fossae have been dissected. The bone of the lateral wall of the orbit has been cut away but smooth muscle bridging the inferior orbital fissure (8) has been left in situ. The anterior (15) and posterior (17) deep temporal nerves are shown as they pass into the temporal muscle (20). The masseteric nerve (18) passes laterally across the external pterygoid muscle (16) to enter the mandibular notch. An articular branch of this nerve is visible. (18, lower pointer). Other dissections of branches of the mandibular nerve to the muscles of mastication are to be found in 64-7 ff.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Mucosal lining of sphenoid sinus Lower pointer: Olfactory bulb  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ophthalmic artery Lower pointer: Optic nerve (II)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic nerve (VI)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Periorbita  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve passing through foramen rotundum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Orbital muscle (smooth muscle within inferior orbital fissure) Lower pointer: Inferior part of orbit  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygopalatine fossa  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior posterior alveolar branches superior alveolar nerves  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid venous plexus (partially removed)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep temporal nerve anterior  16\n\t\t\t\t\t\t.\n\t\t\t\t\t External pterygoid muscle (superior fascicle)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep temporal nerve posterior  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Masseteric nerve Lower pointer: Articular branch of masseteric nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery (anterior branch)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis muscle (medial surface)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Hypophysis (midsagittal section) Lower pointer: Sella turcica (bone removed anteriorly to display sphenoid sinus)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Abducens nerve (VI) Lower pointer: Internal carotid artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Major portion of trigeminal nerve (V)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid nerve plexus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar ganglion and minor portion trigeminal nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sphenoid bone (cut across at junction of body and pterygoid process) Lower pointer: Venous plexus of foramen ovale (bony wall removed)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Major superficial petrosal nerve  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lesser superficial petrosal nerve Lower pointer: Middle meningeal artery (cut across)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Facial nerve (VII) (within internal acoustic meatus) Lower pointer: Cochlea  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vestibulocochlear nerve (VIII) (vestibular part) Lower pointer: Vestibule  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniculate ganglion facial nerve  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Chorda tympani  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Semicircular canal lateral  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Incus  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic cavity  36\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Capitulum condyloid process of mandible Lower pointer: Articular disc of mandible (partially cut away)  37\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus"}
{"_id": "stanford_medicine_head_clean$$$corpus_188", "text": "Floor of cranial cavity\n\t\t\t\t\t\t\t\t\t\t Structures inferior to left middle cranial fossa, superior view\n\t\t\t\t\t\t\t\t\t\tThe bone has been cut away from central and lateral regions of the middle cranial fossa. The cavities of the left middle and inner ear have been opened.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosa of sphenoid sinus (bony wall removed)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Periorbita (in areas adjacent to this the bony roof of the orbit has been partially cut away to reveal an extensive network of veins within the substance of the bone)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III) and trochlear nerve (IV)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve (V2) passing into foramen rotundum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic nerve (Vl)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater wing of sphenoid (cut across near junction with body of sphenoid bone)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular nerve (V3) passing into foramen ovale  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum covering contents of pterygopalatine fossa (exposed by cutting away overlying bone)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum of infratemporal fossa (fibers of origin of external pterygoid muscle are visible)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen ovale (periosteal lining intact)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Thickened margin of dura mater along crest which separates anterior from middle cranial fossa  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sella turcica  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Major superficial petrous nerve and middle meningeal artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Cochlea  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII) (pointer at junction of internal acoustic meatus and facial canal)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vestibule Lower pointer: Semicircular canal (lateral)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior part of tympanic cavity Lower pointer: Incus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular disc of mandible  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic antrum  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum of external acoustic meatus"}
{"_id": "stanford_medicine_head_clean$$$corpus_189", "text": "Floor of cranial cavity\n\t\t\t\t\t\t\t\t\t\t Middle cranial fossa; dissection of left cavernous sinus (continued); internal carotid artery; hypophysis sectioned in midsagittal plane\n\t\t\t\t\t\t\t\t\t\tCommunicating branches between the sympathetic plexus on the internal carotid artery and the abducens nerve have been exposed and the ophthalmic sympathetic nerve (2) traced onto the ophthalmic artery. The course of the internal carotid artery (13) is seen in relation to the sella turcica (12).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypophyseal branch of internal carotid artery right  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic artery and ophthalmic nerve plexus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II) (anterior clinoid process cut away)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Oculomotor nerve (III) Lower pointer: Trochlear nerve (IV)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic nerve entering superior orbital fissure  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior ophthalmic vein (bone of lateral wall of orbit cut away)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior clinoid process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Infundibulum Lower pointer: Posterior pituitary (hypophysis)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior pituitary (hypophysis)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar venous plexus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sella turcica (dura mater stripped away posteriorly to expose small veins and artery)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Abducens nerve (VI)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavernous nerve plexus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of internal carotid artery to semilunar ganglion and meninges of cavernous sinus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenopetrosal ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar ganglion"}
{"_id": "stanford_medicine_head_clean$$$corpus_190", "text": "Floor of cranial cavity\n\t\t\t\t\t\t\t\t\t\t Middle cranial fossa; dissection of left cavernous sinus (continued); portio minor of trigeminal nerve; abducens nerve; carotid plexus\n\t\t\t\t\t\t\t\t\t\tThe trigeminal nerve has been turned laterally to expose its motor root (18), the fibrous tissue partially closing the foramen lacerum (16), and the relations of the carotid artery and cavernous plexus of nerves (14).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Circular sinus and hypophysis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery and optic nerve (II)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery within cavernous sinus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Branch of internal carotid artery to meninges and semilunar ganglion Lower pointer: Communication between internal carotid sympathetic plexus and ophthalmic nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic nerve (V1)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavernous sinus near junction with superior ophthalmic vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve (V2)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior clinoid process  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Petroclinoid ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Abducens nerve (VI) Lower pointer: Apex of pyramid  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavernous nerve plexus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater forming medial wall of trigeminal (Meckel's) cave  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater bridging across sphenopetrous fissure  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar ganglion  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Minor portion trigeminal nerve (V)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater superficial petrosal nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Major portion of trigeminal nerve (V) (reflected laterally)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser superficial petrosal nerve"}
{"_id": "stanford_medicine_head_clean$$$corpus_191", "text": "Floor of cranial cavity\n\t\t\t\t\t\t\t\t\t\t Middle cranial fossa; dissection of left cavernous sinus (continued); semilunar ganglion; petrosal nerves\n\t\t\t\t\t\t\t\t\t\tMore veins have been cut away to expose the three divisions of the trigeminal nerve (8,10,20) the abducens nerve (14) and the petrosal nerves (19,21).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Circular sinus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberculum sellae  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Band of dura mater extending between anterior and posterior clinoid processes  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic foramen  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic nerve (V1)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior orbital fissure  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve (V2) entering foramen rotundum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar venous plexus and posterior clinoid process  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentous band of dura mater extending from tip of petrous part of temporal bone to sphenoid bone (petrodinoid ligament)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Abducens nerve (VI)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Major portion of trigeminal nerve (V)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Meckel's cave  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Filament of cavernous nerve plexus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar ganglion (trigeminal)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Thin lamina of bone which covers carotid canal Lower pointer: Major superficial petrous nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular nerve (V3)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser superficial petrosal nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery (cut off)"}
{"_id": "stanford_medicine_head_clean$$$corpus_192", "text": "Floor of cranial cavity\n\t\t\t\t\t\t\t\t\t\t Middle cranial fossa; dissection of left cavernous sinus, superolateral view\n\t\t\t\t\t\t\t\t\t\tThe dura mater to the left of the midline has been cut away. Structures which pass through the cavernous sinus are partially exposed. The continuity of the venous spaces in this sinus with those in the circular and basilar sinuses is illustrated. Latex-filled veins have been cleared away from the internal carotid artery at 15.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery right and optic nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior clinoid process  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of superior orbital fissure  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic nerve (V)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavernous sinus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inner surface of an unusual venous sinus which passed posteriorly into the superior petrosal sinus (see also Section I, 42)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cranial fossa  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of internal carotid artery to hypophysis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V) entering Meckel's cave  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Circular sinus and infundibulum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum sellae  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III) and posterior clinoid process  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar venous plexus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery (cavernous part)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavernous nerve plexus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of communication of cavernous nerve plexus with oculomotor, trochlear and ophthalmic nerves  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater enclosing trigeminal nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater part of trigeminal nerve (V)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of tentorium cerebelli  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar ganglion (trigeminal)"}
{"_id": "stanford_medicine_head_clean$$$corpus_193", "text": "Floor of cranial cavity\n\t\t\t\t\t\t\t\t\t\t Structures in region of sella turcica; origin of ophthalmic arteries, superior view\n\t\t\t\t\t\t\t\t\t\tThe optic nerves have been transected and elevated. To the left of the midline the dura mater has been cut away to display the cavernous sinus (8), basilar plexus of veins (11) and dorsum sellae (20).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tract  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II) (elevated)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic artery and anterior clinoid process  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm of sella  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic nerve (VI)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior communicating artery and oculomotor nerve (III)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavernous sinus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tentorium cerebelli (cut away)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar ganglion (trigeminal)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar venous plexus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Boundary between anterior and middle cranial fossae  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Arachnoid matter (extending into optic canal)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberculum sellae  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of internal carotid artery right to hypophysis  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypophysis (visible through diaphragmatic foramen)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Infundibulum (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve entering cavernous sinus (note sac-like eversion of dura mater similar to Meckel's cave)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior clinoid process  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum sellae  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Orifice in margin of tentorium cerebelli to accommodate trochlear nerve (IV)"}
{"_id": "stanford_medicine_head_clean$$$corpus_194", "text": "Floor of cranial cavity\n\t\t\t\t\t\t\t\t\t\t Structures inferior to anterior and middle cranial fossae; orbit and sinuses opened\n\t\t\t\t\t\t\t\t\t\tViews of the dissection of the contents of the orbit from this approach are found in 54-1 ff.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Infundibulum leading into nasofrontal duct  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Frontal nerve Lower pointer: Levator palpebrae superioris  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ethmoidal nerve (usually a branch of the ophthalmic nerve in this case the fibers accompany the trochlear nerve)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ethmoidal artery in posterior ethmoidal foramen  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal nerve and superior ophthalmic vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Periorbita (area of fusion with common annular tendon)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve (V2)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Abducens nerve (VI)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Vidian nerve of pterygoid canal (below floor of sphenoid sinus)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar ganglion (trigeminal)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular nerve (V3)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavernous nerve plexus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal cell (anterior)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior ethmoidal nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Cribriform plate ethmoid bone  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior ethmoidal artery (in anterior ethmoidal foramen)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal cell (posterior)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ethmoidal vein  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Aperture of sphenoid sinus Lower pointer: Sphenoid sinus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (ll)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Circular sinus Lower pointer: Hypophysis (left half removed)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Sella turcica  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum sellae  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar venous plexus"}
{"_id": "stanford_medicine_head_clean$$$corpus_195", "text": "Floor of cranial cavity\n\t\t\t\t\t\t\t\t\t\t Structures inferior to anterior and middle cranial fossae\n\t\t\t\t\t\t\t\t\t\tBone has been removed to expose structures underlying the floor of the anterior part of the cranial vault.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosa of frontal sinus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital part of frontal bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of anterior ethmoidal foramen (opened)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory bulb  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Periorbita  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosa of ethmoidal cell (posterior)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of maxillary sinus (in depths of view)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary nerve (V)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Part of pterygoid venous plexus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep temporal nerve posterior  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic nerve (VI)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t External pterygoid muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Abducens nerve (VI)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista galli  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosa of sphenoid sinus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cranial fossa  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerves (II)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery (right and left)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypophysis (left half cut away)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Sella turcica  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum sellae"}
{"_id": "stanford_medicine_head_clean$$$corpus_196", "text": "Floor of cranial cavity\n\t\t\t\t\t\t\t\t\t\t Anterior cranial fossa; terminal nerve; olfactory bulb and tract, superior view\n\t\t\t\t\t\t\t\t\t\tThe dura mater has been removed from the bone to the left of the midline except in the region of the cribriform plate. Ther terminal nerve (3) was cut at the point of its penetration through the arachnoid membrane covering the gyrus rectus on the inferior surface of the frontal lobe.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of foramen caecum frontal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior meningeal artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Terminal nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory bulb (several of the numerous olfactory nerves are visible passing from the bulb into the cribriform plate)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tract  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser wing sphenoid bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior clinoid process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Crista galli Lower pointer: Cut edge of falx cerebri  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater covering orbital part of frontal bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerves (ll)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Ophthalmic artery Right pointer: Internal carotid artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_197", "text": "Floor of cranial cavity\n\t\t\t\t\t\t\t\t\t\t Cranial fossae and sites of exit of cranial nerves, posterior view\n\t\t\t\t\t\t\t\t\t\tThe dura mater has been stripped from the left half of the posterior fossa to open venous sinuses. Views of the atlantooccipital ligaments are to be found in 80-2 ff.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Olfactory tract Lower pointer: Optic nerve (II)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sella turcica  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Venous sinus (unnamed) Middle pointer: Trochlear nerve (IV) Right pointer: Oculomotor nerve (III)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Trigeminal nerve (V) Lower pointer: Superior petrosal sinus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Facial nerve (VII) (intermediate nerve lies just below pointer) Lower pointer: Acoustic nerve (VllI)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse sinus (sigmoid part)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery (retracted laterally)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal root cervical nerve II  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cranial fossa  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser wing sphenoid bone (covered by dura mater)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Middle meningeal artery Lower pointer: Middle cranial fossa  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar venous plexus (connecting inferiorly with inferior petrosal sinus)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Abducens nerve (VI)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cranial fossa  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (Xll)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior meningeal artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal cord  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of axis"}
{"_id": "stanford_medicine_head_clean$$$corpus_198", "text": "General orientation views of dissection\n\t\t\t\t\t\t\t\t\t\t Midsagittal section of head and neck, right lateral view\n\t\t\t\t\t\t\t\t\t\tA close-up view of the larynx of this specimen is to be found in 83-6.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Scalp  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Calvaria  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Falx cerebri Lower pointer: Superior sagittal sinus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Great cerebal vein Left pointer: Straight sinus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Mesencephalon Lower pointer: Cerebral aqueduct  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Confluence of the sinuses  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Fourth ventricle Lower pointer: Pons  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebellum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medulla oblongata  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Margins of foramen magnum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebellomedullary cistern (cisterna magna)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch atlas  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior arch atlas Lower pointer: Dens axis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process axis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal cord  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Laryngeal part of pharynx  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Fornix Right pointer: Corpus callosum  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Third ventricle Lower pointer: Interpeduncular cistern  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Optic chiasm Lower pointer: Hypophysis  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal cavity  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal septum (partially cut away)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Bony auditory tube Lower pointer: Nasal part pharynx  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Hard palate  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Oral cavity Lower pointer: Soft palate  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Tongue  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Oral part pharynx  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniohyoid muscle  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Hyoid bone  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottis  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Larynx (plica vocalis)  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea"}
{"_id": "stanford_medicine_head_clean$$$corpus_199", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Ansa lenticularis\n\t\t\t\t\t\t\t\t\t\tThis view is a close-up of the previous one but the specimen is now turned at right angles so that the midline is at the bottom. Details of the ansa lenticularis (13) in its course around the medial edge of the cerebral peduncle are revealed. Some fibers of this group are also seen as they pass inward between fascicles of the peduncle and these join others above the peduncle to form the fasciculus lenticularis (H2 field of Forel) in the subthalamic region.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral geniculate body  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic tract (cut and retracted posteriorly)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary body  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Putamen  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal capsule  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Globus pallidus (external division)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior commissure  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ansa lenticularis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of Heubner  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Diagonal band of Broca  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Radiating fibers of rostral lamina of corpus callosum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cerebral artery (cut across)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory trigone  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)"}
{"_id": "stanford_medicine_head_clean$$$corpus_200", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Relations of internal capsule, lentiform nucleus and ansa lenticularis\n\t\t\t\t\t\t\t\t\t\tThe anterior half of the lentiform nucleus has been cut away to expose the internal capsule. Broken ends of fibres seen protruding from the capsule joined the external medullary lamina which is visible on the cut surface of the lentiform nucleus. The upper part of the external capsule remains in place. The mass of fibers (15) passing across the cerebral peduncle consists mainly of efferent fibers from the medial division of the globus pallidus which loop around the medial margin of the peduncle. Some of these fibers penetrate between bundles of the peduncle (or internal capsule) to form the fasciculus lenticularis internally. The optic tract is divided and turned posteriorly.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal part of operculum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent artery of Heubner  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cerebral artery (retracted laterally)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t External capsule (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal capsule  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior longitudinal fasciculus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lentiform nucleus (putamen)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniculocalcarine tract  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of caudate nucleus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibers radiating from rostral lamina of corpus callosum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital gyrus (dissected)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tract  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic chiasm  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior part of anterior commissure  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ansa lenticularis  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic tract (retracted posteriorly)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery (cut across)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons"}
{"_id": "stanford_medicine_head_clean$$$corpus_201", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t External capsule, lentiform nucleus and deeper course of striate arteries\n\t\t\t\t\t\t\t\t\t\tThe main trunk of the middle cerebral artery has been retracted far laterally, the medullary center of the insula removed and the claustrum scraped away. The external capsule has been partially removed, the remaining portion being turned laterally to expose the lentiform nucleus. The course of the lateral striate arteries into the lentiform nucleus is visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital gyrus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cerebral artery (divided and turned laterally)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior longitudinal fasciculus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal part of operculum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t External capsule (reflected laterally)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lentiform nucleus (putamen)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral striate artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Amygdaloid nucleus (partially removed)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Stria terminalis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniculocalcarine tract (cut across close to its origin from lateral geniculate body)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior occipitofrontal fasciculus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fissure (cerebral)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory trigone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent branch of anterior cerebral artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuber cinereum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroidal artery (anterior)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Interpeduncular fossa  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery (divided)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampus (cut across)"}
{"_id": "stanford_medicine_head_clean$$$corpus_202", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Medullary substance of insula\n\t\t\t\t\t\t\t\t\t\tThe cortex of the insula has been removed to expose the medullary substance immediately beneath it. The brain is now viewed from a slightly different angle but the configuration of branches of the middle cerebral artery is easily compared with the previous stage of dissection. The temporal lobe is not cut away further nor is the inferior occipitofrontal bundle altered. The choroid plexus is removed from the opened inferior horn of the lateral ventricle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Meninges (at former limit of temporal lobe)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of insula  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Uncinate fasciculus (cut across)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal part of operculum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Roof of inferior horn, lateral ventricle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral geniculate body  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroidal branch of posterior cerebral artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cerebral artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic tract  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior occipitofrontal fasciculus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebellum (cut across)"}
{"_id": "stanford_medicine_head_clean$$$corpus_203", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Inferior occipitofrontal fasciculus, limen insulae and arteries of choroid plexus\n\t\t\t\t\t\t\t\t\t\tMore tissue of the temporal lobe and hippocampus has been removed. The relation of the inferior occipitofrontal fasciculus to both the insula and the inferior horn of the lateral ventricle is demonstrated. The uncinate bundle is cut off as it courses deep to the limen insulae. The anterior choroidal artery is seen as it penetrates the choroid plexus of the inferior horn of the lateral ventricle. The choroidal branch of the posterior cerebral artery is visible as its passes across the inferior surface of the lateral geniculate body.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cerebral artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Limen insulae  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Uncinate fasciculus (cut across)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior occipitofrontal fasciculus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Long insular gyrus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Amygdaloid nucleus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroidal artery (anterior)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior horn of lateral ventricle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal part of operculum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroidal branch of posterior cerebral artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral geniculate body  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampus (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Fusiform gyrus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic tract  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior communicating artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons"}
{"_id": "stanford_medicine_head_clean$$$corpus_204", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Contents of lateral fissure exposed by partial resection of temporal lobe\n\t\t\t\t\t\t\t\t\t\tThe temporal lobe has been further cut away to expose the insula, the frontal operculum and branches of the middle cerebral artery lying in the lateral fissure. The arachnoid membrane and pia mater which covered a part of the resected temporal lobe are left in situ. The hypophysis has been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Meninges (arachnoid and pia mater encephali)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbitofrontal branch of middle cerebral artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior temporal artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Insula  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal part of operculum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cerebral artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Striate artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of precentral sulcus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior occipitofrontal fasciculus (cut obliquely)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior horn of lateral ventricle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tapetum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial temporal gyrus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior temporal gyrus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior temporal sulcus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Fusiform gyrus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital branch of anterior cerebral artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tract  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroidal artery (anterior)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic tract  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary body  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampus (cut across)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral fissure  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar artery  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Olive"}
{"_id": "stanford_medicine_head_clean$$$corpus_205", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Close-up view of arteries entering anterior perforated substance\n\t\t\t\t\t\t\t\t\t\tThe hypophysis and optic chiasm are retracted toward the pons. The right posterior communicating artery (17) is divided and the internal carotid artery displaced forward to demonstrate the recurrent branch of the anterior cerebral artery (artery of Heubner) and the perforating branches of the anterior choroidal artery.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital gyrus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cerebral artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral striate branch of middle cerebral artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Entrance to insula  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroidal artery (anterior)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Amygdaloid nucleus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus lateral ventricle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tract  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fissure (cerebral)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Straight gyrus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital branch of anterior cerebral artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior communicating artery (divided)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cerebral artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent artery of Heubner  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic chiasm  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic tract  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypophysis  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_206", "text": "General orientation views of dissection\n\t\t\t\t\t\t\t\t\t\t Deep dissection of head and neck, left lateral view; brain removed\n\t\t\t\t\t\t\t\t\t\tThe left half of the calvaria has been removed and the cerebral hemispheres cut away to expose the left optic tract (2) encircling the cerebral peduncle (26). The close-up views which illustrate more details of this dissection are to be found as follows\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Falx cerebri  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic tract  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus muscle (lateral wall of orbit cut away)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic nerve in cavernous sinus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Maxillary nerve Lower pointer: Sphenopalatine artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal cavity (opened)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Buccal nerve (crossing internal maxillary artery) Lower pointer: Lateral plate of pterygoid process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxilla (partially cut away)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle (cut away to expose tongue)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Tongue Lower pointer: Medial incisor (sectioned)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual gland  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior belly digastric muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricothyroid muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery (cut across)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternoclavicular articulation  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Junction of tentorium cerebelli with falx cerebri  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Lambdoidal suture  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lateral geniculate body Lower pointer: Base of peduncles  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar ganglion (CN V)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: External acoustic meatus (auricle removed) Lower pointer: Mastoid cells (dissected)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  31\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid artery  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly of digastric muscle  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior alveolar nerve Lower pointer: Lingual nerve  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pterygoid muscle  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  36\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle  37\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve IV  38\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus cervicis muscle  39\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  40\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  41\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scalene muscle  42\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial plexus (cut across through roots)  43\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery (cut off)  44\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I (periosteum removed to show small area of rib)"}
{"_id": "stanford_medicine_head_clean$$$corpus_207", "text": "General orientation views of dissection\n\t\t\t\t\t\t\t\t\t\t Deep facial dissection, left lateral view; internal maxillary artery\n\t\t\t\t\t\t\t\t\t\tThe bony lateral wall of the orbit has been completely removed except for a narrow bridge at the orbital margin. The dura mater of the anterior (4) the middle (6) cranial fossae is visible through openings cut in the skull. The internal maxillary artery (11) has been exposed by removal of much of the left half of the mandible as well as the temporal and internal pterygoid muscles. Close-up views which illustrate more details of this dissection are to be found as follows\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronal suture  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior temporal line  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater encephali (in anterior cranial fossa)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior lacrimal gland  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery and dura mater encephali (in middle cranial fossa)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic bone (partially cut away)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal maxillary artery (note plexus venosus pterygoideus)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pterygoid muscle (area for insertion on angle of mandible appears as broad crescentic white portion at inferior end of muscle)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental nerve (emerging from mental foramen)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior belly digastric muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid muscle (reflected laterally)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal bone  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of temporalis muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle temporal artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital bone (squamous part)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Lambdoidal suture and intersutural bone  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cut end of zygomatic arch Lower pointer: Articular disc for mandible  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: External acoustic meatus Lower pointer: Styloid process temporal bone  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid cells (cut open)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly of digastric muscle  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid nerve  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual nerve (pointer in area of submandibular ganglion)  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Common facial vein  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (Xll)  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  36\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery (pointer at bifurcation)  37\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_208", "text": "General orientation views of dissection\n\t\t\t\t\t\t\t\t\t\t Deep facial dissection, lateral view; temporal muscle; course of facial nerve through parotid gland\n\t\t\t\t\t\t\t\t\t\tThe masseter muscle has been completely removed and the zygomatic arch cut away. The parotid gland and duct have been preserved. The superficial part of the gland has been dissected to expose the course of the facial nerve (23) from the stylomastoid foramen through the substance of the gland. The sternocleidomastoid muscle has been cut from its cranial attachments. Close-up views which illustrate more details of this dissection are to be found as follows\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronal suture  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cut end of zygomatic arch Lower pointer: Muscle tendon arising from deep surface of zygomatic arch, inserting with temporalis muscle but innervated by a branch of the masseteric nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of coronoid process of mandible  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Attachment of tendon of masseter muscle to zygomatic bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Accessory parotid gland Lower pointer: Parotid duct  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of mandible  13\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular gland  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lambdoidal suture  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipitalis muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital branch of posterior auricular nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial temporal artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser occipital nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: External acoustic meatus Lower pointer: Mastoid process  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle (pointer in area previously covered by sternocleidomastoid muscle)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII) and parotid gland  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (cut off)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior deep cervical lymph nodes  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior facial vein  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein (visible in opening cut through carotid sheath)"}
{"_id": "stanford_medicine_head_clean$$$corpus_209", "text": "General orientation views of dissection\n\t\t\t\t\t\t\t\t\t\t Deep facial dissections; masseter muscle reflected, anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe orbicularis oculi muscle has been removed except for remnants of its origins medially. The tarsal plate (4) of the upper eyelid has been exposed together with the corrugator supercilii muscle (2) and nerves emerging through the orbital septum. The skeleton of the nose has been exposed. In the oral region muscle fibers have been retracted to demonstrate the labial arteries (12,15). The masseter muscle has been freed from its zygomatic origin as well as its mandibular insertion and then reflected posteriorly. The masseteric nerve and vessels can thus be traced through the depths of the muscle from their entry point near its posterosuperior border. Close-up views which illustrate more details of this dissection are to be found as follows\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscle frontalis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscle corrugator supercilii  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Supratrochlear nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tarsus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscle procerus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Palpebral part of orbicularis oculi muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular head of levator labii superioris muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal branch of angular artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater alar cartilage  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of infraorbital nerve and facial nerve (infraorbital plexus)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscle orbicularis otis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Depressor labii inferioris muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior labial artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Depressor anguli oris (reflected downward from labial commissure)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscle temporalis  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatico-orbital artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic arch and zygomatic muscle (cut off)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of zygomatic levator labii superioris muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid process of mandible (cut ends of fibers of insertion of masseter muscle cover the bone)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscle masseter (reflected posteriorly)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Body adiposum buccae Lower pointer: Parotid duct (cut off)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscle buccinator  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep facial lymph nodes and lymph vessels  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular gland"}
{"_id": "stanford_medicine_head_clean$$$corpus_210", "text": "General orientation views of dissection\n\t\t\t\t\t\t\t\t\t\t Parotid gland; distribution of facial nerve, lateral view\n\t\t\t\t\t\t\t\t\t\tThe parotideomasseteric fascia has been cut away to reveal the parotid gland and various branches of the facial nerve. In the temporal region the auricular muscles, orbicularis oculi muscle, galea aponeurotica and underlying temporal fascia have been resected but superficial branches of nerves and arteries have been preserved. The course of the external maxillary artery and anterior facial vein is displayed. The latter consists of several small vessels superiorly. In the cervical region the platysma has been extensively cut away and the external layer of deep cervical fascia removed. Close-up views which illustrate more details of this dissection are to be found as follows\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal fascia  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Auriculotemporal nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal branches of facial nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oculi muscle (partially removed)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic branches of facial nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticus muscle (cut across and reflected superiorly)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital branches of facial nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator labii superioris muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal branches of facial nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior facial vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Marginal mandibular branches of facial nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Platysma (cut across and reflected)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Mentalis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia enclosing submandibular gland  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch colli facial nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipitalis muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser occipital nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid gland  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater auricular nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseter muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (branch to trapezius muscle)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneus colli nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t External jugular vein  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial cervical lymph glands"}
{"_id": "stanford_medicine_head_clean$$$corpus_211", "text": "General orientation views of dissection\n\t\t\t\t\t\t\t\t\t\t Superficial structures of head and neck, posterior view\n\t\t\t\t\t\t\t\t\t\tClose-up views which illustrate more details of this dissection are to be found as follows\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Galea aponeurotica  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery (lateral branches)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior auricular muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipitalis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular lymph nodes  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle (covered by supeficial fascia)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous filaments of lesser occipital nerve and greater auricular nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Platysma  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (covered by superficial fascia)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior supraclavicular nerves  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Galea aponeurotica virtually absent in this area  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery (medial branch)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser occipital nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cervical triangle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous branch of posterior branch cervical nerve V"}
{"_id": "stanford_medicine_head_clean$$$corpus_212", "text": "General orientation views of dissection\n\t\t\t\t\t\t\t\t\t\t Superficial structures of head and neck; lateral view\n\t\t\t\t\t\t\t\t\t\tThe skin has been removed and the subcutaneous connective tissue dissected to display nerves, blood vessels and the facial musculature. Close-up views of selected areas of this dissection are to be found as follows\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal branch superficial temporal artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of supraorbital nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontalis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch frontal superficial temporal artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior auricular muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticotemporal branch zygomatic nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oculi muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatico-orbital artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic branches facial nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular head levator labii superioris muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory parotid gland  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal branch facial nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital head levator labii superioris muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Risorius muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbicularis oris muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Depressor anguli oris muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Depressor labii inferioris muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Mentalis muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Platysma  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Galea aponeurotica  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Auricularis superior muscle Lower pointer: Superficial temporal branches of auriculotemporal nerve  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser occipital nerve  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular lymph nodes  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid fascia  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Sterniocleidomastoid muscle (covered by superficial fascia)  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches lesser occipital nerve  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of greater auricular nerve  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater auricular it  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cervical triangle  36\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (covered by superficial fascia)  37\n\t\t\t\t\t\t.\n\t\t\t\t\t External jugular vein  38\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion  39\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle"}
{"_id": "stanford_medicine_head_clean$$$corpus_213", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right lower incisor, canine and first premolar teeth, anteroposterior roentgenogram\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial incisors (left and right)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral incisor  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar I  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar II  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual cusp  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal (facial) cusp  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Crown  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Root  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Substantia adamantina (enamel)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Substantia eburnea (dentine)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavity  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar border  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Interalveolar septa  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Root canal  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of root"}
{"_id": "stanford_medicine_head_clean$$$corpus_214", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right lower molar and premolar teeth, lateromedial roentgenogram\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Distolingual cusp  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mesiolingual cusp  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Mesiobuccal (mesiofacial) cusp  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar I  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar II  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar II  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar III (dens serotinus)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Distobuccal (distofacial) cusp  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Substantia adamantina (enamel) Lower pointer: Substantia eburnea (dentine)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavity  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Root canal  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular canal  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Crown  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Root  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of mandible  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental foramen"}
{"_id": "stanford_medicine_head_clean$$$corpus_215", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right upper premolar, canine and incisor teeth, anterosposterior roentgenogram\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial incisor  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral incisor  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar I  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar II  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial (buccal) cusp  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual cusp  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial border of right maxilla  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Alveolus Lower pointer: Root  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Interalveolar septa  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Root canal  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tooth neck  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Substentia eburnea (dentine)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Crown  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavity  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Substantia adamantina (enamel)"}
{"_id": "stanford_medicine_head_clean$$$corpus_216", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right upper molar and premolar teeth, lateromedial roentgenogram\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary sinus (Highmore)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots molar III (serotini) (incompletely formed)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar I  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar II  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar II  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar III (serotinus incompletely erupted)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior surface of maxilla  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior wall of maxillary sinus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine process of maxilla  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Root of canine  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Interalveolar septa  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Root canal  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar border  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavity  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Substantia ebumea (dentine)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Substantia adamantina (enamel)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Floor of maxillary sinus (note close proximity to dental alveoli)"}
{"_id": "stanford_medicine_head_clean$$$corpus_217", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Permanent right upper and lower teeth, lingual surfaces\n\t\t\t\t\t\t\t\t\t\tA. Superior teeth  B. Inferior teeth\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial incisor  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral incisor  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar II  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar II  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar III (dens serotinus)"}
{"_id": "stanford_medicine_head_clean$$$corpus_218", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Permanent right upper and lower teeth, facial surfaces\n\t\t\t\t\t\t\t\t\t\tA. Superior teeth. B. Inferior teeth.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial incisor  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral incisor  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar I  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar II  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar II  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar III  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Surface of mastication  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Crown  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Root  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of root  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Enamel  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Bony substance"}
{"_id": "stanford_medicine_head_clean$$$corpus_219", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Deciduous and permanent dentition at six years\n\t\t\t\t\t\t\t\t\t\tParts of the maxilla and mandible have been cut away to reveal the roots of the deciduous teeth and the nonerupted permanent teeth in various stages of development. The maxillary sinus has been opened. The permanent upper lateral incisor lies deep to the neighboring teeth and is not visible in the preparation.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary sinus (opened)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar II (permanent)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar II (permanent )  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar process of maxilla  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar I (permanent)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar II (deciduous)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar I (deciduous)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar II (permanent)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar I (permanent)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar II (deciduous)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar II (permanent)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Molar I (deciduous) Lower pointer: Premolar I (permanent)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental foramen  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform aperature  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital foramen  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine (permanent)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial incisor (permanent)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar I (permanent)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar border  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine (deciduous)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial incisor (deciduous)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral incisor (deciduous)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial and lateral incisors (deciduous)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine (deciduous)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial incisor (permanent)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral incisor (permanent)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine (permanent)"}
{"_id": "stanford_medicine_head_clean$$$corpus_220", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Dental alveoli of maxilla, inferior view\n\t\t\t\t\t\t\t\t\t\tThe third molar teeth are absent bilaterally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveoli for incisor  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolus for canine  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveoli for premolars  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveoli for molars  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Horizontal plate palatine bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Choanae  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plateofpterygoid process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular fossa  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid canal  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular fossa  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermaxillary suture  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Incisive canal  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Incisive foramen  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine process of maxilla  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Median palatine suture  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar border  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital foramen  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Interalveolar septa  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process of maxilla  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic bone  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary tubercle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Vomer  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process temporal bone  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Basal part occipital bone  25\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital condyle & foramen magnum  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process"}
{"_id": "stanford_medicine_head_clean$$$corpus_221", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Dental alveoli of mandible, superior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveoli for incisors  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolus for canine  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveoli for premolars  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveoli for molars  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental protuberance  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental tubercle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar border  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Interalveolar septa  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of mandible  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique line  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal crest  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of mandible  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid process  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular incisure  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Condyloid process  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental spine  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar part"}
{"_id": "stanford_medicine_head_clean$$$corpus_222", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Roentgenogram, mandible, posteroanterior oblique view\n\t\t\t\t\t\t\t\t\t\tDetailed roentgenographic views of the teeth are to be found in 47-6 and 47-7.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Interalveolar septum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar part of mandible  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of mandible  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of mandible  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of mandible  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of mandible  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular canal  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular incisure  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Condyloid process of mandible"}
{"_id": "stanford_medicine_head_clean$$$corpus_223", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Mandible and permanent teeth, superior view\n\t\t\t\t\t\t\t\t\t\tThe occlusal surfaces of some teeth of this specimen show evidence of abrasive wear.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial incisor  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral incisor  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar I  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar II  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar II  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar III (dens serotinus)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator crest  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of mandible  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual surface  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Labial surface  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Surface contactus medialis (mesial surface)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Surface contactus lateralis (distal surface)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Surface contactus anterior (mesial surface)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Surface contactus posterior (distal surface)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal surface  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid fovea  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular incisure  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual surface  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Surface of mastication (occlusal surface)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental spine  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual fovea"}
{"_id": "stanford_medicine_head_clean$$$corpus_224", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Mandible, inferior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental protuberance  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Digastric fossa  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual fovea  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of mandible  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of mandible  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental tubercle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental spines (upper pointer indicates spine for origin of geniohyoid muscle, lower pointer that for origin of genioglossus muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular fovea  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid line  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid sulcus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Condyloid process  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular foramen  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingula of mandible"}
{"_id": "stanford_medicine_head_clean$$$corpus_225", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Mandible, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Condyloid process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingula of mandible  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular foramen  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid sulcus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of mandible  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of mandible  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular fovea  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid line  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental spine  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual fovea  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar part  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid process  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of mandible"}
{"_id": "stanford_medicine_head_clean$$$corpus_226", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Mandible, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular incisure  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of mandible  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator crest  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar part  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental foramen  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus for external maxillary artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of mandible  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental protuberance  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Condyloid process  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique line  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar ridge  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of mandible  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of mandible"}
{"_id": "stanford_medicine_head_clean$$$corpus_227", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left maxilla and permanent teeth, inferior view\n\t\t\t\t\t\t\t\t\t\tThe third molar (dens serotinus) is absent in this specimen. The central incisor (1) has a deeper lingual fossa than is commonly encountered. The contact surfaces of the teeth (19, 20, 26) are labeled in accordance with modern dental terminology as well as with the conventional BNA names. In the modern system the contact surfaces are named mesial or distal with reference to the midline of the dental arch.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial incisor  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral incisor  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar I  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar II  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar II  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual surface  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Incisive bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Incisive foramen (completed by opposite maxilla)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Incisive suture  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar process  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine process  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for opposite maxilla  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for horizontal plate of palatine bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine spine  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine sulcus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Labial surface  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral surface (distal surface)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior surface (mesial surface)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccal surface  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital foramen  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine fossa  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratemporal surface  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior surface (distal surface)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Masticatory surface  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary tubercle"}
{"_id": "stanford_medicine_head_clean$$$corpus_228", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left maxilla, superior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body maxilla  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital surface  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine process  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal process (articular surface for frontal bone)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for nasal bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior nasal spine  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital sulcus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior margin of inferior orbital fissure  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for zygomatic bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital canal  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital margin  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal incisure  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal sulcus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lacrimal crest  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior surface (note Alveolar ridge)"}
{"_id": "stanford_medicine_head_clean$$$corpus_229", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left  maxilla, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital sulcus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior margin of inferior orbital fissure  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratemporal surface  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary tubercle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar II  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior margin of inferior orbital fissure  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar foramen  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body maxilla  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine process  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial incisor"}
{"_id": "stanford_medicine_head_clean$$$corpus_230", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left maxilla, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for artery in periosteum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior surface  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal incisure  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal crest  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior nasal spine  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar ridge  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital surface  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital margin  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital foramen & Infraorbital suture  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine fossa  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar process"}
{"_id": "stanford_medicine_head_clean$$$corpus_231", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Roentgenogram, left maxilla, mediolateral view\n\t\t\t\t\t\t\t\t\t\tThe third molar is not present in this specimen. Detailed roentgenographic views of the teeth are to be found in 47-4 ff.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial incisor  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral incisor  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar I  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Premolar II  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Molar II  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital surface  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary sinus (occupies entire body of maxilla)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratemporal surface  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process (in background)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Canal for superior posterior alveolar artery (in background)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine process (in foreground)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal process (note canal for small artery)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital sulcus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Canal for superior anterior alveolar artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior nasal spine  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar process"}
{"_id": "stanford_medicine_head_clean$$$corpus_232", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left maxilla, medial view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for frontal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal margin  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal sulcus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary sinus, visible through maxillary hiatus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for orbital process palatine bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of maxilla  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for perpendicular part palatine bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for pyramidal process palatine bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygopalatine sulcus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for horizontal process palatine bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar process  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine process  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal process  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista ethmoidalis (faintly visible)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Conchal crest  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal surface  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal incisure  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior nasal spine  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for right maxilla  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Incisive canal"}
{"_id": "stanford_medicine_head_clean$$$corpus_233", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left maxilla, lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lacrimal crest  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital margin  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital foramen  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior surface  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal incisure  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior nasal spine  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine fossa  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar ridge  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for frontal bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal margin  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal incisure  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital surface  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital sulcus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of maxilla  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratemporal surface  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary tubercle"}
{"_id": "stanford_medicine_head_clean$$$corpus_234", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right zygomatic bone, medial view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontosphenoidal process (pointer on articular surface for zygomatic process of frontal bone)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital border  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital surface  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatico-orbital foramen  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital process  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for maxilla  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary border  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseteric border  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal process  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for greater wing sphenoid bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Marginal process  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticotemporal foramen & temporal surface  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal border  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for zygomatic process temporal bone"}
{"_id": "stanford_medicine_head_clean$$$corpus_235", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right zygomatic bone, superolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for zygomatic process of frontal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontosphenoidal process  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Marginal process  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for zygomatic process temporal bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Malar surface  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticofacial foramen  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseteric border  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for greater wing sphenoid bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital surface  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticoorbital foramen  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital margin  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital process  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary border  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Malar tubercle"}
{"_id": "stanford_medicine_head_clean$$$corpus_236", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right palate bone, lateral view\n\t\t\t\t\t\t\t\t\t\tThe maxillary process (12) of this specimen is unusually well developed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenopalatine incisure  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid process  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Perpendicular part  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygopalatine sulcus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior nasal spine  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Horizontal plate  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Surface forming part of pterygoid fossa  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramidal process (articular surface for pterygoid process sphenoid bone)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of orbital process forming part of the orbital floor  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary surface  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary process"}
{"_id": "stanford_medicine_head_clean$$$corpus_237", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right palate bone, anterolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Perpendicular part  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Opening of small canal leading inferiorly to lesser palatine foramen  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygopalatine sulcus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramidal process  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine canal  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater palatine foramen  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for maxilla  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid process  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary surface  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal surface  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal crest  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Horizontal plate"}
{"_id": "stanford_medicine_head_clean$$$corpus_238", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right palate bone, posteromedial view\n\t\t\t\t\t\t\t\t\t\tThe orbital process (8) of this specimen is attenuated and presents a rough articular surface superiorly.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal crest  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenopalatine incisure  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Perpendicular part (nasal surface)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary process  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal crest  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior nasal spine  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser palatine foramen  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid process  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista conchalis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for medial plate of pterygoid process  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for lateral plate of pterygoid process  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Horizontal plate (nasal surface)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine surface  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Surface facing pterygoid fossa  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramidal process"}
{"_id": "stanford_medicine_head_clean$$$corpus_239", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Vomer, left lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior border for articulation with perpendicular plate of ethmoid bone and cartilagenous nasal septum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior border for articulation with sphenoid ridge  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala of vomer  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior (free) border  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus for nasopalatine nerve & sphenopalatine artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior border for articulation with maxilla and palate"}
{"_id": "stanford_medicine_head_clean$$$corpus_240", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Inferior nasal conchae, medial and lateral views\n\t\t\t\t\t\t\t\t\t\tA. Inferior nasal concha right, medial aspect B. Inferior nasal concha left, lateral aspect.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal process  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior free border  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior free border  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior free border  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary process"}
{"_id": "stanford_medicine_head_clean$$$corpus_241", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Lacrimal bones, medial and lateral views\n\t\t\t\t\t\t\t\t\t\tA. Lacrimal bone left, medial surface.B. Lacrimal bone right, lateral (orbital) surface.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin for articulation with orbital part of frontal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin for articulation with lamina papyracea ethmoid bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin for articulation with maxilla  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal sulcus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior lacrimal crest  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin for articulation with frontal process of maxilla  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Fossa of lacrimal sac  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Hamulus of lacrimal bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Conchal process for articulation with inferior nasal concha"}
{"_id": "stanford_medicine_head_clean$$$corpus_242", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Nasal bones, anterior and posterior views\n\t\t\t\t\t\t\t\t\t\tA. Nasal bone right, anterior surface B. Nasal bone left, posterior surface.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior margin for articulation with nasal part of frontal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral margin for articulation with frontal process of maxilla  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal foramina  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial borders for articulation with each other  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal sulcus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior borders for articulation with lateral nasal cartilage"}
{"_id": "stanford_medicine_head_clean$$$corpus_243", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Ethmoid bone, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for sphenoidal crest  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista galli  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal labyrinth  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Cribriform plate  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal cells  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina papyracea  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Perpendicular plate  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior nasal meatus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Uncinate process  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal meatus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior nasal concha  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal concha  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for vomer"}
{"_id": "stanford_medicine_head_clean$$$corpus_244", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Roentgenogram, ethmoid bone, anteroposterior view\n\t\t\t\t\t\t\t\t\t\tThe ethmoidal labyrinths (6) consist of numerous air cells separated by thin bony walls, and are connected at their superior margins by the cribriform plate (2). The superior surface of the cribriform plate lies in the anterior cranial fossa while its inferior surface forms the roof of the nasal fossae.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista galli  1\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista galli  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cribriform plate  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulci for anterior ethmoidal vessels and nerves  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior nasal concha (in depths of view)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Cribriform plate  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Perpendicular plate (somewhat deflected)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina papyracea  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Uncinate process  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Uncinate process  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal labyrinth  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal concha  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal bulla  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal labyrinth  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal meatus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular border for frontal spine  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal concha  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal cells  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Perpendicular plate  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal meatus"}
{"_id": "stanford_medicine_head_clean$$$corpus_245", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Ethmoid bone, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista galli  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar process  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulci for anterior ethmoidal vessels and nerves  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Cribriform plate  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina papyracea  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Uncinate process  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal concha  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal labyrinth  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular border for frontal spine  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal cells  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Perpendicular plate  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal meatus"}
{"_id": "stanford_medicine_head_clean$$$corpus_246", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Ethmoid bone, lateral view\n\t\t\t\t\t\t\t\t\t\tThe ethmoidal labyrinth occupies nearly all of the view. The anterior and posterior ethmoidal foramina, not distinguishable in this specimen, are shown in 38-2.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for frontal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for sphenoidal crest  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for body of sphenoid  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina papyracea  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for orbital process palatine bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal concha  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista galli  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal cells  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for maxilla  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Uncinate process"}
{"_id": "stanford_medicine_head_clean$$$corpus_247", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Ethmoid bone, inferior view\n\t\t\t\t\t\t\t\t\t\tThe perpendicular lamina is deviated to the right of the midline. This is a common condition.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular border of perpendicular plate for septal cartilage  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular border for vomer  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Alas processes  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal labyrinth  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista galli (in background)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Cribriform plate  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Perpendicular plate  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal concha  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Uncinate process"}
{"_id": "stanford_medicine_head_clean$$$corpus_248", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Roentgenogram, ethmoid bone, superoinferior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal labyrinth  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista galli  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal bulla  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Paper lamina  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal concha  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Cribriform plate  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Perpendicular plate"}
{"_id": "stanford_medicine_head_clean$$$corpus_249", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Ethmoid bone, superior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista galli  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cribriform plate  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Grooves for anterior ethmoidal vessels and nerves (ethmoidal foramina not visible in this specimen)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal labyrinth (entire area below pointers)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal cells (anterior)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for frontal bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal cells (posterior)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for sphenoidal spine  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina papyracea"}
{"_id": "stanford_medicine_head_clean$$$corpus_250", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Sphenoid bone, posterolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal angle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser wing  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic foramen  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberculum sellae  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior clinoid process  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior orbital fissure  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus for recurrent meningeal branch of lacrimal artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal angle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal surface  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic margin  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral surface  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen rotundum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Squamous margin  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen ovale  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular spine  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid process  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater wing  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior clinoid process  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum sellae  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Sella turcica  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Clivus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus for abducens nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Body  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid sulcus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingula  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plate of pterygoid process  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plate of pterygoid process"}
{"_id": "stanford_medicine_head_clean$$$corpus_251", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Sphenoid bone, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral surface  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Squamous margin  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen rotundum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid sulcus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular spine  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Scaphoid fossa  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plate of pterygoid process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid fossa  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plate of pterygoid process  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid hamulus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body (cut away from basal part occipital bone)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid process  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal angle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser wing  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior orbital fissure  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum sellae  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior clinoid process  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic foramen  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater wing  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingula  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus of auditory tube  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid canal  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid fissure"}
{"_id": "stanford_medicine_head_clean$$$corpus_252", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Roentgenogram, sphenoid bone, anteroposterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater wing  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal surface  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital surface  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Squamous margin  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoidal sinus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum sellae  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic foramen  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior Orbital fissure  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser wing  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic margin  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen rotundum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid canal  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular spine"}
{"_id": "stanford_medicine_head_clean$$$corpus_253", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Sphenoid bone, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater wing  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser wing  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal margin  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital surface  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic margin  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Aperture of sphenoidal sinus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoidal crest  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen rotundum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sphenomaxillary surface Lower pointer: Rostrum of sphenoid  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Medial plate of pterygoid process Lower pointer: Pterygopalatine sulcus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for pyramidal process of palatine bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid fissure  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove (often a foramen) for recurrent meningeal branch of lacrimal artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of optic foramen  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior orbital fissure  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal fossa  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for ethmoid bone  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoidal concha  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratemporal fossa  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid canal  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Processus vaginalis  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular spine  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plate of pterygoid process  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid hamulus"}
{"_id": "stanford_medicine_head_clean$$$corpus_254", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Roentgenogram, sphenoid bone, inferosuperior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal angle (articular surface for parietal bone)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater wing  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen rotundum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Squamous margin  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen ovale (incomplete medially)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen spinosum (incomplete medially)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular spine  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior wall of sella turcica  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic margin  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital surface  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Rostrum of sphenoid  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoidal sinus (smaller than usual)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic foramen  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser wing  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior clinoid process  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum sellae & posterior clinoid process  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid process"}
{"_id": "stanford_medicine_head_clean$$$corpus_255", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Sphenoid bone, inferior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior orbital fissure  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Foramen rotundum Lower pointer: Sphenomaxillary surface  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sphenoidal concha Lower pointer: Articular surface for vomer  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for pyramidal process of palatine bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plate of pterygoid process  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plate of pterygoid process  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Processus vaginalis  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Basopharyngeal canal  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid hamulus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for orbital process of palatine bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for ethmoid bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tip of sphenoid  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoidal crest  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoidal sinus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic foramen  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral spine  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser wing  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital surface  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater wing  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic margin  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Facies temporalis  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Squamous margin  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista infratemporalis  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratemporal surface  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal canal  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen ovale  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen spinosum  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular spine"}
{"_id": "stanford_medicine_head_clean$$$corpus_256", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Sphenoid bone, superior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal angle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater wing  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoidal jugum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic foramen & chiasmatic sulcus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior clinoid process  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen rotundum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberculum sellae  8\n\t\t\t\t\t\t.\n\t\t\t\t\t SeIla turcica  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum sellae  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular spine  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser wing  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoidal crest  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior orbital fissure  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior clinoid process  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen ovale  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen spinosum  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingula of sphenoid  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid sulcus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Clivus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus for abducens nerve"}
{"_id": "stanford_medicine_head_clean$$$corpus_257", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Occipital bone, lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior angle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lambdoidal margin  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular process  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal canal  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular tubercle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Clivus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar part (cut away from body of sphenoid bone)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior petrosal sulcus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen for inferior petrosal sinus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Intrajugular process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital condyle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Squamous part of occipital bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral angle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen magnum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle for attachment of alar ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Condyloid canal  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse sulcus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular incisure"}
{"_id": "stanford_medicine_head_clean$$$corpus_258", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Roentgenogram, occipital bone, internal view\n\t\t\t\t\t\t\t\t\t\tNumerous channels for diploic veins (4) are visible close to the dense bone which bounds the foramen magnum (8) posteriorly and laterally. These channels are continuous upward into the squamous part of the bone near the midline. Less prominent bilateral channels are present near the mastoid border of the bone.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Squamous part of occipital bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lambdoidal margin  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse sulcus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Channels within bone for occipital diploic veins  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid margin  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital condyle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar part  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen magnum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular tubercle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular incisure  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal canal"}
{"_id": "stanford_medicine_head_clean$$$corpus_259", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Occipital bone, internal view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior angle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sagittal sulcus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal occipital protuberance (summit of cruciate eminence)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse sulcus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal occipital crest (lower part of cruciate eminence)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen magnum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse sulcus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular incisure  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle for attachment of alar ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular tubercle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Clivus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar part  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior occipital fossa  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lambdoidal margin  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior occipital fossa  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral angle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid margin  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Condyloid canal  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Intrajugular process  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior petrous sulcus"}
{"_id": "stanford_medicine_head_clean$$$corpus_260", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Occipital bone, external view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lambdoidal margin  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Supreme nuchal line  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior nuchal line  4\n\t\t\t\t\t\t.\n\t\t\t\t\t External occipital crest  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nuchal line  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen magnum (occipital bone)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Condyloid fossa  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular tubercle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle for attachment of alar ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital condyle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal tubercle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar part  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital plane  14\n\t\t\t\t\t\t.\n\t\t\t\t\t External occipital protuberance  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral angle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Nuchal plane  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid margin  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Condyloid canal  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular process  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part"}
{"_id": "stanford_medicine_head_clean$$$corpus_261", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left temporal bone, inferior view; middle and inner ear cavities dissected\n\t\t\t\t\t\t\t\t\t\tThe petrous and tympanic parts of the bone have been ground away from below to expose the tympanic cavity (middle ear), which occupies the central area of the view, and the osseous labyrinth (inner ear), medial to the tympanic cavity. The cochlea has been opened parallel to the modiolus (6) to expose its basal, middle, and apical turns.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid canal  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Helicotrema  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Wall of modiolus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Scala vestibuli Lower pointer: Scala tympani  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Spiral canal of modiolus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of modiolus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal acoustic meatus (pointer on transverse crest)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina bony spiral  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Spherical recess of vestibule (rough white area in view is macula cribrosa superior)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior bony ampulla (deep in vestibule) Lower pointer: Eliptical recess of vestibule  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Opening of common crus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: posterior bony ampulla Lower pointer: Posterior semicircular canal  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular fossa  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Semicanal of auditory tube  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor tympani muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrotympanic fissure (pointer indicates site of emergence of chorda tympani)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of tympanic part  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Cochleariform process  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Epitympanic recess (deep part of cavity)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of oval window (obscured by promontorium)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Prominence of facial canal  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontorium (note promontory sulcus for tympanic plexus)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Round window (cut open)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramidal eminence  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic sinus  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Canal for stapedius muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial canal"}
{"_id": "stanford_medicine_head_clean$$$corpus_262", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left temporal bone, inferior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal surface  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoidal margin  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrotympanic fissure  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosal part  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramidal apex  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pyramidal surface  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid canal  8\n\t\t\t\t\t\t.\n\t\t\t\t\t External opening cochlear canal  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosal fossa  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic canaliculus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular fossa  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of styloid process  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylomastoid foramen  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus occipital artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital margin  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal bone (squamous part)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for zygomatic bone  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular tubercle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular fossa  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic part  23\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanomastoid fissure  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid incisure  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid part"}
{"_id": "stanford_medicine_head_clean$$$corpus_263", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Roentgenogram, right temporal bone; ear ossicles in situ\n\t\t\t\t\t\t\t\t\t\tThe temporal bone was decalcified after removal of the ear ossicles. These ossicles were then replaced in their normal positions. The view is from above. The ossicles are shown in detail in 62-6 ff.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid canal  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosal part  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cochlea Lower pointer: Vestibulum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal acoustic meatus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Semicircular canal superior  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Semicircular canal posterior  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylomastoid foramen  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal bone (squamous part)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Tympanic cave Lower pointer: Manubrium of malleus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum of malleus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body incus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Stapes (base of stapes lies in fenestra vestibuli medial to pointer)"}
{"_id": "stanford_medicine_head_clean$$$corpus_264", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Roentgenogram, right temporal bone, superior view\n\t\t\t\t\t\t\t\t\t\tThe contours of the bony labyrinth are visible because of the air which fills the labyrinth and contrasts with the surrounding petrous bone.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosal part  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid canal (partially beneath cochlea)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cochlea  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Borders of internal acoustic meatus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Common crus semicircular canal  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Semicircular canal superior (note ampulla near junction of anterior crus with vestibule)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus simplex semicircular canal  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Semicircular canal posterior (ampulla is visible at inferior termination of canal in vestibule)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal bone (squamous part)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic part  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Malleus (faintly visible within middle ear cavity)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Incus (faintly visible)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus (beneath squama)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial canal  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylomastoid foramen (in background)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Semicircular canal lateral (ampulla difficult to distinguish at anterior termination of canal)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process"}
{"_id": "stanford_medicine_head_clean$$$corpus_265", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left temporal bone, superior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal margin  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral surface  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tegmen tympani  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of petrosquamous fissure  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal bone (squamous part)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus for middle meningeal artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Hiatus facial canal  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosal part  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal impression  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior pyramidal surface  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pyramidal angle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of internal acoustic meatus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior pyramidal surface  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Arcuate eminence Lower pointer: Superior petrosal sulcus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Intrajugular process  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid sulcus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital margin  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid part"}
{"_id": "stanford_medicine_head_clean$$$corpus_266", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left temporal bone, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal bone (squamous part)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid foramen  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid part  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle of articulation  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of styloid process  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital margin  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pyramidal angle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior pyramidal surface  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosal part  12\n\t\t\t\t\t\t.\n\t\t\t\t\t External opening of vestibular aqueduct  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Subarcuate fossa  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal acoustic meatus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t External opening cochlear canal  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior pyramidal angle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramidal apex  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pyramidal surface  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Intrajugular process  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular fossa  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid canal"}
{"_id": "stanford_medicine_head_clean$$$corpus_267", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left temporal bone, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal incisure  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid sulcus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate eminence  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Hiatus facial canal  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniculum of facial canal (within hiatus)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus greater (superficial) petrosal nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus lesser petrosal (superficial) nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior pyramidal surface  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramidal apex  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid canal  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Canal for Tensor tympani  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of styloid process  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal margin  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal bone (squamous part)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tegmen tympani  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoidal margin  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosquamous fissure (nearly obliterated)"}
{"_id": "stanford_medicine_head_clean$$$corpus_268", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left temporal bone; close-up view of fundus of internal auditory meatus\n\t\t\t\t\t\t\t\t\t\tThe crista transversa (11) divides the fundus into a superior and inferior fossa. The apex of the petrous pyramid is to the right of the view.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior petrous sulcus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Subarcuate fossa  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vestibular area  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vestibular area  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen singulare (faintly visible)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t External opening of vestibular aqueduct  7\n\t\t\t\t\t\t.\n\t\t\t\t\t External opening cochlear canal  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate eminence  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pyramidal angle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Area facial nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista transversa  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Cochlear area  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of internal acoustic meatus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior pyramidal angle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pyramidal surface"}
{"_id": "stanford_medicine_head_clean$$$corpus_269", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t The posterior perforated substance and oculomotor nerves\n\t\t\t\t\t\t\t\t\t\tThe posterior cerebral arteries, together with most of the branches which entered the interpeduncular fossa, are divided and retracted toward the medulla. The fossa, particularly its posterior recess, is well exposed. The line along which the filaments of the third nerve leave the brain stem appears on each side of the fossa. Note the \"posterior perforated substance,\" an appearance created by pulling out numerous small arteries from the tegmentum in the depths of the fossa.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tract  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary body  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic tract  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery (divided)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital branch of anterior cerebral artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Infundibulum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Uncus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Interpeduncular fossa (the posterior perforated substance forms the surface within the fossa)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial central branch of posterior cerebral artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery (cut across and retracted)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_270", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Arteries of interpeduncular fossa\n\t\t\t\t\t\t\t\t\t\tThe numerous branches of the posterior cerebral arteries are illustrated in this close-up view as they enter the posterior perforated substance in the depths of the interpeduncular fossa. A piece of arachnoid membrane covers the left third nerve and cerebral peduncle (right side of view). The space seen between this membrane and the brain represents a portion of the interpeduncular cistern.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tract right  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic tract  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Interpeduncular fossa  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fissure (cerebral)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic chiasm  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Infundibulum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuber cinereum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary body  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial central branch of posterior cerebral artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampal gyrus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_271", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Relations of tip of inferior horn of lateral ventricle\n\t\t\t\t\t\t\t\t\t\tThe medial portion of the right temporal lobe, including the uncus and part of the hippocampal structures, has been cut away. The inferior horn of the lateral ventricle is thus opened and the choroid plexus exposed. The arachnoid membrane is intact in several areas.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cerebral fissure (Sylvian)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cerebral artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery (cut across)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroidal artery (anterior)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Amygdaloid nucleus (partially removed)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior horn of lateral ventricle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampus (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampal gyrus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral fissure  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal auditory artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII) and vestibulocochlear (VIII)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal (IX) and vagus (X) nerves  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tract  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Straight gyrus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cerebral artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Infundibulum  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Pituitary  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Uncus (hippocampal gyrus)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Abducens nerve (VI)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Medulla oblongata (pyramid)"}
{"_id": "stanford_medicine_head_clean$$$corpus_272", "text": "Exploration of the brain from its basal aspect\n\t\t\t\t\t\t\t\t\t\t Arteries of basal surface of brain\n\t\t\t\t\t\t\t\t\t\tThe vertebral and internal carotid arteries are visible as they reach the basal surface of the brain to enter into the formation of the arterial circle of Willis. A portion of the right temporal lobe has been cut away to reveal the middle cerebral artery with some of its branches deep in the lateral fissure. The optic chiasm is partially removed to display the anterior communicating artery. The internal auditory arteries are not clearly demonstrated in this specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior communicating artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cerebral artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cerebral artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroidal artery (anterior)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior communicating artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar artery (double on right, single vessel on left)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch to pons from basilar artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior cerebellar artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior spinal artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tract left  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Straight gyrus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic chiasm and optic tract  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Infundibulum and infundibular recess third ventricle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuber cinereum  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Uncus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary body  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Fissura collateralis  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Arachnoid (in situ)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Fusiform gyrus  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Abducens nerve (VI)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cerebellar peduncle  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VIII)  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Flocculus  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Medulla oblongata  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerves (IX) and vagus (X); Choroid plexus fourth ventricle"}
{"_id": "stanford_medicine_head_clean$$$corpus_273", "text": "Exploration of the meninges and brain in situ\n\t\t\t\t\t\t\t\t\t\t Posterior cranial fossa, basilar and vertebral arteries, petrosal sinuses and basilar plexus of veins\n\t\t\t\t\t\t\t\t\t\tThe left half of the brain stem has been removed and the basilar part of the pons cut away on the right to reveal the course of the basilar artery (19). The inferior petrosal sinus and basilar plexus have not been opened but their positions under the dura are identified by the blue color of the latex with which they are filled.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery left (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Falx cerebri (upper pointer) and olfactory tract  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery left (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III) within cavernous sinus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV) within cavernous sinus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic nerve (VI) within cavernous sinus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavernous sinus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar ganglion (trigeminal) and trigeminal nerve (V)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cranial fossa (dura removed)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII) and Vestibulocochlear (VIII) entering internal acoustic meatus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior petrosal sinus (opened)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse sinus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of sigmoid portion of transverse sinus (unopened)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cranial fossa  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral aqueduct  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Arteries within interpeduncular fossa  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar arteries  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Straight sinus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebellar lingula  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar part of pons (cut away)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar plexus (upper pointer) and abducens nerve (VI)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal auditory artery  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior cerebellar artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus fourth ventricle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery right  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X) and inferior petrosal sinus (upper pointer indicates position of this sinus beneath the dura)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots hypoglossal nerve (XII)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Medulla oblongata (cut across to midline)"}
{"_id": "stanford_medicine_head_clean$$$corpus_274", "text": "Exploration of the meninges and brain in situ\n\t\t\t\t\t\t\t\t\t\t Middle cranial fossa, middle meningeal vessels and cavernous sinus\n\t\t\t\t\t\t\t\t\t\tThe dura mater has been partly stripped away from the middle fossa to open the cavernous sinus and a large sinus lateral to it (11, lower pointer). This latter receives the middle and several inferior cerebral veins (11) anteriorly and communicates posteriorly with the superior petrosal sinus (9). It also communicates with the cavernous sinus and middle meningeal veins.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporalis muscle (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery (anterior branch)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic nerve (VI) (within cavernous sinus)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle meningeal artery (posterior branch)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavernous sinus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar ganglion (trigeminal)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tegmen tympani (a small dural sinus lies over the tegmen)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate eminence  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior petrosal sinus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser wing sphenoid bone (covered with dura)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cerebral vein and venous sinus connecting posteriorly with superior petrosal sinus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior clinoid process  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior communicating artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III) (lower pointer indicates the part of the nerve within the interpeduncular cistern, upper pointer indicates the portion within the cavernous sinus)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of tentorium cerebelli  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Substantia nigra  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV) (upper pointer indicates the nerve within the cavernous sinus, lower pointer indicates the nerve within the subarachnoid space)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar artery (cut across)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VIII)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachium pontis (middle cerebellar peduncle) (cut across)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots glossopharyngeal nerve (IX) and vagus (X)"}
{"_id": "stanford_medicine_head_clean$$$corpus_275", "text": "Exploration of the meninges and brain in situ\n\t\t\t\t\t\t\t\t\t\t Close-up view of relation of internal cerebral veins to pineal body\n\t\t\t\t\t\t\t\t\t\tThe arachnoid has been removed from the pineal body and nearby vessels. In this specimen the pineal body is curved upward around the splenium of the corpus callosum and the internal cerebral veins life along its lateral borders. The great cerebral vein (of Galen), which is formed by the confluence of the internal cerebral veins along the upper surface of the pineal body is unusually short here. The subarachnoid space between the cerebellum and the cerebral veins is somewhat comma-shaped and is known as the cisterna venae magnae cerebri (cisterna ambiens).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum (trunk)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial longitudinal stria  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior surface of right fornix  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal cerebral vein left  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Massa intermedia  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Interventricular foramen (of Monro)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Free part of column of fornix  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch posterior cerebral artery (lateral central branch)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Falx cerebri  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Great cerebral vein (of Galen)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Straight sinus (opened)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of superior cerebellar artery and layer of arachnoid membrane which bounds the cisterna venae magnae cerebri laterally  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pineal body  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior colliculus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebellum"}
{"_id": "stanford_medicine_head_clean$$$corpus_276", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Roentgenogram, left temporal bone, mediolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal bone (squamous part)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid foramen  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid cells  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid sulcus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic antrum (in mid-part specimen)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Semicircular canal superior  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibules  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Cochlea  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus for posterior branch of middle meningeal artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process (in background)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus (in background)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular fossa (on inferior surface of bone)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosal part"}
{"_id": "stanford_medicine_head_clean$$$corpus_277", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left temporal bone, medial view\n\t\t\t\t\t\t\t\t\t\tThe petrous part of the bone projects into the foreground. The squamous part lies above and to its right, the mastoid portion to the left.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal margin  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal incisura  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid sulcus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid foramen  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital margin  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior petrous sulcus & subarcuate fossa  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Aperture of external vestibular aqueduct  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior pyramidal surface  9\n\t\t\t\t\t\t.\n\t\t\t\t\t External aperture cochlear canaliculi  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal acoustic meatus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior pyramidal angle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pyramidal surface  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal bone (squamous part)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral surface  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for posterior branch of middle meningeal artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate eminence  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Tegmen tympani  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoidal margin  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ant. pyramidal surface  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramidal apex  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process"}
{"_id": "stanford_medicine_head_clean$$$corpus_278", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left temporal bone, lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal bone (squamous part)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal surface  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior root of zygomatic process  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior root of zygomatic process and articular tubercle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular fossa  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle root of zygomatic process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrotympanic fissure  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic part  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of styloid process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal margin  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal incisura (note sutural bone)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal line  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus middle temporal artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprameatal spine and mastoid fossa  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid foramen  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanomastoid fissure  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid part  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus for occipital artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid incisura  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process  23\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus"}
{"_id": "stanford_medicine_head_clean$$$corpus_279", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left parietal bone, internal surface\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sagittal margin  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal foramen  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sagittal sulcus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital angle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital margin  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse sulcus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid angle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Squamous margin  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal angle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal margin  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Arterial sulci  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoidal angle"}
{"_id": "stanford_medicine_head_clean$$$corpus_280", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left parietal bone, external surface\n\t\t\t\t\t\t\t\t\t\tThe superior and inferior temporal lines of this specimen are indistinct but these are visible in the lateral view of the skull (35-1).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal angle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal margin  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoidal angle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Squamous margin  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid angle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sagittal margin  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal foramen  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital angle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal tuber  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital margin"}
{"_id": "stanford_medicine_head_clean$$$corpus_281", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Frontal bone, inferior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal tuber  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital foramen  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Fossa of lacrimal gland  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal line & temporal surface  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for greater wing sphenoid bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Surface facing middle cranial fossa  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Area which forms roof over ethmoidal cells  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ethmoidal foramen  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal incisure  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal bone (squamous part)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal margin  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Glabella  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal margin  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal spine  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Area forming part of roof of nasal fossa  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Canal opening into diploic space  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital margin  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear pit  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior-ethmoidal foramen  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital surface"}
{"_id": "stanford_medicine_head_clean$$$corpus_282", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Frontal bone, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal margin  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral surface  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sagittal sulcus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for branch of middle meningeal artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital part (note digital impressions)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal crest  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen caecum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ostium of Frontal sinus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal spine  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal part  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for lesser wing sphenoid bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for greater wing sphenoid bone"}
{"_id": "stanford_medicine_head_clean$$$corpus_283", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Roentgenogram of frontal bone, anteroposterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal bone (squamous part)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital part  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal part  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Channels for frontal diploic vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal crest"}
{"_id": "stanford_medicine_head_clean$$$corpus_284", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Frontal bone, anterior view\n\t\t\t\t\t\t\t\t\t\tA supraorbital notch (14) is present on the left side. A single internal opening on the right leads to two external foramina, supraorbital (5) and frontal (6).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal bone (squamous part)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Glabella  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superciliary arch  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital foramen  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal foramen  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of frontal suture (metopic suture)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal part  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal spine  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal margin  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal surface  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal tuber  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal line  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Supraorbital incisure Lower pointer: Supraorbital margin  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal margin"}
{"_id": "stanford_medicine_head_clean$$$corpus_285", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right temporal, infratemporal and pterygopalatine fossae, inferolateral view\n\t\t\t\t\t\t\t\t\t\tThe sphenopalatine foramen (21) is visible in the medial wall of the pterygopalatine fossa (22).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process temporal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sphenosquamous suture Lower pointer: Temporal fossa  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratemporal crest sphenoid bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratemporal fossa  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen ovale  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen spinosum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen of Vesalius  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Angular spine sphenoid bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosal part of temporal bone (apex pyramidis)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen lacerum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plate of pterygoid process  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Vomer  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramidal process palatine bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Basal part occipital bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid ha\u0300mulus sphenoid bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbit  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Surface malaris zygomatic bone  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior orbital fissure  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process of maxilla  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratemporal surface of maxilla  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenopalatine foramen  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygopalatine fossa  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar process of maxilla  24\n\t\t\t\t\t\t.\n\t\t\t\t\t First molar"}
{"_id": "stanford_medicine_head_clean$$$corpus_286", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right temporal fossa and mandible viewed from above\n\t\t\t\t\t\t\t\t\t\tThe relations of the coronoid process of the mandible to the zygomatic arch and temporal fossa are illustrated.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process of frontal bone & zygomaticofrontal suture  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal line  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal bone (squamous part)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar process of maxilla  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Third molar  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronal suture  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbit  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticofacial foramen  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontosphenoidal process of zygomatic bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of mandible  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal process of zygomatic bone & zygomaticotemporal suture  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid process  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process temporal bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Squamous suture & temporal bone (squamous part)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of mandible"}
{"_id": "stanford_medicine_head_clean$$$corpus_287", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Hard palate, inferior surface\n\t\t\t\t\t\t\t\t\t\tNote the presence of a third molar tooth (9) on the right only. This tooth is incompletely erupted and shows no signs of wear on its occlusal surface whereas the remaining teet are considerably worn. The posterior tips of the conchae are visible through the choanae, and a  part of the cribriform plate appears in the roof of the nasal fossa.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial incisor  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral incisor  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine  4\n\t\t\t\t\t\t.\n\t\t\t\t\t First premolar  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Second pre-molar  6\n\t\t\t\t\t\t.\n\t\t\t\t\t First molar  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Second molar  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Palatine sulcus Lower pointer: Greater palatine foramen  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Third molar (serotinus)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior orbital fissure  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater wing of sphenoid  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Suture between pyramidal process of palate bone and pterygoid process of sphenoid bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plate of pterygoid process  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plate of pterygoid process  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid process palatine bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Incisive foramen  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine process of maxilla  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Median palatine suture  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar process of maxilla  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process of maxilla  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse palatine suture  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Horizontal plate palatine bone Lower pointer: Median palatine suture  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramidal process palatine bone  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid hamulus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal concha  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal concha  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Vomer"}
{"_id": "stanford_medicine_head_clean$$$corpus_288", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Lateral wall of left nasal fossa dissected\n\t\t\t\t\t\t\t\t\t\tThe left middle and superior conchae have been cut away and ethmoidal air cells widely opened. A window has been cut through the inferior concha to reveal the position of the nasal opening of the nasolacrimal canal (24). The specimen is viewed from the right side.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ethmoidal foramen  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal cells (posterior)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus left  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Line of attachment of superior nasal concha  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior nasal meatus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenopalatine foramen  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Line of attachment of middle nasal concha Lower pointer: Middle nasal meatus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary sinus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal process inferior nasal conchae  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plate of pterygoid process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Perpendicular part palatine bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatomaxillary suture  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Position of greater palatine foramen Lower pointer: Horizontal plate palatine bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Orbital part of frontal bone Lower pointer: Anterior ethmoidal foramen  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal cells (anterior)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Opening of frontonasal duct into frontal recess of middle nasal meatus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Hiatus semilunaris  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal bulla  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal infundibulum  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Uncinate process ethmoid bone  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal bone  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal process inferior nasal conchae  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal opening of nasolacrimal canal visible through window cut in inferior concha)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal meatus  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine process of maxilla"}
{"_id": "stanford_medicine_head_clean$$$corpus_289", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Lateral wall of right nasal fossa\n\t\t\t\t\t\t\t\t\t\tThe osseous septum has been cut away from the specimen seen in view 37-7 to reveal the bones which together form the right lateral wall of the nasal fossa. The right sphenoid sinus (15) is visible through a window cut in the septum which separates the two sinuses.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal process of maxilla  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lacrimal bone Lower pointer: Lacrimoconchal suture  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal process inferior nasal conchae  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Openings of maxillary sinus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal concha  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal meatus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior nasal spine  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Incisive canal (for communicating branch between posterior nasal septal artery and greater palatine artery)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Cribriform plate \u00e9thmoid bone (above left nasal fossa)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Perpendicular plate of ethmoid bone (cut away)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior nasal concha  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoethmoidal recess  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus left  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus right (sphenoidal septal sinuses partially cut away)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sella turcica  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior nasal meatus Lower pointer: Middle nasal concha  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasopharyngeal meatus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Perpendicular part of palatine bone  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plate of pterygoid process  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatomaxillary suture  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasomaxillary crest  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine process of maxilla  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Incisive canal (for nasopalatine nerve)"}
{"_id": "stanford_medicine_head_clean$$$corpus_290", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Bony nasal septum, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe skull has been cut in a parasagittal plane a few millimeters to the left of the midline.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasomaxillary suture  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Perpendicular plate of ethmoid bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Cleft to accommodate sphenoid process cartilaginous septum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal concha  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior opening of incisive canal  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior nasal spine  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Dental alveolus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Cribriform plate of ethmoidal bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Aperture of sphenoid sinus (margin partially cut away) Lower pointer: Tip of sphenoid (note small sutural bone beyond pointer)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Body sphenoid bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vomer (pointer on groove for nasopalatine nerve)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plate of pterygoid process  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plate of pterygoid process  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid hamulus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal crest  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Hard palate  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar process of maxilla"}
{"_id": "stanford_medicine_head_clean$$$corpus_291", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Nasal fossae, posterior view through choanae\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid process sphenoid bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal canal  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plate of pterygoid process  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Cribriform plate (faintly shown)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid fossa  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Bony nasal septum (vomer)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plate of pterygoid process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasofrontal suture & nasal bone (in depths of view)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramidal process palatine bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser palatine foramen  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater palatine foramen  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Median palatine suture  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Body sphenoid bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala of vomer  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid process palatine bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior nasal concha & superior nasal meatus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal bulla  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Infundibulum of ethmoid bone & uncinate process  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal concha & middle nasal meatus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal concha &Inferior nasal meatus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid hamulus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Horizontal plate palatine bone  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse palatine suture  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine process of maxilla"}
{"_id": "stanford_medicine_head_clean$$$corpus_292", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Roentgenogram of paranasal sinuses, anterior view\n\t\t\t\t\t\t\t\t\t\tThis view of the sinuses of a normal adult woman was made with a 23 degree upward inclination from the anteroposterior axis. An area of calcification is present in the falx cerebri (1).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcification in falx cerebri  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Nasal septum Lower pointer: Nasal cavity  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital foramen  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary sinus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoidal sinus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid process of mandible  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular articulation (pointer on articular cavity)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum (condyloid process) mandible  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbit  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Area occupied by ethmoidal cells  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic arch  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of mandible  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior arch atlas  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens"}
{"_id": "stanford_medicine_head_clean$$$corpus_293", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Nasal fossae and orbits, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital part of frontal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontomaxillary suture  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasomaxillary suture  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticofrontal suture  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater wing of sphenoid  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital surface of zygomatic bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenozygomatic suture  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior orbital fissure  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital foramen  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticomaxillary suture  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Body maxillae  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasofrontal suture  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Nasal bone Lower pointer: Internasal suture  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior orbital fissure  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal concha & middle nasal meatus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Perpendicular plate of ethmoid bone  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal concha & inferior nasal meatus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Vomer & anterior nasal spine  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriformis aperture  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermaxillary suture"}
{"_id": "stanford_medicine_head_clean$$$corpus_294", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Nasolacrimal canals, anterosuperior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasolacrimal canal  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lacrimal incisura (maxilla) Lower pointer: Anterior lacrimal crest  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticomaxillary suture  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Grooves and openings for nutrient arteries  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasomaxillary suture  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior surface of maxilla  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal suture (metopic suture)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superciliary arch  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbit  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimal bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasion  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Internasal suture & nasal bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal process of maxilla  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform aperture"}
{"_id": "stanford_medicine_head_clean$$$corpus_295", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Roentgenogram of left orbit and optic canal\n\t\t\t\t\t\t\t\t\t\tThis is an anterior view with an upward and medial angulation in line with the axis of the optic canal. The posterior portion of the skull has been cut away to avoid conflicting shadows. The relation of the anterior clinoid process (11) to the optic canal (10) is shown.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus (ethmofrontal)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal cells (along medial wall of orbit)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoidal sinus (in b\u00e2ckground)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Borders of Nasolacrimal canal (in foreground)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital margin  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal line of frontal bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticofrontal suture  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Outline of posterior opening of optic canal  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior orbital fissure  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Outline of optic foramen (anterior opening of optic canal)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior clinoid process (lower pointer indicates tip of this process)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior limit of inferior orbital fissure  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital margin  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital foramen (maxillary sinus underlies floor of orbit in this region)"}
{"_id": "stanford_medicine_head_clean$$$corpus_296", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right orbit, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital margin  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital surface of frontal bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenofrontal suture  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticofrontal suture  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior orbital fissure  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Optic foramen Lower pointer: Lateral rectus spine  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower root of Lesser wing sphenoid bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Orbital tubercle of zygomatic bone Lower pointer: Body sphenoid bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital process palatine bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater wing of sphenoid  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenozygomatic suture  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior orbital fissure  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ethmoidomaxillary suture Lower pointer: Orbital surface of maxilla  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital sulcus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticomaxillary suture  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital foramen  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal part of frontal bone  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior ethmoidal foramen  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasofrontal suture  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontomaxillary suture  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ethmoidal foramen  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Orbital plate of ethmoid Lower pointer: Lacrimoethmoidal suture  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimomaxillary suture  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Fossa of lacrimal sac  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lacrimal crest  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior lacrimal crest  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal process of maxilla  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital margin  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Infraorbital suture Lower pointer: Infraorbital foramen"}
{"_id": "stanford_medicine_head_clean$$$corpus_297", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Interior of base of skull; middle cranial fossa\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital part of frontal bone &sphenofrontal suture  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser wing sphenoid bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater wing of sphenoid  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic foramen  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior orbital fissure  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior clinoid process  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen rotundum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid body bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior clinoid process  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen lacerum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid canal  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosal part of temporal bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal fossa  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic arch  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenosquamous suture  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal bone (squamous part)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen of Vesalius  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen ovale  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen spinosum  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Hiatus facial canal"}
{"_id": "stanford_medicine_head_clean$$$corpus_298", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Interior of base of skull; cribriform plate\n\t\t\t\t\t\t\t\t\t\tcribriform plate\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ethmoidal fissure Lower pointer: Groove for anterior ethmoidal artery & nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital part of frontal bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cribriform plate  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontoethmoidal suture  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior etlunoidal foramen  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenofrontal suture  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal suture (metopic suture) & foramen caecum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista galli  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista of sphenoid bone"}
{"_id": "stanford_medicine_head_clean$$$corpus_299", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Interior of base of skull\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista gall & lamina cribrosa ethmoid bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital part of frontal bone & sphenofrontal suture  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser wing sphenoid bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater wing sphenoid bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenosquamous suture  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal bone (squamous part)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid canal & foramen lacerum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosquamous fissure  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosal part of temporal bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Squamous suture  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipitomastoid suture  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid part of temporal bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital bone (squamous part)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lambdoidal suture  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen magnum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal occipital crest (cruciate eminence)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cranial fossa  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic foramen & anterior clinoid process  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Sella turcica & posterior clinoid process  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen ovale  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen spinosum  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cranial fossa  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Clivus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Condyloid canal  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cranial fossa  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Intersutural bone"}
{"_id": "stanford_medicine_head_clean$$$corpus_300", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Skull, midsagittal section\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater wing of sphenoid & sphenoparietal suture  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Squamous suture &temporal bone (squamous part)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital bone (squamous part)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lambdoidal suture  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus for posterior branch of middle meningeal artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosal part of temporal bone & internal acoustic meatus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipitomastoid suture  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid sulcus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen magnum (lateral margin)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal canal  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital condyle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Basi occiput  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid process sphenoid bone and choana  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular foramen  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Horizontal plate palatine bone  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid sulcus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid line  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronal suture  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal bone (squamous part)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus for anterior branch of middle meningeal artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasion  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal bone  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista gall & lamina cribrosa  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior nasal concha (visible through opening in nasal septum)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Perpendicular plate of ethmoid bone (partially cut away posteriorly)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Vomer  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal concha  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal incisura  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine process of maxilla  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar process of maxilla"}
{"_id": "stanford_medicine_head_clean$$$corpus_301", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Skull, superior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Alveolar process of maxilla  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital margin  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic arch  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal process of maxilla  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuber of frontal bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Squamous part of frontal bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronal suture  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sagittal suture  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal foramen  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lambdoidal suture and occipital bone (squamous part)"}
{"_id": "stanford_medicine_head_clean$$$corpus_302", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Skull, posterior view\n\t\t\t\t\t\t\t\t\t\tA large sutural bone is present near the junction of the sagittal and lambdoid sutures.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal foramen  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Intersutural bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lambdoidal suture  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital bone (squamous part)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietomastoid suture  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipitomastoid suture  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior nuchal line  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular foramen  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sagittal suture  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid part of temporal bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid foramen  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid incisura  15\n\t\t\t\t\t\t.\n\t\t\t\t\t External occipital protuberance (unusually prominent)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of mandible"}
{"_id": "stanford_medicine_head_clean$$$corpus_303", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Skull, inferior close-up view, area of petrous part of temporal bone\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid process palatine bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plate of pterygoid process  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid fossa  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plate of pterygoid process  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala of vomer  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenooccipital fissure  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen lacerum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingula of sphenoid  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Basal part occipital bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior surface of temporal bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Petro-occipital fissure  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital condyle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen magnum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular foramen  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Infratemporal surface of sphenoid bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenosquamous suture  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of mandible  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen ovale  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen spinosum  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrotympanic fissure  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid canal  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic canaliculus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid canaliculus (partially obscured by posterior wall of jugular fossa)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Canaliculus chordae tympani  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylomastoid foramen  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular fossa  28\n\t\t\t\t\t\t.\n\t\t\t\t\t External aperture of cochlear canaliculi"}
{"_id": "stanford_medicine_head_clean$$$corpus_304", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Roentgenogram of skull, inferosuperior view\n\t\t\t\t\t\t\t\t\t\tIn this specimen one of the depressions (18) in the parietal bone which accommodates arachnoidal granulations (see Section I, 1-3) is unusually prominent as an area of rarification in the bone.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior orbital fissure  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary sinus (posterior portion)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Wall of cranial vault separating middle cranial fossa (below) from infratemporal fossa (above)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser wing of sphenoid bone (note continuation medially into anterior clinoid process)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of mandibular fossa  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior margin of petrosal part of temporal bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipitomastoid suture  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasolacrimal canal  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior surface of maxilla (pointer near Infraorbital foramen)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral wall of cranial vault (anterior cranial fossa lies medial to this)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic arch  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus (ethmoidal cells visible anteriorly)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid canal  16\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen magnum occipital (junction of coronal suture and sagittal suture visible in background)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Depression in parietal bone for arachnoidal granulations  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sagittal suture"}
{"_id": "stanford_medicine_head_clean$$$corpus_305", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Skull and mandible, inferior view\n\t\t\t\t\t\t\t\t\t\tThe anteroposterior diameter of the foramen magnum is unusually large in this skull. The view of the occipital bone (41-2) demonstrates the more common shape of this opening.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticomaxillary suture  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater palatine foramen  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic arch  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior border of vomer bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen ovale  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen spinosum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosal part of temporal bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  10\n\t\t\t\t\t\t.\n\t\t\t\t\t External acoustic meatus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylomastoid foramen  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipitomastoid suture  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital foramen  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of maxilla  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Median palatine suture & Palatine process of maxilla  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Horizontal plate & Sphenoid.process palatine bone  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid process  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid hamulus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plate of pterygoid process  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plate of pterygoid process  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Body sphenoid bone  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen lacerum (lingula of sphenoid bone seen crossing this opening)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Basal part occipital bone  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrooccipital fissure  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid canal  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular fossa  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital condyle  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Sagittal suture (visible through foramen magnum)  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid foramen  32\n\t\t\t\t\t\t.\n\t\t\t\t\t External occipital crest (unusually prominent)"}
{"_id": "stanford_medicine_head_clean$$$corpus_306", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Roentgenogram of skull, anteroposterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sagittal suture (in background of view)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic process of frontal bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Ethmoidal cells (sella turcica and clinoid processes lie posterior to this area)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Borders of petrosal part of temporal bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic arch  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular articulation  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of mandible  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal fossa  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbit  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Bony nasal septum Lower pointer: Hard palate  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary sinus (in foreground)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingula of mandible  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular canal"}
{"_id": "stanford_medicine_head_clean$$$corpus_307", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Skull, anterior view\n\t\t\t\t\t\t\t\t\t\tA supraorbital foramen occurs on the right, a supraorbital notch on the left. Note that within the notch there is a small superciliary canal which extends into the frontal bone. This canal gives passage to a small nutrient artery, an emissary vein, and a nerve filament. The deviation of the bony nasal septum is not unusual.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal bone (squamous part)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superciliary arch  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraorbital foramen  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal fossa  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital surface of frontal bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontomaxillary suture  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal process of maxilla  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasomaxillary suture  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital surface of maxilla  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle nasal concha  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraorbital foramen  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Bony nasal septum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal concha  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of condylar process of mandible  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid process of mandible  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Canine  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of mandible  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental foramen  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasofrontal suture & Nasal bone  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal incisura  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticofrontal suture  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior orbital fissure  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic foramen  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital surface of the greater wing of the sphenoid and Sphenozygomatic suture  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior orbital fissure  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic bone  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticomaxillary suture & Zygomatic process of maxilla  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior nasal spine  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process (temporal bone)  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermaxillary suture  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of mandible  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of mandible  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental protuberance"}
{"_id": "stanford_medicine_head_clean$$$corpus_308", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Roentgenogram of head and neck, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe head was turned to the right in this view of the living female subject so that the cervical vertebrae lie in various degrees of rotation. The lower vertebrae are more nearly in the anteroposterior position than the upper ones. The respiratory passages and oral cavity are outlined by their content of air, which produces a dark shadow in the view. Soft tissues are only faintly visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronal suture  2\n\t\t\t\t\t\t.\n\t\t\t\t\t SelIa turcica  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior wall orbit (pointer indicates left orbit)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus (in midline)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic bone (margin which borders left temporal fossa indicated by pointer)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Maxillary sinus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Hard palate  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Soft palate  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of hyoid bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottis (outlined by air in valleculae and in pharynx)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pharyngeal cavum Lower pointer: Laryngeal ventricle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Body cervical vertebra VI  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lambdoidal suture  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Petrosal part of temporal bone Lower pointer: Mastoid cells  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Condyloid process of mandible Lower pointer: Occipital condyle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch atlas  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens (crossed by anterior arch of atlas)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavity between articular processes of right second and third cervical vertebra  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramen (for cervical nerves IV & V)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of overlapping of articular processes of fifth and sixth cervical vertebrae  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle"}
{"_id": "stanford_medicine_head_clean$$$corpus_309", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Roentgenogram of skull, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe position of sutures on the left (near) surface of skull has been indicated by solid lines in the drawing.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronal suture  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal bone (squamous portion)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of temporal line left  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior wall of orbit (the two dotted lines above represent the floor of the left and right anterior cranial fossae) 6. Margin of left orbit (faintly visible in view)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater wing of sphenoid (bordering left middle cranial fossa)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fossa of lacrimal sac (faintly visible)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sella turcica  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenopalatine foramen (Pterygopalatine fossa visible slightly inferiorly)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic bone (faintly visible superimposed on maxillary sinus)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Mental foramen  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inner surface of cranial vault in midsagittal plane  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal bone (grooves for middle meningeal artery visible anteriorly; channels for temporal posterior diploic vein visible posteriorly)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Squamous suture  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal bone (squamous part)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lambdoidal suture  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid cells (extending into temporal bone (squamous part)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of external acoustic meatus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse sinus leading anteriorly into sigmoid sinus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t External occipital protuberance  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process (occipital condyles visible slightly anteriorly)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic arch left (faintly visible)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid process of sphenoid bone  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Hard palate (inferior surface in midline)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular canal"}
{"_id": "stanford_medicine_head_clean$$$corpus_310", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Skull, right lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior temporal line  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior temporal line  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Squamous suture  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenosquamous suture  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal bone (squamous part)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lambdoidal suture  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital bone (squamous part)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Intersutural bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipitomastoid suture  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External occipital protuberance (unusually prominent)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: External acoustic meatus (tympanic prominence visible in interior) Lower pointer: Condylar process of mandible  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital condyle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plate of pterygoid process  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Coronoid process of mandible Lower pointer: Ramus of mandible  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronal suture  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal bone (squamous part)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoparietal suture  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenofrontal suture  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater wing of sphenoid  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticofrontal suture  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontolacrimal suture  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacrimomaxillary suture  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Fossa of lacrimal sac  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasomaxillary suture  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenozygomatic suture  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic arch (pointer indicates zygomaticotemporal suture)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomaticomaxillary suture  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Zygomatic bone  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior nasal spine  33\n\t\t\t\t\t\t.\n\t\t\t\t\t First molar  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of mandible (pointer near mental foramen)"}
{"_id": "stanford_medicine_head_clean$$$corpus_311", "text": "Radiographs of the brain\n\t\t\t\t\t\t\t\t\t\t Postero-anterior (P-A) pneumoencephalogram\n\t\t\t\t\t\t\t\t\t\tThe subject has been placed in a prone position. The lateral ventricles are completely outlined by air. Some air is also contained within the third ventricle (3). The fourth ventricle (2) and the cerebral aqueduct are less distinct and are in part obscured by air in the frontal sinuses (11). Small collections of air (not drawn) can be seen within the subarachnoid spaces in many sulci of the brain. (These films have been reproduced through the courtesy of Dr. Howard L. Jones of the Palo Alto Hospital.)\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Calvaria  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Fourth ventricle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Third ventricle (partially filled)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior horn lateral ventricle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Central part lateral ventricle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior horn lateral ventricle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior horn of lateral ventricle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal surface of frontal bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital part of frontal bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Outline of petrosal part of temporal bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Outline of Basilar part of occipital bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal concha  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Bony nasal septum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal cavity  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of mandible."}
{"_id": "stanford_medicine_head_clean$$$corpus_312", "text": "Radiographs of the brain\n\t\t\t\t\t\t\t\t\t\t Antero-posterior (A-P) pneumoencephalogram\n\t\t\t\t\t\t\t\t\t\tThis roentgenogram was made with the patient in a supine position. The anterior horns and central parts of the lateral ventricles have been visualized by their content of air. The third ventricle (2) and cerebral aqueduct (1) are also well filled. The cisterns of the lateral fossae (14) are clearly outlined by their content of air. The basal cisterns likewise contain quantities of air but the margins of these spaces are obscured. (These films have been reproduced through the courtesy of Dr. Howard L. Jones of the Palo Alto Hospital.)\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral aqueduct  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Third ventricle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior horn lateral ventricle right  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Calvaria  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Central part lateral ventricle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital part of frontal bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Outline of petrosal (pyramidal) part of temporal bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal sinus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Cribriform plate ethmoid bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Bony nasal septum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal concha  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal cavity  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Foramen rotundum sphenoid bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Cistern of lateral cerebral fossa  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid part of temporal bone"}
{"_id": "stanford_medicine_head_clean$$$corpus_313", "text": "Radiographs of the brain\n\t\t\t\t\t\t\t\t\t\t Lateral pneumoencephalogram; lateral ventricles and third ventricle\n\t\t\t\t\t\t\t\t\t\tAir which was injected into the ventricles through the two trephine holes (15), partially fills each lateral ventricle (areas of overlapping indicated by dense stipple in drawing), the third ventricle and the cerebral aqueduct. The third ventricle is clearly visible only because it is somewhat dilated. The positions of its various recesses and borders, however, are not displaced appreciably. An oval area (8), of greater density than the surrounding outline of the third ventricle, may represent the massa intermedia. However, the position of this area is somewhat anterior to the usual location for this structure.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital part of frontal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cribriform plate ethmoid bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus of left middle meningeal artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior horn lateral ventricle left  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Interventricular foramen  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus of middle meningeal artery (anterior branch)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus middle meningeal artery (posterior branch)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of opacity due to soft tissue, possibly the massa intermedia  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Third ventricle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Central part of left lateral ventricle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of overlapping air shadows of the right and left lateral ventricles  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Atrium of the lateral ventricle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior horn lateral ventricle left  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior horn lateral ventricle right  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Trephine openings  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral margin of orbit  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Hard palate  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior wall of middle cranial fossa right  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior wall of middle cranial fossa left  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior clinoid process sphenoid bone  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic recess third ventricle (supraoptic recess)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior clinoid process sphenoid bone  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoidal sinus (anterior boundaries are not clearly defined)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Infundibular recess third ventricle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior horn of lateral ventricle right  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Pineal recess  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral aqueduct  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprapineal recess  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Margins of operative resection of occipital bone"}
{"_id": "stanford_medicine_head_clean$$$corpus_314", "text": "Radiographs of the brain\n\t\t\t\t\t\t\t\t\t\t Lateral pneumoencephalogram\n\t\t\t\t\t\t\t\t\t\tAir was injected into the lumbar subarachnoid space of this subject, a 1 year old child. The gas has entered the subarachnoid spaces surrounding the brain. The major subarachnoid cisterns are filled and, in addition, the sulci of the cerebral hemispheres in many places contain enough gas to render them visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Cribriform plate of ethmoid bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Chiasmatic cistern  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Interpeduncular cistern  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragma sellae (upper pointer) & sella turcica (lower pointer)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior horn of lateral ventricle (lower pointer indicates overlapping of the outlines of the right and left ventricles)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pontine cistern and pons  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral aqueduct  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part of pontine cistern  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Outline of petrosal part of temporal bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Fourth ventricle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior arch of atlas  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial aperture fourth ventricle (foramen Magendie)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebellomedullary cistern (cisterna magna)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Fastigium  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital part of frontal bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior horn of lateral ventricle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronal Suture  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Trephine opening (note surgical clips)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Third ventricle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Interventricular foramen (of Monro)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Central part lateral ventricle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Cisterna venae magnae cerebri (cisterna ambiens)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Atrium of lateral ventricle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior horn lateral ventricle"}
{"_id": "stanford_medicine_head_clean$$$corpus_315", "text": "Radiographs of the brain\n\t\t\t\t\t\t\t\t\t\t Right vertebral angiogram, arterial phase\n\t\t\t\t\t\t\t\t\t\tDiodrast was injected into the right vertebral artery of a living subject and films exposed during the phase of arterial filling. The vertebral artery is visible in relation to the axis and atlas (12), and as it passes through the foramen magnum. The posterior inferior cerebellar branch (11) is given off before the vertebral arteries unite to form the basilar artery (4). The basilar artery terminates by branching into the paired superior cerebellar arteries (2, 3) and the paired posterior cerebral arteries (7, 9). Branches of the latter which pass to the inferior surfaces of the temporal and occipital lobes are indistinct. (These films have been reproduced through the courtesy of Dr. Earl Miller of the University of California Hospital.)\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum sellae  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar artery left  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar artery right  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar artery (obscured by the petrous parts of the temporal bones)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Parieto-occipital branch of posterior cerebral artery left  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery right  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcarine branch of posterior cerebral artery right  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery left  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosal part of temporal bone left  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior inferior cerebellar artery right  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery right"}
{"_id": "stanford_medicine_head_clean$$$corpus_316", "text": "Radiographs of the brain\n\t\t\t\t\t\t\t\t\t\t Left internal carotid angiogram, venous phase\n\t\t\t\t\t\t\t\t\t\tThe procedure is the same as that of the previous view except that films were exposed as the opaque material passed into the venous side of the cerebral vascular system. (These films have been reproduced through the courtesy of Dr. Earl Miller of the University of California Hospital.)\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebral vein left (one of a group of anterior veins entering the superior sagittal sinus)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Terminal vein left (branches ramify upon caudate nucleus)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Small anastomotic vein of Labbe\u0301  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cerebral vein (lower pointer indicates the middle cerebral vein, which lies along the lateral cerebral fissure and is continuous with the great anastomotic vein)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cerebral vein (lateral occipital veins)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebral veins (from medial surface of left hemisphere)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebral veins (from lateral surface of left hemisphere)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior sagittal sinus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Great anastomotic vein of Trolard  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal cerebral vein left  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Great cerebral vein of Galen  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Basal veins  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Straight sinus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Confluence of the sinuses  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse sinus left (filling defect between pointers)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid part of transverse sinus right  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid part of transverse sinus left  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein left (filling defect from left sigmoid sinus to upper end of this vein)"}
{"_id": "stanford_medicine_head_clean$$$corpus_317", "text": "Radiographs of the brain\n\t\t\t\t\t\t\t\t\t\t Left internal carotid angiogram, arterial phase\n\t\t\t\t\t\t\t\t\t\tDiodrast was injected into the internal carotid artery of a living subject and films exposed during the phase of arterial filling. The carotid artery can be followed through the carotid canal of the temporal bone (below pointer 10), into its typical double bend in the region of the cavernous sinus (above pointer 10). The ophthalmic artery (9) and anterior choroidal artery (17) branch from the carotid before it divides into the middle (18) and anterior (3) cerebral arteries. Both anterior cerebral arteries are filled but the left one is more clearly outlined than the right. (These films have been reproduced through the courtesy of Dr. Earl Miller of the University of California Hospital.)\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Callosomarginal branch of anterior cerebral artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontopolar branch of anterior cerebral artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cerebral artery left  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Striate arteries (pointer indicates one of several)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending frontoparietal branch of middle cerebral artery (the posterior branch of this vessel is the artery of the precentral sulcus)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbitofrontal branch of middle cerebral artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior temporal branch of middle cerebral artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital branch of anterior cerebral artery left  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ophthalmic artery left  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle medial frontal and posterior medial frontal branches of callosomarginal artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericallosal branch of anterior cerebral artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior parietal branch of middle cerebral artery (artery of postcentral sulcus)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior parietal branch of middle cerebral artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of angular gyrus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior temporal branch of middle cerebral artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroidal artery (anterior)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cerebral artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas"}
{"_id": "stanford_medicine_head_clean$$$corpus_318", "text": "Frontal section of brain\n\t\t\t\t\t\t\t\t\t\t Olfactory structures visible in frontal section through anterior perforated substance\n\t\t\t\t\t\t\t\t\t\tThe plane of section is slightly oblique so that the right side is cut more posteriorly than the left. The view is from behind. The olfactory tracts can be traced posteriorly from the olfactory bulbs into the foreground of the view where the olfactory trigone is visible. The medial olfactory stria is more clearly seen on the left whereas the lateral olfactory stria can be traced on the right side across the anterior perforated substance into the limen insulae. The relations of the medial olfactory stria and the subcallosal gyrus (11) are shown. The anterior cerebral arteries are cut off from their origin from the middle cerebral arteries. The anterior communicating artery is visible and beyond this the two vessels course in the depths of the longitudinal fissure around the genu of the corpus callosum and reappear as cut ends in the upper part of the view.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fissure  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Corona radiata  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior occipitofrontal fasciculus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of caudate nucleus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior horn lateral ventricle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal part internal capsule  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Putamen  8\n\t\t\t\t\t\t.\n\t\t\t\t\t External capsule  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Globus pallidus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior occipitofrontal fasciculus and uncinate fasciculus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcallosal gyrus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial and intermediate stria of olfactory trigone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cerebral artery (within lateral fissure)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal lobe  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulate gyrus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Claustrum  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Septum pellucidum  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Stria terminalis  20\n\t\t\t\t\t\t.\n\t\t\t\t\t External medullary lamina of lentiform nucleus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior commissure  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina terminalis  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral olfactory stria and limen insulae  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior communicating artery  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Straight gyrus and olfactory tract"}
{"_id": "stanford_medicine_head_clean$$$corpus_319", "text": "Serial transverse sections of the brain stem\n\t\t\t\t\t\t\t\t\t\t Telencephalon.\n\t\t\t\t\t\t\t\t\t\tThis section is 12 mm. above the level of the previous section.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulate sulcus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum (near genu)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal capsule (anterior limb)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Septum pellucidum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavity of septum pellucidum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fissure (cerebral)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Semioval centrum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus corpus callosum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior horn lateral ventricle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of caudate nucleus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Putamen  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum (near rostrum)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal pole  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Straight gyrus"}
{"_id": "stanford_medicine_head_clean$$$corpus_320", "text": "Serial transverse sections of the brain stem\n\t\t\t\t\t\t\t\t\t\t Telencephalon.\n\t\t\t\t\t\t\t\t\t\tThis section, 7 mm. above the previous level, illustrates the anterior limb of the internal capsule as it passes forward between the head of the caudate nucleus and the lentiform nucleus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital lobe  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulate gyrus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior occipitofrontal fasciculus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal capsule (posterior limb)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior horn lateral ventricle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Septum pellucidum (a few fibers of column of fornix are included)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Insula  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Claustrum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t External capsule  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of caudate nucleus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior horn lateral ventricle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Corona radiata  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Caudate nucleus (tail)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Stria terminalis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Globus pallidus and external medullary lamina of lentiform nucleus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Putamen  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcallosal gyrus (peduncles corpus callosum)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal capsule (anterior limb)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fissure (cerebral)"}
{"_id": "stanford_medicine_head_clean$$$corpus_321", "text": "Serial transverse sections of the brain stem\n\t\t\t\t\t\t\t\t\t\t Diencephalon and telencephalon; level of anterior commissure\n\t\t\t\t\t\t\t\t\t\tThis section is 6 mm. above the level of the previous view. Relations of the anterior commissure (24) are visible. The frontal stalk of the thalamus (11) can be traced into the anterior limb of the internal capsule. The section passes just below the interventricular foramina (23).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Corona radiata  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior occipitofrontal fasciculus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal stalk of thalamus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal capsule (posterior limb)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t External capsule  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Putamen  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Globus pallidus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary laminae of lentiform nucleus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Intralaminar nucleus of thalamus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal stalk of thalamus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Claustrum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Uncinate fasciculus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of caudate nucleus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcarine fissure  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior horn lateral ventricle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulate gyrus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Caudate nucleus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral ventricle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior nucleus of thalamus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral nucleus of thalamus (ventral anterior nucleus)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial nucleus and internal medullary lamina of thalamus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus adjacent to interventricular foramen (of Monro)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior commissure  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Preoptic nucleus  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cerebral arteries and longitudinal fissure (cerebral)"}
{"_id": "stanford_medicine_head_clean$$$corpus_322", "text": "Serial transverse sections of the brain stem\n\t\t\t\t\t\t\t\t\t\t Diencephalon and telencephalon.\n\t\t\t\t\t\t\t\t\t\tThe level of this section is 7 mm. above that of the last. The lentiform nucleus is sectioned through its mid-portion. Efferent fibers of the globus pallidus pass, as the ansa lenticularis, around the medial margin of the internal capsule.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Caudate nucleus (tail)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior limb of internal capsule  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal lateral nucleus of thalamus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Claustrum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t External capsule  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Putamen  7\n\t\t\t\t\t\t.\n\t\t\t\t\t External medullary lamina and external division of globus pallidus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal medullary lamina and internal division of globus pallidus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior part of anterior commissure  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Uncinate fasciculus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina terminalis and optic recess  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cerebral fissure  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital gyri  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulate gyrus and sulcus corpus callosum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Stria terminalis  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix (body)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral nucleus of thalamus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal medullary lamina of thalamus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial nucleus of thalamus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillothalamic fasciculus [Vicq d'Azyr]  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Frontal part internal capsule  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ansa lenticularis  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Tectal part of column of fornix and hypothalamus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior communicating artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory trigone  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Straight gyrus"}
{"_id": "stanford_medicine_head_clean$$$corpus_323", "text": "Serial transverse sections of the brain stem\n\t\t\t\t\t\t\t\t\t\t Diencephalon.\n\t\t\t\t\t\t\t\t\t\tA section 4 mm. in thickness has been removed. The tegmental fields (of Forel) are visible at this level.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Caudate nucleus (tail)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Circular sulcus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Third ventricle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital part internal capsule (posterior limb)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t External medullary lamina (thalamus)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Thalamic fasciculus (H1 field of Forel)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lenticular fasciculus (H2 field of Forel)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Claustrum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t External capsule  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lentiform nucleus and posterior part of anterior commissure (lower pointer)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypothalamic nucleus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance and striate arteries  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic chiasm  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral ventricle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix (body)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus third ventricle and taenia thalami (lower pointer)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral nucleus of thalamus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal medullary lamina of thalamus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial nucleus of thalamus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Tegmental field (H field of Forel)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary body  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuber cinereum  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Amygdaloid nucleus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Infundibulum (cut across)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery"}
{"_id": "stanford_medicine_head_clean$$$corpus_324", "text": "Serial transverse sections of the brain stem\n\t\t\t\t\t\t\t\t\t\t Diencephalon.\n\t\t\t\t\t\t\t\t\t\tThis section is 5 mm. above the previous level. The medial lemnisci have now terminated within the ventral posterior lateral nuclei of the thalamus (5). On the left fibers from this nucleus are visible as they pass toward the internal capsule to form the parietal stalk or sensory radiation of the thalamus (5, upper pointer). The capsule of the red nucleus (6) consists largely of fibers which pass from the opposite dentate nucleus of the cerebellum by way of the brachium conjunctivum to the ventral lateral nucleus of the thalamus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Crura fornices  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterolateral nucleus of thalamus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lentiform nucleus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior commissure and pretectal region (lower pointer)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral posterior lateral nucleus and beginning of parietal stalk of thalamus (upper pointer)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Capsule of red nucleus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic tract (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublenticular part of internal capsule  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Substantia nigra  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Interpeduncular fossa  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous area which includes uncinate fasciculus and inferior occipitofrontal fasciculus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Amygdaloid nucleus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Central part lateral ventricle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Caudate nucleus (tail)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampal commissure (lower pointer) and corpus callosum  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Centrum (median) of thalamus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral geniculate body and lateral zone of Wernicke (upper pointer)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Red nucleus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior horn of lateral ventricle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic chiasm  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tract  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal pole"}
{"_id": "stanford_medicine_head_clean$$$corpus_325", "text": "Serial transverse sections of the brain stem\n\t\t\t\t\t\t\t\t\t\t Junction of mesencephalon and diencephalon.\n\t\t\t\t\t\t\t\t\t\tThe plane of section is 7 mm. above that of the last view and is slightly oblique so that the plane on the left side is higher than the right. The cerebral peduncles (22) are prominent although a fragment of the pons is still present. Fibers of the brachium conjunctivum, after crossing the midline are seen approaching the lower end of the red nucleus (20). The pulvinar of the thalamus is cut and fibers pass from it through the retrolenticular part of the internal capsule (3) toward the cortex of the parietal and occipital lobes.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcarine fissure  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Caudate nucleus (tail)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Retrolenticular part of internal capsule (posterior stalk of thalamus)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulvinar  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior colliculus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial geniculate body and medial lemniscus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral geniculate body  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampal fimbria  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior horn of lateral ventricle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampal fissure  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampal gyrus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum (splenium)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Central part lateral ventricle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix (crus)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Pineal body  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Stratum zonale thalami  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral aqueduct and posterior commissure  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial longitudinal fasciculus (nucleus of oculomotor nerve lies above pointer)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Red nucleus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Substantia nigra  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior recess of interpeduncular fossa  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Straight gyrus"}
{"_id": "stanford_medicine_head_clean$$$corpus_326", "text": "Serial transverse sections of the brain stem\n\t\t\t\t\t\t\t\t\t\t Mesencephalon.\n\t\t\t\t\t\t\t\t\t\tThis section is 5 mm. above the previous level. Within the tegmentum the massive decussation of the brachium conjunctivum (8) occupies a large area. The medial lemniscus (14) is more clearly seen on the right side. It lies close to the surface at this level and is crescent-shaped in cross section. The nucleus (13) of the trochlear nerve lies just above fibers of the medial longitudinal fasciculus (7). The cut passes through the inferior colliculi (11) which lie in the tectum of the mesencephalon. The lateral lemniscus (2, lower pointer) is lateral to and just beneath the nucleus of the inferior colliculus on either side. Some fibers of this bundle enter the colliculus; others ascend, as the inferior quadrigeminal brachium, to reach the medial geniculate body.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual gyrus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Commissure of inferior colliculi (upper pointer) and lateral lemniscus (lower Pointer)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral ventricle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t \"Alveus\"  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampal gyrus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial longitudinal fasciculus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Decussation brachium conjunctivum (superior cerebellar peduncle)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic nerve (II)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Arachnoid (within transverse fissure)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Nucleus inferior colliculus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral aqueduct  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Nucleus trochlear nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial lemniscus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep pontine fibers  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fasciculus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial pontine fibers  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cerebral artery right  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tract"}
{"_id": "stanford_medicine_head_clean$$$corpus_327", "text": "Serial transverse sections of the brain stem\n\t\t\t\t\t\t\t\t\t\t Pons.\n\t\t\t\t\t\t\t\t\t\tAt this level and in the remaining views of this series another brain has been substituted for the specimen used thus far. The cut surfaces are unstained, inasmuch as there is sharper contrast between gray and white matter at higher levels of the brain stem and in the region of the basal ganglia.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual gyrus left  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fissure (cerebral)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral aqueduct and brachium conjunctivum (superior cerebellar peduncle)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral lemniscus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tegmental tract  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep pontine fibers  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fasciculus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial pontine fibers  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery left  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory tract  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Orbital gyri  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lobule and ala central lobule  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Locus caeruleus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial longitudinal fasciculus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial lemniscus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachium pontis (middle cerebellar peduncle)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Fusiform gyrus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral fissure  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Uncus (hippocampal gyrus)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic chiasm  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Straight gyrus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal pole"}
{"_id": "stanford_medicine_head_clean$$$corpus_328", "text": "Serial transverse sections of the brain stem\n\t\t\t\t\t\t\t\t\t\t Pons.\n\t\t\t\t\t\t\t\t\t\tA section 3.5 mm. thick has been removed. On the right side the cut passes through the fibers of the fifth nerve as they leave the pons. No cranial nerve nucleus, except the mesencephalic root of the fifth nerve, is present in this region of the brain stem. The nucleus of the lateral lemniscus (13) lies in the midst of the fibers of the lemniscus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior medullary velum (lingula attached to its upper surface)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Fourth ventricle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial longitudinal fasciculus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Raphe  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachium pontis (middle cerebellar peduncle)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep pontine fibers  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fasciculus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial pontine fibers  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fissure (cerebral)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachium conjunctivum (superior cerebellar peduncle)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending root (mesencephalic) of trigeminal nerve (V)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tegmental tract  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral lemniscus and nucleus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial lemniscus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporal lobe"}
{"_id": "stanford_medicine_head_clean$$$corpus_329", "text": "Serial transverse sections of the brain stem\n\t\t\t\t\t\t\t\t\t\t Pons.\n\t\t\t\t\t\t\t\t\t\tThis section is 4 mm. above the last one. Fibers of the trigeminal nerve (4) pass obliquely medially through the brachium pontis. On the right side the motor nucleus (13) of this nerve is visible. The spinal tract of the trigeminal nerve, which begins its descending course through the brain stem at this level, is not clearly seen here. The trapezoid body (5) is prominent. The superior olive (15) is still present and the lateral lemniscus (14) is larger at this level than in the previous section.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Vermis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Fourth ventricle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachium pontis (middle cerebellar peduncle)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V) (fibers within pons)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezoid body and medial lemniscus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep pontine fibers  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fasciculus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial pontine fibers  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic chiasm  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Commissural fibers of cerebellum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachium conjunctivum (superior cerebellar peduncle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Restiform body (inferior cerebellar peduncle)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Motor nucleus of trigeminal nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral lemniscus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior olivary nucleus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tegmental tract  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Olfactory trigone"}
{"_id": "stanford_medicine_head_clean$$$corpus_330", "text": "Serial transverse sections of the brain stem\n\t\t\t\t\t\t\t\t\t\t Pons.\n\t\t\t\t\t\t\t\t\t\tA section 4 mm. thick has been removed. Within the tegmentum of the pons the abducens nucleus (17) and fibers of the abducens nerve (21) are visible. The peripheral part of the nerve, which leaves the brain stem just behind the pons, is not shown on this specimen. The nucleus of the facial nerve (17, lower pointer) is still present in this section and fibers of the nerve (18) lie just above the nucleus as they pass from the internal genu (16) toward their exit point. Transverse fibers of the trapezoid body (9) are visible as they pass through the medial lemniscus. The superior olive and beginnings of the lateral lemniscus lie lateral to this area. These structures are part of the central auditory pathway.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual gyrus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Vermis  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fastigial nucleus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachium conjunctivum (superior cerebellar peduncle)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Restiform body (inferior cerebellar peduncle)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocerebellar fibers (juxtarestiform body)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial longitudinal fasciculus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal trigeminal tract and nucleus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezoid body  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep pontine fibers  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fasciculus (pontine pyramid)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial pontine fibers  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Globose nucleus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Dentate nucleus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Fourth ventricle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial colliculus and genu (internal) roots of facial nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Nucleus of abducens nerve and nucleus of facial nerve (lower pointer)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Second part of roots of facial nerve (VII)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior olivary nucleus (the lateral lemniscus is forming lateral to this nucleus)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tegmental tract  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Root abducens nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Uncus (hippocampal gyrus)"}
{"_id": "stanford_medicine_head_clean$$$corpus_331", "text": "Serial transverse sections of the brain stem\n\t\t\t\t\t\t\t\t\t\t Junction of medulla and pons.\n\t\t\t\t\t\t\t\t\t\tThis section cuts across the mid-portion of the fourth ventricle and the nodulus at a level 3.5 mm. higher than the previous section. The cerebellar nuclei are prominent and the beginnings of the brachium conjunctivum (15) visible. The restiform bodies are extending upwards into the cerebellum and fibers of the juxtarestiform body are passing from the acoustic area (5) toward the cerebellum at (4).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual gyrus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Nodulus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fourth ventricle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Juxtarestiform tract  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Area acustica and medial longitudinal fasciculus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral cochlear nucleus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial lemniscus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pontobulbar body  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramid (medulla oblongata)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons and foramen caecum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Fusiform gyrus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Uncus (hippocampal gyrus)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Emboliform nucleus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Fastigial nucleus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachium conjunctivum (superior cerebellar peduncle)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dentate nucleus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachium pontis (middle cerebellar peduncle)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Restiform body (inferior cerebellar peduncle)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal trigeminal tract  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VII) vestibular part  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadrangular lobule  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Nucleus facial nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tegmental tract (tegmental olivary tract)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cerebral artery (cut across)"}
{"_id": "stanford_medicine_head_clean$$$corpus_332", "text": "Serial transverse sections of the brain stem\n\t\t\t\t\t\t\t\t\t\t Medulla oblongata.\n\t\t\t\t\t\t\t\t\t\tAt this level, 3 mm. above the preceding section, the cochlear nuclei are well defined on each side of their positions above and lateral to the restiform body. The incoming cochlear nerves (20), however, are partially hidden by the flocculi. The vestibular nerves (19) are also obscured by the flocculi but are well seen in the following view as they enter the brain stem. The region between the exit point of the facial nerve and that of the acoustic nerve is transversed by obliquely directed pontine fibers which enter a nuclear area known as the pontobulbar body (21). The medial lemniscus (9) is becoming triangular in shape as it approaches the pons.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dentate nucleus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial longitudinal fasciculus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus fourth ventricle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Area acustica  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Restiform body (inferior cerebellar peduncle)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Reticular gray matter  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal trigeminal tract  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior olivary nucleus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial lemniscus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramid (medulla oblongata)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate nuclei  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Emboliform nucleus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Globose nucleus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Nodulus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal cochlear nucleus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Floccular peduncle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral cochlear nucleus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Flocculus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VIII) vestibular part  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VIII) cochlear part  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII) and \"corpus pontobulbare\"  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic chiasm"}
{"_id": "stanford_medicine_head_clean$$$corpus_333", "text": "Exploration of the meninges and brain in situ\n\t\t\t\t\t\t\t\t\t\t Rhomboid fossa\n\t\t\t\t\t\t\t\t\t\tThe choroid plexus and tela chorioidea have been removed to expose the entire left half of the fourth ventricle. The inferior margin of the lateral recess of the ventricle is marked by the cut edge of the taenia ventriculi quarti (29) which can be traced laterally across several rootlets of the ninth and tenth nerves.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cranial fossa  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of posterior cerebral artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlear nerve (IV)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar artery (cut across)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Major portion of trigeminal nerve (V)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Minor portion of trigeminal nerve (V)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal auditory artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII) and vestibulocochlear (VIII)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior cerebellar artery (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots glossopharyngeal nerve (IX), vagus (X), and accessory (XI)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal root of accessory nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve root (XII) (other rootlets of this nerve also visible)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery left  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cranial fossa  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior inferior cerebellar arteries  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal medulla  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Great cerebral vein (of Galen)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior colliculus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Falx cerebri  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Straight sinus (opened)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachium pontis (middle cerebellar peduncle) (cut across)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar peduncle (cut across)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior part of rhomboid fossa  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Arbor vitae  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cerebellar peduncle(cut across)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Nucleus dorsalis cochlear nerve  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate part of rhomboid fossa  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral recess of rhomboid fossa and taenia fourth ventricle  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior part of rhomboid fossa  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Falx cerebelli"}
{"_id": "stanford_medicine_head_clean$$$corpus_334", "text": "Serial transverse sections of the brain stem\n\t\t\t\t\t\t\t\t\t\t Medulla oblongata.\n\t\t\t\t\t\t\t\t\t\tThe inferior olivary nucleus and medial accessory olive are prominent at this level, 4 mm. higher in the medulla. From these nuclei numerous olivocerebellar fibers pass as internal arcuate fibers to the restiform bodies which in this section are not completely organized. The hypoglossal nucleus (4) is still present, although not as clearly defined as before, and an emerging filament of the nerve is seen below the right olive.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fissure (cerebral)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Uvula (vermis)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus fourth ventricle and area acustica  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Nucleus hypoglossal nerve (XII).  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tractus solitarius  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal trigeminal tract and nucleus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior olivary nucleus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial accessory olivary nucleus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramid (medulla oblongata)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VII)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Emboliform nucleus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Hilus dentate nucleus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Dentate nucleus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tonsil (ventral paraflocculus)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterolateral fissure  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Taenia fourth ventricle and dorsal motor nucleus of vagus nerve (X) (dorsal motor nucleus of the vagus nerve)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Restiform body (inferior cerebellar peduncle )  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral cochlear nucleus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of nucleus ambiguous  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial lemniscus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX) and vagus (X)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VIII)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cerebellar peduncle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Pons  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Oculomotor nerve (III)"}
{"_id": "stanford_medicine_head_clean$$$corpus_335", "text": "Exploration of a brain cut in frontal section at the splenium of the corpus callosum\n\t\t\t\t\t\t\t\t\t\t Hippocampal commissures; meninges within transverse fissure\n\t\t\t\t\t\t\t\t\t\tA block of tissue including the cingulum and hippocampal structures has been removed on the right side to expose the right pulvinar. Vessels and meninges remain in their normal position within the transverse fissure thus opened. The splenium and gyri cinguli are cut away. The central parts of the lateral ventricles and the forward course of the fornix with the hippocampal commissure interconnecting its two crura are now seen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal fissure (cerebral)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus lateral ventricle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix (crus)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulvinar  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior colliculus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Fusiform gyrus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulate gyrus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampal commissure  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroidal branch of posterior cerebral artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Meninges  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior medullary velum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachium pontis (middle cerebellar peduncle) (cut across)"}
{"_id": "stanford_medicine_head_clean$$$corpus_336", "text": "Exploration of a brain cut in frontal section at the splenium of the corpus callosum\n\t\t\t\t\t\t\t\t\t\t Cingulum, fornix, pulvinar and choroidal arteries\n\t\t\t\t\t\t\t\t\t\tOn the right side the cingulum is now exposed in its curved course around the splenium. On the left the occipital radiation of the corpus callosum and the hippocampal structures are divided and portions removed to display the crus of the fornix, the pulvinar of the thalamus and branches of the posterior cerebral artery within the area.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t External sagittal stratum (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tapetum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Choroid plexus lateral ventricle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix (ems)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulvinar  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Hippocampus (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cerebral artery (note its choroidal branches)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fourth ventricle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital part of radiations of corpus callosum (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial longitudinal stria  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pineal body  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral fissure  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior colliculus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cerebellar artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal part of pons (tegmentum of the pons)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior olivary nucleus"}
{"_id": "stanford_medicine_head_clean$$$corpus_337", "text": "Exploration of those parts of the brain supplied by the posterior cerebral artery\n\t\t\t\t\t\t\t\t\t\t Lentiform nucleus and inferior occipitofrontal fasciculus\n\t\t\t\t\t\t\t\t\t\tThe temporopontine fibers of the internal capsule have now been cut away to reveal the gray matter of the lentiform nucleus directly above. The inferior occipitofrontal fasciculus is seen lateral to the nucleus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Parieto-occipital fissure  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial surface of frontal lobe  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital part radiations of corpus callosum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Cingulum (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus callosum (splenium)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulvinar  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Mesencephalon (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Cerebral peduncle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior perforated substance  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Optic chiasm  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary substance of occipital lobe  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tapetum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t External sagittal stratum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix (ems) (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Caudate nucleus (tail) (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior thalamic radiation  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral geniculate body (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Temporopontine tract (cut across)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lentiform nucleus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior occipitofrontal fasciculus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Amygdaloid nucleus (dissected)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Uncinate fasciculus"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_1", "text": "Sagittal sections of right foot\n\t\t\t\t\t\t\t\t\t\t Section through lateral part of foot, viewed from lateral side\n\t\t\t\t\t\t\t\t\t\tThe plane of section traverses the fibula, the lateral parts of the talus and calcaneus, the cuboid bone and the fourth metatarsal.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior tibiofibular ligament Lower pointer: Posterior talofibular ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Subtalar articulation  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tarsal sinus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of calcaneus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle (covered superficially by lateral part of plantar aponeurosis)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Long plantar ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneocuboid articulation (part of transverse tarsal joint)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Cuboid bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (tendon cut obliquely within tendon sheath)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t 2nd plantar interosseus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t 4th dorsal interosseus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous membrane of leg  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Talocrural articulation (pointer on lateral malleolar surface of trochlea of talus)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlea of talus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Intermediate root of inferior extensor retinaculum Right pointer: Extensor digitorum longus muscle (tendons)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis brevis muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral tarsal artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle (additional unlabeled part of muscle belly visible distally)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cuneiform bone  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of 3rd metatarsal bone  25\n\t\t\t\t\t\t.\n\t\t\t\t\t 3rd dorsal interosseus muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t 4th metatarsal bone  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle (tendon of insertion)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of proximal phalanx  29\n\t\t\t\t\t\t.\n\t\t\t\t\t 4th digit"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_2", "text": "Sagittal sections of right foot\n\t\t\t\t\t\t\t\t\t\t Section through medial part of foot, viewed from lateral side\n\t\t\t\t\t\t\t\t\t\tThe plane of section passes through the calcaneus posteriorly and the shaft of the second metatarsal anteriorly, displaying the medial part of the longitudinal arch of the foot.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle (sectioned nearly longitudinally)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery (sectioned longitudinally)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Talocrural articulation  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle (tendon cut obliquely)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of calcaneus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle (fibers pass obliquely laterally)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Calcaneocuboid articulation Right pointer: Cuboid bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum brevis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus plantae muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (tendon of insertion, faintly visible)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique head of adductor hallucis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle (tendons distal to attachment of quadratus plantae)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse head of adductor hallucis muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle (sectioned longitudinally)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Subtalar articulation  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Tarsal sinus Right pointer: Neck of talus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Head of talus Right pointer: Talocalcaneonavicular articulation  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Navicular bone  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cuneiform bone  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate cuneiform bone  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of 2nd metatarsal bone  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar arch  30\n\t\t\t\t\t\t.\n\t\t\t\t\t 1st dorsal interosseus muscle (visible both above and below metatarsal)  31\n\t\t\t\t\t\t.\n\t\t\t\t\t 2nd dorsal interosseus muscle  32\n\t\t\t\t\t\t.\n\t\t\t\t\t 2nd metatarsophalangeal articulations"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_3", "text": "Cross sections of right foot\n\t\t\t\t\t\t\t\t\t\t Horizontal section of lower part of leg through tibiofibular syndesmosis\n\t\t\t\t\t\t\t\t\t\tThe specimen, cut across just above the ankle joint, is viewed from below so that the side-to-side relations of the structures that have been followed through the preceding sections of the foot remain unchanged.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lateral malleolar artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibiofibular ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous tibiofibular ligament (continuous above with the interosseous membrane of leg)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibiofibular ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (tendon)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser saphenous vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep transverse septum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior extensor retinaculum  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (tendon within synovial sheath surrounded by flexor retinaculum)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Medial plantar nerve Lower pointer: Lateral plantar nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneal branch of lateral posterior tibial artery"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_4", "text": "Cross sections of right foot\n\t\t\t\t\t\t\t\t\t\t Oblique section through ankle joint and subtalar joint\n\t\t\t\t\t\t\t\t\t\tThe plane of this section passes obliquely upward and forward from the heel to transect the dorsum of the foot through the anterior part of the trochlea of the talus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extensor retinaculum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle (tendon within synovial sheath)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlea of talus (pointer on superior surface)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolar surface of trochlea of talus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Subtalar articular space  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior talofibular ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fossa of lateral malleolus of fibula  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle (tendon within synovial sheath)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (tendon within synovial sheath)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneofibular ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of calcaneus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle (tendon and muscle)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle (tendon and muscle)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Surface of medial malleolar trochlea of talus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibiotalar part of deltoid ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (tendon within synovial sheath)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Flexor digitorum longus muscle (tendon within synovial sheath) Lower pointer: Flexor hallucis longus muscle (tendon within synovial sheath)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Medial plantar nerve Lower pointer: Lateral plantar nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle (origin)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_5", "text": "Cross sections of right foot\n\t\t\t\t\t\t\t\t\t\t Section through sustentaculum tali and tarsal sinus\n\t\t\t\t\t\t\t\t\t\tThe plane of the cut is nearly vertical and is such that the anterior part of the ankle joint (2) is included in the section with the posterior part of the talocalcaneonavicular joint (17). The relation of the flexor tendons to the sustentaculum tali is illustrated. In the plane of section all of the long tendons are enclosed within synovial sheaths reinforced by fibrous sheaths.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle (tendon)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Talocrural articular space  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extensor retinaculum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Talus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of lateral tarsal artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intemediate root of inferior extensor retinaculum Lower pointer: Tarsal sinus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle (tendon)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior peroneal retinaculum Lower pointer: Peroneus longus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Long plantar ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum brevis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis (lateral and intermedial portions)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle (tendon)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle (tendon)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Talocalcaneonavicular articular space (articulation between talus and middle surface of calcaneus)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibiocalcaneal part of deltoid ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (tendon within synovial sheath)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Sustentaculum tali  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle (tendon within synovial sheath)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Flexor hallucis longus muscle (tendon within synovial sheath) Lower pointer: Medial plantar nerve (medial plantar artery lies slightly inferior to nerve and is small)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus plantae muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar artery and vein"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_6", "text": "Cross sections of right foot\n\t\t\t\t\t\t\t\t\t\t Section through region of mid-tarsal joint\n\t\t\t\t\t\t\t\t\t\tIncluded in the section are portions of the head of the talus (16), the navicular bone (18), the calcaneus (5) and the cuboid bone (7). The spheroidal shape of the talonavicular joint is evident in the section as is the saddle-shape of the calcaneocuboid joint.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extensor retinaculum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle (tendons)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral tarsal artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Bifurcate ligament  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cuboid bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Long plantar ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle (tendon)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Tendinous sheath of peroneus longus and plantaris muscles Lower pointer: Peroneus longus muscle (sesamoid bone present in tendon)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tela subcutanea  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle (tendon)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Talonavicular ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle (tendon)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of talus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Navicular bone  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (upper pointer indicates sesamoid bone in tendon)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar calcaneonavicular ligament (spring ligament)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle (tendon in common sheath with tendon of flexor hallucis longus)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle (tendon)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plantar nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneocuboid plantar ligament  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus plantae muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum brevis muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar nerve  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar artery"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_7", "text": "Cross sections of right foot\n\t\t\t\t\t\t\t\t\t\t Section through navicular, cuneiform and cuboid bones\n\t\t\t\t\t\t\t\t\t\tThe section passes through the posterior parts of the three cuneiform bones, the anterior part of the navicular and cuboid bones, and through the tuberosity of the fifth metatarsal. The tendon of insertion of the tibialis posterior has been split into several fascicles (18) passing to the cuneiforms and to the base of the first metatarsal. The peroneus longus tendon (8) lies more laterally than in the previous section and is in an osteofibrous tunnel bounded below by the anterior continuation of the long plantar ligament (not labeled).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle (tendons)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis brevis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal cuneocuboid ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cuneiform bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cuboid bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (tendon within fibro-osseous tunnel)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus tertius muscle (tendon)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of 5th metatarsal bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle (tendon)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi brevis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle (tendon)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Navicular bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate cuneiform bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle (tendon)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cuneiform bone  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (tendon of insertion split into several slips)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis brevis muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle (tendon)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle (tendons)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plantar nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus plantae muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum brevis muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar nerve  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar artery and vein"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_8", "text": "Cross sections of right foot\n\t\t\t\t\t\t\t\t\t\t Section of foot through tarsometatarsal joints, viewed from in front\n\t\t\t\t\t\t\t\t\t\tThe plane of section passes through the bases of all of the metatarsals and portions of the three cuneiform bones. Several interosseous ligaments (6, 8, 18) are visible. The potential fascial spaces between layers of muscle in the central compartment of the foot have been emphasized by pulling the muscles slightly apart from each other.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intermediate cuneiform bone Lower pointer: 1st metatarsal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle (tendons covered by fascia of dorsalis pedis)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cuneiform bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t 2nd metatarsal bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal interosseous ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t 5th metatarsal bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal interosseous ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t 5th metatarsal bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar artery and vein  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral intermuscular septum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle (tendon)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cuneiform bone  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Cuneometatarsal interosseous ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle (tendon inserting on 1st metatarsal)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t metatarsal bone  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (tendon)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis brevis muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle (tendon)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique head of adductor hallucis muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plantar nerve  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle (origins of lumbrical muscles visible medial to pointer fibers of insertion of quadratus plantae faintly visible lateral to pointer)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum brevis muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_9", "text": "Cross sections of right foot\n\t\t\t\t\t\t\t\t\t\t Section through proximal parts of metatarsal shafts, viewed from in front\n\t\t\t\t\t\t\t\t\t\tThis section, cut 2 cm. posterior to the plane of the previous section, illustrates the layers of the muscle (19, 4, 14, 5) deep to the plantar aponeurosis (20) in the central part of the foot. The width of the fascial cleft located deep to the second layer of muscles (4) has been exaggerated by slight downward retraction of the layers superficial to it.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of dorsalis pedis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle (tendons)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Flexor digitorum longus muscle (tendon) Left pointer: 3rd lumbrical muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous muscle (see previous view for identification of individual dorsal and plantar interossei)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi brevis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tela subcutanea  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis brevis muscle (tendon)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle (tendon)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep plantar branch of dorsalis pedis artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar arch (partially cut away)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique head of adductor hallucis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis brevis muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle (tendon)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plantar nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum brevis muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar nerve"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_10", "text": "Cross sections of right foot\n\t\t\t\t\t\t\t\t\t\t Section of foot through distal ends of metatarsals, viewed from in front\n\t\t\t\t\t\t\t\t\t\tThe plane of this section is 6 mm. posterior to that of the section shown in the preceding view. The direction of view has been reversed for the present photograph so that the distal surface is illustrated in relation to the remainder of the foot. In the remaining sections of this series the distal surfaces are shown.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Extensor digitorum longus muscle (tendon to 2nd toe) Left pointer: Extensor digitorum brevis muscle (tendon to 2nd toe passing obliquely medially)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle (tendon to 3rd toe)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: 2nd dorsal interosseous muscIe Left pointer: 1st plantar interosseous muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse head of adductor hallucis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t 4th dorsal interosseus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t 3rd plantar interosseous muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t 5th metatarsal bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis brevis muscle (tendon)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle (tendon)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t 1st dorsal interosseus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis brevis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle (tendon)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique head of adductor hallucis muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Flexor digitorum longus and brevis muscles (to 2nd toe) Right pointer: 1st lumbrical muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Flexor digitorum longus and brevis muscles (to 3rd toe) Right pointer: 2nd lumbrical muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis (several thick tendon-like bundles of aponeurotic fibers visible in this plane)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Common plantar digital nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle et brevis (to 4th toe)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle (to 5th toe)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_11", "text": "Cross sections of right foot\n\t\t\t\t\t\t\t\t\t\t Section of distal part of foot, viewed from behind\n\t\t\t\t\t\t\t\t\t\tThe plane of section passes through the sesamoid bones of the first metatarsophalangeal joint medially and the head of the fifth metatarsal laterally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of metatarsal bone I (note articular cartilage covering lower part of head)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament for metatarsophalangeal articulation  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle (tendon approaching insertion)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sesamoid bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle (tendon)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor hallucis muscle (tendon of oblique head)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Common plantar digital nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: 1st lumbrical muscle Right pointer: Flexor digitorum longus and brevis muscles (tendons cut off within fibrous sheath)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Common plantar digital nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: 2nd lumbrical muscle Right pointer: Flexor digitorum longus and brevis muscles (tendons cutoff in sheath)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse head of adductor hallucis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus and brevis muscles (to 4th toe)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle (tendon)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis brevis muscle (tendon)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: 1st dorsal interosseus muscle Right pointer: 2nd metatarsal bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle (tendon to 2nd toe)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle (tendon to second toe)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t First dorsal interosseus muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t 1st plantar interosseous muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t 3rd dorsal interosseus muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t 2nd plantar interosseous muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: 3rd plantar interosseous muscle (approaching insertion) Lower pointer: Collateral ligament  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of 5th metatarsal bone (cut across within articular cavity)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Sesamoid bone  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle (tendon to 5th toe)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t 4th dorsal interosseus muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_12", "text": "Joints of left ankle and foot\n\t\t\t\t\t\t\t\t\t\t Metatarsophalangeal and interphalangeal joints, viewed from above\n\t\t\t\t\t\t\t\t\t\tThe joints of the first two toes have been opened.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral parts of extensor expansion  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle part of extensor expansion  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep transverse metatarsal ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsophalanx articular capsule  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Interphalangeal articular space  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor expansion (insertion of lumbrical)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament (divided)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament (divided)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of 1st metatarsal bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of 1st metatarsal bone"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_13", "text": "Joints of left ankle and foot\n\t\t\t\t\t\t\t\t\t\t Joints of foot opened and viewed from above\n\t\t\t\t\t\t\t\t\t\tThe intertarsal, tarsometatarsal and intermetatarsal joints have been opened by incising the ligaments and capsules of these joints. The adjoining bones have been pulled apart to demonstrate the internal configuration of the various cavities. Interosseous ligaments between the bases of the metatarsals (10), between the cuneiform bones (13), and between the lateral cuneiform and the cuboid bone (3) have also been divided. The interior of the tarsometatarsal joint of the first toe is also illustrated in view 202-4.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermetatarsal articulations (opened)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tarsometatarsal articulations (opened)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cuneocuboid interosseous ligament (cut through) Lower pointer: Lateral cuneiform bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cuboid bone Lower pointer: Cuneocuboid articulation (opened)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Cuboideonavicular articulation (opened)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of calcaneus for cuboid  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tarsal sinus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Metatarsal interosseous ligament Lower pointer: Base of second metatarsal bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cuneiform bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intercuneiform articulation Lower pointer: Intermediate cuneiform bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intercuneiform interosseous ligament Lower pointer: Intercuneiform articulation  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cuneonavicular articular space Lower pointer: Navicular bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Talonavicular ligament (cut) Lower pointer: Talocalcaneonavicular articulation  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar calcaneonavicular ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of talus for navicular bone  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlea of talus"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_14", "text": "Joints of left ankle and foot\n\t\t\t\t\t\t\t\t\t\t Subtalar and talocalcaneonavicular joints, opened and viewed from above\n\t\t\t\t\t\t\t\t\t\tThe talus has been removed from the specimen to reveal the articular surfaces of the calcaneus and the navicular bone together with the plantar calcaneonavicular ligament (20).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal cuneonavicular ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cuboid bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal cuboideonavicular ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Bifurcate ligament (calcaneocuboid ligament not clearly visible)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus (superior tubercle)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical ligament (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extensor retinaculum (upper pointer: intermediate root; lower pointer: medial root)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tarsal sinus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior talocalcaneal ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior peroneal retinaculum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneofibular ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral tubercle process of calcaneus bone (in background)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneal subtendinous bursa  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cuneiform bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Navicular bone  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Talonavicular ligament (cut off)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Navicular bone (articular surface for talus)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior articular surface of calcaneus for talus (not separate from middle articular surface (21) in this specimen)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar calcaneonavicular ligament (spring ligament)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial articular surface of calcaneus for talus (also see 19)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Talocalcaneonavicular articular capsule  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligament of tarsal canal (attached within calcaneal groove)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid ligament (cut off)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior articular surface of calcaneus for talus  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial process of tuberosity of calcaneus (in background)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Subtalar articular capsule  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_15", "text": "Joints of left ankle and foot\n\t\t\t\t\t\t\t\t\t\t Interior of ankle joint, anterior view\n\t\t\t\t\t\t\t\t\t\tThe tibia and fibula have been detached from the tarsal bones. The foot has been placed in a position of partial extension.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular surface of tibia  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Talocrural articular capsule (cut edge)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Malleolar articular surface  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid ligament (divided)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of talus (pointer on cut margin of joint capsule)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of talus (covered by ligaments)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Talonavicular ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Navicular bone (covered by ligaments)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous tibiofibular ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibiofibular ligament (divided)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Malleolar articular surface Lower pointer: Transverse tibiofibular ligament  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior talofibular ligament (divided)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior surface of trochlea of talus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tarsal sinus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus (pointer on superior tubercle)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal cuboideonavicular ligament"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_16", "text": "Joints of left ankle and foot\n\t\t\t\t\t\t\t\t\t\t Interior of ankle joint and subtalar joint in relation to deep ligaments, posterior view\n\t\t\t\t\t\t\t\t\t\tThe joint capsules have been widely opened. All of the major ligaments of the ankle joint and subtalar joint have been kept intact for the purpose of this photograph. In the following views the bones have been separated by transection of the ligaments.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibiofibular ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Transverse tibiofibular ligament Lower pointer: Lateral malleolar surface trochlea of talus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Talocrural articular capsule (cut edge of capsule traceable as thin ridge of tissue around margin of opened joint cavity)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior talofibular ligament (note massive size and depth of ligament)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneofibular ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior articular surface of calcaneus for talus Lower pointer: Calcaneus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lateral tubercle of posterior talar process Lower pointer: Subtalar articular capsule (posterior talocalcaneal ligament)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Groove for flexor hallucis longus tendon Lower pointer: Medial tubercle of posterior talar process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of calcaneus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior surface of trochlea of talus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Malleolar groove (for tibialis posterior muscle)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibiotalar part of deltoid ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibiocalcaneal part of deltoid ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial talocalcaneal ligament (fibers run horizontally)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for flexor hallucis longus tendon  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Sustentaculum tali  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of navicular bone (tendon of tibialis posterior cut off at attachment)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_17", "text": "Joints of left ankle and foot\n\t\t\t\t\t\t\t\t\t\t Interior of ankle joint and subtalar joint in relation to ligaments, posterior view\n\t\t\t\t\t\t\t\t\t\tThe fascia posterior to the joints has been removed and the capsules have been partly opened to reveal parts of the talus and calcaneus within the joint cavities.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibiofibular ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlea of talus (exposed within talocrural joint)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Talocrural articular capsule  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for peroneal tendons  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior talofibular ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Subtalar articulation (opened)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior talocalcaneal ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior surface of tibia  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for tibialis posterior muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibiotalar part of deltoid ligament  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for flexor hallucis longus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Tibiocalcaneal part of deltoid ligament Lower pointer: Sustentaculum tali"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_18", "text": "Joints of left ankle and foot\n\t\t\t\t\t\t\t\t\t\t Ligaments of ankle and subtalar joints, posterior view\n\t\t\t\t\t\t\t\t\t\tThe capsules of the ankle and subtalar (talocalcaneal)joints remain intact. In addition, a layer of fascia (5) has been retained posteriorly. This layer continued laterally into the superior peroneal retinaculum and blended medially into the flexor retinaculum.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibiofibular ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior peroneal retinaculum (divided)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia posterior to ankle joint (this layer blended with superior peroneal retinaculum)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneofibular ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Subtalar articular capsule  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior peroneal retinaculum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral tubercle process of calcaneus bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Groove for tendon of tibialis posterior muscle Lower pointer: Groove for tendon of flexor digitorum longus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Talocrural articular capsule  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for tendon of flexor hallucis longus muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (cut off at insertion into tuberosity of navicular)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sustentaculum tali  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal bone"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_19", "text": "Joints of left ankle and foot\n\t\t\t\t\t\t\t\t\t\t Interior of ankle and mid-tarsal joints in relation to ligaments, lateral view\n\t\t\t\t\t\t\t\t\t\tThe thin parts of the capsules of the ankles and mid-tarsal joints have been cut away to emphasize the position of the ligaments in relation to the bony and cartilaginous parts of these joints.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlea of talus (pointer on superior surface)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior talofibular ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical ligament  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Talonavicular ligament  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneonavicular ligament (part of bifurcate ligament)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneocuboid ligament (part of bifurcate ligament)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal cuneonavicular ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibiofibular ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral process of talus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Lateral talocalcaneal ligament Right pointer: Calcaneofibular ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior peroneal retinaculum (opened)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Inferior extensor retinaculum (intermediate root) Right pointer: Tarsal sinus (leading into deeply placed tarsal canal)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal calcaneocuboid ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal cuboideonavicular ligament"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_20", "text": "Joints of left ankle and foot\n\t\t\t\t\t\t\t\t\t\t Ligaments of ankle and foot, lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibiofibular ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Talocrural articular capsule  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior talofibular ligament  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tarsal canal in depths of tarsal sinus (pointer on medial root of inferior extensor retinaculum)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of talus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Talonavicular ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Navicular bone (covered by ligaments)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Bifurcate ligament (pointer on calcaneonavicular ligament; calcaneocuboid ligament not visible in dissection)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal cuboideonavicular ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal cuneonavicular ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Subtalar articular capsule  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lateral talocalcaneal ligament Lower pointer: Calcaneofibular ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral tubercle process of calcaneus bone  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial processs (plantar aponeurosis cut across)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior peroneal retinaculum (opened)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extensor retinaculum (upper pointer, intermediate root; lower pointer, lateral root)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tubercle of calcaneus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal calcaneocuboid ligament  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Long plantar ligament  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Cuboid bone (covered by ligaments)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle (tendon cut off at insertion)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal cuneocuboid ligament  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metatarsal ligament"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_21", "text": "Joints of left ankle and foot\n\t\t\t\t\t\t\t\t\t\t Ligaments of ankle and foot, dorsal view\n\t\t\t\t\t\t\t\t\t\tThe bifurcate ligament is obscured in this photograph by bands of the dorsal calcaneocuboid ligament medial to the area indicated by pointer 5. It is visible in view 203-3.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metatarsal ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal cuneocuboid ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of peroneus brevis muscle on tuberosity of 5th metatarsal bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Dorsal cuneonavicular ligament (also see no. 19) Lower pointer: Dorsal cuboideonavicular ligament  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal calcaneocuboid ligament  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tubercle of calcaneus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate root of inferior extensor retinaculum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tarsal sinus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral root of inferior extensor retinaculum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior talofibular ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlea of talus (lateral border, covered by articular capsule)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibiofibular ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal tarsometatarsal ligaments  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal intercuneiform ligaments  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle (tendon at insertion)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cuneiform bone (covered by periosteum and ligaments)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal cuneonavicular ligament (also see no. 4)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Navicular bone (covered by periosteum and ligaments)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Talonavicular ligament  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar calcaneonavicular ligament (upper part of spring ligament)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of talus (covered by ligaments)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibiotalar part of deltoid ligament  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid ligament  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlea of talus (covered by talocrural articular capsule)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_22", "text": "Joints of left ankle and foot\n\t\t\t\t\t\t\t\t\t\t Ligaments of ankle and foot, medial view\n\t\t\t\t\t\t\t\t\t\tThe tendons of the peroneus longus and tibialis posterior muscles have been cut off at their insertions (1, 3, 7) to permit the deeper-lying ligaments to be brought to view. The groove marking the course of the peroneus longus tendon across the plantar part of the foot can be readily traced in the specimen (13). Facets on the calcaneus and cuboid bone are visible along the path occupied by this tendon.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior tibiotalar ligament Lower pointer: Tibionavicular ligament (part of deltoid ligament)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibiocalcaneal ligament (part of deltoid ligament)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibiotalar ligament (part of deltoid ligament)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Subtalar articular capsule  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for flexor hallucis longus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial process of tuberosity of calcaneus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sustentaculum tali  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar calcaneonavicular ligament (spring ligament)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneocuboid plantar ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Long plantar ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for peroneus longus tendon  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar cuneonavicular ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia (pointer indicates remnant of superior extensor retinaculum)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Talocrural articular capsule  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Talonavicular ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of navicular bone  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal cuneonavicular ligament  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle (tendon of insertion)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t 1st tarsometatarsal articular capsule  23\n\t\t\t\t\t\t.\n\t\t\t\t\t metatarsal bone"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_23", "text": "Joints of left ankle and foot\n\t\t\t\t\t\t\t\t\t\t Ligaments of plantar aspect of foot, deep layer\n\t\t\t\t\t\t\t\t\t\tThe tendons of the peroneus longus and tibialis posterior muscles have been cut off at their insertions (1, 3, 7) to permit the deeper-lying ligaments to be brought to view. The groove marking the course of the peroneus longus tendon across the plantar part of the foot can be readily traced in the specimen (13). Facets on the calcaneus and cuboid bone are visible along the path occupied by this tendon.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (insertion on 1st metatarsal)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar tarsometatarsal ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (part of insertion)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cuneiform bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar cuneonavicular ligament  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar cuboideonavicular ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (principal insertion on navicular bone)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar calcaneonavicular ligament (spring ligament)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sustentaculum tali  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial process of tuberosity of calcaneus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar metatarsal ligaments  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for peroneus longus tendon  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of cuboid bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneocuboid plantar ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Long plantar ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior peroneal retinaculum"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_24", "text": "Joints of left ankle and foot\n\t\t\t\t\t\t\t\t\t\t Ligaments of planar aspect of foot\n\t\t\t\t\t\t\t\t\t\tIn the dissection of the left foot shown in this photograph and in the subsequent views of this series the muscles, nerves and blood vessels have been entirely removed to illustrate the ligaments and joints of the ankle and foot. In connection with the study of these structures reference should also be made to view 198-4 which illustrates the ligaments on the dorsum of the foot and to view 202-4 in which the metatarsophalangeal joint of the great toe has been opened.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous metatarsal space  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of interosseous muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of peroneus longus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cuneiform bone (covered by ligaments)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar cuboideonavicular ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of navicular bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of tibialis posterior muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar calcaneonavicular ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sustentaculum tali (pointer indicates groove for tendon of flexor hallucis longus muscle)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus (pointer indicates groove for tendon of tibialis posterior muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Medial process of tuberosity of calcaneus Lower pointer: Plantar aponeurosis  13\n\t\t\t\t\t\t.\n\t\t\t\t\t 5th metatarsal bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of 5th metatarsal bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle (part of insertion)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneocuboid plantar ligament (short plantar ligament)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cuboid bone (surface for tendon of peroneus longus)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Long plantar ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior peroneal retinaculum  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral tubercle process of calcaneus bone  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior peroneal retinaculum (pointer also indicates lateral malleolus)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_25", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Nerve supply to dorsal interosseous muscles; interior of first metatarsophalangeal joint\n\t\t\t\t\t\t\t\t\t\tThe plantar interossei have been detached and removed from the dissection to provide a better view of the dorsal interossei and their nerves. In addition, the capsule of the first metatarsophalangeal joint has been opened by a wide incision to expose the interior of the joint.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sesamoid bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t 1st metatarsophalangeal articular capsule (opened)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of 1st metatarsal bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar metatarsal artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep plantar branch of dorsalis pedis artery (joining plantar arch)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating branch  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tarsometatarsal articular capsule  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cuneiform bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of navicular bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of tibialis posterior muscle (cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscles  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of lateral plantar nerve to interosseous muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t 5th metatarsal bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi brevis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar arch  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch lateral plantar nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of peroneus longus muscle (exposed within opened tendon sheath)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Long plantar ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sesamoid fibrocartilage in tendon of peroneus longus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneocuboid plantar ligament"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_26", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Interosseous muscles and plantar arch, close-up plantar view\n\t\t\t\t\t\t\t\t\t\tDetails of the dissection illustrated in the previous view are shown in this close-up photograph of the interossei, their nerves and the branches of the plantar arch related to them.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Common digital artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for flexor tendons of third toe  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor hallucis muscle (cut off at insertion)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t 1st and 2nd dorsal interosseous muscles (3rd and 4th dorsal interossei not labeled)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal plantar arteries  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar venous arch  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar arch  9\n\t\t\t\t\t\t.\n\t\t\t\t\t 1st tarsometatarsal articular capsule  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of adductor hallucis muscle (oblique head)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t 4th lumbrical muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar interosseous muscles  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Opponens digiti minimi muscle (nearly inseparable from flexor digiti minimi brevis)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi brevis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar metatarsal artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of lateral plantar nerve to flexor digiti minimi brevis  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral intermuscular septum  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of peroneus longus muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_27", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Interosseous muscles, general plantar view\n\t\t\t\t\t\t\t\t\t\tThe adductor hallucis (1) has been cut close to its insertion on the base of the first phalanx of the great toe. The plantar arch and the deep branch of the lateral plantar nerve have been preserved.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor hallucis muscle (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal plantar arteries  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar arch  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of adductor hallucis muscle (oblique head)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of peroneus longus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of tibialis posterior muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sustentaculum tali (pointer indicates groove for flexor digitorum longus muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper plantar digital artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Common plantar digital artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi brevis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch lateral plantar nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Long plantar ligament  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneocuboid plantar ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of quadratus plantae. muscle from calcaneus"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_28", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Nerve supply to adductor hallucis muscle; plantar arterial arch, close-up view\n\t\t\t\t\t\t\t\t\t\tThe adductor hallucis has been detached and elevated to reveal the positions of the plantar arterial and venous arches, the deep plantar nerve and the more medially placed interosseous muscles.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor tendons in digital sheath  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous sheath (opened)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse head of adductor hallucis muscle (detached at origin)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep transverse metatarsal ligament (cut off)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle (tendon cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous sheath (opened)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sesamoid bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis brevis muscle (cut off at insertion)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle (cut off at insertion)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of deep plantar nerve to transverse head of adductor hallucis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique head of adductor hallucis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of deep plantar nerve to oblique head of adductor hallucis  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Plantar venous arch Lower pointer: Plantar arch  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (tendon of insertion)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of oblique head of adductor hallucis  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch lateral plantar nerve (elevated)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t 4th lumbrical muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal plantar arteries  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of lateral plantar nerve to interosseous muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi brevis muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar artery"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_29", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Adductor hallucis muscle, general view\n\t\t\t\t\t\t\t\t\t\tThe flexor tendons have been cut off and removed. The plantar interosseous fascia has been removed distally nearly as far as the heads of the metatarsals. The transverse and oblique heads of the adductor hallucis (3, 5) have been uncovered.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle (tendon, cut off in digital sheath)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Synovial sheath  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse head of adductor hallucis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique head of adductor hallucis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cuneiform bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of navicular bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (tendon of insertion)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for flexor digitorum longus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for flexor hallucis longus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis (attachment to tuberosity of calcaneus)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor tendons (cut off in digital sheaths)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t 4th lumbrical muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of deep plantar nerve to adductor hallucis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar metatarsal artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi brevis muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of 5th metatarsal bone  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch lateral plantar nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (tendon, covered by ligaments)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus plantae muscle (cut off)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Long plantar ligament  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of abductor digiti minimi muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_30", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Long flexor tendons and lumbrical muscles\n\t\t\t\t\t\t\t\t\t\tThe lateral tendons of the flexor digitorum longus have been slightly elevated.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Common plantar digital artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle (tendon within opened digital sheath)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor hallucis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis brevis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch lateral plantar nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of flexor digitorum brevis muscle and plantar aponeurosis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle (tendon within opened flexor retinaculum at ankle)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of calcaneus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscles  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi brevis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus plantae muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of tendon of peroneus longus muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle (cut off at origin)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory peroneus muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus (pointer on groove for peroneal tendons)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_31", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Deep branch of lateral plantar nerve; nerve supply to flexor digiti minimi brevis and fourth lumbrical muscles Description.\n\t\t\t\t\t\t\t\t\t\tThe tendons of the flexor digitorum longus have been retracted medially to display the insertion into them of the quadratus plantae and the nearby origin of an unusually large fourth lumbrical muscle. At a deeper level the interosseous fascia has been removed exposing the deep branch of the lateral plantar nerve. Motor branches of this nerve pass to the flexor digiti minimi brevis (15), the fourth lumbrical (10), and the interosseous muscles.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t 1st and 2nd lumbrical muscles  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique head of adductor hallucis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle (tendon exposed within digital sheath)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis brevis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle (tendons elevated)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch lateral plantar nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plantar artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendons of flexor digitorum brevis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendons of flexor digitorum longus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of lateral plantar nerve to 4th lumbrical muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t 4th lumbrical muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi brevis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Opponens digiti minimi muscle (consisting of a few fibers deep to flexor brevis that attach to metatarsal)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of lateral plantar nerve to flexor digiti minimi brevis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar arch  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus plantae muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_32", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Nerve supply to quadratus plantae, flexor digiti minimi brevis and abductor digiti minimi muscles\n\t\t\t\t\t\t\t\t\t\tThe abductor digiti minimi has been cut off near its calcaneal origin. Branches of the lateral plantar nerve that enter the posterior part of the muscle have been preserved. The quadratus plantae (14) has been dissected to expose its general structural arrangement and its nerve supply.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis brevis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle (tendon)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle (tendons)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of medial plantar nerve to quadratus plantae muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of navicular bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Synovial sheath  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plantar nerve (cut off)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (tendon of insertion)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of sustentaculum tali  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi brevis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of lateral plantar nerve to flexor digiti minimi brevis  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch lateral plantar nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus plantae muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of lateral plantar nerve to abductor digiti minimi muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle (cut and reflected)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis (cut at tuberosity of calcaneus)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plantar artery"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_33", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Nerve supply to flexor hallucis brevis muscle\n\t\t\t\t\t\t\t\t\t\tThe flexor hallucis brevis has been dissected to show the branches of the medial plantar nerve entering the muscle along with the branches of the medial plantar artery. The flexor digitorum brevis has been excised.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Common plantar digital artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of metatarsophalangeal joint  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle (cut off)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique head of adductor hallucis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis brevis muscle (dissected)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of medial plantar nerve to flexor hallucis brevis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of medial plantar artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (tendon at insertion into medial cuneiform)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum brevis muscle (tendon cut off within synovial sheath)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Synovial sheath  12\n\t\t\t\t\t\t.\n\t\t\t\t\t 1st, 2nd, and 4th lumbrical muscles (3rd absent)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi brevis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral intermuscular septum  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch lateral plantar nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus plantae muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plantar nerve"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_34", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Flexor tendons of second toe elevated, medial close-up view\n\t\t\t\t\t\t\t\t\t\tThe flexor digitorum brevis has been pulled away from the foot to show the relations of its tendon to that of the flexor digitorum longus within the digital sheath of the second toe.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous sheath (opened)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Heavy fibrous septum alongside proximal phalanx  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Synovial sheath  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Vinculum breve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle (tendon elevated)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Vinculum longum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Vinculum longum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum brevis muscle (tendon elevated)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_35", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Flexor tendons within digital tendon sheaths\n\t\t\t\t\t\t\t\t\t\tThe digital tendon sheaths of the four medial toes have been opened to expose the tendons of the long and short muscles in situ within the sheaths. The proximal limit of the synovial sheath for the tendons of the third toe is indicated at 11. A small artery is visible in this area passing along a part of the synovial membrane that lies superficial to the tendon and is attached to it as a sort of mesotendon.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of flexor hallucis longus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of dorsal digital artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous sheath (opened)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Synovial sheath (lining groove for tendon of flexor hallucis longus)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of medial sesamoid bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t 1st and 2nd lumbrical muscles  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique head of adductor hallucis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis brevis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper plantar digital arteries  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Common plantar digital artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Synovial sheath (proximal limit of sheath)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t 4th lumbrical muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum brevis muscle (tendon to 5th toe not clearly discernible)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Common plantar digital nerve"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_36", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Nerve supply to quadratus plantae muscle\n\t\t\t\t\t\t\t\t\t\tThe abductor hallucis and flexor digitorum brevis have been removed from the dissection. The lateral plantar nerve has been elevated slightly to expose its branch to the quadratus plantae muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique head of adductor hallucis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis brevis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle (tendons)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plantar artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Quadratus plantae muscle Lower pointer: Medial plantar nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Communicating vein between medial plantar veins and dorsal veins of foot  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of lateral plantar nerve to quadratus plantae muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous branch of lateral plantar nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial intermuscular septum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of flexor digitorum brevis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Attachment of plantar aponeurosis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral intermuscular septum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_37", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Nerve supply to first lumbrical muscle\n\t\t\t\t\t\t\t\t\t\tThe branch from the medial plantar nerve to the first lumbrical has been dissected and elevated.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lumbrical muscle I Lower pointer: Branch of medial plantar nerve to first lumbrical  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique head of adductor hallucis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis brevis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Common plantar digital nerves  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle (tendons)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plantar artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum brevis muscle (reflected)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t 2nd and 4th lumbrical muscles (3rd absent)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi brevis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch lateral plantar nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral intermuscular septum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of lateral plantar nerve (common plantar digital nerves)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_38", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Tendons of flexor digitorum longus; lumbrical muscles; quadratus plantae muscle; medial and lateral plantar nerves\n\t\t\t\t\t\t\t\t\t\tThe flexor digitorum brevis has been divided close to its origin (10) to permit the muscle to be reflected distally. A branch (12) of the nerve supplying the muscle (see view 200-2) can be traced to the lateral parts of the muscle belly.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous sheath 1st digit  2\n\t\t\t\t\t\t.\n\t\t\t\t\t 1st and 3rd lumbrical muscles  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis brevis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plantar artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial intermuscular septum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plantar nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of flexor digitorum brevis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneal attachment of plantar aponeurosis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to flexor digitorum brevis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum brevis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t 4th lumbrical muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi brevis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle (tendons)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral intermuscular septum  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus plantae muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_39", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Digital tendon sheaths in relation to digital arteries and nerves, close-up view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous sheath of pars cruciformis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Common plantar digital nerves and medial plantar nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of medial plantar artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis brevis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum brevis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper plantar digital nerves  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper plantar digital arteries  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Common plantar digital artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Attachment of plantar aponeurosis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Common plantar digital nerves and lateral plantar nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi brevis muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_40", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Nerve supply to abductor hallucis muscle\n\t\t\t\t\t\t\t\t\t\tThe course of the branch of the medial plantar nerve into the abductor hallucis has been demonstrated in this specimen by the removal of small fascicles of the muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis brevis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of medial plantar nerve to abductor hallucis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of navicular bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plantar nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor retinaculum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tela subcutanea  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of calcaneus"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_41", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Abductor hallucis, flexor digitorum brevis and abductor digiti minimi muscles; nerve supply to flexor digitorum brevis\n\t\t\t\t\t\t\t\t\t\tThe plantar aponeurosis (10) has been reflected toward the toes. Its attachments to intermuscular septa are visible in several places. The nerve to the flexor digitorum brevis (3) enters the plantar surface of the muscle and is visible in the dissection.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis brevis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of medial plantar artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to flexor digitorum brevis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum brevis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial intermuscular septum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis (cut at attachment to calcaneus)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor retinaculum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis (reflected)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Common plantar digital nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi brevis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral intermuscular septum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of calcaneus"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_42", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Plantar aponeurosis\n\t\t\t\t\t\t\t\t\t\tThe tela subcutanea has been removed from most of the foot. Cutaneous nerves and vessels to the sole of the foot have been preserved.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper plantar digital nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous sheath of 1st digit  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Common plantar digital nerves and medial plantar nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis (central part)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneal branch of tibial nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial process of tuberosity of calcaneus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of calcaneus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Common plantar digital nerves and lateral plantar nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi brevis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of 5th metatarsal bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part of plantar aponeurosis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral tubercle process of calcaneus bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sural nerve"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_43", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Plantar digital nerves\n\t\t\t\t\t\t\t\t\t\tThe superficial dissection has been extended onto the toes with the exposure of the common and proper plantar digital nerves. The subcutaneous tissue (2) has been retained on the second toe to preserve some semblance of the original shape of the ball of the foot.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper plantar digital artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tela subcutanea  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous sheath of 1st digit  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Common plantar digital nerves and medial plantar nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Common plantar digital nerves and lateral plantar nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of lateral plantar artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi brevis muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_44", "text": "Dissection of plantar aspect of left foot\n\t\t\t\t\t\t\t\t\t\t Tela subcutanea; superficial vessels and nerves of plantar surface of foot\n\t\t\t\t\t\t\t\t\t\tA margin of skin has been preserved laterally and distally on the foot. The tela subcutanea has been variously dissected. In some areas it has been kept intact to illustrate the relative thickness of this layer on different parts of the foot. Elsewhere the superficial vessels and nerves and the plantar aponeurosis have been exposed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous sheath  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper plantar digital nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper plantar digital nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of medial plantar artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous nerve (also see view 198-5)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle (covered by thin medial part of plantar aponeurosis)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneal branch of medial tibial nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse fasciculus of plantar aponeurosis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of lateral plantar nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of lateral plantar artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tela subcutanea  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle (covered by lateral portion of plantar aponeurosis)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of lateral plantar artery"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_45", "text": "Posterior aspect of left ankle and foot\n\t\t\t\t\t\t\t\t\t\t Grooves for flexor tendons and peroneal tendons at ankle, posterior view\n\t\t\t\t\t\t\t\t\t\tThe tendons have been cut off and removed from the various grooves across the posterior part of the ankle joint.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneal artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous membrane  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Malleolar branch of lateral peroneal artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for tendon of peroneus brevis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for tendon of peroneus longus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneal branch of peroneal artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Talocrural articular capsule  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (tendon, cut off)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of common peroneal artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for tibialis posterior muscle (behind medial malleolus)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for flexor digitorum longus muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor retinaculum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for flexor hallucis longus muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (tendon, cut off)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of sustentaculum tali  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal bone"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_46", "text": "Posterior aspect of left ankle and foot\n\t\t\t\t\t\t\t\t\t\t Peroneus accessorius muscle; long flexor tendons in relation to ankle, posterior view\n\t\t\t\t\t\t\t\t\t\tThe peroneus longus and brevis muscles have been cut off. A peroneus accessorius muscle (7) is present with a small muscular portion attached to the lateral side of the calcaneus and a slender tendon extending upward to blend with the posterior intermuscular septum of the leg. The calcaneal tendon has been divided slightly above its attachment of the calcaneus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intermuscular septum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of accessory peroneus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior peroneal retinaculum (divided)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for peroneal tendons  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneal branch of peroneal artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory peroneus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Rete calcaneum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (tendon, cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of calcaneus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneal branch of the posterior tibial artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve (pointer on medial plantar nerve, cut off)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor retinaculum (opened to expose tendons)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle (tendon)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle (tendon)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (tendon)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis brevis muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_47", "text": "Posterior aspect of left ankle and foot\n\t\t\t\t\t\t\t\t\t\t Tendo calcaneus; plantar aponeurosis; abductor hallucis and abductor digiti minimi muscles, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser saphenous vein  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sural nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneal branch of peroneal artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral tubercle process of calcaneus bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle (covered by plantar fascia)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of lateral plantar nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus (covered by crural fascia)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor retinaculum  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of calcaneus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneal branch of medial tibial nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial process of tuberosity of calcaneus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Common plantar digital nerve"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_48", "text": "Dissection of medial aspect of left foot and ankle\n\t\t\t\t\t\t\t\t\t\t Long flexor tendons within flexor retinaculum, medial view of ankle\n\t\t\t\t\t\t\t\t\t\tThe flexor retinaculum (3) has been opened to reveal the course of the tendons of the tibialis posterior (10), flexor digitorum longus (11) and flexor hallucis longus (12) from the leg into the foot.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor retinaculum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus plantae muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous sheath of flexor digitorum longus (opened)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis brevis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (tendon within opened synovial sheath)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle (tendon within opened synovial sheath)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle (tendon within opened synovial sheath)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of navicular bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cuneiform bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t metatarsal bone"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_49", "text": "Dissection of medial aspect of left foot and ankle\n\t\t\t\t\t\t\t\t\t\t Medial and lateral plantar vessels and nerves, medial view\n\t\t\t\t\t\t\t\t\t\tThe abductor hallucis has been excised and the fascia of the plantar part of the foot has been removed. The flexor retinaculum (4) has also been cut away to reveal the posterior tibial vessels and the tibial nerve passing around the ankle into the plantar region of the foot.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep transverse fascia of leg  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery (accompanied by posterior tibial veins)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor retinaculum (divided)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneal branch of posterior tibial artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle (origin)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis (attachment to calcaneus)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plantar artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum brevis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (covered by flexor retinaculum)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Great saphenous vein  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plantar nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle (insertion)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Communicating veins from medial plantar to large saphenous vein  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (insertion)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis brevis muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_50", "text": "Dissection of medial aspect of left foot and ankle\n\t\t\t\t\t\t\t\t\t\t Abductor hallucis reflected; posterior tibial vessels and tibial nerve at ankle, medial view\n\t\t\t\t\t\t\t\t\t\tThe abductor hallucis has been detached from its origin and reflected downward exposing the fascial bed in which it lay.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor retinaculum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneal branch of the posterior tibial artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial calcaneal branches of tibial nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial bed of abductor hallucis  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle (reflected)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Great saphenous vein  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal medial cutaneous nerve"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_51", "text": "Dissection of medial aspect of left foot and ankle\n\t\t\t\t\t\t\t\t\t\t Superficial nerves and vessels in relation to abductor hallucis muscle and tendons of foot, medial view\n\t\t\t\t\t\t\t\t\t\tThe fascia covering the abductor hallucis has been cut away. The distal part of the large saphenous vein and the superficial nerves of the foot have been preserved. Above the ankle the crural fascia (2) has been removed in a manner that demonstrates its relation to the deep transverse fascia (1) of the leg.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep transverse fascia of leg (partially removed)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Crural fascia (narrow band retained to show relations to deep transverse fascia)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Tibial nerve Lower pointer: Posterior tibial artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor retinaculum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial calcaneal branches of tibial nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Proximal phalanx  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (tendon covered by flexor retinaculum)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal medial cutaneous nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle (tendon)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extensor retinaculum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle (tendon)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of dorsalis pedis"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_52", "text": "Dissection of medial aspect of left foot and ankle\n\t\t\t\t\t\t\t\t\t\t Superficial nerves and blood vessels of foot, medial view\n\t\t\t\t\t\t\t\t\t\tThe tela subcutanea has been dissected to reveal the superficial nerves, arteries and veins of the medial aspect of the left foot. A margin of skin and subcutaneous tissue has been preserved at the borders of the dissected area. Copyright holder\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor retinaculum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial calcaneal branches of tibial nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneal branch of the posterior tibial artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tela subcutanea  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle (covered by fascia)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal medial cutaneous nerve (note branch crossing superficial to saphenous nerve to reach plantar aspect of foot)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia overlying metatarsophalangeal joint"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_53", "text": "Dissection of dorsolateral aspect of left foot and ankle\n\t\t\t\t\t\t\t\t\t\t Arteries and ligaments of foot, lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial veins  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lateral malleolar artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extensor retinaculum (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral tarsal artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsalis pedis artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal cuneonavicular ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal intercuneiform ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal bone II  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metatarsal arteries  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal digital artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor expansion  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating branch of peroneal artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibiofibular ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for tendon of peroneus brevis muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneal branch of the posterior tibial artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (tendon)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneocuboid articular capsule  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle (tendon of insertion)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus tertius muscle (tendon)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal cuneocuboid ligament  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Opponens digiti minimi muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t 3rd-4th dorsal interosseous muscles"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_54", "text": "Dissection of dorsolateral aspect of left foot and ankle\n\t\t\t\t\t\t\t\t\t\t Dorsal metatarsal arteries; dorsal interosseous muscles, viewed from above\n\t\t\t\t\t\t\t\t\t\tThe dorsal interossei have been separated slightly from their bony origins to expose the metatarsal arteries. In this foot these vessels spring largely from the perforating arteries rather than from the arcuate artery (12) which is extremely small.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor expansion  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar digital artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal digital artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of extensor digitorum longus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of extensor digitorum brevis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t 1st-4th dorsal interosseous muscles  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metatarsal arteries  8\n\t\t\t\t\t\t.\n\t\t\t\t\t 5th metatarsal bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial expansion covering metatarsophalangeal joint  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle (accessory tendon also present)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating branch of plantar metatarsal artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Deep plantar branch of dorsalis pedis artery Lower pointer: Arcuate artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsalis pedis artery"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_55", "text": "Dissection of dorsolateral aspect of left foot and ankle\n\t\t\t\t\t\t\t\t\t\t Blood vessels and extensor tendons of toes; terminal branches of deep peroneal nerve, viewed from above\n\t\t\t\t\t\t\t\t\t\tThe extensor tendons continue distally onto the toes to form extensor expansions (1) similar to those found in the fingers.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor expansion  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal digital arteries  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metatarsal arteries  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendons of extensor digitorum brevis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t 5th metatarsal bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendons of extensor digitorum longus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal digital nerve to medial second toe  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal digital nerve to lateral first toe  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Capsule of 1st metatarsophalangeal joint  10\n\t\t\t\t\t\t.\n\t\t\t\t\t 1st dorsal interosseus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsalis pedis artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep peroneal nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis brevis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of extensor digitorum longus tendon"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_56", "text": "Dissection of dorsolateral aspect of left foot and ankle\n\t\t\t\t\t\t\t\t\t\t Nerve supply to extensor digitorum brevis and extensor hallucis brevis muscles\n\t\t\t\t\t\t\t\t\t\tThe short extensor muscles have been detached at their origins and elevated to permit dissection of the branch from the deep peroneal nerve (3) that supplies these muscles. The specimen is viewed from a lateral direction.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep peroneal nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsalis pedis artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of deep peroneal nerve (to short extensors)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral tarsal artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle (reflected, extensor hallucis brevis muscle in background)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus tertius muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lateral malleolar artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extensor retinaculum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneocuboid articular capsule  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle (tendon exposed within synovial sheath)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (tendon exposed within synovial sheath)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Cuboid bone (covered by periosteum)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of 5th metatarsal bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Opponens digiti minimi muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t 5th metatarsal bone"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_57", "text": "Dissection of dorsolateral aspect of left foot and ankle\n\t\t\t\t\t\t\t\t\t\t Dorsalis pedis artery; intrinsic muscles of dorsum of foot, viewed from in front\n\t\t\t\t\t\t\t\t\t\tThe long extensor tendons have been cut away to reveal the  extensor hallucis brevis (5) and extensor digitorum brevis (12) in situ.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extensor retinaculum (cut away laterally)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsalis pedis artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis brevis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep peroneal nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t 1st dorsal interosseus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle (tendons of insertion)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metatarsal artery"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_58", "text": "Dissection of dorsolateral aspect of left foot and ankle\n\t\t\t\t\t\t\t\t\t\t Nerve supply to abductor digiti minimi muscle, close-up lateral view\n\t\t\t\t\t\t\t\t\t\tThe abductor digiti minimi has been reflected downward to expose the branch of the lateral plantar nerve (12) as it passes within the substance of the muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal lateral cutaneous nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (tendon covered by inferior peroneal retinaculum)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle (tendon covered by inferior peroneal retinaculum)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of 5th metatarsal bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory peroneus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneal branch of peroneal artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior peroneal retinaculum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus (covered by periosteum)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of lateral plantar artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of lateral plantar nerve (to abductor digiti minimi muscle)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle (reflected downward)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_59", "text": "Dissection of dorsolateral aspect of left foot and ankle\n\t\t\t\t\t\t\t\t\t\t Relations  of tendons of peroneal muscles at ankle with retinacula and tendon sheaths opened, lateral view\n\t\t\t\t\t\t\t\t\t\tThe superior (11) and inferior (16) peroneal retinacula have been divided and synovial tendon sheaths of the peroneus longus and brevis muscles have been opened. A small peroneus accessorius muscle (13) is present in this specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus tertius muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extensor retinaculum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lateral malleolar artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (tendon)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser saphenous vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Synovial sheath of peroneal muscles (upper margin of opened sheath)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior peroneal retinaculum (divided to expose peroneal tendons)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory peroneus muscle (origin from calcaneus, insertion superiorly on posterior intermuscular septum)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneal branch of peroneal artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior peroneal retinaculum (divided to expose tendons)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of 5th metatarsal bone"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_60", "text": "Dissection of dorsolateral aspect of left foot and ankle\n\t\t\t\t\t\t\t\t\t\t Extensor retinacula and tendon sheath of extensor digitorum longus and peroneus tertius opened, anterolateral view of foot\n\t\t\t\t\t\t\t\t\t\tThe superior and inferior extensor retinacula (1,6) have been cut away to reveal the underlying tendons.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior extensor retinaculum (partially removed)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus tertius muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle (tendons exposed deep to retinaculum)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus tertius muscle (tendon of insertion exposed deep to retinaculum)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle (tendon covered by retinaculum)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extensor retinaculum (divided and reflected)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous sheath (opened above level of upper pointer)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis brevis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of dorsalis pedis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser saphenous vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior peroneal retinaculum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lateral malleolar artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal lateral cutaneous nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior peroneal retinaculum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle (tendon of insertion)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_61", "text": "Dissection of dorsolateral aspect of left foot and ankle\n\t\t\t\t\t\t\t\t\t\t Synovial sheath of extensor tendons\n\t\t\t\t\t\t\t\t\t\tAir has been injected into the synovial sheath (5) of the long extensor tendons of the toes to distend the portion of this sheath that extends distal to the inferior extensor retinaculum (11). The specimen is viewed from an anterolateral direction.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal intermediate cutaneous nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal medial cutaneous nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle (tendons covered by extensor retinaculum)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous sheath of extensor digitorum pedis longus muscle (inflated)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis brevis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep peroneal nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsalis pedis artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle (tendons of insertion)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser saphenous vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extensor retinaculum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneal branch of lateral sural nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal lateral cutaneous nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (tendon covered by inferior peroneal retinaculum)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle (tendon)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus tertius muscle (tendon of insertion)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of 5th metatarsal bone  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of dorsalis pedis  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle (tendons)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_62", "text": "Dissection of dorsolateral aspect of left foot and ankle\n\t\t\t\t\t\t\t\t\t\t Tendons, muscles and retinacula of dorsum of foot, viewed from in front\n\t\t\t\t\t\t\t\t\t\tNerves and blood vessels have been cut away from the specimen and the fascia of the foot has been removed except for its thickened parts which form the retaining structures (1,12,15) for the tendons.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior extensor retinaculum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis brevis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsalis pedis artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscles  8\n\t\t\t\t\t\t.\n\t\t\t\t\t metatarsal bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus tertius muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extensor retinaculum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle (tendon)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (tendon)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior peroneal retinaculum  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus tertius muscle (tendon of insertion)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of 5th metatarsal bone  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_63", "text": "Dissection of dorsolateral aspect of left foot and ankle\n\t\t\t\t\t\t\t\t\t\t Superficial nerves and vessels of dorsum of foot in relation to muscles and tendons, viewed from in front\n\t\t\t\t\t\t\t\t\t\tThe superficial nerves have been preserved along with the major superficial venous pathways. The dorsal fascia of the foot has been partially removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal medial cutaneous nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extensor retinaculum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis brevis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsalis pedis artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Venous arch of dorsalis pedis  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep peroneal nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle (tendon)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior extensor retinaculum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal intermediate cutaneous nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous sheath of extensor digitorum longus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of deep peroneal nerve to lateral side of second toe  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of dorsalis pedis  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle (tendons)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_64", "text": "Dissection of dorsolateral aspect of left foot and ankle\n\t\t\t\t\t\t\t\t\t\t Superficial nerves and vessels of foot in relation to muscles and tendons, lateral view\n\t\t\t\t\t\t\t\t\t\tThe skin and subcutaneous connective tissue have been entirely removed from the specimen. Only the principal branches of the small saphenous vein have been preserved. The deep fascia has been dissected, with retention of the retinacula at the ankle. A band of the dorsal fascia of the foot (5) has also been kept intact across the metatarsal region.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior extensor retinaculum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal intermediate cutaneous nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extensor retinaculum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle (tendons)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of dorsalis pedis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser saphenous vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sural nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (tendon)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior peroneal retinaculum Lower pointer: Lateral malleolus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral calcaneal branch of sural nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal lateral cutaneous nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior peroneal retinaculum (pointer also indicates tendon of peroneus longus muscle)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle (tendon)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus tertius muscle (tendon)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of 5th metatarsal bone  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle (tendons)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal digital nerves"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_65", "text": "Dissection of dorsolateral aspect of left foot and ankle\n\t\t\t\t\t\t\t\t\t\t Superficial nerves and blood vessels of dorsum of foot\n\t\t\t\t\t\t\t\t\t\tA margin of intact skin and tela subcutanea has been retained surrounding the area of the foot and ankle which has been dissected. The cutaneous nerves and superficial veins have been exposed by dissection of the tela subcutanea. The deep fascia has not been disturbed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal intermediate cutaneous nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal medial cutaneous nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of dorsalis pedis (overlying extensor digitorum brevis muscle)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendons of extensor digitorum longus muscle (covered by fascia)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Venous arch of dorsalis pedis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal veins of dorsalis pedis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser saphenous vein  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sural nerve (continuing on foot as dorsal lateral cutaneous nerve)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tela subcutanea  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Venous network  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal digital nerves"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_66", "text": "Dissection of posterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Interosseous membrane; area of origin of tibialis posterior muscle\n\t\t\t\t\t\t\t\t\t\tThe tibialis posterior has been removed by dividing its fibres close to their origins (2) to demonstrate the interosseous membrane in relation to the posterior aspects of the tibia and fibula.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal artery (at point of bifurcation into tibial vessels)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (area of origin)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous membrane of leg  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneal artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteus muscle (area of insertion)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of nutrient artery entering tibia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular and periosteal branch of tibialis posterior  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Communicating branch of peroneal artery"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_67", "text": "Dissection of posterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Nerves and blood vessels to tibialis posterior\n\t\t\t\t\t\t\t\t\t\tThe upper part of the tibialis posterior has been dissected to demonstrate the course of nerves and vessels within the muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteus muscle (tendon of origin lying within subpopliteal recess)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch tibial nerve (to tibialis posterior muscle; upper pointer indicates branch to tibiofibular joint and tibia accompanying nutrient artery (II))  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Popliteal artery (at division into anterior and posterior tibial arteries) Lower pointer: Posterior tibial artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial vein (cut off)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle (origin)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (dissected)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle (insertion)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial inferior genicular artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteus muscle (area of insertion)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Nutrient artery to tibia  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteal artery"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_68", "text": "Dissection of posterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Tibialis posterior muscle\n\t\t\t\t\t\t\t\t\t\tThe flexor hallucis longus and flexor digitorum longus muscles have been cut away to reveal the deeply placed tibialis posterior (10). The flexor retinaculum (4) at the ankle has been cut across to open the passageways for the flexor tendons.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneal artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of fibula  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle (area of origin)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor retinaculum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of tibia  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle (origin)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior surface of tibia  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (tendon of insertion)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_69", "text": "Dissection of posterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Nerve supply to popliteus muscle\n\t\t\t\t\t\t\t\t\t\tThe popliteus has been detached from its insertion on the tibia and reflected upward to display its nerve supply derived from the tibial nerve. The posterior tibial recurrent artery (4) that ramifies within the muscle is a branch of the first part of the anterior tibial artery.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteus muscle (reflected upward)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of tibial nerve (to popliteus muscle)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of tibial nerve (to tibialis posterior muscle)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior recurrent tibial artery Lower pointer: Fibular circumflex branch of posterior tibial artery (in this instance it arises from first part of anterior tibial artery)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle (insertion)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial inferior genicular artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteus muscle (area of insertion)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Nutrient artery of tibia Lower pointer: Tendinous arch of tibialis posterior muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle (origin from Soleal line)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_70", "text": "Dissection of posterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Popliteus muscle, close-up view\n\t\t\t\t\t\t\t\t\t\tThe heavy fascia that covered the popliteus has been cut away.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of tibial nerve (stretched)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteus muscle (tendon of origin emerging through capsule of knee joint)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Subpopliteal recess  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of tibial nerve (to tibialis posterior muscle)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of tibial nerve (to popliteus muscle)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle (origin)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneal artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral head of gastrocnemius muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral inferior genicular artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique popliteal ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle (insertion)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial inferior genicular artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteus muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_71", "text": "Dissection of posterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Nerves to deep flexor muscles, close-up view of upper area of leg\n\t\t\t\t\t\t\t\t\t\tThe tibial nerve has been elevated and put under traction to stretch the various muscular branches that have been exposed within the dissected area.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique popliteal ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral inferior genicular artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve (elevated)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch Tibial nerve (to popliteus muscle and tibialis posterior muscle)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of tibial nerve (to flexor digitorum longus muscle)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of fibula  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial artery (passing into anterior compartment of leg)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle (origin)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of tibial nerve (to flexor hallucis longus muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneal artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial inferior genicular artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle (insertion)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle (insertion)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle (insertion)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Semitendinosus muscle (insertion)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial veins"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_72", "text": "Dissection of posterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Posterior tibial and peroneal arteries; tibialis posterior muscle\n\t\t\t\t\t\t\t\t\t\tThe flexor digitorum longus and flexor hallucis longus have been pulled apart to reveal the belly of the tibialis posterior (11) lying deeply placed between the two muscles. The changing relations of the tendons of the deep flexors is evident as the tendons pass behind the ankle into the foot. The peroneal and posterior tibial arteries (3,9) are shown divested of accompanying veins.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneal artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle (retracted)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor retinaculum (cut to reveal passage of tendons across ankle)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus plantae muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial surface of tibia  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_73", "text": "Dissection of posterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Flexor digitorum longus and flexor hallucis longus muscles; posterior tibial vessels; nerve supply to deep part of soleus muscle\n\t\t\t\t\t\t\t\t\t\tThe muscles and blood vessels within the deep compartment have been separated and more fully exposed than in the previous view. In addition, the small penniform component of the deep aspect of the soleus has been dissected to reveal the nerves and blood vessels that supply this portion of the muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch tibial nerve (to deep part of soleus)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sural arteries  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of tibial nerve (to flexor hallucis longus muscle)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle (origin from soleal line)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneal artery (accompanied by peroneal veins)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial veins  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_74", "text": "Dissection of posterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Muscles of deep posterior compartment of leg\n\t\t\t\t\t\t\t\t\t\tThe gastrocnemius and soleus muscles have been reflected upward. The deep transverse fascia of the leg, enclosing the flexor hallucis longus (13), the flexor digitorum longus (10) and the tibialis posterior (15), has been cut away except for a narrow band retained to indicate the fibrous character and thickness of the fascia.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle (reflected superiorly and laterally)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle (reflected)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle (origin from soleal line)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle (covered by deep transverse fascia of leg)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating vein (accompanied by cutaneous branch of posterior tibial artery)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor hallucis longus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial surface of tibia  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (tendon)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_75", "text": "Dissection of posterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Plantaris muscle, close-up view of muscle belly and nerves supply\n\t\t\t\t\t\t\t\t\t\tThe plantaris muscle, which is absent from the specimen used for most of the views in this series, is shown in this close-up view of the upper posterior part of the left leg of a different specimen. The long, slender tendon of insertion (14) is visible for only a short distance in its course to the calcaneus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal surface  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of tibial nerve (to plantaris muscle)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantaris muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of tibial nerve (to soleus muscle)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral head of gastrocnemius muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial head of gastrocnemius muscle (cut off)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve (elevated)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle (tendon of insertion)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle (origin of medial head)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle of femur  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle (insertion)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of plantaris muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_76", "text": "Dissection of posterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Nerve supply to soleus muscle\n\t\t\t\t\t\t\t\t\t\tThe muscle fibres have been separated and divided in various ways to expose the muscular branches of the tibial nerve passing through the soleus. Branches of the posterior tibial vessels paralleling the nerves have also been exposed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle (lateral head cut off at origin)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle (tendon of insertion)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of tibial nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch posterior tibial artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle (dissected)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle (cut off)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle (caput mediale, cut off near origin)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle of femur  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle (cut off at insertion)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Semitendinosus muscle (cut off at insertion)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteus muscle (covered by vertically directed aponeurotic fibers)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_77", "text": "Dissection of posterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Soleus muscle, posterior view\n\t\t\t\t\t\t\t\t\t\tThe gastrocnemius has been detached and removed from teh specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser saphenous vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum brevis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior surface of tibia (covered by periosteum)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_78", "text": "Dissection of posterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Nerve supply to gastrcnemius muscle\n\t\t\t\t\t\t\t\t\t\tThe aponeurosis on the posterior surface of the gastrocnemius has been partially removed to permit separation of the fascicles of the muscle. The oblique direction of these fascicles in their course from the superficial aponeurosis of origin to the deeply placed aponeurotic tendon of insertion is discernible in the dissection. The nerves within the muscles communicate in a plexiform manner.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of tibial nerve (to lateral head of gastrocnemius)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sural artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral head of gastrocnemius muscle (dissected and elevated)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sural nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal vein (popliteal artery obscured by vein)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal lymph node  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of tibial nerve (to medial head Of gastrocnemius)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial head of gastrocnemius muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Bursa of semimembranosus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle (tendon of insertion, cut off)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sural artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of origin of gastrocnemius muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of insertion of gastrocnemius muscle (deep within substance of muscle)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_79", "text": "Dissection of posterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Bursa of semimembranosus muscle, close-up posterior view\n\t\t\t\t\t\t\t\t\t\tThe bursa that lies between the medial head of the gastrocnemius and semimembranosus muscle has been opened longitudinally. The gastrocnemius has been retracted slightly to reveal the interior of the bursal sac.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal fossa  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal lymph node  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of tibial nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle (lateral head)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sural nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle (medial head)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Bursa of semimembranosus muscle (opened)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Semitendinosus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of tibia (covered by periosteum)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_80", "text": "Dissection of posterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Muscles, blood vessels and nerves of lower leg ankle, posterior view\n\t\t\t\t\t\t\t\t\t\tThe crural fascia has been removed, although nerves and vessels that lay superficial to it have been retained. The flexor retinaculum (15) at the ankle has been opened to expose the posterior tibial vessels and the tibial nerve. Fat has been removed deep to the calcaneal tendon. The spiraling course of the fibres of the calcaneal tendon is evident in the photograph.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intermuscular septum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser saphenous vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sural nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous sural nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial veins  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle (tendon)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor retinaculum"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_81", "text": "Dissection of posterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Muscles of leg, posterior view\n\t\t\t\t\t\t\t\t\t\tThe crural fascia has been cut away. The small saphenous vein and the cutaneous nerves of the back of the leg have been preserved  approximately to their normal locations to illustrate the relations of these structures to the musculature.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle (lateral head)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous sural nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser saphenous vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of medial sural cutaneous nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle (covered by crural fascia)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle (medial head)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Communication between great and small saphenous veins  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sural nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus (Achilles)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_82", "text": "Dissection of posterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Superficial nerves and blood vessels of leg, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating vein (connecting with veins in gastrocnemius muscle)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous sural nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Crural fascia  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser saphenous vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tela subcutanea  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous branch of posterior tibial artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of medial sural cutaneous nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Communication between large and small saphenous veins  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sural nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus (covered by fascia)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_83", "text": "Dissection of medial aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Large saphenous vein; muscles of leg and foot, medial view\n\t\t\t\t\t\t\t\t\t\tThe deep fascia of the leg and foot has been removed.  However, the superficial nerves (1,7,18) and the large saphenous vein (11) have beem retained to illustrate their relations to the deeper structures.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous nerve (traceable to great toe)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus (Achilis)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor retinaculum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial calcaneal branches of tibial nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor hallucis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar aponeurosis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial surface of tibia  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum longus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis posterior muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle (tendon, covered by superior retinaculum)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal medial cutaneous nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle (tendon)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_84", "text": "Dissection of medial  aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Superficial nerves and blood vessels of medial side of leg\n\t\t\t\t\t\t\t\t\t\tThe tela subcutanea has been dissected. In the upper part of the field a small area of skin has been reflected upward to expose a cutaneous artery ramifying beneath the dermis.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Crural fascia (overlying triceps surae muscle)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory saphenous vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Communicating vein between greater and lesser saphenous veins  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus (Achilles)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Skin border above ankle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of medial malleolus (extending below field of image)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Everted skin flap (see text above)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Infrapatellar branch of saphenous nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of tibia  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial surface of tibia"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_85", "text": "Dissection of lateral aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Nerves and blood vessels to peroneus brevis muscle\n\t\t\t\t\t\t\t\t\t\tThe peroneus brevis has been detached from its origins on the fibula (10) and anterior intermuscular septum (2). The muscle has been dissected and turned posteriorly to reveal the course of nerves and blood vessels into muscle substance.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial peroneal nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior intermuscular septum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal medial cutaneous nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal intermediate cutaneous nerve (this nerve passed along superficial surface of peroneus brevis)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus tertius muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of anterior tibial artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle (in background)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of superficial peroneal nerve (to peroneus brevis muscle)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle (reflected)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral surface of fibula  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcutaneous surface of fibula"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_86", "text": "Dissection of lateral aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Nerve supply to peroneus longus and brevis muscles\n\t\t\t\t\t\t\t\t\t\tBranches of the superficial peroneal nerve that enter the peroneus longus and peroneus brevis muscles (9,5) are visible in this view of the upper part of the previous dissection.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep peroneal nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of anterior tibial artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior intermuscular septum Lower pointer: Crural fascia  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of superficial peroneal nerve (to peroneus brevis muscle)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial peroneal nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of superficial peroneal nerve (to peroneus longus muscle)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of fibula (area of origin of peroneus longus)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (reflected)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intermuscular septum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_87", "text": "Dissection of lateral aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Peroneus brevis muscle\n\t\t\t\t\t\t\t\t\t\tThe peroneus brevis (14) has been uncovered by reflecting the peroneus longus posteriorly. The relations of the peroneus tertius (6) and the muscles of the anterior compartment of the leg to the peroneus brevis are also visible in the specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep peroneal nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial peroneal nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus tertius muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior extensor retinaculum (divided)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous sheath of extensor digitorum pedis longus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of dorsalis pedis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of superficial peroneal nerve (to peroneus longus muscle)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (reflected posteriorly)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of fibula (area of origin of peroneus longus muscle)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intermuscular septum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula (subcutaneous part)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus (Achilles)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior peroneal retinaculum Lower pointer: Lateral malleolus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (tendon covered by inferior peroneal retinaculum)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle (tendon covered by inferior peroneal retinaculum)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of 5th metatarsal bone"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_88", "text": "Dissection of lateral aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Relation of common peroneal nerve to head of fibula, close-up lateral view\n\t\t\t\t\t\t\t\t\t\tThe proximal end of the peroneus longus has been detached and reflected anteriorly to demonstrate the course of the common peroneal nerve (1) into the lateral compartment from the popliteal space. The division of the nerve into superficial (6) and deep (4) peroneal nerves is evident at this level.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Common peroneal nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle (tendon of insertion)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep peroneal nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of superficial peroneal nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial peroneal nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (reflected)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial sural cutaneous nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser saphenous vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Common peroneal branch  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle (reflected)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intermuscular septum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_89", "text": "Dissection of lateral aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Peroneal muscles separated; anterior and posterior intermuscular septa\n\t\t\t\t\t\t\t\t\t\tThe muscles of the leg have beem separated from each other and from the anterior and posterior intermuscular septa that subdivide the leg into anterior, lateral and posterior compartments. The lateral compartment, containing the peroneus longus (1) and peroneus brevis (7) muscles, occupies the central portion of the dissected area. The anterior compartment lies to the left of the anterior intermuscular septum (2).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior intermuscular septum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of anterior tibial artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial peroneal nerve (dorsal intermediate cutaneous nerve)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial peroneal nerve (dorsal medial cutaneous nerve)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus tertius muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal intermediate cutaneous nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor retinaculum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intermuscular septum  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser saphenous vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sural nerve"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_90", "text": "Dissection of lateral aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Muscles of leg and foot, lateral view\n\t\t\t\t\t\t\t\t\t\tThe retinacula that hold the peroneal and extensor tendons in position across the ankle have been preserved in the dissection.  Elsewhere the deep fascia of the leg and foot has been cut away .\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior intermuscular septum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal medial cutaneous nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior extensor retinaculum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal intermediate cutaneous nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Common peroneal branch  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intermuscular septum of leg  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sural nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser saphenous vein  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus (Achilles)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal lateral cutaneous nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_91", "text": "Dissection of lateral aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Muscles of leg, lateral view\n\t\t\t\t\t\t\t\t\t\tThe tela subcutanea has been cut away and the crural fascia (18) has been removed above the region of the ankle. However, the cutaneous branches of the peroneal nerve (6,9,10) have been preserved distal to their points of exit through the crural fascia. These branches have been placed across the underlying muscles in positions that approximately parallel their original peripheral courses.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle (insertion)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial tuberosity  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior intermuscular septum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial peroneal nerve (dorsal medial cutaneous nerve)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus tertius muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of extensor hallucis longus muscle (visible deep to crural fascia)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial peroneal nerve (dorsal intermediate cutaneous nerve)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sural cutaneous nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Common peroneal branch  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser saphenous vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intermuscular septum  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Crural fascia (blending below with superior extensor retinaculum)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus (Achilles)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_92", "text": "Dissection of anterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Anterior tibial and dorsal pedal vessels; anterolateral view of leg and foot\n\t\t\t\t\t\t\t\t\t\tThe dissection  illustrates the course of the anterior tibial vessels through the anterior compartment of the leg and oto the dorsum of the foot (9,10,4). The extensor hallucis longus muscle has been preserved within the compartment to show its relation to these vessels.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial recurrent artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of tibia  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsalis pedis artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal digital nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle (tendon)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep peroneal nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial veins  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (area of origin from fibula)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intermuscular septum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior intermuscular septum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle (cut off)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lateral malleolar artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle (tendon)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle (tendon)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_93", "text": "Dissection of anterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Deep peroneal nerve; nerve supply to extensor hallucis longus muscle, anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe tibialis anterior and extensor digitorum longus muscles have been removed from the dissection. The extensor hallucis  longus (9) has been elevated. Two branches of the deep peroneal nerve (8, 10) enter the muscle. The larger, upper branch passes between the anterior tibial artery and one of its accompanying veins in its course toward the muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep peroneal nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle (origin)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior intermuscular septum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of fibula (area of origin of peroneus longus muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of deep peroneal nerve (to extensor hallucis longus muscle)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle (retracted laterally)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of deep peroneal nerve (to extensor hallucis longus muscle)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_94", "text": "Dissection of anterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Deep peroneal nerve; nerve supply to tibialis anterior, extensor digitorum longus and peroneus tertius muscles\n\t\t\t\t\t\t\t\t\t\tThe anterior compartment of the leg has been widely opened by retracting the tibialis anterior and extensor digitorum longus muscles (5,11). The course of the deep peroneal nerve (8) through the leg is visible in this view and in the following photographs of the specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial recurrent artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous membrane of leg  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral surface of tibia (area of origin of tibialis anterior)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of deep peroneal nerve (to tibialis anterior muscle)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle (reflected)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteal branch of deep peroneal nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep peroneal nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of deep peroneal nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial artery (accompanied by anterior tibial veins)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle (reflected)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of deep peroneal nerve (to extensor digitorum longus muscle and peroneus tertius)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_95", "text": "Dissection of anterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Nerves and blood vessels to upper part of tibialis anterior muscle\n\t\t\t\t\t\t\t\t\t\tThe tibialis anterior has been detached from its origins on the tibia and interosseous membrane. The muscle has been retracted laterally. Branches of the deep peroneal nerve (10, 12) enter the anterior muscular compartment by passing through the anterior intermuscular septum (8). The upper one of these branches supplies periosteum as well as muscle, whereas the lower branch passes directly into the muscle. The recurrent branch of the anterior tibial artery (11), with its accompanying veins, sends branches into the muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of tibia  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Infrapatellar branch of saphenous nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial tuberosity  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous membrane of leg  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein (note several perforating branches entering posterior muscular compartment of leg)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial surface of tibia  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior border of tibia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior intermuscular septum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteal branch of deep peroneal nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial recurrent artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of deep peroneal nerve (to tibialis anterior muscle)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial vein  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle (reflected)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle (reflected)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_96", "text": "Dissection of anterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Nerve supply to extensor digitorum longus, close-up view of upper part of leg\n\t\t\t\t\t\t\t\t\t\tThis close-up photograph of the upper part of the leg the details of the blood vessels and nerves within the anterior compartment of the leg are clearly visible. Nerves that enter the extensor digitorum longus have been preserved in reflecting the muscle posteriorly.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial tuberosity  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior intermuscular septum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial recurrent artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of deep peroneal nerve (to tibialis anterior muscle)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial veins  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of deep peroneal nerve (to extensor digitorum longus muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intermuscular septum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial peroneal nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep peroneal nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of fibula (area of origin of peroneus longus muscle)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle (reflected)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of anterior tibial artery"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_97", "text": "Dissection of anterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Extensor hallucis longus muscle, anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe extensor digitorum longus has been divided at its origin and reflected posteriorly, together with the peroneus tertius, to expose the belly of the extensor hallucis longus (4).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial veins  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of dorsalis pedis (partially removed)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of common peroneal nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of fibula  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle (reflected laterally)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus tertius muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendo calcaneus (Achilles' tendon)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_98", "text": "Dissection of anterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Muscles of leg and foot; extensor retinacula, anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the preceding view has been rotated to expose the anterolateral parts of the ankle and foot. The relations of the extensor muscles to the extensor retinacula (13,15) are shown. the peroneus tertius is visible in its entirety (11).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis brevis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t 1st dorsal interosseus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus longus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus brevis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus tertius muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior extensor retinaculum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extensor retinaculum  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of peroneus longus muscle (adjacent to tendon of peroneus brevis)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum brevis muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tela subcutanea  19\n\t\t\t\t\t\t.\n\t\t\t\t\t 5th metatarsal bone"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_99", "text": "Dissection of anterior aspect of left leg\n\t\t\t\t\t\t\t\t\t\t Muscles of left leg and foot, anterior view\n\t\t\t\t\t\t\t\t\t\tThe superficial structures of the leg and foot have been removed from this specimen. Views of the superficial vessels and nerves of the leg are shown elsewhere (193-1, 194-1, 194-3). The deep fascia has been resected from the leg and foot, with the exception of the thickened extensor retinacula (6, 13) which have been retained across the ankle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleus muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial surface of tibia  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis longus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extensor retinaculum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor hallucis brevis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t metatarsal bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t 1st dorsal interosseus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibialis anterior muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digitorum longus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneus tertius muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior extensor retinaculum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_100", "text": "Dissection of knee\n\t\t\t\t\t\t\t\t\t\t Cavity of right tibiofibular joint in relation to knee joint, posterior view\n\t\t\t\t\t\t\t\t\t\tThe posterior ligament of the head of the fibula has been divided. The fibula has been rotated forward to open the tibiofibular articulation.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cruciate ligament (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior meniscofemoral ligament (ligament of Wrisberg)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cruciate ligament (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial meniscus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of tibia (superior articular surface)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular capsule (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial collateral ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial inferior genicular artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of insertion of sartorius muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament of fibula  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral meniscus (pointer on surface for tendon of popliteus muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of tibia (superior articular surface)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Subpopliteal recess  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal arcuate ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Articular surface of fibula Lower pointer: Articular surface of head of fibula  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior head of fibula ligament (divided)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous membrane of leg  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of fibula"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_101", "text": "Dissection of knee\n\t\t\t\t\t\t\t\t\t\t Interior of right knee joint, posterosuperior view with bones separated\n\t\t\t\t\t\t\t\t\t\tThe femur and tibia have been completely disarticulated. The tibia is viewed from above and behind. The femur has been pulled forward to expose its posteroinferior aspect.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle (tendon cut at insertion)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Capsule of knee joint  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intercondylar line Lower pointer: Medial genicular artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cruciate ligament (divided)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of femur  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial collateral ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Synovial membrane  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior intercondylar area (note the absence of a transverse ligament in this specimen)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial meniscus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of tibia (articular surface)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cruciate ligament (divided)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior meniscofemoral ligament Lower pointer: Posterior meniscofemoral ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of tibia  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial superior genicular artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral superior genicular artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of femur  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament of fibula (divided)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteus muscle (tendon of origin)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar ligament (cut off)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral meniscus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface on inner surface of tendon of popliteus muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of tibia (articular surface)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral inferior genicular artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal arcuate ligament (cut at attachment to apex of fibula)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Subpopliteal recess"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_102", "text": "Dissection of knee\n\t\t\t\t\t\t\t\t\t\t Interior of right knee joint, medial view\n\t\t\t\t\t\t\t\t\t\tThe medial parts of the joint capsule have been cut away to display the cavity in relation to the ligaments and the medial meniscus. The margins of the narrow part of the joint space located below the meniscus are indicated by pointer 20.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadriceps tendon  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprapatellar bursa  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar articular surface  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular capsule (pointers indicate margins of opening into joint cavity)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Area occupied by infrapatellar fat body  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of tibia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial tuberosity  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial inferior genicular artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower attachment of medial patellar retinaculum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of femur  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral superior genicular artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle (tendon at insertion on adductor tubercle of femur)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle of femur  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Rete articulare genus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament of tibia (anterior portion removed)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of femur  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial meniscus (border attached to anterior portion of medial collateral ligament)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular capsule (thickened posterior portion)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Margins of articular space below meniscus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle (tendon of insertion)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_103", "text": "Dissection of knee\n\t\t\t\t\t\t\t\t\t\t Interior of right knee joint, posterior view of meniscofemoral and posterior cruciate ligaments\n\t\t\t\t\t\t\t\t\t\tThe arcuate and oblique popliteal ligaments have been resected. The posterior meniscofemoral and posterior cruciate ligaments are visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of femur  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial superior genicular artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle (tendon at insertion on adductor tubercle)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular capsule (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial genicular artery (passing into intercondylar fossa)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of femur  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cruciate ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior meniscofemoral ligament (ligament of Wrisberg)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle (tendon of insertion, cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial inferior genicular artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of tibia  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral superior genicular artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercondylar line  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of femur  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament of fibula  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral meniscus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteus muscle (tendon of origin)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of tibia (articular surface)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle (tendon of insertion, cut off)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Subpopliteal recess  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral inferior genicular artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior head of fibula ligament  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal artery (cut off)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_104", "text": "Dissection of knee\n\t\t\t\t\t\t\t\t\t\t Interior of right knee joint, posterior view showing capsular ligaments and internal structures\n\t\t\t\t\t\t\t\t\t\tWindows have been cut in the joint capsule posterior to the femoral and tibial condyles to expose the interior of the joint and at the same time to preserve the major capsular ligaments posteriorly.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal femoral surface  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial superior genicular arteries  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle (tendon of insertion)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular capsule genus (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of femur (covered by articular cartilage)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial genicular artery (origin in common with lateral superior genicular artery)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Oblique popliteal ligament Lower pointer: Posterior meniscofemoral ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament of tibia  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial meniscus (pointer indicates area of fusion with articular capsule)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle (tendon of insertion, cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial inferior genicular artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of tibia  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral superior genicular artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle of femur  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of femur (visible through opening in joint capsule)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal arcuate ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral lemniscus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament of fibula  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteus muscle (tendon of origin, cut off)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral inferior genicular artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Subpopliteal recess  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of fibula  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial artery"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_105", "text": "Dissection of knee\n\t\t\t\t\t\t\t\t\t\t Interior of right knee joint, lateral view\n\t\t\t\t\t\t\t\t\t\tThe joint capsule (3) has been opened to reveal the internal contours of the joint in relation to the ligaments on its lateral aspect.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of femur  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral superior genicular artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of Articular capsule  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle of femur  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament of fibula  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of popliteus muscle (upper pointer, extracapsular portion; lower pointer, portion covered by reflection of synovial membrane)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of femur  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal arcuate ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle (tendon of insertion, cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior head of fibula ligament.  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of fibula.  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial recurrent artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprapatellar bursa  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of quadriceps muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar articular surface  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Space occupied by infrapatellar fat body  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral meniscus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of tibia (articular surface)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular capsule (coronary ligament)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial tuberosity"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_106", "text": "Dissection of knee\n\t\t\t\t\t\t\t\t\t\t Interior of right knee joint, anterior view showing relations of ligaments to internal structures\n\t\t\t\t\t\t\t\t\t\tIn this specimen, shown previously in view 189-7, the iliotibial tract and the patellar retinacula have been removed. The joint capsule has been opened to reveal the extent of the joint cavity anteriorly (5, 9, 17, 21) in  relation to the collateral ligaments 97,18) and menisci (8, 19).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of femur  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadriceps tendon  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral superior genicular artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle of femur  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular capsule (cut margins of articular capsule)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of femur (pointer on articular cartilage)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament of fibula  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lateral meniscus Lower pointer: Lateral inferior genicular artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lateral condyle of tibia (pointer on articular cartilage) Lower pointer: Articular capsule (cut to open joint cavity below meniscus)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle (tendon of insertion)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial tuberosity  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial recurrent artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Patella  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial superior genicular artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle of femur  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular capsule (cut margin)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament of tibia  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial meniscus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of tibia (articular surface)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular capsule (cut to open joint cavity below medial meniscus)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar ligament  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial inferior genicular artery"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_107", "text": "Dissection of knee\n\t\t\t\t\t\t\t\t\t\t Interior of right knee joint, cruciate ligaments divided\n\t\t\t\t\t\t\t\t\t\tThe collateral ligaments and cruciate ligaments have been cut through to permit the separation of the femur from the tibia.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cruciate ligament (divided)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cruciate ligament (divided)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of femur  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament of fibula (divided)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral meniscus (note its separation from fibular collateral ligament)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of tibia (articular surface)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Infrapatellar fat body  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar articular surface  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Line of reflection of articular capsule  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of femur  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament of tibia (divided)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior meniscofemoral ligament (cut off) Lower pointer: Anterior meniscofemoral ligament (cut off)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial meniscus (note fusion with tibial collateral ligament)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of tibia (articular surface)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_108", "text": "Dissection of knee\n\t\t\t\t\t\t\t\t\t\t Interior of right knee joint, anterior cruciate ligament\n\t\t\t\t\t\t\t\t\t\tThe infrapatellar synovial fold (12) has been cut off to reveal the anterior cruciate ligament (9). Synovial membrane partially encloses the cruciate ligament.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar femoral surface  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of femur  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular surface of tibia  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral meniscus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Infrapatellar fat body  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar articular surface  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprapatellar bursa  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cruciate ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of femur  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial meniscus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Infrapatellar synovial fold (cut off)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_109", "text": "Dissection of knee\n\t\t\t\t\t\t\t\t\t\t Interior of right knee joint, anterior view\n\t\t\t\t\t\t\t\t\t\tThe joint capsule has been widely incised to permit the downward reflection of the quadriceps tendon, patella and patellar ligament.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprapatellar bursa  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of femur  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral meniscus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Infrapatellar fat body  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar articular surface  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadriceps femoris muscle (reflected)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Synovial membrane  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular capsule  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercondylar fossa  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of femur  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Infrapatellar synovial fold  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial meniscus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament of tibia  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar folds"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_110", "text": "Dissection of knee\n\t\t\t\t\t\t\t\t\t\t Capsule, ligaments and arteries of right knee, medial view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of femur  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of quadriceps muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprapatellar bursa (opened)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Patella  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular capsule genus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial patellar retinaculum (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial tuberosity  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of popliteal artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial superior genicular artery (passing into rete articulare genus)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of descending genicular artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of femur  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament of tibia  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of tibia  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendons of insertion of sartorius, gracilis and semitendinosus muscles  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of fibula  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_111", "text": "Dissection of knee\n\t\t\t\t\t\t\t\t\t\t Capsule, ligaments and arteries of right knee, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of femur  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral superior genicular arteries (duplicated)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle (tendon of insertion)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial genicular artery (passing into intercondylar fossa)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of femur  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle (tendon of insertion)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique popliteal ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament of tibia  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of tibia  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral inferior genicular artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Semitendinosus muscle (tendon of insertion)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of tibia  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleal line  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of popliteal artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending genicular artery (cut off)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial superior genicular artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament of fibula  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal arcuate ligament  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps fern oris muscle (tendon of insertion)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteus muscle (tendon of origin)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial inferior genicular artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of fibula  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous membrane of leg"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_112", "text": "Dissection of knee\n\t\t\t\t\t\t\t\t\t\t Capsule, ligaments and arteries of right knee, lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of popliteal artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral superior genicular artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of femur (in background)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of femur (covered by ligaments)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Semitendinosus muscle (tendon of insertion)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament of fibula  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Popli teal arcuate ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle (tendon of insertion)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior head of fibula ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial recurrent artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of fibula  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Patella  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral patellar retinaculum  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar ligament  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of tibia  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial tuberosity  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of tibia  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous membrane of leg"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_113", "text": "Dissection of knee\n\t\t\t\t\t\t\t\t\t\t Capsule, ligaments and arteries of right knee, anterior view\n\t\t\t\t\t\t\t\t\t\tThe superficial structures and the muscles have been cut away to reveal the fibrous reinforcements of the anterior aspect of the right knee.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral patellar retinaculum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of tibia  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial recurrent artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of fibula  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous membrane of leg  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadriceps tendon  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Patella  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle of femur  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar ligament  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of tibia  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial tuberosity  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Crural fascia  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior border of tibia"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_114", "text": "Dissection of knee\n\t\t\t\t\t\t\t\t\t\t Superficial vessels and nerves of left knee; patellar retinaculum;  medial view\n\t\t\t\t\t\t\t\t\t\tThe tela subcutanea has been dissected to display the superficial blood vessels and nerves on the medial aspect of the knee. The great saphenous vein (9) has been divided and removed to permit better exposure of the branches of the saphenous nerve. The fascia lata (11) has been retained in the area immediately anterior to the medial intermuscular septum. Elsewhere the fascia has been cut away to expose underlying muscles and tendons that pass medial to the knee joint.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Semitendinosus muscle (retracted)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of medial epicondyle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous branch of descending genicular artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial femoral intermuscular septum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia lata  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous branch of descending genicular artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus medialis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Infrapatellar branch of saphenous nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Patella  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial patellar retinaculum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar ligament"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_115", "text": "Dissection of knee\n\t\t\t\t\t\t\t\t\t\t Superficial vessels and nerves of left knee; patellar retinaculum; iliotibial tract,  lateral view\n\t\t\t\t\t\t\t\t\t\tThe lateral patellar retinaculum (4) and the lower part of the iliotibial tract (2) reinforce the knee joint laterally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadriceps femoris muscle (tendon of insertion)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Patella  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral patellar retinaculum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Infrapatellar branch of saphenous nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating veins  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Crural fascia  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle (in background)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous sural nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Common peroneal nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of head of fibula  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous branches of common peroneal nerve"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_116", "text": "Dissection of knee\n\t\t\t\t\t\t\t\t\t\t Superficial vessels and nerves of left knee, anterior view\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in view 185-3 is seen in this close-up photograph illustrating the superficial structures in the region of the left knee joint.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous branches of anterior femoral nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous branch of descending genicular artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Infrapatellar branch of saphenous nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tela subcutanea  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of insertion of sartorius muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial recurrent artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia lata  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Patella  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of patellar ligament on tibial tuberosity"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_117", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Quadriceps femoris muscle (continued).\n\t\t\t\t\t\t\t\t\t\tThe quadriceps tendon has been elevated to display the fascicles of the articularis genus (3) in relation to the suprapatellar bursa (5).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus intermedius muscle (elevated)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle (tendon, cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Articularis genus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus medialis muscle (insertion)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprapatellar bursa (unopened)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Patella  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of femur  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular capsule genus (pointer indicates position of collateral ligament of tibia)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_118", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Quadriceps femoris muscle (continued).\n\t\t\t\t\t\t\t\t\t\tThe rectus femoris, vastus medialis and vastus lateralis muscles have been cut away to reveal the vastus intermedius.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of Intertrochanteric line  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of femur  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus intermedius muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of insertion of upper part of vastus lateralis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of rectus femoris muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Patella  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_119", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Quadriceps femoris muscle (continued).\n\t\t\t\t\t\t\t\t\t\tThe specimen has been turned to expose the posterior aspect of the quadriceps in relation to the femur. The adductor muscles and hamstrings have been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus femoris muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle (near insertion on lesser trochanter)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus medialis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial lip of linea aspera  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal surface  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral lip of linea aspera  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle (cut off close to insertion)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_120", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Quadriceps femoris muscle (continued).\n\t\t\t\t\t\t\t\t\t\tThe rectus femoris has been divided near its origin (8) and again close to the point at which its tendon fuses with the vastus muscles (5). The muscle belly has been removed to reveal the vastus intermedius.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus minimus muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Hip articular capsule  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle (retracted laterally)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus lemons muscle (tendon of insertion)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Patella  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle (tendon of origin)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus intermedius muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus medialis muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_121", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Quadriceps femoris muscle.\n\t\t\t\t\t\t\t\t\t\tThe components of the right  quadriceps femoris have been separated from each other to show their relations in a specimen from which most of the other muscles of the thigh have been removed. In the following views of this sequence the major features of this muscle complex are illustrated.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Patella  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inguinal ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus medialis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial patellar retinaculum"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_122", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Nerve supply to Obturator externus muscle\n\t\t\t\t\t\t\t\t\t\tThe obturator externus has been reflected downward from its origin.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac lymph node  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior ramus of pubic bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator artery and vein (emerging through obturator canal)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of obturator nerve (to obturator externus muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of obturator externus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Obturator nerve Lower pointer: Obturator artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle (origin)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator membrane  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Hip articular capsule  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial femoral circumflex artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus femoris muscle (origin)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle (reflected downward)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_123", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Obturator externus muscle\n\t\t\t\t\t\t\t\t\t\tA portion of the adductor minimus (4) has been removed from the dissection to permit full visualization of the extensive area of origin of the obturator externus from the pubis and ischium.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle (origin)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior branch of obturator nerve Lower pointer: Obturator canal  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor brevis muscle (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor minimus muscle (two pointers indicate origin and insertion of excised part of adductor minimus)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch of obturator nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus femoris muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor minimus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor brevis muscle (insertion)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle (insertion)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Hip articular capsule  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Acetabular branch of medial circumflex femoral artery Lower pointer: Deep branch of medial circumflex femoral artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral femoral circumflex artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser trochanter  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus intermedius muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_124", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Posterior branch of obturator nerve; innervation of adductor magnus by obturator nerve\n\t\t\t\t\t\t\t\t\t\tThe adductor brevis has been divided and removed to reveal the posterior branch of the obturator nerve passing into the adductor magnus. Branches of the sciatic nerve that enter the adductor magnus on its posterior aspect are visible in the dissection shown in view 184-4.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of obturator nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle (cut off at origin)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor brevis muscle (origin)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle (origin)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch of obturator nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle (upper pointer indicates adductor minimus)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle (insertion)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor brevis muscle (insertion)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep femoral artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliacus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral femoral circumflex artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser trochanter (tendon of iliopsoas visible)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of femoral nerve (to vastus intermedius muscle)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus intermedius muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus medialis muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_125", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Nerve supply to adductor brevis muscle; medial femoral circumflex artery\n\t\t\t\t\t\t\t\t\t\tThe pectineus and adductor longus muscles have been removed from the specimen. The anterior (3) and posterior (7) branches of the obturator nerve have been exposed as they emerge from the obturator canal to pass in front of and behind the adductor brevis. Branches of the anterior branch that supply the adductor brevis have been traced into this muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of obturator nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle (cut off at origin)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubis (pointer indicates attachment of rectus abdominis)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Superficial branch of medial circumflex artery (divided) Right pointer: Posterior branch of obturator nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor brevis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle (near insertion)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep femoral artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliacus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle (cut off)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Medial femoral circumflex artery Lower pointer: Deep branch of medial femoral circumflex artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Hip articular capsule  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch of lateral femoral circumflex artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus intermedius muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of femoral nerve (to upper part of vastus medialis muscle)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_126", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Nerve supply to left vastus medialis, anteromedial view\n\t\t\t\t\t\t\t\t\t\tThe vastus medialis has been dissected to permit exposure of the branch of the femoral nerve (6) that enters the midportion of the muscle. In the following view (188-2) another nerve is visible supplying the proximal part of the muscle belly.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle (cut off)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending genicular artery (muscular branch)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of femoral nerve (to vastus medialis muscle)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus medialis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle (cut off)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_127", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Deep femoral artery and perforating arteries of left thigh viewed from medial side\n\t\t\t\t\t\t\t\t\t\tThe specimen has been turned in such a way that the medial aspect of the upper part of the left thigh may be visualized. The adductor longus has been removed from the dissection except for a short segment of it has been removed from the dissection except for a short segment of it that has been retained close to its femoral insertion (6). By reflecting this remnant of the adductor longus the deep femoral artery has been exposed. Perforating branches (4) from the artery pass through the openings in the insertion of the adductor brevis and adductor magnus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliacus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor brevis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle (cut off near insertion)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor fascia lata muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep femoral artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of femoral nerve (to vastus medialis muscle)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus medialis muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_128", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Nerve supply to gracilis muscle, anterior view\n\t\t\t\t\t\t\t\t\t\tThe adductor longus has been cut away. The gracilis has been turned medially and dissected to reveal branches of the obturator nerve that penetrate the muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle (tendon of origin)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of obturator nerve (to gracilis muscle)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor brevis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch of obturator nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep femoral artery (muscular branches)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral femoral circumflex artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor fasciae latae muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep femoral artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus intermedius muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_129", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Nerve supply to adductor longus muscle, anterior view\n\t\t\t\t\t\t\t\t\t\tThe adductor longus has been reflected medially and dissected to reveal branches of the obturator nerve entering the posterior aspect of the muscle belly.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic tubercle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of obturator nerve (upper pointer, branches to gracilis muscle; lower pointer, branches to adductor longus muscle)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor brevis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle (reflected medially)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep femoral artery (muscular branch)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliacus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial femoral circumflex artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral femoral circumflex artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor fasciae latae muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus intermedius muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_130", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Nerve supply to lower part of sartorius; saphenous nerve; adductor canal and adductor hiatus, medial view\n\t\t\t\t\t\t\t\t\t\tThe lower part of the thigh is viewed from the medial side to visualize the nerves which enter the sartorius. This muscle has been divided and reflected posteriorly.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch femoral nerve (to sartorius muscle)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle (cut off and reflected)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending genicular artery (saphenous branch)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal artery (in background)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery (within opened adductor canal)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia bridging across hiatus adductorius  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of hiatus adductorius  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of adductor magnus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus medialis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Patella  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Infrapatellar branch of saphenous nerve"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_131", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Nerve supply to vastus lateralis muscle\n\t\t\t\t\t\t\t\t\t\tThe rectus femoris (10) has been cut off close to its origin. The vastus lateralis has been dissected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of femoral nerve (to vastus intermedius)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of femoral nerve (to vastus medialis)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral vein (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle (cut off and reflected medially)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliacus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle (cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor fasciae latae muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ascending branch of lateral femoral circumflex artery Lower pointer: Transverse branch of lateral femoral circumflex artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch of lateral femoral circumflex artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of femoral nerve (to vastus lateralis muscle)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus intermedius muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus medialis muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_132", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Nerve supply to rectus femoris muscle\n\t\t\t\t\t\t\t\t\t\tThe rectus femoris (15) has been turned laterally to display its nerve supply and the arteries from the descending branch of the lateral circumflex femoral artery that enter the muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Inguinal ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Femoral artery Lower pointer: Deep femoral artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of femoral nerve (to sartorius muscle)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous branches of anterior femoral nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of femoral nerve (to vastus medialis muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliacus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of femoral nerve (to rectus femoris muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of femoral nerve (to vastus intermedius muscle)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse branch of lateral femoral circumflex artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch of lateral femoral circumflex artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle (reflected and dissected)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus intermedius muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_133", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Adductor longus and pectineus muscles\n\t\t\t\t\t\t\t\t\t\tThe femoral artery and nerve have been retracted laterally to reveal the insertions of the pectineus and adductor longus. The deep femoral artery has also been partially exposed. Only the distal parts of the deep femoral veins have been preserved in the dissection.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac lymph node  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Peritoneum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: External iliac vein Lower pointer: Inguinal ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pectineus muscle Lower pointer: Branch of femoral nerve to pectineus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of pubic symphysis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep femoral artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle (divided and partially excised)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliacus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery (retracted laterally)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial femoral circumflex artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_134", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Nerve supply to sartorius and pectineus muscles; branches of femoral artery\n\t\t\t\t\t\t\t\t\t\tThe sartorius muscle has been divided close to its origin. The muscle belly has been pulled medially toward the pubis to reveal the course of branches of the femoral nerve into the upper part of the muscle. View 187-4 illustrates the nerves in the lower part of the sartorius. The nerve to the pectineus (7) passes medially behind the femoral vessels to enter the muscle. In this dissection the femoral vein and most of its branches within the femoral triangle have been resected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Inguinal ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral vein (cut off)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Peritoneum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of femoral nerve (to Pectineus muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of obturator nerve (descending in front of adductor brevis)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch femoral nerve (to sartorius muscle)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle (reflected; also see no. 15)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of femoral nerve (to Vastus medialis muscle)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of femoral nerve (to sartorius muscle)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle (origin)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliacus muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor fasciae latae muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch femoral nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lateral femoral circumflex artery Lower pointer: Transverse branch of lateral femoral circumflex artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch of lateral femoral circumflex artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep femoral artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle (reflected)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus intermedius muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_135", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Anterior branches of obturator nerve and vessels in relation to adductor longus\n\t\t\t\t\t\t\t\t\t\tThe pectineus has been elevated and the gracilis muscle has been turned posteriorly. The anterior branches (1) of the obturator nerve, artery and vein are shown in relation to the adductor longus (3).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior branch of obturator nerve Lower pointer: Anterior branch of obturator artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor brevis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery (pointer at upper end of adductor canal)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of obturator nerve to gracilis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle (reflected medially)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous branches of anterior femoral nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous branch of obturator nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of pubic bone (pointer on overlying reflex inguinal ligament)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inguinal ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle (elevated)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor fasciae latae muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_136", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Interior of femoral vein, opened to illustrate valves\n\t\t\t\t\t\t\t\t\t\tThe femoral vein has been opened by a longitudinal incision. The latex cast within the vessel has been cut away to expose the two paired valves (3).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Commissure of valve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Valve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Opening of tributary into femoral vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of valve sinus (collapsed)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_137", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Femoral vessels and nerve in femoral triangle; deep inguinal lymphatics, anterior view of left thigh\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep circumflex iliac artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Genital branch of genitofemoral nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac lymph node  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior epigastric artery (cut off)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Inguinal ligament Right pointer: Femoral sheath enclosing femoral canal (note lymphatic vessels entering femoral canal)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic tubercle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep inguinal lymph node  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pectineus muscle Lower pointer: Anterior branch of obturator nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral femoral cutaneous nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Femoral branch of genitofemoral nerve Lower pointer: Femoral nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial circumflex iliac artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph duct  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery and vein  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor fasciae latae muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_138", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Femoral sheath; vascual and muscular spaces deep to inguinal ligament, viewed from below\n\t\t\t\t\t\t\t\t\t\tThe structures that pass into the femoral triangle from above are shown in cross-section in this discussion. The specimen was prepared by dis-articulating the right thigh at the hip joint. The obturator externus and pectineus muscles have been completely removed. In the region immediately anterior to the acetabulum the iliopsoas muscle, femoral nerve and femoral vessels have been cut off inferior to the inguinal ligament (14). The structures lying within the spaces deep to the inguinal ligament can thus be identified. The iliopsoas muscle (3) and the femoral nerve (2) occupy the muscular space, separated by the slanting iliopectineal arch (1), from the femoral vessels (13) and femoral canal (15) located in the vascular space.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopectineal arch (iliopectineal ligament)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine (origin of rectus femoris muscle)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Femoral sheath (posterior lamina; note attachment of this layer to iliopubic eminence) Lower pointer: Location of iliopubic (pectineal) eminence  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus minimus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabular margin  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of External oblique muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia lata (cut across and elevated)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral sheath (anterior lamina)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery and vein (within femoral canal)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inguinal ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral canal (cut across at its apex canal widens medially within femoral sheath as it approaches level of inguinal ligament)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Round ligament of uterus (emerging through superficial inguinal ring)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic tubercle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of femoral ring (obscured by medial wall of femoral sheath)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineal ligament (ligament of Cooper)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator artery and vein  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator membrane  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischium"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_139", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Femoral sheath\n\t\t\t\t\t\t\t\t\t\tBelow the inguinal ligament the femoral sheath (13) has been exposed by removing the superficial inguinal lymph nodes, the cribiform fascia and part of the fascia lata which bounds the saphenous opening. The inferior part of the falciform margin of this opening has been retained (17).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Inguinal ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of femoral canal (note lymphatic vessels penetrating femoral sheath in this area) 3. Intercrural fibers  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial inguinal ring (left pointer, medial crus; right pointer, lateral crus)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ilioinguinal nerve (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Spermatic cord (external spermatic fascia removed cremasteric fascia exposed)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle (covered by fascia)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle (covered by fascia lata)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral femoral cutaneous nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle (covered by iliopsoas fascia)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous branches of anterior femoral nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial circumflex iliac artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral sheath  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle (covered by fascia lata)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein (cut off)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep inguinal lymph node  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Margo falciformis (inferior horn)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia lata"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_140", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Left femoral triangle with superficial nerves and vessels retained, anterior view\n\t\t\t\t\t\t\t\t\t\tThe fascia lata has been retained in the area surrounding the saphenous opening. Superficial inguinal lymph nodes have beem cut away althrough the lymphatic vessels (7)  that drain these nodes and pass through the cribriform fascia (8) have been preserved.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Transversalis fascia  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inguinal ligament (slightly elevated)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic tract  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior epigastric veins  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior epigastric artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Round ligament of uterus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymphatic vessel (note other lymphatic vessels in the area)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cribriform fascia Lower pointer: Greater saphenous vein (approaching ovalis fossa of fascia lata)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t External pudendal arteries  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia lata  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous branches of anterior femoral nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral femoral cutaneous nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor fasciae latae muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral branch of genitofemoral nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Margo falciformis hiatus sapheni  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_141", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Right tensor fasciae latae muscle, anterior view\n\t\t\t\t\t\t\t\t\t\tThe tensor fasciae latae (6) has been divested of its aponeurotic covering to expose its insertion into the iliotibial tract (9).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of External oblique muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral femoral cutaneous nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis between tensor fasciae latae and gluteus maximus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor fasciae latae muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus abdominis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inguinal ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_142", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Muscles of right thigh, anteromedial view\n\t\t\t\t\t\t\t\t\t\tThe specimen has been turned so that the view is directed toward the anteromedial aspect of the right thigh. The muscles have been spread apart.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of pubic symphysis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis External oblique muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inguinal ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor fasciae latae muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pectineus muscle Lower pointer: Femoral vein  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus medialis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Patella  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial patellar retinaculum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor fasciae latae muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_143", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Muscles of left thigh, anterior view\n\t\t\t\t\t\t\t\t\t\tThe muscles have been cleared of connective tissue and separated slightly from each other. The fascia lata has been retained over part of the femoral triangle (3). The anterior border of the iliotibial tract has been partially removed to show the underlying vastus lateralis.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Inguinal ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior epigastric artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia lata  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cutaneous branch of femoral nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous branch of obturator nerve (joining femoral nerve)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral femoral cutaneous nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor fasciae latae muscle (covered by upper part of iliotibial tract)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral branch of genitofemoral nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus medialis muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Patella"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_144", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t Superficial structures overlying left femoral triangle, anterior view\n\t\t\t\t\t\t\t\t\t\tThe inguinal canal has been opened in the dissection of the anterior abdominal wall. In the thigh the tela subcutanea has been dissected and the fascia lata remains intact. The boundaries of the femoral triangle may be identified by locating the inguinal ligament (4), the rounded border of the adductor longus (8) and the sartorius muscle (12). The latter two structures are covered by fascia lata so that their contours are ill-defined.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic tract (deep femoral arch)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial inguinal lymph nodes  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Round ligament of uterus (lying within inguinal canal)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inguinal ligament  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph duct (draining labium majus to inguinal lymph nodes)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium majus (dissected)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t External pudendal artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle (covered by fascia lata)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory saphenous vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph duct  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle (faintly visible deep to fascia lata)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor fasciae latae muscle (covered by fascia lata)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia lata  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral femoral cutaneous nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral branch of genitofemoral nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral femoral cutaneous vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tela subcutanea  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous branch of anterior femoral nerve,"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_145", "text": "Dissection of anterior and medial aspects of thigh\n\t\t\t\t\t\t\t\t\t\t General view of superficial vessels and nerves of left thigh; anterior muscles of right thigh\n\t\t\t\t\t\t\t\t\t\tThe tela subcutanea has been dissected to expose the cutaneous nerves and superficial vessels of the left thigh. On the right side the muscles of the thigh have been exposed and cleaned. Detailed close-ups of the superficial structures are shown in views 185-4, 189-4, 189-5, 189-6.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor fasciae latae muscle (pointer indicates insertion into Iliotibial tract)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus medialis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Patella  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral patellar retinaculum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial patellar retinaculum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial inguinal lymph node  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lateral femoral cutaneous nerve Lower pointer: Femoral branch of genitofemoral nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Greater saphenous vein Lower pointer: Accessory saphenous vein  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tela subcutanea  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral femoral cutaneous vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia lata  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cutaneous branch of femoral nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Infrapatellar branch of saphenous nerve"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_146", "text": "Dissection of iliopsoas muscle and lumbar plexus\n\t\t\t\t\t\t\t\t\t\t Right iliopsoas muscle in relation to spine, pelvis and femur\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial arcuate ligament of diaphragm (medial lumbocostal arch)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligament of vertebral body (cut in sagittal plane)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliacus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser trochanter  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament (joined above this level by right crus of diaphragm which has been cutoff)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater (lying within vertebral canal)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_147", "text": "Dissection of iliopsoas muscle and lumbar plexus\n\t\t\t\t\t\t\t\t\t\t Nerves and blood supply to iliacus muscle\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left common iliac vein  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovarian veins (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid colon  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic cavity  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovary  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Fundus of uterus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Round ligament of uterus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Genitofemoral nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve (retracted laterally)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of femoral nerve (to iliac muscle)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar artery and vein (iliac branch)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t External oblique muscle (at insertion on external lip of iliac crest)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Transversus abdominis muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal oblique muscle (at origin from intermediate line of iliac crest)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliacus muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac fascia (remnant)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep circumflex iliac artery"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_148", "text": "Dissection of iliopsoas muscle and lumbar plexus\n\t\t\t\t\t\t\t\t\t\t Lumbar plexus; nerves to psoas major\n\t\t\t\t\t\t\t\t\t\tThe left psoas major has been detached from its spinal origins and turned laterally. Nerves to the psoas, as well as the major parts of the lumbar plexus, have been exposed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Right crus of diaphragm  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right kidney  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Abdominal aorta (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk (pointer on sympathetic trunk ganglia)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. II-III  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar artery and vein (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus lumborum muscle covered by transversalis fascia  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliohypogastric nerve (faintly visible)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ilioinguinal nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral femoral cutaneous nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Genitofemoral nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Common iliac artery and vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial arcuate ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm (Lateral arcuate ligament lies in area between pointers)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcostal nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of nerve L. II  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Genitofemoral nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar nerve II  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral femoral cutaneous nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar nerve III  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus lumborum muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar nerve IV  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliacus muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_149", "text": "Dissection of iliopsoas muscle and lumbar plexus\n\t\t\t\t\t\t\t\t\t\t Iliopsoas and quadratus lumborum muscles, anterior view\n\t\t\t\t\t\t\t\t\t\tThe relations of the iliopsoas muscles to the lumbar vertebrae, pelvic girdle and thigh are illustrated in this dissection. In the following two views details of the lumbar plexus and of the innervation of the iliopsoas muscle have been worked out on the left side of the same specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Abdominal aorta  2\n\t\t\t\t\t\t.\n\t\t\t\t\t 7th costal cartilage  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ren dexter  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Transversalis fascia  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid colon  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Uterus Lower pointer: Urinary bladder  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic crest  11\n\t\t\t\t\t\t.\n\t\t\t\t\t 12th rib  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcostal nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t 3rd vertebral ligament (covered by anterior longitudinal ligament)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliohypogastric nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus lumborum muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle (psoas minor muscle absent in this specimen)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Common iliac artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliacus muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral femoral cutaneous nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep circumflex iliac artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_150", "text": "Dissection of posterior aspect of left thigh\n\t\t\t\t\t\t\t\t\t\t Adductor minimus muscle\n\t\t\t\t\t\t\t\t\t\tThe sciatic nerve has been retracted laterally and the adductor magnus has been slightly deflected medially to reveal the adductor minimus. This muscle is often fused with the adductor magnus and is usually described as a part of it.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochanter tertius  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle (reflected)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus femoris muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of biceps femoris muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of semimembranosus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of semitendinosus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial femoral circumflex artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor minimus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of sciatic nerve (to adductor magnus muscle)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_151", "text": "Dissection of posterior aspect of left thigh\n\t\t\t\t\t\t\t\t\t\t Adductor magnus muscle; nerve supply from sciatic nerve\n\t\t\t\t\t\t\t\t\t\tThe biceps, semitendinosus and semimembranosus muscles have been resected. The branch (18) of the sciatic nerve that supplies the extensor part of the adductor magnus is shown in this dissection. The remainder of the muscle receives its innervation from the obturator nerve as illustrated in view 188-3.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending branch of medial femoral circumflex artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus femoris muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor minimus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of sciatic nerve (to adductor magnus muscle)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Short head of biceps femoris muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Biceps femoris muscle (tendon of origin) Lower pointer: Semimembranosus muscle (origin)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial femoral circumflex artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating arteries  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Popliteal vein Lower pointer: Adductor hiatus"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_152", "text": "Dissection of posterior aspect of left thigh\n\t\t\t\t\t\t\t\t\t\t Nerves supply to semimembranosus muscle and short head of biceps femoris\n\t\t\t\t\t\t\t\t\t\tThe semimembranosus has been dissected to illustrate the entrance of branches of the sciatic nerve into the muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus femoris muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor minimus muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of sciatic nerve (to short head of biceps)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Short head of biceps femoris  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Long head of biceps femoris  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of sciatic nerve (to semimembranosus muscle)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal artery and vein"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_153", "text": "Dissection of posterior aspect of left thigh\n\t\t\t\t\t\t\t\t\t\t Semimembranosus muscle and short head of biceps femoris\n\t\t\t\t\t\t\t\t\t\tThe long head of the biceps (4) has been cut off near its junction with the short head. The semitendinosus has been removed to expose the semimembranosus (9).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle (covered by Iliotibial tract)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Short head of biceps femoris muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Long head of biceps femoris (cut off)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Common peroneal nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal vein  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_154", "text": "Dissection of posterior aspect of left thigh\n\t\t\t\t\t\t\t\t\t\t Nerve supply to semitendinosus muscle\n\t\t\t\t\t\t\t\t\t\tThe long head of the biceps has been excised to expose the nerves that enter the semitendinosus. The semitendinosus has been cut across at its origin and turned slightly medially.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus femoris muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of sciatic nerve (to semitendinosus muscle)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of medial femoral circumflex artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle (near insertion)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral intermuscular septum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Semitendinosus muscle (reflected)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_155", "text": "Dissection of posterior aspect of left thigh\n\t\t\t\t\t\t\t\t\t\t Nerve supply to hamstring muscles\n\t\t\t\t\t\t\t\t\t\tThe biceps and semitendinosus muscles have been detached from their origins on the ischial tuberosity to permit them to be dissected. Branches of the tibial nerve and of the medial circumflex femoral artery enter the proximal parts of the muscle bellies.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendons of origin of biceps femoris and semitendinosus (detached)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle (origin)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending branch of medial femoral circumflex artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus femoris muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor minimus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral intermuscular septum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle (insertion)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Short head of biceps femoris muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial femoral circumflex artery (deep branch)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of sciatic nerve (to semitendinosus muscle)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of sciatic nerve (to long head of biceps femoris)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of sciatic nerve (to semimembranosus muscle)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Semitendinosus muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Long head of biceps femoris  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_156", "text": "Dissection of posterior aspect of left thigh\n\t\t\t\t\t\t\t\t\t\t Biceps femoris muscle\n\t\t\t\t\t\t\t\t\t\tThe long head of the biceps (8) has been detached from its origin and has been rotated medially to expose the nerve and blood vessels that enter the belly of the muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus femoris muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle (cut across near insertion)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of sciatic nerve (branch of common peroneal nerve to short head of biceps femoris)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle (upper pointer, long head; lower pointer, short head)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle (covered by iliotibial tract)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Common peroneal nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal fossa  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of sciatic nerve (to long head of biceps femoris)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Semitendinosus muscle (retracted)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle (passing across medial epicondyle of femur)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_157", "text": "Dissection of posterior aspect of left thigh\n\t\t\t\t\t\t\t\t\t\t Deep relations of sciatic nerve in popliteal fossa\n\t\t\t\t\t\t\t\t\t\tThe popliteal fossa is shown in view 183-1 with its contents exposed in their normal relations. In the present stage of the dissection the hamstring muscles have been widely separated, the gastrocnemius has been dissected, and the tibial nerve has been retracted laterally to reveal the course of the popliteal artery and vein. Lymph nodes and lymphatic vessels are preserved within the fossa.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract (covering vastus lateralis muscle)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Common peroneal nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve (retracted laterally)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal artery (upper pointer indicates muscular branch)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous sural nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle (lateral head)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Medial cutaneous sural nerve Lower pointer: Lesser saphenous vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of sciatic nerve (to semimembranosus muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor hiatus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Semitendinosus muscle (retracted medially)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal lymph node  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of tibial nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Sural artery and vein"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_158", "text": "Dissection of posterior aspect of left thigh\n\t\t\t\t\t\t\t\t\t\t Relations of sciatic nerve in upper part of thigh (continued)\n\t\t\t\t\t\t\t\t\t\tThe sciatic nerve has been exposed from the greater sciatic foramen downward into the thigh. The relations of the nerve to the ischial tuberosity (19) and greater trochanter (6) are shown. Several arteries (1, 2, 7, 14, 21) ramify within the area of the dissection. These vessels, together with branches of the lateral circumflex femoral artery (not shown) form the cruciate anastomosis.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery supplying sciatic nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial femoral circumflex artery (ascending branch)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia lata (between gluteus maximus muscle and tensor fasciae latae muscle)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochanteric bursa of gluteus maximus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle (reflected)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus femoris muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor minimus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating arteries  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral intermuscular septum  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Short head of biceps femoris muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of sciatic nerve (to hamstring muscles)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial femoral circumflex artery (deep branch)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Semitendinosus muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Long head of biceps femoris"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_159", "text": "Dissection of posterior aspect of left thigh\n\t\t\t\t\t\t\t\t\t\t Relations of sciatic nerve in upper part of thigh\n\t\t\t\t\t\t\t\t\t\tThe long head of the biceps has been displaced medially to reveal the passage of the sciatic nerve deep to this muscle. The fascial layer (5) that extends inward between the two heads of the biceps is continuous above the fascia deep to the gluteus maximus. The lateral intermuscular septum (4) extends upward to blend with the tendon of insertion of the gluteus maximus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior femoral cutaneous nerve (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle (reflected)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of posterior femoral cutaneous nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral intermuscular septum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial layer between long and short heads of biceps femoris  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle (covered by iliotibial tract)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of sciatic nerve (to short head of biceps)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Short head of biceps femoris muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal branch of posterior femoral cutaneous nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiopubic ramus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Semitendinosus muscle (Semimembranosus muscle not visible)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle (long head)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_160", "text": "Dissection of posterior aspect of left thigh\n\t\t\t\t\t\t\t\t\t\t Course of sciatic nerve in thigh, general view\n\t\t\t\t\t\t\t\t\t\tThe hamstring muscles (biceps, semitendinosus and semimembranosus) have been pulled aside to reveal the sciatic nerve in situ.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior femoral cutaneous nerve (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial septum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle (covered by iliotibial tract)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal fossa  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Common peroneal nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Semitendinosus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle (heads of origin separated)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_161", "text": "Dissection of posterior aspect of left thigh\n\t\t\t\t\t\t\t\t\t\t Popliteal fossa, close-up view\n\t\t\t\t\t\t\t\t\t\tThe lower part of the dissection illustrated in view 182-6 is shown in this photograph. Adipose tissue has been removed from the popliteal fossa. The hamstring muscles (3, 8, 9) have been separated from each other to expose the sciatic nerve passing into the fossa from above. Reference should be made to view 182-5 for the superficial dissection of this area and to views 183-5 and 190-2 for deeper dissections.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior femoral cutaneous nerve (nerve extends downward to skin at lower margin of dissection but has been partially omitted from drawing for clarity)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Common peroneal nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Gastrocnemius muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Crural fascia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Semitendinosus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal fossa  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal lymph node  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser saphenous vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Saphenous nerve"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_162", "text": "Dissection of posterior aspect of left thigh\n\t\t\t\t\t\t\t\t\t\t Posterior muscles of upper part of thigh, close-up view\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the preceding photograph is illustrated here in a close-up view of the upper thigh.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of greater trochanter  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cluneal nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior femoral cutaneous nerve (note cutaneous branches passing medially that penetrated fascia lata to reach skin)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial layer between long and short heads of biceps femoris (not lateral intermuscular septum)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle (upper pointer, long head; lower pointer, short head)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiorectal fossa  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Urogenital diaphragm  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal branch of posterior femoral cutaneous nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Semitendinosus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_163", "text": "Dissection of posterior aspect of left thigh\n\t\t\t\t\t\t\t\t\t\t Posterior muscles of thigh\n\t\t\t\t\t\t\t\t\t\tThe fascia lata has been removed and the underlying muscles have been cleaned of connective tissue and slightly separated from each other.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior femoral cutaneous nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Long head of biceps femoris muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Short head of biceps femoris muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Common peroneal nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser saphenous.vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal branch of posterior femoral cutaneous nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Semitendinosus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t muscle gastrocnemius"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_164", "text": "Dissection of posterior aspect of left thigh\n\t\t\t\t\t\t\t\t\t\t Superficial vessels and nerves of popliteal region\n\t\t\t\t\t\t\t\t\t\tThis close-up view of the lower area of dissection shown in 182-3 illustrates details of the superficial structures of the popliteal region.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of posterior femoral cutaneous nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle (tendon visible through fascia lata)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal fossa (covered by fascia)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia lata  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory saphenous vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Semitendinosus muscle (tendon visible through fascia)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_165", "text": "Dissection of posterior aspect of left thigh\n\t\t\t\t\t\t\t\t\t\t Superficial vessels and nerves of mid-thigh, posterior view\n\t\t\t\t\t\t\t\t\t\tThis photograph is a close-up view of the specimen which was shown in the previous view. Details of the branching of the posterior femoral cutaneous nerve and of the distribution of branches of other nerves that reach the posterior aspect of the thigh are visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle (covered by fascia lata)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of lateral femoral cutaneous nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior femoral cutaneous nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract (overlying vastus lateralis muscle)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of perforating artery accompanied by perforating vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle (covered by fascia lata)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of obturator nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory saphenous vein"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_166", "text": "Dissection of posterior aspect of left thigh\n\t\t\t\t\t\t\t\t\t\t Superficial vessels; fascia lata; posterior femoral cutaneous nerve\n\t\t\t\t\t\t\t\t\t\tThe tela subcutanea has been dissected to expose the cutaneous blood vessels and nerves of the posterior aspect of the thigh. For other views of the superficial structures of the hip and thigh reference should be made to views 179-5, 182-4, and 182-5.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle (covered by fascia)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cluneal nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Fascia lata Lower pointer: Posterior femoral cutaneous nerve (exposed by opening fascia lata)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle (tendon visible through fascia)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal fossa  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory saphenous vein  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater saphenous vein"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_167", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Interior of left hip joint, lateral view\n\t\t\t\t\t\t\t\t\t\tThe articular capsule has been widely opened. The femur has been partially dislocated from the acetabulum and adducted so that the shaft of the bone lies against the pubic symphysis.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ilium  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Line of reflection of synovial membrane at margin of joint cavity  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabular margin  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Synovial membrane covering fat pad within acetabular fossa  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligament of femoral head (pointer near attachment of ligament to fovea of head of femur)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle (tendon of origin)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliofemoral ligament (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabular lunate surface  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular capsule (cut through)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of femur  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of femur (in background)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular branch of sciatic nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular capsule (ischiofemoral ligament)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ischium  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial ramus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (tendon near insertion on greater trochanter)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of femur (covered by synovial membrane)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular capsule (reflected to display zona orbicularis)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_168", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Interior of left hip joint, viewed from below\n\t\t\t\t\t\t\t\t\t\tA large window has been cut through the inferior part of the hip joint capsule. The transverse acetabular ligament has been partially cut away to expose the ligament of the head of the femur.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopectineal bursa  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopectineal arch  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopectineal arch  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Articular space Lower pointer: Acetabular margin  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve (emerging through obturator canal)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabular branch of obturator artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabular notch  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligament of femoral head  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse acetabular ligament (divided to expose ligament of femoral head)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle (origin)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular capsule (pointer on iliofemoral ligament)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Zona orbicularis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular capsule (retracted pointer on zona orbicularis)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of femur (covered by synovial membrane)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiofemoral ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of femur  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Fovea of head of femur  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ischium"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_169", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Capsule and ligament of left hip joint, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve (reflected)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (tendon of insertion)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle (tendon of insertion)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle (tendon of insertion)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadrate tubercle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertrochanteric crest  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochanter tertius  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Subtendinous bursa of obturator internus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle (tendon, cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular branch of sciatic nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiofemoral ligament  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Flip articular capsule  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of femur  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser trochanter  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of femur"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_170", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Capsule and ligaments of left hip joint, viewed from below\n\t\t\t\t\t\t\t\t\t\tThe femur has been abducted approximately 30\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Femoral sheath Right pointer: Femoral artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inguinal ligament  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Spermatic cord  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubis  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator canal (note obturator nerve and artery emerging)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabular branch of obturator artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator membrane  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Urogenital diaphragm  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle (straight head)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopectineal bursa  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliofemoral ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Hip articular capsule (part of capsule not well reinforced by ligaments)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser trochanter  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of insertion of obturator externus muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubofemoral ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiofemoral ligament  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Acetabular notch Right pointer: Transverse acetabular ligament  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial ramus"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_171", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Capsule and ligaments of left hip joint, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Femoral artery Right pointer: Femoral nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of external oblique muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Superficial inguinal ring Right pointer: Inguinal ligament  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Spermatic cord  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator membrane (Obturator internus muscle visible through membrane)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus (pointer indicates area of origin of pectineus muscle)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial ramus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubofemoral ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopectineal bursa  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of origin of rectus femoris muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Hip articular capsule (pointer on iliofemoral ligament)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertrochanteric line  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser trochanter  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of femur"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_172", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Piriformis and obturator muscles, posterior view of right side\n\t\t\t\t\t\t\t\t\t\tThis dissection has been photographed to illustrate the relations of the piriformis and the obturator internus and externus muscles to the capsule of the hip joint and to the bony pelvis and femur.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Median sacral crest  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral horn  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeal horn  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial posterior sacrococcygeal ligament  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinous ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to obturator internus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus femoris muscle (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Hip articular capsule  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle (tendon of insertion)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser trochanter  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Infrapiriform foramen  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ilium  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle of iliac crest  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Tendon of obturator internus muscle Lower pointer: Inferior gemellus muscle (note absence of a superior gemellus muscle)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of insertion of obturator externus muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadrate tubercle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of femur  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochanter tertius"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_173", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Intrapelvic portions of obturator internus and piriformis muscles, medial view\n\t\t\t\t\t\t\t\t\t\tThe pelvic contents have been removed and the sacral plexus on the right side has been cut away to expose the piriformis muscle. The nerves to the piriformis (19), derived from the first and second sacral nerves, have been preserved. The obturator internus (10) has also been dissected with its nerve supply. The insertions of both muscles are visible in the dissections illustrated in views 180-4 and 181-4.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral artery (branch of Iliolumbar artery)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar branch of iliolumbar artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior gluteal artery Lower pointer: Body of ilium  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar artery (iliac branch)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Obturator artery (entering obturator canal) Lower pointer: Pubic branch of obturator artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischium  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t S1 nerve (emerging from posterior sacral foramen)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus communicans  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve II  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral bone (body cut through to expose sacral canal)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral bone  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to piriform muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic foramen (piriform muscle passing through)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx bone  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to Obturator internus muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_174", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Quadratus femoris and obturator externus muscles, viewed from below\n\t\t\t\t\t\t\t\t\t\tThe specimen has been turned so that the obturator externus (17) and the insertion of the iliopsoas (19) are visible in relation to the quadratus femoris (5).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gemellus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus femoris muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadrate tubercle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser trochanter  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule of vagina  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of clitoris  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of adductor muscles  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery (in background)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle (near insertion on lesser trochanter)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep femoral artery"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_175", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Obturator internus and quadratus femoris muscles, posterior view\n\t\t\t\t\t\t\t\t\t\tThe piriformis and the gluteal muscles have been cut away. The sciatic nerve has been cut off close to the greater sciatic foramen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of gluteus medius muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ischium  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus femoris muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Gemelli muscles  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch of S. II  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal foramen S. III  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx bone  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_176", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Relation of gluteus minimus to capsule of hip joint; nerve to hip joint\n\t\t\t\t\t\t\t\t\t\tThe gluteus minimus has been reflected downward to reveal the capsule of the hip joint. A branch of the superior gluteal nerve to the capsule is stretched around the retracted muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of Gluteus maximus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of Gluteus medius muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of Anterior gluteal line  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of Gluteus minimus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabular margin (visible through capsule of hip joint)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Reflected head of origin of Rectus femoris muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Branch of Superior gluteal nerve to hip joint capsule Lower pointer: Hip articular capsule  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus minimus muscle (reflected)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract (covering tensor fasciae latae muscle)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior inferior iliac spine  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of Greater sciatic foramen  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (divided)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Obturator internus muscle Lower pointer: Sciatic nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle (origin of long head)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus femoris muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to tensor fasciae latae muscle (cut off)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_177", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Nerve to quadratus femoris muscle\n\t\t\t\t\t\t\t\t\t\tBranches of the sacral plexus have been elevated in order to demonstrate the nerve to the quadratus femoris (4) in its course across the posterior surface of the ischium deep to the gemelli and obturator internus muscles.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral plexus (elevated)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal pelvic fascia  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to Quadratus femoris muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ischium  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus minimus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve (elevated)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut off close to insertion)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of quadrate tubercle of femur  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus femoris muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinous ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to obturator internus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament (cut and reflected medially)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Pudendal nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pudendal canal Lower pointer: Lunate fascia (reflected to open pudendal canal)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiorectal fossa (anterior recess)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep transverse perineal muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery supplying sciatic nerve"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_178", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Contents of greater sciatic foramen\n\t\t\t\t\t\t\t\t\t\tThe tendon of the piriformis (9) has been divided near its insertion to allow the muscle (1) to be reflected upward. The sacrotuberous ligament (24) has also been divided and its upper part reflected medially. The sacral plexus is partially exposed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral plexus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery and vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Inferior gluteal nerve Left pointer: Posterior femoral cutaneous nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus minimus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ischium (covered by periosteum)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (tendon of insertion, cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter (covered by tendon of Gluteus medius muscle)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle (tendon of insertion)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Obturator externus muscle Lower pointer: Medial femoral circumflex artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cluneal nerve (medial)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal vein (cut off)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph node  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating cutaneous nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to obturator internus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sacrospinal ligament Lower pointer: Pudendal nerve (slightly elevated)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery and vein  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament (divided and retracted)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep transverse perineal muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Gemelli muscles  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery supplying sciatic nerve  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus femoris muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_179", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Nerve supply to gluteus minimus\n\t\t\t\t\t\t\t\t\t\tThe gluteus maximus (9) and gluteus medius (7) muscles have been cut off close to their insertions.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of Gluteus maximus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of Gluteus medius muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal nerve (to gluteus minimus and tensor fasciae latae)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus minimus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor fasciae latae muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle (insertion)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle (cut off near insertion)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (emerging through Greater sciatic foramen)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Gemelli muscles  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus femoris muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_180", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Gluteus minimus muscle; superior gluteal vessels and nerve\n\t\t\t\t\t\t\t\t\t\tDetachment of the gluteus medius from its origin above the anterior gluteal line (7) has permitted it to be reflected downward. Connective tissue has been removed from the underlying muscle, vessels and nerves.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus minimus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle of iliac crest  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to tensor fasciae latae muscle (nerve passes through gluteus minimus)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis (fascia lata) enclosing tensor fasciae latae muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochanteric bursa of gluteus maximus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of Gluteus medius muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of anterior gluteal line  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of posterior gluteal line  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of iliac origin of gluteus maximus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior sacroiliac ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of superior gluteal artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of superior gluteal artery (upper pointer, inferior branch; lower pointer, superior branch)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle (reflected downward)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_181", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Gluteus medius and piriformis muscles; sciatic nerve, left posterolateral view\n\t\t\t\t\t\t\t\t\t\tThe aponeurosis covering the anterior part of the gluteus medius has been reflected anteriorly. The gluteus maximus has been cut off close to its origins to demonstrate the underlying bony landmarks and ligaments in relation to the remaining muscles.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis overlying gluteus medius (reflected)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Obturator internus muscle (tendon) Lower pointer: Quadratus femoris muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle (reflected)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochanteric bursa of gluteus maximus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of Gluteus maximus muscle on ilium  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Median sacral crest  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacroiliac ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of superior gluteal artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cluneal nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior gluteal artery Lower pointer: Inferior gluteal nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_182", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Close-up view of nerves and blood vessels of gluteus maximus muscle\n\t\t\t\t\t\t\t\t\t\tThe fascia deep to the gluteus maximus has been dissected to expose the inferior gluteal nerve (7) and the branches of the superior and inferior gluteal vessels (2, 8) that supply the muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery and vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sciatic nerve Lower pointer: Artery supplying sciatic nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle (divided and reflected)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gemellus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior femoral cutaneous nerve"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_183", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Deep relations of gluteus maximus, left posterolateral view\n\t\t\t\t\t\t\t\t\t\tThe gluteus maximus has been divided transversely across its midportion and the ends of the muscle have been reflected medially and laterally. The medial part of the lamina of fascia lata underlying the muscle has been removed. The gluteus medius and piriformis muscles have been exposed together with the sciatic nerve and branches of the gluteal vessels and nerves. The medial area of this dissection is shown in detail in the following view.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery (accompanied by superior gluteal vein)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus lumborum muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius (partially covered by fascia lata)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior gluteal nerve Lower pointer: piriform muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia lata (deep to gluteus maximus)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle (divided and reflected)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of greater trochanter  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cluneal nerve (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior femoral cutaneous nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral spinous process of L. IV  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery supplying sciatic nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal branch of posterior femoral cutaneous nerve"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_184", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Gluteus maximus in relation to lumbosacral spine, posterior view\n\t\t\t\t\t\t\t\t\t\tThe erector spinae muscle of the left side has been removed to reveal the lower lumbar vertebrae, the sacrum and the posterior part of the ilium, together with ligaments associated with these bones. The gluteal muscles have been retained.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cluneal nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter (covered by aponeurosis of gluteus maximus)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cluneal nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral spinous process of L. V  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine (covered by fibrous tissue)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cluneal nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral horn  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx bone  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Adipose body of ischiorectal fossa"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_185", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Superficial vessels and nerves of gluteal region\n\t\t\t\t\t\t\t\t\t\tThe tela subcutanea has been dissected to expose the numerous small arteries and veins that perforate the fascia lata to ramify superficially over the buttock. The superior (1) and inferior (4) clunial nerves have been dissected. The more laterally placed inferior clunial nerves (4, lower pointer) are derived from the posterior femoral cutaneous nerve, whereas those emerging more medially arise from the perforating cutaneous nerve (S2, S3). Middle clunial nerves are not clearly shown in this preparation but are demonstrated in the following view.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cluneal nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle (covered with fascia lata)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cluneal nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Erector spinae muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater (exposed within sacral canal)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anococcygeal nerve, Lower pointer: Coccyx bone (terminal part)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiorectal fossa"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_186", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t Insertion of gluteus maximus and tensor fasciae latae into iliotibial tract, right lateral view\n\t\t\t\t\t\t\t\t\t\tIn this dissection the fascia covering the gluteus maximus and that over the tensor fasciae latae has been cut away to illustrate the manner in which these two muscles converge toward their insertions into the iliotibial tract (4) of the fascia lata. Fascia lata has been removed elsewhere from the thigh.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle (covered by fascia lata)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia lata  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sartorius muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor fasciae latae muscle (exposed by removing fascia lata)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_187", "text": "Exploration of gluteal region and hip\n\t\t\t\t\t\t\t\t\t\t General view of gluteal muscles\n\t\t\t\t\t\t\t\t\t\tThe fascia covering the gluteus maximus muscles has been resected, together with the superficial vessels and nerves of the buttocks. The adipose tissue within the left ischiorectal fossa has been dissected away. The posterior part of the fascia lata has been cut away.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (overlying erector spinae muscle)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar triangle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t External oblique muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest (covered by fascia and periosteum)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral bone (covered by connective tissue)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Coccyx bone Lower pointer: Ischiorectal fossa  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Adipose body of ischiorectal fossa Lower pointer: Anus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vastus lateralis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliotibial tract  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Semitendinosus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps femoris muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_188", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Angiogram, right lower limb of newborn infant\n\t\t\t\t\t\t\t\t\t\tThe arteries have been filled with thoratrast.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Femur (diaphysis)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral superior genicular artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Femur (epiphysis)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial genicular artery (branch of lateral superior genicular artery)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral inferior genicular artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia (epiphysis)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial recurrent artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia (diaphysis)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tibial artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lateral malleolar artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral tarsal artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsalis pedis artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep plantar branch of dorsalis pedis artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metatarsal artery (two other dorsal metatarsal arteries lie laterally)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Proximal phalanx  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sural artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Peroneal artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior tibial artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Talus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus calcaneus branch of the posterior tibial artery  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial plantar artery  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral plantar artery  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcus plantaris  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Plantar metatarsal artery (additional plantar metatarsal arteries parallel the labeled vessel)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_189", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Left foot, oblique dorsoplantar view\n\t\t\t\t\t\t\t\t\t\tThe direction of view is such that the transverse tarsal joint and the bones and joints distal to it are visualized with a minimum of overlapping shadows. This film was obtained through the courtesy of Dr. Grant Melvin Stevens.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t 5th metatarsal bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cuneiform bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Tarsometatarsal articulation  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Cuboid bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse tarsal articulation  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of calcaneus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Interphalangeal articulation  10\n\t\t\t\t\t\t.\n\t\t\t\t\t 1st metatarsophalangeal articulations  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sesamoid bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cuneiform bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate cuneiform bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Navicular bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Head of talus Lower pointer: Neck of talus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_190", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Right foot, dorsoplantar view\n\t\t\t\t\t\t\t\t\t\tThis film was obtained through the courtesy of Dr. Melvin J. Figley.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Proximal phalanx  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysial line  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sesamoid bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t metatarsal bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysial line  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tarsometatarsal articulation I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cuneiform bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertarsal articulations  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Cuneonavicular articulation  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Navicular bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of talus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Interphalangeal articulations  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysial line (note distal location of epiphysial lines in four lateral metatarsals)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cuneiform bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Cuboid bone  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse tarsal articulation  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_191", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Left foot, lateromedial view\n\t\t\t\t\t\t\t\t\t\tThis film was obtained through the courtesy of Dr. Grant Melvin Stevens.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Talocrural articulation  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of talus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of talus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse tarsal articulation (indicated by two arrows)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Navicular bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cuneiform bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Subtalar articulation  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of calcaneus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Tarsal sinus Lower pointer: Talocalcaneonavicular joint  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Cuboid bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t 5th metatarsal bone"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_192", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Mortise of left ankle joint, posteroanterior view\n\t\t\t\t\t\t\t\t\t\tThe foot has been positioned so that the talus is seen in profile within the talocrural joint. The tarsal bones and intertarsal joints are more clearly visible in the following radiographs. This film was obtained through the courtesy of Dr. Melvin J. Figley.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibular notch  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior trochlear surface of talus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of calcaneus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral tubercle process of calcaneus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cuboid bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysial line  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Talocrural articular space  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of talus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Navicular bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate cuneiform bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cuneiform bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cuneiform bone"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_193", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Left knee, posteroanterior view illustrating intercondylar fossa\n\t\t\t\t\t\t\t\t\t\tThe knee is slightly flexed so that the femur inclines posteriorly. This film was obtained through the courtesy of Dr. Melvin Grant Stevens.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of femur  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Patella (in background)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle of femur  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral border of intercondylar fossa  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of femur  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Knee articular space  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of tibia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle of femur  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercondylar eminence (upper pointer, lateral intercondylar tubercle; lower pointer, medial intercondylar tubercle)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of femur  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of tibia  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysial line  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of tibia"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_194", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Right knee, mediolateral view\n\t\t\t\t\t\t\t\t\t\tThis film was obtained through the courtesy of Dr. Grant Melvin Stevens.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of femur  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Patella  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of tibia  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial tuberosity  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal surface  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercondylar fossa  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle femoris (in background)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle femoris (in foreground)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysial line  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibiofibular articular space  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of fibula"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_195", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Right knee of 16-year-old male, anteroposterior view\n\t\t\t\t\t\t\t\t\t\tThis film was obtained through the courtesy of Dr. Grant Melvin Stevens.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of femur  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Patella  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysial line  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of femur  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular space  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of tibia  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysial line  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of fibula  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercondylar eminence (left pointer, lateral intercondylar tubercle; right pointer, medial intercondylar tubercle)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of femur  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of tibia  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysial line  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of tibia"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_196", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Right hip, anteroposterior view\n\t\t\t\t\t\t\t\t\t\tThis film of the right hip joint of a young man was obtained through the courtesy of Dr. Melvin J. Figley.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ilium  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior margin of acetabulum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of femur  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochanteric fossa  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser trochanter  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of femur  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulurn  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior margin of acetabulum (not as clearly defined as posterior margin)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Fovea of head of femur  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator foramen  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_197", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated bones of left foot, medial aspect\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of calcaneus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sustentaculum tali  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of navicular bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of cuboid bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove or peroneus longus tendon  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of 5th metatarsal bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t 5th metatarsal bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlea of talus (pointer indicates Superior surface)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Surface of medial malleolus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of talus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of talus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Navicular bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cuneiform bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Proximal phalanx"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_198", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated bones of left foot, inferior aspect\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of distal phalanx  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Distal phalanx  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Proximal phalanx  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sesamoid bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Metatarsal bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cuneiform bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate cuneiform bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cuneiform bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Navicular bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of navicular bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of talus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sustentaculum tali  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for flexor hallucis longus tendon  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial tubercle of posterior process of talus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cuboid bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of 5th metatarsal bone  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for peroneus longus tendon  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of cuboid bone  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial process of tuberosity of calcaneus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral tubercle process of calcaneus bone  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of calcaneus"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_199", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated bones of left foot, lateral aspect\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlea of talus (pointer on lateral malleolar surface)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of talus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Navicular bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cuneiform bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate cuneiform bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral process of talus bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior process of talus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of calcaneus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tarsal sinus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of cuboid bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for peroneus longus tendon  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Cuboid bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of 5th metatarsal bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of 5th metatarsal bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of 5th metatarsal bone  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of 5th metatarsal bone  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Proximal 5th phalanx"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_200", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated bones of left foot, superior aspect\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle 2nd phalanx  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of 5th phalanx  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of 5th phalanx  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of 5th phalanx  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of 5th metatarsal bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of 5th metatarsal bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of 5th metatarsal bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of 5th metatarsal bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Cuboid bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tarsal sinus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral process of talus bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral tubercle process of calcaneus bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Calcaneus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Distal 1st phalanx  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Proximal 1st phalanx  16\n\t\t\t\t\t\t.\n\t\t\t\t\t 1st metatarsal bone  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cuneiform bone  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate cuneiform bone  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cuneiform bone  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Navicular bone  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of navicular bone  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of talus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of talus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Surface of medial malleolar trochlea of talus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlea of talus (pointer on facies superior)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior process of talus (pointer on lateral tubercle)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_201", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right tibia and fibula, posterior view of lower parts\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of tibia (Posterior surface)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Malleolar groove (groove for tibialis posterior)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular surface  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Malleolar articular surface  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior surface of fibula  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior border of fibula  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral surface of fibula  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibular notch  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Fossa of lateral malleolus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_202", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right tibia and fibula, anterior views of lower parts\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous border of fibula  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior surface  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior border of fibula  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral surface  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcutaneous surface  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Malleolar articular surface  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of tibia  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Malleolar articular surface  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface inferior"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_203", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right tibia and fibula, proximal ends viewed from above\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of tibia  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial tuberosity  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior intercondylar area  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle (pointer on superior articular surface)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial intercondylar tubercle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercondylar eminence  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercondylar area  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral intercondylar tubercle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Area occupied in life by infrapatellar bursa  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle (pointer on superior articular surface)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of fibula"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_204", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right tibia and fibula, posterior view of upper parts\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral intercondylar tubercle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercondylar eminence  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial intercondylar tubercle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercondylar area  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle of tibia (pointer indicates superior articular surface)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysial line  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleal line  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior surface  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Nutrient foramen  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle of tibia (pointer on superior articular surface)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of fibula  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of fibula  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of head of fibula  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of fibula  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior surface"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_205", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right tibia and fibula, anterior view of upper parts\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercondylar eminence  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of head of fibula  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of fibula  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral surface  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous border  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior surface  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior border  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial tuberosity  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral surface  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial surface  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior border"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_206", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right patella, posterior part\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of patella  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface (medial surface)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of patella (area of attachment of ligamentum patellae)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface (lateral surface)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral margin"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_207", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right patella, anterior aspect\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of patella  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior surface  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral margin  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of patella"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_208", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right femur, posterior view of distal part\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial supracondylar line (continuous superiorly with medial lip of linea aspera)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercondylar line  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor tubercle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral supracondylar line (continuous superiorly with lateral lip of linea aspera)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal surface  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercondylar fossa (note nutrient foramen)"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_209", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Radiograph of proximal end of right femur, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of femur  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of femur  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertrochanteric crest (in background)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of femur  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Fovea of head of femur  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysial line  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser trochanter  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Compact substance  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medullary cavity"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_210", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right femur, posterior view of proximal part\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fovea of head of femur  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of femur  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysial line  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of femur  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser trochanter  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineal line  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochanteric fossa  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadrate tubercle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertrochanteric crest  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteal tuberosity"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_211", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right femur, anterior view of proximal part\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of femur  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysial line  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of femur  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical tubercle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertrochanteric line  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of femur  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fovea of head of femur  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser trochanter"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_212", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right femur, tibia and fibula, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t -\n\t\t\t\t\t\t.\n\t\t\t\t\t Femur  1\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of femur  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of femur  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertrochanteric crest  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser trochanter  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineal line  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteal tuberosity  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial lip of linea aspera  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral lip of linea aspera  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Popliteal surface  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor tubercle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercondylar fossa  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle  -\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercondylar eminence  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Soleal line  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Nutrient foramen  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior surface  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus  -\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of fibula  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior surface  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial crest  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior border  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_213", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right femur, tibia and fibula, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t -\n\t\t\t\t\t\t.\n\t\t\t\t\t Femur  1\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of femur  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysial line  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of femur  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertrochanteric line  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser trochanter  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of femur  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Patellar surface  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle  -\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibula  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of fibula  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral surface  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior border  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior surface  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous border  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial surface  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral malleolus  -\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibia  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral condyle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial condyle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Tibial tuberosity  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral surface  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior border  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial surface  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial malleolus"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_214", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Radiograph of right coxal bone, lateral view\n\t\t\t\t\t\t\t\t\t\tStrong bony trabeculae are visible passing medially and upward from the acetabulum (15) and from the region of the ischial tuberosity (11) toward the auricular surface of the ilium (3) which articulates with the sacrum.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac fossa  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricular surface for sacrum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory articular surface for sacrum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior inferior iliac spine  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic notch  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabular margin  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic notch  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial ramus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Acetabular lunate surface Lower pointer: Acetabular fossa  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic (pectineal) eminence  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator foramen  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubis  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of union of ischial and pubic rami"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_215", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left coxal bone, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac tuberosity  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Nutrient foramen  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory articular surface  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricular surface  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior inferior iliac spine  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate line  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pecten pubis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic tubercle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic crest  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Symphyseal surface  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac fossa  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal lip of iliac crest  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate line of iliac crest  18\n\t\t\t\t\t\t.\n\t\t\t\t\t External lip of iliac crest  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ilium  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic (pectineal) eminence  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ischium (pointer on acetabulum)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator foramen  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial ramus"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_216", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left coxal bone, medial view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac tuberosity  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory surface of sacroiliac articulation  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricular surface  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic notch  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ischium  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic notch  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial ramus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac fossa  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ilium  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic (pectineal) eminence  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubis  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Symphyseal surface  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator foramen"}
{"_id": "stanford_medicine_lower_extremity_clean$$$corpus_217", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left coxal bone, lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle of iliac crest  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal lip of iliac crest  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate line of iliac crest  4\n\t\t\t\t\t\t.\n\t\t\t\t\t External lip of iliac crest  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ilium (pointer on inferior gluteal line)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum (pointer on margin)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic (pectineal) eminence  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pecten pubis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic tubercle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubis  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator groove  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator foramen  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabular notch  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac fossa  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior gluteal line  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior gluteal line  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior inferior iliac spine  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic notch  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabular fossa  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic notch  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabular lunate surface  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial ramus"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_1", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Coccyx, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeal cornu (horn)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Proximal piece (pointer on transverse process)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle piece  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Terminal piece"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_2", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Coccyx, anterior view\n\t\t\t\t\t\t\t\t\t\tThis specimen consists of three segments, the terminal one of which comprises two small terminal pieces fused together.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeal cornu (horn)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for sacrum"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_3", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Sacrum, viewed from above\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral crest  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Median sacral crest  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral canal  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramen  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_4", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Sacrum, left lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of sacrum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic surface  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Median sacral crest  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral tuberosity (note accessory articular facet on posterior part of tuberosity)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral crest"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_5", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Sacrum, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Base  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior sacral foramen (pelvic sacral foramen in background)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate sacral crest  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral cornu (horn)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral canal  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral tuberosity  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory articular facet (of sacroiliac joint)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Median sacral crest  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral crest  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral hiatus"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_6", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Radiograph of sacrum, anteroposterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of sacrum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse line (remnant of intervertebral disc S. I-II; note similar transverse lines at lower levels of sacrum)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral hiatus (pointers indicate margins)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of sacrum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramen (pointers indicate upper and lower walls of foramen)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface (note dense bone underlying the articular surface for the ilium as well as heavy bony trabeculae passing medially and upward toward base)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral crest (in background)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic sacral foramen (dorsal sacral foramen visible in background)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_7", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Sacrum, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of sacrum (pointer on Promontory)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic sacral foramen  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse line (note lack of fusion between first and second sacral bodies in this young specimen)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of sacrum"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_8", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated male pelvis, posteroinferior view\n\t\t\t\t\t\t\t\t\t\tThe configuration of the male pelvic outlet is shown in this view and should be compared with that of the female pelvis in 154-1.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior inferior iliac spine  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Wing (ala) of ilium (gluteal surface)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Body pubic bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of pubis symphysis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process of sacrum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate sacral crest  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral crest  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral hiatus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral promontory  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (upper pointer indicates coccygeal horn)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Great sciatic notch  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic notch"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_9", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated male pelvis, anterosuperior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part sacrum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ilium  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal lip of iliac crest  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intermediate line of iliac crest Lower pointer: External lip of iliac crest  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic eminence  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic tubercle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process sacrum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Median sacral crest  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral canal  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of sacrum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Linea arcuata (part of terminal line which marks superior pelvic aperture)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Body pubic bone"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_10", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated male pelvis, anteroinferior view\n\t\t\t\t\t\t\t\t\t\tThe specimen is viewed from in front and slightly below in order that details of the obturator foramina may be seen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Wing (ala) of ilium (pointer indicates iliac fossa)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate line of ilium  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic eminence  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pecten pubic bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior ramus pubic bone Lower pointer: Pubic tubercle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body pubic bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior ramus pubic bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part sacrum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic sacral foramen  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse line  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of sacrum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacroiliac joint  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Body ilium  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Body ischium  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator foramen  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_11", "text": "Dissection of muscles of male perineum and pelvic diaphragm\n\t\t\t\t\t\t\t\t\t\t Pelvic diaphragm viewed from above\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the previous view has been turned so that the pelvic diaphragm is seen from above and in front. The obturator fascia (14) has been preserved above the diaphragm on both sides and the superior fascia of the pelvic diaphragm (24) has been retained on the left side.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. IV (pointer also indicates anterior longitudinal ligament)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process vertebra L. IV  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral sacroiliac ligament (lower pointer also indicates position of sacroiliac joint)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala of ilium  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliococcygeus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubococcygeus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Puborectalis muscle (9-11 make up the levator ani muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous arch of levator ani muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of coccyx  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator fascia (obturator internus muscle visible through fascia)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum (cut across at perineal flexure)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostate  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Puboprostatic muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethra  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part of sacrum  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Nutritive foramen  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut off)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intervertebral disc L. V - S. I Lower pointer: Coccyx  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic foramen  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior fascia of pelvic diaphragm (Levator ani muscle visible beneath fascia)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Linea terminalis Lower pointer: Line of attachment of fascia of psoas major muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Obturator fascia Lower pointer: Obturator canal  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Inguinal ligament  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineal ligament  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacunar ligament  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_12", "text": "Dissection of muscles of male perineum and pelvis diaphragm\n\t\t\t\t\t\t\t\t\t\t Levator ani muscle viewed from below\n\t\t\t\t\t\t\t\t\t\tThe urogenital diaphragm has been entirely removed and the inferior fascia of the pelvic diaphragm has been cut away. Part of the obturator fascia (4) remains on the left side of the specimen. A gap in the levator ani muscle on the left side is bridged by fascia.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic arcuate ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Membranous part of urethra Lower pointer: Apex of prostate  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Medial margin of levator ani muscle Lower pointer: Prostatic fascia  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator fascia (partially removed)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Puboprostatic muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator canal  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous arch of levator ani muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Puborectalis muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubococcygeus muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliococcygeus muscle (17-19 are part of the levator ani muscle)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine (in background)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_13", "text": "Dissection of muscles of male perineum and pelvic diaphragm\n\t\t\t\t\t\t\t\t\t\t Superior fascia of urogenital diaphragm\n\t\t\t\t\t\t\t\t\t\tThe muscular tissue within the urogenital diaphragm has been removed to bring the thin superior fascia of the diaphragm into view. This fascia is intact on the right side of the dissection and has been cut through on the left where it is seen to be closely related to the inferior fascia of the pelvic diaphragm. It is also continuous with obturator fascia laterally on each side. The medial borders of the levator ani muscles are visible lateral to the prostate gland. Some of the fibers of these muscles converge posteriorly toward the central tendon of the perineum and the wall of the anal canal, whereas other fibers appear to spread out superficially at the sides of the anus. Although fibers of the small rectourethral muscle are not distinctly shown, these pass from the anterior wall of the rectum toward the urethra and are cut across in the central part of the dissection between anus and prostate (17).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Prostate Right pointer: Membranous part of urethra  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostatic fascia  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior fascia of urogenital diaphragm (continuous medially as a thin, semitransparent layer across puborectalis part of levator ani muscle)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Puborectalis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator fascia  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal vein of the penis (cut off)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse perineal ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut margin of superior fascia of urogenital diaphragm (fascia removed medially)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior fascia of pelvic diaphragm (pointer indicates area of fusion with superior fascia of urogenital diaphragm)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator fascia  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Area occupied by fibers of rectourethralis muscle (not clearly defined)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_14", "text": "Dissection of muscles of male perineum and pelvic diaphragm\n\t\t\t\t\t\t\t\t\t\t Muscles of urogenital diaphragm\n\t\t\t\t\t\t\t\t\t\tThe inferior fascia of the urogenital diaphragm has been removed to reveal the sphincter of the urethra within the deep perineal space. There was no evident deep transverse perineal muscle on either side of this specimen. The bulbourethral gland has been excised. Muscle fibers (4, lower pointer) that are directed posteriorly toward the central point of the perineum were found to be continuous with fibers of the superficial transverse perineal muscle on the left.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Penis (sectioned)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal vein of the penis  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Dorsal nerve of the penis Lower pointer: Dorsal artery of penis  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sphincter muscle of urethra Lower pointer: Muscle fibers within urogenital diaphragm that pass medially towards central tendinous point of perineum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Penis artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior fascia of urogenital diaphragm  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator fascia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibers of levator ani muscle passing to tissue alongside anus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic arcuate ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse perineal ligament  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Membranous part of urethra (cut off at lower surface of urogenital diaphragm)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator membrane  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior border of obturator foramen  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_15", "text": "Dissection of muscles of male perineum and pelvic diaphragm\n\t\t\t\t\t\t\t\t\t\t Inferior fascia of urogenital diaphragm (perineal membrane)\n\t\t\t\t\t\t\t\t\t\tThe penis has been transected opposite the pubic symphysis. The inferior fascia of the urogenital diaphragm has been preserved and the dorsal nerves, arteries, and vein of the penis are visible in relation to the anterior border of the diaphragm.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of penis (covered by penile fascia)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus spongiosum of penis (pointer indicates cut end of urethra)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpora cavernosa penis (joined by septum penis)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic arcuate ligament  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Dorsal nerve of the penis Lower pointer: Dorsal artery of penis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligament of the penis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal vein of the penis  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse perineal ligament  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethra (cut off at junction of membranous and spongy parts)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Sphincter muscle of urethra (visible through thin part of perineal membrane) Right pointer: Inferior fascia of urogenital diaphragm  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior border of urogenital diaphragm  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibers of levator ani that insert in tissue alongside anus"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_16", "text": "Dissection of muscles of male perineum and pelvic diaphragm\n\t\t\t\t\t\t\t\t\t\t Root of penis; inferior fascia of urogenital diaphragm\n\t\t\t\t\t\t\t\t\t\tThe muscles of the superficial perineal space have been cut away to expose the crura (4) and bulb (5) of the penis in relation to the inferior fascia of the urogenital diaphragm.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of penis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus spongiosum of penis  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of penis (small, not clearly outlined)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulb of penis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Muscle fibers emerging from deep compartment of perineum to join superficial transverse perineal muscle Right pointer: Central tendon of perineum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibers of puborectalis muscle (Levator ani muscle) that terminated in connective tissue of ischiorectal fossa  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: External anal sphincter muscle Right pointer: Anus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator membrane  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of coccyx  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior fascia of urogenital diaphragm  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_17", "text": "Dissection of muscles of male perineum and pelvic diaphragm\n\t\t\t\t\t\t\t\t\t\t Muscles of superficial space of perineum\n\t\t\t\t\t\t\t\t\t\tIn this dissection of a young male subject the blood vessels and nerves have been sacrificed in order to demonstrate the arrangement of muscles related to the pelvic outlet. The muscles that lie within the superficial perineal space have been exposed. The ischiorectal fossae have been dissected to demonstrate muscles of the pelvic diaphragm. Several muscles on the left side of this specimen are considerably larger than the corresponding muscles on the right. These are the bulbospongiosus (1), superficial transverse perineal muscle (15) and subcutaneous part of the sphincter ani externus muscle (18). Also it should be noted that the puborectalis muscle (6) on each side extends into the subcutaneous connective tissue of the ischiorectal fossa alongside the anus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Crus of penis Lower pointer: Ischiocavernosus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior fascia of urogenital diaphragm  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibers of puborectalis muscle that extend into subcutaneous connective tissue of ischiorectal fossa  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator fascia  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator canal  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator membrane  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of coccyx  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior fascia of urogenital diaphragm Lower pointer: Superficial transverse perineal muscle (note asymmetry on two sides)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  18\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle (subcutaneous part) Note asymmetry ot this muscle on the two sides  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_18", "text": "Dissection of anal triangle and ischiorectal fossae\n\t\t\t\t\t\t\t\t\t\t Course of internal pudendal artery and pudendal nerve in pudendal canal; muscles of pelvic diaphragm\n\t\t\t\t\t\t\t\t\t\tThe sacrotuberous ligament has been cut away on the left to expose the course of the internal pudendal artery and the pudendal nerve as these structures pass posterior to the ischial spine (8) to enter the pudendal canal (15). The lunate fascia has been reflected to open the entire length of the pudendal canal which extends anteriorly to the posterior border of the urogenital diaphragm. The latter is obscured by the muscles that occupy the superficial perineal space.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Erector spinae muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sacrotuberous ligament (cut off) Lower pointer: Coccygeus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal pudendal artery (crossing ischial spine) Middle pointer: Dorsal nerve of the penis Lower pointer: Perineal nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior femoral cutaneous nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sciatic nerve Lower pointer: Quadratus femoris muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser trochanter  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament (cut off)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior rectal nerve Lower pointer: Inferior rectal artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Obturator fascia Right pointer: Lunate fascia covering pudendal canal (reflected to open canal)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anus Lower pointer: External anal sphincter muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial dorsal sacrococcygeal ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Coccyx (end piece) Lower pointer: Anococcygeal nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor brevis muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate fascia at posterior border of urogenital diaphragm  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiocavernosus muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Penis"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_19", "text": "Dissection of anal triangle and ischiorectal fossae\n\t\t\t\t\t\t\t\t\t\t Posterior recesses of ischiorectal fossae; sacrotuberous ligaments\n\t\t\t\t\t\t\t\t\t\tBoth gluteus maximus muscles have been cut off close to their origins from the sacrotuberous ligaments, coccyx and sacrum. In the left ischiorectal fossa the inferior fascia of the pelvic diaphragm has been resected. On the right the inferior rectal vessels and nerves have been cut off but the fascia has been left intact. Blending with the inferior fascia of the pelvic diaphragm on the right is the lunate fascia which covers the pudendal canal (21).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (terminal piece)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle (fibers cut off at origin from sacrotuberous ligament)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Infrapiriform foramen (part of greater sciatic foramen through which inferior gluteal vessels and nerves emerge) Lower pointer: Posterior femoral cutaneous nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal nerves  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate fascia (covering pudendal canal and obscuring obturator fascia)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiocavernosus muscle (visible through deep perineal fascia)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scrotal nerve (exposed by removal of membranous layer of superficial perineal fascia to the left of midline)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal branch of inferior rectal nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulb of penis  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cluneal nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior fascia of pelvic diaphragm  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate fascia covering pudendal canal  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anus Lower pointer: External anal sphincter muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior margin of urogenital triangle (membranous layer of superficial perineal fascia intact to right of midline in this area)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_20", "text": "Dissection of anal triangle and ischiorectal fossae\n\t\t\t\t\t\t\t\t\t\t Close-up view of anus and nerves, vessels and fascia of ischiorectal fossae\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the preceding view is seen here in a close-up photograph to illustrate the details of structures within the ischiorectal fossae. Lobules of fat have been cleared from the ischiorectal fossae leaving in place an irregular layer of fascia with crescentic bands that partially subdivide the area. This fascia, which lies external to the inferior fascia of the pelvic diaphragm and medial to the obturator fascia, is known as the lunate fascia (7). Its continuity with the membranous layer of superficial fascia in the urogenital triangle can be readily traced.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum overlying coccyx  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cluneal nerves  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiorectal fossa (pointer indicates inferior fascia of pelvic diaphragm)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal nerves  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate fascia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anus Lower pointer: External anal sphincter muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t posterior perineal branches femoral cutaneous nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia lata  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiorectal fossa (pointer indicates posterior recess deep to sacrotuberous ligament)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of inferior rectal artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous tissue superficial to tuber ischiadicum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of transverse perineal artery (passing parallel to posterior border of urogenital triangle)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of posterior scrotal nerves  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Supeficial perineal fascia (Colles' fascia) covering bulb of penis"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_21", "text": "Dissection of anal triangle and ischiorectal fossae\n\t\t\t\t\t\t\t\t\t\t General view of male perineum and ischiorectal fossae\n\t\t\t\t\t\t\t\t\t\tThe membranous layer of superficial fossae (Colles' fascia) has been preserved in the urogenital triangle. In the anal triangle the ischiorectal fossae (10) have been dissected and the anal sphincter has been exposed. The irregular lunate fascia (12) has been preserved in the fossae and it is apparent that there is a continuity between this layer and Colles' fascia anteriorly. The left thigh has been sectioned slightly below the level of the trochanters of the femur.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cluneal nerves  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (covered by periosteum and ligaments)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle (portion arising from sacrotuberous ligament)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anus Lower pointer: External anal sphincter muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cluneal nerves  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior perineal branches femoral cutaneous nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia lata  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superficial perineal fascia (Colles' fascia) Lower pointer: Scrotum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiorectal fossa (pointer indicates posterior recess of fossa)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Inferior rectal nerves Right pointer: Inferior rectal artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lunate fascia Lower pointer: Posterior border of urogenital triangle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scrotal nerves  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Semimembranosus muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Semitendinosus muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t adductor magnus muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_22", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Close-up view of vessels and nerves anterior to coccyx\n\t\t\t\t\t\t\t\t\t\tThe lower part of the dissection illustrated in the previous view is shown in this photograph. A plexus formed by the right lateral sacral artery (7) and the middle sacral artery (20) lies anterior to the coccyx. At the level of the end piece of the coccyx the glomus coccygeum (24) is visible. The sympathetic trunks converge behind the artery slightly below the glomus. No ganglion impar is present, however.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dural filum terminale (right coccygeal nerve fused to posterior aspect of filum and not visible in view)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral canal (pointer indicates interior surface of superficial dorsal sacrococcygeal ligament covering sacral hiatus)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve V  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Rami communicantes  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve IV  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to Levator ani muscle and coccygeus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of lateral sacral artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sacral nerve V (visible through opening in tendon of coccygeus muscle) Lower pointer: Branch of lateral sacral artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anal canal (remnant cut across close to pelvic diaphragm)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal vertebral venous plexus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve V  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeal nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk (a ganglion lies just above pointer)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve IV  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (body partially removed)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve V  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum on anterior surface of coccyx  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunks  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle (cut off)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion of sympathetic trunk  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Coccygeal glomus Lower pointer: Periosteum covering end piece of coccyx (fibers transversely banded):  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (end piece)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_23", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Lumbosacral part of vertebral canal, opened and viewed from in front\n\t\t\t\t\t\t\t\t\t\tThe vertebral canal has been opened by grinding away parts of the bodies of the fourth and fifth lumbar vertebrae, the sacrum and the coccyx. Areolar connective tissue has been removed from the canal and many of the veins that formed the internal vertebral plexus have also been cut away. A fibrous band (7) extending from the dura to the posterior longitudinal ligament at the upper part of the sacral canal has been cut off. The intervertebral foramina have been opened on the left side. The left coccygeal nerve (36) is faintly visible, whereas the right coccygeal nerve is fused with the filum durae matris spinalis and therefore is not visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. III-IV (pointer on anulus fibrosus)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. III (partly resected)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior internal vertebral venous plexus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. IV-V (pointer on nucleus pulposus)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal dura mater  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous attachment of dura to posterior longitudinal ligament (cut off)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sacrum (corpus, resected) Lower pointer: Remnant of intervertebral disc S. I-lI  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral arteries  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral plexus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle (posterior border of pelvic diaphragm)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal vertebral venous plexus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process vertebrae L. IV  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum flavum  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle of arch of vertebra L. V (cut across)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Spinal ganglion lumbar nerve V Lower pointer: Spinal branch iliolumbar artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral femoral cutaneous nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala of sacrum  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve I (in anterior (pelvic) sacral foramen)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Dural filum spinal cord (coccygeal nerves fused with this at lower level)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve II  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral canal (lined by periosteum)  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve III  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve IV  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve V  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  36\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeal nerve  37\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (covered by periosteum)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_24", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Piriformis muscle and nerve supply, medial view\n\t\t\t\t\t\t\t\t\t\tThe right sacral plexus has been resected to permit a view of the piriformis muscle. The nerves to this muscle (19), derived from the first and second sacral nerves and given off from the adjacent part of the sacral plexus, have been preserved.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral artery (branch of iliolumbar artery)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar branch iliolumbar artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior gluteal artery Lower pointer: Body of ilium  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar artery (iliac branch of)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Obturator artery (entering obturator canal) Lower pointer: Pubic branch of obturator artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischium  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve I (emerging from anterior (pelvic) sacral foramen)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus communicans  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve II  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrum (body cut through to expose sacral canal)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrum  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to piriform muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic foramen (piriform muscle passing through)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to obturator internus muscle"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_25", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Obturator internus muscle and nerve supply, medial view\n\t\t\t\t\t\t\t\t\t\tThe pelvic diaphragm has been removed from the specimen and the obturator fascia has been stripped away.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac branch of iliolumbar artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis (sectioned)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic arcuate ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus communicans (to sacral nerve I)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve I (ventral ramus)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk (pointer on ganglion)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior (pelvic) sacral foramen (pointer indicates opening within sacral canal exposed by cutting through sacrum)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Rami communicantes  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Sacral nerve II Right pointer: Sacral nerve III  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrum  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve IV  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior rectal nerve Lower pointer: Pudendal nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Branch of sacral nerve III to posterior femoral cutaneous nerve Lower pointer: Sciatic nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to obturator internus muscle (indicated in two places)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of ischial spine  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament (cut off at attachment)  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_26", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Sacral plexus and pelvic diaphragm, medial view with blood vessels removed\n\t\t\t\t\t\t\t\t\t\tThe arteries and veins have been removed from the central area of dissection to expose the sacral plexus as it passes through the greater sciatic foramen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliacus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Linea terminalis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens (cut off)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery and vein (passing downward deep to inguinal ligament)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis (sectioned)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle (covered by obturator fascia)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous arch pelvic fascia  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethra (opened)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Urogenital diaphragm (dissected)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk (pointer on ganglion)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Greater sciatic foramen Right pointer: Sciatic nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrum (partially resected)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve III (ventral ramus)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriformis muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve IV  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior gluteal artery Lower pointer: Internal pudendal artery  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to Levator ani muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Anal canal"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_27", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Nerve supply to levator ani and coccygeus muscles, medial view\n\t\t\t\t\t\t\t\t\t\tThe prostate has been removed. The superior fascia of the pelvic diaphragm has been dissected to expose the branches from the third and fourth sacral nerves that supply the muscles of the right half of the diaphragm. Note that one nerve (25) passes into the coccygeus muscle and emerges inferiorly on the medial side of the levator ani.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Lateral umbilical ligament (cut off) Right pointer: Superior vesical artery (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliacus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Obturator artery Lower pointer: Obturator nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery and vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lacunar ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator fascia (obturator internus visible deep to fascia)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (puborectalis muscle, covered by fascia)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous arch of pelvic fascia  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Superior gluteal artery Right pointer: Lateral sacral artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve I  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Internal pudendal artery Right pointer: Inferior gluteal artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve II  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrum (cut away near midline)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve III  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrum (dorsal surface)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pudendal nerve Lower pointer: Sciatic nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to Levator ani muscle and coccygeus muscle (this branch penetrates muscle, reappearing on the inner surface of the muscle nearly opposite the anal canal)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to Levator ani muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of ischial spine  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (pointer on iliococcygeus muscle)  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (pointer on pubococcygeus muscle)  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous arch of levator ani muscle (not clearly defined in this specimen)  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Anal canal  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Urogenital diaphragm  36\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethra"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_28", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Blood vessels and nerves of right lateral pelvic wall\n\t\t\t\t\t\t\t\t\t\tVisceral branches of vessels and nerves have been cut away. The prostate and seminal vesicles have been retained in situ. The view is from the left and slightly anterior.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Common iliac artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal iliac vein (pointer at origin of superior gluteal vein) Lower pointer: Superior gluteal artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior gluteal artery Lower pointer: Internal pudendal artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery and vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator vein  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral umbilical ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Obturator artery Lower pointer: Obturator nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior epigastric artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis (sectioned)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal urethral opening  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostate  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal branch iliolumbar artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve I (ventral ramus)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic surface of sacrum  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Right sympathetic trunk  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral veins  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve II (ventral ramus)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve III  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal vein  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pelvic splanchnic nerve (cut off) Lower pointer: Pudendal nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve IV (ventral ramus)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of piriform muscle (mostly removed)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic splanchnic nerve (cut off)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to Levator ani muscle  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior fascia of pelvic diaphragm (at posterior border of pelvic diaphragm)  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Seminal vesicle  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Anal canal"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_29", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Posterior pelvic wall viewed from in front and to the left\n\t\t\t\t\t\t\t\t\t\tThe specimen is the same as that shown in view 172-2 but in this instance it is viewed in such a way that the structures associated with the posterior wall of the pelvic cavity are visible. The rectum has been resected and the bladder has been pulled forward with the reflected anterior abdominal wall.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Common iliac artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior hypogastric plexus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliacus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Genitofemoral nerve (femoral)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Genitofemoral nerve (genital branch)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery and vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ganglion of sympathetic trunk Lower pointer: Lateral sacral artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesicular arteries (note several vessels which pass to bladder ureter ductus deferens and prostate)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Testicular artery and vein  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral umbilical ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Transversalis fascia (covering transversus muscle)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis (sectioned)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala of sacrum  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar artery and vein  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve I (ventral ramus, emerging through anterior sacral foramen)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ramus communicans Lower pointer: Sympathetic trunk (pointer on ganglion)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic surface of sacrum  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve II (ventral ramus)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (area of origin)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve III (ventral ramus)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve IV (ventral ramus)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Portion of sacral venous plexus  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle (cut off)  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle right  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Seminal vesicle  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostate"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_30", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Pelvic plexus of right side, medial view\n\t\t\t\t\t\t\t\t\t\tThe pelvic plexus on the right side of the specimen has been freed of connective tissue. The superior hypogastric plexus is visible entering from above. Extending to the pelvic plexus from the sacral part of the sympathetic trunk is one sacral splanchnic nerve (18). The pelvic splanchnic nerves (19, 20) from the 3rd and 4th sacral nerves carry parasympathetic fibers to the plexus. Branches of the pelvic plexus to the ureter, ductus deferens, bladder, prostate and rectum are visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Common iliac artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior hypogastric plexus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter right  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal iliac artery Lower pointer: Nerve to ureter from superior hypogastric plexus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery and vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Deferential plexus Right pointer: Ductus deferens  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral umbilical ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostate  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anal canal  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac vein  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Sacral nerve I Right pointer: Sympathetic trunk (pointer on ganglion)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve II  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve I right (in background)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral splanchnic nerve (sympathetic)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic splanchnic nerve (parasympathetic)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic splanchnic nerve (parasympathetic)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic ganglion (in pelvic plexus)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectal branch of pelvic plexus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Filament of prostatic plexus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Vesical plexus Right pointer: Seminal vesicle"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_31", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t General view of interior of right pelvic wall with peritoneum and pelvic fascia removed\n\t\t\t\t\t\t\t\t\t\tThe pelvic peritoneum has been entirely removed. The pelvic fascia has been teased away from the structures within the right side of the pelvic cavity so that the interrelations of the ureter, ductus deferens, lateral umbilical ligament, lymphatics, blood vessels and nerves may be examined.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Right common iliac artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter right  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: External iliac artery Right pointer: Internal iliac artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliacus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral umbilical ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac lymph nodes  8\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Umbilical prevesical fascia (related to lateral umbilical ligament)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Deferential plexus Right pointer: artery of ductus deferens  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator artery (in background)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior hypogastric plexus (pelvic plexus)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal pelvic fascia (partially removed from pelvic plexus)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostate  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior hypogastric plexus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Common iliac artery and vein  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Middle sacral artery Right pointer: Promontory  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Right internal iliac vein Lower pointer: Superior gluteal artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar vein  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve I  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior gluteal artery Lower pointer: Internal pudendal artery  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral splanchnic nerve (from sacral sympathetic trunk)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Piriform muscle Lower pointer: Pelvic splanchnic nerve (parasympathetic)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Seminal vesicle"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_32", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Anal canal opened, close-up anterolateral view\n\t\t\t\t\t\t\t\t\t\tThis view is a close-up of the lower part of the dissection illustrated in the preceding photograph and is centered on the anal canal. The canal has been opened by an incision placed laterally through the wall of the canal and connected above with an anterior midline incision through the wall of the rectum. The wall of the anal canal posterior to the incision has been retracted. The mucosa of the anal canal has not been stretched sufficiently to reveal the pectinate line formed by the anal valves at the lower ends of the anal columns. The position of this line is indicated in the drawing at 17.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Circular layer of muscular tunic of rectum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostate  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical sphincter muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphincter muscle of urethra (dissected)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Urogenital diaphragm (pointers on superior and inferior fascial layers)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Spongy part of urethra  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulb of penis (dissected)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal layer of muscular tunic of rectum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosal tunic of rectum (pointer at level of perineal flexure)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (divided near its insertion into wall of anal canal)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of insertion of Levator ani muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anal sinus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal anal sphincter muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle (superficial part)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Level of pectinate line (not visible unless mucosa stretched)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle (subcutaneous part)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Hemorrhoidal venous plexus (section passes through thrombus)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Anal columns  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anal verge  22\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle (divided see labels numbered 12, 16, 18)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle (sectioned along midline)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_33", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Sigmoid colon, rectum and anal canal opened in situ, left anterolateral view\n\t\t\t\t\t\t\t\t\t\tA longitudinal incision has been made through the anterior wall of the sigmoid colon and rectum to demonstrate the features of the lumen of this part of the intestine. At the perineal flexure of the rectum a short transverse cut has been made to connect with a laterally placed longitudinal incision into the anal canal. The specimen is viewed from in front and to the left.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac lymph node  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter right  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lateral umbilical ligament Lower pointer: Ductus deferens  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder (opened)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus abdominis muscle right (reflected downward and to the right)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis (sectioned)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostate  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac vein  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid colon (opened)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Left internal iliac artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens left (cut off)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic plexus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum (opened note outer longitudinal and inner circular layers of smooth muscle visible in cut section of wall)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Plicae transversales of rectum (middle and lower)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Ureter left (cut off) Right pointer: Seminal vesicle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Anal canal"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_34", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Prostatic utricle and ejaculatory duct in relation to seminal colliculus, left anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe prostate has been sectioned in a sagittal plane, the cut passing slightly to the left of the midline posterior to the ejaculatory duct. The prostatic utricle (8) has been opened to demonstrate its size and relations to the seminal colliculus (15) onto the summit of which it opens, and to the ejaculatory duct (12) which courses parallel and slightly lateral to it to open on the side of the colliculus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Diverticulum of ductus deferens  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ampulla of ductus deferens (opened)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens right  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Seminal vesicle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle lobe of prostate (sectioned in midline)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical sphincter muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal urethral opening  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostatic utricle (opened)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostatic sinus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Seminal vesicle (opened)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Excretory duct  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ejaculatory duct  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Glandular substance of prostate (sectioned near median plane)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Opening of ejaculatory duct at seminal colliculus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Seminal colliculus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethral crest"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_35", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Interior of seminal vesicle, ejaculatory duct and ampulla of ductus deferens\n\t\t\t\t\t\t\t\t\t\tThe prostate shown in the preceding view has been removed from the body for separate dissection. The median lobe (7) has been removed to the left of the midline to gain access to the left ejaculatory duct. The ejaculatory duct has been opened and incisions have been continued to open the left seminal vesicle and the ampulla of the ductus deferens. An aberrant diverticulum (2) of the ampulla of the ductus deferens is present on the left. Approximately 2 mm. of the terminal, blind extremity of this diverticulum was cut off. The diverticulum communicates with the ampulla posteromedially near the beginning of the ejaculatory duct.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens left  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Aberrant diverticulum from ductus deferens  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ampulla of ductus deferens (opened)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens right  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Seminal vesicle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ampulla of ductus deferens  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle lobe of prostate (resected to left of midline)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal urethral opening  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical sphincter muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Seminal vesicle (opened)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ejaculatory duct (upper pointer indicates confluence of excretory duct of seminal vesicle with ductus deferens, lower pointer indicates opening of ejaculatory duct at seminal colliculus)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lobe of prostate  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Isthmus of prostate (sectioned)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Prostatic utricle (opened) Lower pointer: Seminal colliculus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostatic sinus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethral crest"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_36", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Prostate and sphincter of bladder, viewed from above\n\t\t\t\t\t\t\t\t\t\tAll of the bladder has been taken away with the exception of the right half of the sphincter (9), which has been preserved to illustrate the intimate relation of the bladder musculature to the base of the prostate. The prostatic part of the urethra has been opened by means of an anterior midline incision.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior fascia of pelvic diaphragm  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vesical artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Seminal vesicle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ampulla of ductus deferens  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator fascia  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous arch of pelvic fascia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (visible through opening in fascia)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical sphincter muscle (preserved on right side of specimen)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Puboprostatic ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle (in background)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Aberrant vesicle from ductus deferens (blind terminal part cut off approximately 2 mm. from its tip)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Seminal vesicle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of prostate (pointer on middle lobe)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lobe of prostate  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal urethral opening (opened, pointer on mucosa)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Seminal colliculus (lying in opened prostatic part of urethra) Lower pointer: Prostatic sinus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethral crest  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Membranous part of urethra"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_37", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Interior of prostatic urethra; seminal colliculus, anterior view\n\t\t\t\t\t\t\t\t\t\tA midline incision has been made beginning at the internal urethral orifice and extending downward through the isthmus of the prostate to open the prostatic and membranous parts of the urethra. The left lobe of the prostate has been pulled aside to provide adequate exposure of the urethral lumen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubovesicalis muscle (also see view 170-7)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical sphincter muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Uvula of bladder  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal urethral opening  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Puboprostatic ligament (pubovesical part)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostate (sectioned in midline)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Puboprostatic ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphincter muscle of urethra (cut ends separated, posterior part elevated)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Interpubic disc  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal vein of the penis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lobe of prostate  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Isthmus of prostate (sectioned)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Openings of ejaculatory ducts (opening on seminal colliculus)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostatic utricle (opening on summit of seminal colliculus)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostatic part of urethra (pointer indicates prostatic sinus)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (medial margin)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Urogenital diaphragm (upper and lower pointers indicate superior and inferior fasciae of diaphragm)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulb of penis (sectioned in midline)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Spongy part of urethra"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_38", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t External muscles and ligaments at neck of bladder; tendinous arch of pelvic fascia, viewed from above\n\t\t\t\t\t\t\t\t\t\tThe bladder and prostate have been pulled to the left to expose bands of smooth muscle alongside the neck of the bladder which form the m. pubovesicalis (24) and which continue anteriorly into the medial puboprostatic ligament (26). Laterally, the thickened part of the pelvic fascia known as the tendinous arch of the pelvic fascia (25) is seen to be attached to the prostate and neck of the bladder by the lateral puboprostatic ligament (16, upper pointer). The lateral ligament of the bladder, consisting of fibrous tissue and smooth muscle associated with the pelvic plexus and hyogastric vessels, has been removed from the specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter (retracted)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (covered by fascia)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Ampulla of ductus deferens  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostatic venous plexus, prostatic vein (uninjected and cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Seminal vesicle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vesical artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (covered by superior fascia of pelvic diaphragm)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle (covered by obturator fascia)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator vein  12\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral umbilical ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lateral puboprostatic ligament Lower pointer: Obturator canal  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus (pointer on pectineal ligament)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic branch of obturator artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of urinary bladder  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vesical artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal muscle of ureter extending into pubovesicalis muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vesical artery (branch communicating with artery of penis shown in 170-2, label no. 9)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervix of bladder  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubovesicalis muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous arch of pelvic fascia  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Puboprostatic ligament  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal vein of the penis  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Interpubic disc  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_39", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Trigone of bladder dissected\n\t\t\t\t\t\t\t\t\t\tThe mucosa has been removed from the left half of the trigone to reveal the very delicate muscle fibers that continue from the longitudinal muscle of the left ureter into the trigone, extending toward the opposite ureter and also toward the urethral orifice. A heavy, sling-like layer of muscle, identified here as the m. pubovesicalis (19), lies alongside the neck of the bladder. Posteriorly its fibers appear continuous with the outer longitudinal layer of muscle of the bladder and with fibers extending upward on the ureter from this layer. Anteriorly it encircles the neck of the bladder and sends some fibers into the puboprostatic ligament.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter left  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Uterine opening Left pointer: Interureteric fold (dissected to show muscle fibers continuous with longitudinal muscle of ureter)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Fundus of bladder Left pointer: Uterine opening  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Deferential plexus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of bladder  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of bladder  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Retropubic space  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligament of the penis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal vein of the penis  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal artery of penis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphincter muscle of urethra  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Seminal vesicle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostate  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Trigone of urinary bladder (dissected) Lower pointer: Internal urethral opening  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cervix of bladder Lower pointer: Pubovesicalis muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (cut off)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Urogenital diaphragm (dissected; pointers indicate superior and inferior fasciae)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Membranous part of urethra Lower pointer: Spongy part of urethra  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulb of penis (sectioned in midline)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_40", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Interior of bladder\n\t\t\t\t\t\t\t\t\t\tA large opening has been made in the left wall of the bladder to afford a view of the interior, particularly the area of the trigone.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ureteric opening  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Fundus of bladder (mucosal tunic intact)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Interureteric fold Left pointer: Trigone of urinary bladder (pointer indicates central part of trigone)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right utereric opening  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Apex of bladder Left pointer: Umbilicovesical fascia  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Umbilical prevesical fascia  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal urethral opening  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Retropubic space  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Puboprostatic ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Transverse perineal ligament Lower pointer: Dorsal vein of the penis (passing inward to prostatic plexus)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter left (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Seminal vesicle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostate (pointer on base)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubovesicalis muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular tunic of bladder  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (medial border of puborectalis muscle)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior fascia of urogenital diaphragm  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphincter muscle of urethra (remnant surrounding wall of membranous part of urethra) 21. Spongy part of urethra (opened)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_41", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Left anterolateral view of pelvic organs in situ, peritoneum partially removed\n\t\t\t\t\t\t\t\t\t\tThe pelvic peritoneum remains in place to the right of the midline. The anterior abdominal wall has been folded downward.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac lymph node  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid colon (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle (covered by psoas fascia)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliacus muscle (covered by iliac fascia)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Transversus abdominis muscle (origin)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal oblique muscle (cut off at origin)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut margin of peritoneum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Testicular artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of ureter (covered by peritoneum)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Apex of urinary bladder Lower pointer: Median umbilical ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of urinary bladder (pointer on cut margin of peritoneum)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ductus deferens (cut off) Lower pointer: Ureter (cut off)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior rectal vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior rectal artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Common iliac artery (pointer at bifurcation into internal and external iliac arteries)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Common iliac vein (pointer at origin of external iliac vein)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve (cut off)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar vein  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal pelvic fascia  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery (cut off)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral lymph nodes  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral flexure of rectum  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Seminal vesicle  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of prostate  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal flexure of rectum"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_42", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Pelvic peritoneal cavity\n\t\t\t\t\t\t\t\t\t\tThis view of the pelvic part of the peritoneal cavity in a male subject is inserted to accompany the views of dissections for the purpose of showing the relations of organs in an intact body.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ileum (retracted upward)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vermiform appendix (folded sharply upon itself)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pararectal fossa Lower pointer: Sacral flexure of rectum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of right ureter beneath peritoneum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial umbilical fold  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending colon  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid colon  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of transition from descending colon to sigmoid colon  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral umbilical fold  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Median umbilical fold"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_43", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Relations of bladder, prostate, seminal vesicle and rectovesical septum and pelvic peritoneum\n\t\t\t\t\t\t\t\t\t\tThe bladder, prostate and seminal vesicle have been pulled forward and slightly upward. The rectovesical septum (19) may be seen extending upward from the superior fascia of the urogenital diaphragm between the prostate and rectum to fuse with the under surface of the peritoneum near the bottom of the rectovesical pouch.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral umbilical ligament (cut off close to origin from internal iliac artery)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid colon  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter (straightened by slight upward traction)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery (covered by peritoneum)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of urinary bladder  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of urinary bladder  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans penis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cervix of bladder Lower pointer: Puboprostatic ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut off)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of inferior rectal artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Pararectal fossa (peritoneum intact)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectovesical space  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Seminal vesicle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectovesical septum  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostate  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior fascia of urogenital diaphragm  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethra (opened)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_44", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Prostate gland; puboprostatic ligament; rectovesical septum\n\t\t\t\t\t\t\t\t\t\tThe prostate and rectum have been separated slightly to expose the fascial layers between them. The rectovesical septum (19) has been left against the posterior surface of prostate and seminal vesicle. A thinner layer of this septum, more closely related to the rectal wall, is seen spanning the space separating the rectum and prostate.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Outer longitudinal muscle of bladder extending onto ureter  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of urinary bladder  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Retropubic space  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostatic venous plexus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Puboprostatic ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal vein of the penis  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal artery of penis  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of artery of penis which penetrates urogenital diaphragm and joins a right vesicular artery faintly visible in area above puboprostatic ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid colon  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Seminal vesicle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal peritoneum (lining pelvic cavity)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to Levator ani muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal branch of sacral nerve IV  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectovesical septum (two layers visible)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (cut off and reflected away from its attachment to rectal wall)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostate  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior fascia of urogenital diaphragm  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphincter muscle of urethra (dissected)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Spongy part of urethra (opened)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_45", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Contents of pelvic cavity with pelvic peritoneum removed; blood supply of lower sigmoid colon and rectum\n\t\t\t\t\t\t\t\t\t\tThe peritoneum of the left side of the pelvic cavity has been resected. Nerves and blood vessels have also been removed on the left to display the pelvic organs in situ. The distribution of the superior rectal artery and vein is demonstrated.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter right  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle (covered by fascia)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid colon (cut off and retracted anteriorly)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens (approaching deep inguinal ring)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Umbilical prevesical fascia  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Puboprostatic ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus cavernosum of penis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter left  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior rectal artery and vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum (pointer indicates sacral flexure)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut off)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ampulla of ductus deferens  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Seminal vesicle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectovesical septum  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (terminal part)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (cut off)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum (pointer on perineal flexure)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostate  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Urogenital diaphragm (dissected)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethra (opened)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_46", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Pelvic organs in situ, close-up lateral view\n\t\t\t\t\t\t\t\t\t\tAttention is focused in this close-up photograph on the central part of the specimen that is shown in the preceding view. Of particular interest is the relation of the pelvic plexus (20) to the ureter (17), bladder (10), prostate (25) and rectum (22).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac lymph node  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral umbilical ligament  6\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal peritoneum (external aspect)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic eminence (preserved for orientation)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopectineal arch  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vesical artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical venous plexus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Puboprostatic ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vesical artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter (note associated plexus of nerves and continuation of external layer of muscle of bladder onto lower part of ureter)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve (retracted)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic plexus (note pelvic ganglia within plexus)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostatic vein  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum  23\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to Levator ani muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostate (covered by prostatic fascia)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial border of Levator ani muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Superior fascia of urogenital diaphragm Left pointer: Membranous part of urethra (surrounded by sphincter of urethra)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Spongy part of urethra (opened)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse perineal ligament  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal vein of the penis  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic arcuate ligament (cut in midline)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_47", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t General view of pelvic contents with hip bone removed\n\t\t\t\t\t\t\t\t\t\tThe left coxal bone has been removed from the specimen. The pelvic peritoneum has been retained and the structures that lie external and below the peritoneum have been exposed in situ by removing pelvic fascia. A close-up view of the central part of the dissected area is shown in the following view.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery and vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter right (in background)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Obturator artery Left pointer: External iliac lymph node  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Iliopectineal arch Lower pointer: Remnant of iliopubic eminence (retained for orientation)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Urinary bladder Lower pointer: Superior vesical artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans penis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac lymph node  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Band of iliopsoas fascia retained In situ  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous sacroiliac ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut across near origin)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic ganglion (one of several)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic plexus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum (covered by fascia)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (terminal segment)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (cut across)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Prostate  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Puboprostatic ligament  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Urogenital diaphragm (dissected nearly to midline)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Spongy part of urethra (opened)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_48", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Close-up view of ureterovesical junction\n\t\t\t\t\t\t\t\t\t\tThe central area of the specimen shown in the previous photograph is viewed here to display in more detail the structures that lie immediately adjacent to the ureterovesical junction. The smooth muscle and fibrous tissue that surrounds the pelvic plexus and forms the lateral ligament of the bladder has been preserved. Areolar tissue has been removed from other parts of the specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac lymph node  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ductus deferens Lower pointer: Parietal peritoneum (external aspect)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Obturator artery (cut off) Lower pointer: Superior vesical artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ilium (cut away)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle vesical artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vesical artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical veins (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic ganglion  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Strands of superior hypogastric plexus (embedded in fibrous tissue and smooth muscle of pelvic fascia)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve (retracted)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Smooth muscle and fibrous tissue of lateral ligament of bladder  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureterovesical junction  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior hypogastric plexus (pelvic plexus)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal pelvic fascia (overlying rectum)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Vein draining prostatic plexus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Vein draining vesical plexus"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_49", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t General view of pelvic contents in situ, pelvic diaphragm reflected\n\t\t\t\t\t\t\t\t\t\tThe opening into the pelvis has been somewhat enlarged by the removal of more of the pubic and ischial bones and a small part of the body of the ilium. The obturator fascia has been cut away and the pelvic diaphragm has been split and reflected. Areolar connective tissue has been stripped from the underlying vessels and nerves.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum of ilium  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ilium (partially removed)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator artery (source of two vesical branches)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Parietal peritoneum (external aspect) Lower pointer: Ductus deferens  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve (cut off)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery and vein (cut off)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder (external surface)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vesical artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Transversalis fascia  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis (left pubic bone cut away)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligament of the penis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans penis (dissected)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ureter Lower pointer: Pelvic ganglion (note parts of pelvic plexus associated with ureter)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle (reflected)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Filaments of pelvic plexus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal pelvic fascia  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical veins  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of sacral nerve IV to levator ani muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (reflected)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior fascia of pelvic diaphragm  27\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior fascia of urogenital diaphragm  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethra (opened)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_50", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Sphincter ani externus, close-up lateral view\n\t\t\t\t\t\t\t\t\t\tThe divisions of the sphincter ani externus are not as distinct in this specimen as they are in the preparation shown in view 159-6. The relation of parts of the levator ani muscle to the sphincter ani externus is illustrated here and is also shown in 171-4 after the wall of the anal canal has been opened.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliococcygeus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubococcygeus muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Puborectalis muscle (1-3 are parts of the levator ani muscle)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior fascia of urogenital diaphragm  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal pudendal artery (cutoff) Lower pointer: Pudendal nerve (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethra (opened)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulb of penis (dissected)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle (cut along midline)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (terminal segment)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal branch of sacral nerve IV  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of inferior rectal nerve (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of Levator ani muscle into wall of anal canal  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep part  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial part  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcutaneous part (14-16 refer to the external anal sphincter muscle)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_51", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Relation of pelvic diaphragm to urogenital diaphragm and sphincter ani externus muscle\n\t\t\t\t\t\t\t\t\t\tThe internal pudendal artery has been divided and removed. The urogenital diaphragm has been retracted downward to expose the anterior border of the levator ani muscle. The manner in which the fibers or origin of the levator ani muscle blend with the obturator fascia (4) along the lateral pelvic wall may be observed in this specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous arch of levator ani muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabular labrum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator fascia  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone (dissected)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinous ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal branch of sacral nerve IV  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliococcygeus muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubococcygeus muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Puborectalis muscle (15-17 make up the levator ani muscle)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep part  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial part  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcutaneous part (18-20 are part of the external anal sphincter)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior fascia of urogenital diaphragm (pulled downward)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethra (opened)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_52", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Pelvic diaphragm, close-up view of left side\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the previous view is seen here in a close-up photograph of the lower area of the dissection.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Levator ani muscle Left pointer: Tendinous arch of levator ani muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator fascia  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve, artery, and vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle (fibers of origin of muscle lodged in cleft between obturator fascia (2) and periosteum (6)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinous ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pudendal nerve (also see no. 20)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve IV (perineal branch)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior rectal nerve Lower pointer: Inferior rectal artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Pudendal nerve (also see no. 9) Left pointer: Urogenital diaphragm (partially dissected)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulb of penis (dissected)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Spongy part of urethra (opened)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal artery of penis  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal nerve of the penis"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_53", "text": "Dissection of male pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Left lateral view of pelvis with pelvic diaphragm exposed\n\t\t\t\t\t\t\t\t\t\tThe specimen utilized for the dissection of the perineum has been turned to expose its left side. The musculature of the hip has been resected and parts of the ischium and pubis have been removed. The obturator membrane and obturator internus muscle have been excised. The inferior fascia of the pelvic diaphragm (anal fascia) has been removed so that the levator ani muscle (30) is visible. A portion of the urogenital diaphragm (31) has been retained for purposes of orientation and the internal pudendal artery (28) remains approximately in its original position. The pudendal nerve (22) has been divided and that part of the nerve which extended from the ischial spine to the urogenital diaphragm has been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle of iliac crest  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala of ilium  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Reflected head origin of rectus femoris muscle Lower pointer: Acetabulum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of rectus femoris muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopectineal arch  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve (cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Obturator fascia Lower pointer: Tendinous arch of levator ani muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone (partially removed)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligament of the penis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of penis  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut across)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Pudendal nerve (cut off)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery  29\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Urogenital diaphragm  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulb of penis  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Spongy part of urethra (opened)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_54", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Deep perineal space (continued).\n\t\t\t\t\t\t\t\t\t\tThe bulbourethral gland has been excised and the muscles of the deep perineal space have been dissected to expose their nerve supply. The superior fascia of the urogenital diaphragm lies in the background of the dissected area.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of penis (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus spongiosum of penis  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Spongy part of urethra (opened)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Junction of membranous and spongy parts of urethra  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulb of penis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle (cut along midline raphe)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep transverse perineal muscle (partially resected and elevated)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal membrane (posterior border)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep transverse perineal muscle (portion that lay superior to bulbourethral gland)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial transverse perineal muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Nerve to deep transverse perineal muscle and sphincter muscle of urethra Right pointer: Internal pudendal artery (cut off within deep compartment)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal nerve of the penis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal vein of the penis (note its passage between arcuate pubic ligament and transverse perineal ligament)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic arcuate ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse perineal ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphincter muscle of urethra (middle pointer indicates fibers encircling membranous part of urethra)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal pudendal vein Lower pointer: Superior fascia of urogenital diaphragm  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_55", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Deep perineal space (continued).\n\t\t\t\t\t\t\t\t\t\tThe internal pudendal artery has been divided and removed, together with the artery of the bulb, to reveal more completely the muscles within the deep perineal space. The proximal part of the spongy urethra (4) has been opened.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of penis (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus spongiosum of penis  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Duct of bulbourethral gland  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Spongy part of urethra (opened)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbourethral gland  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulb of penis (dissected)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiocavernosus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Dorsal nerve of the penis Lower pointer: Dorsal artery of penis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal vein of the penis  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic arcuate ligament  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse perineal ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle (visible through obturator membrane)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphincter muscle of urethra  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery (cut off)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior border of urogenital diaphragm  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep transverse perineal muscle"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_56", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Deep perineal space; bulbourethral gland and duct in situ\n\t\t\t\t\t\t\t\t\t\tThe contents of the deep perineal space or pouch have been dissected. A thin layer of muscle that lay superficial to the bulbourethral gland (9) has been cut away and the gland has been freed of connective tissue.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus cavernosum of penis left  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus cavernosum of penis right  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus spongiosum of penis  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Crus of penis Lower pointer: Ischiocavernosus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulb of penis (sectioned in midline)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbourethral gland  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial transverse perineal muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep transverse perineal muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior margin of urogenital diaphragm  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Arcuate pubic ligament Lower pointer: Dorsal nerve of the penis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Dorsal artery of penis Lower pointer: Deep artery of penis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Spongy part of urethra Middle pointer: Duct of bulbourethral gland Lower pointer: Sphincter muscle of urethra  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal artery (pointer at branching of artery of bulb of penis)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_57", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Bulb of penis and deep perineal space; artery of bulb and duct of bulbourethral gland\n\t\t\t\t\t\t\t\t\t\tThe left half of the penile bulb has been opened and cleared of trabeculated erectile tissue. The area of attachment of the bulb to the urogenital diaphragm (9) has been preserved with the artery of the bulb passing through it. The duct of the bulbourethral gland (5) has been dissected from the point at which it emerges from the urogenital diaphragm to its site of penetration of the urethral wall, a distance of approximately two centimeters. The deep perineal space, located between the fascial layers of the urogenital diaphragm, has been opened by the partial resection of the perineal membrane.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus spongiosum of penis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of penis (cut across)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Spongy part of urethra (external aspect)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Duct of bulbourethral gland  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiocavernosus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulb of penis (left half dissected)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior fascia of urogenital diaphragm (tissue of bulb of penis removed)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of bulb of penis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep transverse perineal muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior border of urogenital diaphragm  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Spermatic cord  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Dorsal nerve of the penis Lower pointer: Pubic arcuate ligament (in background)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal artery of penis  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Deep artery of penis Lower pointer: Transverse perineal ligament (In background)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_58", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Navicular fossa within distal part of urethra\n\t\t\t\t\t\t\t\t\t\tThe terminal part of the urethra has been opened to display the dilated navicular fossa within the glans penis. The glans has been separated from the blunt, terminal parts of the corpora cavernosa.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of external urethral opening (not visible)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Incision through wall of penis continued proximally into corpus spongiosum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Navicular fossa of urethra (note longitudinal mucosal ridges along wall)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Spongy part of urethra  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus spongiosum of penis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans penis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Corona of glans  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal artery of penis  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus cavernosum of penis (covered by tunica albuginea)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_59", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t General view of urethral aspect of penis with fascia removed\n\t\t\t\t\t\t\t\t\t\tThe left crus (15) has been cut off about at its junction with the right crus. The bulbospongiosus and ischiocavernosus muscles of the right side have been preserved.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans penis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Corona of glans  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus spongiosum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus cavernosum right  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus cavernosum left  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of penis  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiocavernosus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphincter muscle of urethra  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior fascia of urogenital diaphragm  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of penis (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: artery of penis (pointer at branching of dorsal artery of penis and deep artery of penis) Lower pointer: artery of bulb of penis  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabular branch of obturator artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of coccyx"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_60", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Blood vessels and nerves of penis, close-up lateral view\n\t\t\t\t\t\t\t\t\t\tThe left crus has been cut off and the inferior fascia of the urogenital diaphragm has been removed to display the course of blood vessels and nerves supplying the left half of the penis.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus spongiosum of penis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpora cavernosa of penis  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser trochanter  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of penis (sectioned)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Septum penis (exposed by removal of left crus)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethral arteries  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle (cut along midline raphe)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulb of penis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior fascia of urogenital diaphragm  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphincter muscle of urethra  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal nerve of the penis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal vein of the penis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of dorsal nerve of penis passing upward in suspensory ligament of penis  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligament of the penis  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle (tendon of origin)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Deep artery of penis Lower pointer: Dorsal artery of penis  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Aperture between arcuate pubic ligament and transverse perineal ligament through which dorsal vein passes to prostatic plexus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Nerve filament that accompanies deep artery of penis Lower pointer: artery of bulb of penis"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_61", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Penis, fascia removed, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe penis has been stripped of its fascial layers. The corpus spongiosum has been slightly separated from the corpora cavernosa.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligament of the penis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal nerve of the penis  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal arteries of the penis  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal vein of the penis  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus spongiosum of penis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus cavernosum of penis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of penis  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser trochanter (insertion of right iliopsoas tendon visible)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Tunica albuginea (cut to expose erectile tissue of crus) Lower pointer: Erectile tissue of crus penis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulb Of penis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Spermatic cord  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiocavernosus muscle (near insertion into suspensory ligament of the penis)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle (visible through obturator membrane)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_62", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Suspensory ligament of penis, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the preceding view has been turned to expose the left side of the penis. The suspensory ligament (1) is continuous inferiorly with the deep fascia of the penis. It also receives parts of the insertions of the ischiocavernosus and bulbospongiosus muscles (18). The thick tunica albuginea of the left crus of the penis has been removed to reveal the erectile tissue of the crus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligament of the penis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal nerve of the penis  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus spongiosum of penis  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus cavernosum of penis (covered by tunica albuginea)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep (Buck's) fascia of penis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial penile fascia  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cut edge of tunica albuginea Lower pointer: Erectile tissue of crus of penis  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulb of penis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal membrane  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of origin of adductor longus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Spermatic cord (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Inguinal ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone (periosteum intact)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Insertion of bulbospongiosus muscle Lower pointer: Insertion of Ischiocavernosus muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve (emerging from obturator canal)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator membrane"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_63", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Blood vessels and nerves of dorsum of penis; suspensory ligament of penis\n\t\t\t\t\t\t\t\t\t\tThe superficial and deep fascial layers have been reflected from the dorsal surface of the penis. The fundiform ligament has been removed to expose the suspensory ligament and to demonstrate the relations of nerves and arteries to the latter.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens (retracted laterally)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus III  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal nerves of the penis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal arteries of the penis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal vein of the penis (superficial dorsal veins removed)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep (Buck's) fascia of penis  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial penile fascia  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of penis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans penis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of pubic symphysis  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligament of the penis (fundiform ligament removed)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic tubercle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Spermatic cord  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabular branch of obturator artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator membrane (obturator internus muscle visible through membrane)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone (covered by periosteum)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of penis  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus cavernosum of penis (covered by tunica albuginea)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_64", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Inferior fascia of urogenital diaphragm; deep and dorsal arteries of penis\n\t\t\t\t\t\t\t\t\t\tThe left crus of the penis has been retracted. The cavernous tissue of the crus has been exposed by removing a portion of the tunica albuginea.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus spongiosum of penis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of penis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiocavernosus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial transverse perineal muscle (poorly developed)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Spermatic cord (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of penis (pointer indicates tunica albuginea which has been partially removed elsewhere on crus to reveal underlying cavernous tissue)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Dorsal artery of penis Lower pointer: Deep artery of penis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Obturator canal Lower pointer: Acetabular branch of obturator artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior fascia of urogenital diaphragm (perineal membrane)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulb of penis"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_65", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Bulb of penis; central tendon of perineum\n\t\t\t\t\t\t\t\t\t\tThe left bulbospongiosus muscle has been partially removed. The various insertions of the muscle, anteriorly into the suspensory ligament of the penis (14), onto the deep surface of the corpus spongiosum, and onto the perineal membrane (18), have been preserved. The central tendon of the perineum (6) is exposed in the midline posterior to the bulb of the penis. Transversely directed muscle fibers (10) that extend laterally from the central tendon may represent part of the superficial transverse perineal muscle, although they are seen to turn posteriorly to blend with fascia along the sphincter ani externus muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus spongiosum of penis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right bulbospongiosus muscle (cut along midline raphe)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulb of penis  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ischiocavernosus muscle Lower pointer: Crus of penis  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle (superficial part)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibers of bulbospongiosus muscle (cut off close to origin)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle (deep part)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial transverse perineal muscle (small bundle of fibers that attaches to fascia alongside external anal sphincter)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (puborectalis muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiorectal fossa  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibers of insertion of bulbospongiosus muscle (these pass into suspensory ligament of penis)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiocavernosus muscle (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of penis (indented by Ischiocavernosus muscle)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibers of insertion of bulbospongiosus muscle (upper pointer, fibers passing to attach to upper surface of corpus spongiosum; lower pointer, fibers inserting on perineal membrane; also see no. 14.)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior fascia of urogenital diaphragm (perineal membrane)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal nerve"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_66", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Bulb of penis, left bulbospongiosus muscle reflected\n\t\t\t\t\t\t\t\t\t\tThe left bulbospongiosus muscle has been reflected to expose the underlying corpus spongiosum and its posterior enlargement into the bulb of the penis. The inferior fascia of the urogenital diaphragm (11) is visible in the deep part of the dissection.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of penis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus spongiosum of penis  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of penis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiocavernosus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiorectal fossa  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of perineal nerve that passed through bulbospongiosus muscle to communicate with posterior scrotal nerves (see 166-3)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior fascia of urogenital diaphragm (perineal membrane)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep (Buck's) fascia of penis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle (reflected)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Bulb of penis Right pointer: Crus of penis  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to bulbospongiosus muscle"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_67", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Nerve supply to bulbospongiosus muscle\n\t\t\t\t\t\t\t\t\t\tThe left bulbospongiosus muscle (2) has been dissected to expose branches of the perineal nerve (13) which ramify within the muscle. In addition, another branch of the perineal nerve (3) passes through the posterior part of the muscle near the midline and emerges superficially to send filaments to join the posterior scrotal nerves shown in earlier photographs.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus spongiosum of penis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle (pointer on midline raphe of muscle)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of perineal nerve coursing through bulbospongiosus to join posterior scrotal nerves peripherally (see text above)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior part of superficial perineal fascia  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate fascia forming medial wall of pudendal canal  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiocavernosus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of perineal nerve passing to bulbospongiosus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scrotal nerves  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_68", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Nerve supply to ischiocavernosus muscle\n\t\t\t\t\t\t\t\t\t\tThe ischiocavernosus muscle has been divided posteriorly and spread apart to expose branches of the perineal nerve that supply the muscle. One of these branches terminates in the posterior part of the muscle whereas another branch passes forward to the anterior part of the muscle belly. Posterior scrotal branches of the perineal nerve have been displaced laterally and medially to display the motor branch (21).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep perineal fascia (Buck's fascia)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium (area indicated by lower pointer covered by periosteum)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of penis  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiocavernosus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse perineal artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scrotal nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior part of superficial perineal fascia  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate fascia within ischiorectal fossa  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of perineal nerve (spread to reveal nerve to Ischiocavernosus muscle)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus spongiosum of penis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial perineal fascia (reflected)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of penis  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to anterior part of Ischiocavernosus muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiocavernosus muscle (dissected)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to posterior part of Ischiocavernosus muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal nerve (branch to ischiocavernosus)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery and vein"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_69", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Contents of superficial perineal space\n\t\t\t\t\t\t\t\t\t\tThe deep perineal fascia has been cut away to reveal the bulbospongiosus and ischiocavernosus muscles. The crura of the penis (5) are partially visible as is the corpus spongiosum penis (14). The superficial transverse perineal muscles are poorly developed in this specimen but an example of the muscle may be be seen in view 174-1.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Superficial penile fascia Left pointer: Scrotal sac (retracted upward)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep (Buck's) fascia of penis  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiocavernosus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Crus of penis Left pointer: Ramus of ischium  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiorectal fossa  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Transverse perineal artery Right pointer: Superficial transverse perineal muscle (poorly developed)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus spongiosum of penis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial perineal fascia  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of nerve to bulbospongiosus entering posterior scrotal plexus (see 166-3)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Perineal artery Lower pointer: Transverse perineal artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scrotal nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_70", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Deep perineal fascia\n\t\t\t\t\t\t\t\t\t\tThe superficial perineal fascia (5) has been reflected more completely from the perineal region to expose the deep perineal fascia (Buck's fascia) which encloses the superficial perineal space. The posterior scrotal vessels and nerves have been exposed on the right side and have now been removed from the left side. The superficial and deep fascial layers of the penis (13, 16) may be seen in relation to the fascia of the scrotum and perineum.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dartos fascia (enclosing right testis)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Line of incision separating two halves of scrotum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Septum of scrotum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scrotal vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial perineal fascia (membranous layer or Colles' fascia)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scrotal nerves  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle (faintly visible through deep perineal fascia)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiorectal fossa  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial penile fascia  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Dartos fascia enclosing left testis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Fatty lobule  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep (Buck's) fascia of penis (continuous with deep perineal fascia)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral vein  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiocavernosus muscle (covered by deep perineal fascia)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_71", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Superficial fascia reflected; posterior scrotal nerves and vessels; deep perineal fascia\n\t\t\t\t\t\t\t\t\t\tThe dartos has been split close to the midline at the base of the scrotum. The incision has been extended posteriorly through the membranous layer of superficial fascia (Colles' fascia). This layer has been retracted on the left side to reveal the major branches of the posterior scrotal nerves and artery. The perineal branch of the posterior femoral cutaneous nerve (10) passes anteriorly to join the plexiform branches of the posterior scrotal nerves (13). Note also that the posterior scrotal nerves communicate across the midline with branches derived from nerves of the opposite side. The adductor muscles of the left thigh have been cut away to expose the obturator externus (15). The rami of the pubis and ischium have been stripped of periosteum on the left.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of penis (covered by superficial penile fascia)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dartos fascia (enclosing right testis)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Septum of scrotum (compressed against penis and divided in reflecting parts of scrotum)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep perineal fascia (Buck's fascia)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial perineal fascia (reflected laterally)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior border of area enclosed by superficial perineal fascia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal branch of inferior rectal nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal branch posterior femoral cutaneous nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dartos fascia (enclosing atrophic left testis)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of posterior scrotal nerves  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial perineal fascia  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scrotal branch internal pudendal artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium (periosteum removed)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_72", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Membranous layer of superficial fascia in urogenital triangle\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in view 165-2 is further explored in this preparation and in subsequent dissections of this series. The subcutaneous fat has been removed from the ischiorectal fossa. On the right side of the specimen an opening (6) has been made in the membranous layer of superficial fascia to expose some of the branches of the posterior scrotal artery and nerve. The scrotum has been retracted upward.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of penis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dartos fascia (covering right testis)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery and vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scrotal nerves  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scrotal branch internal pudendal artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of window cut through membranous layer of superficial fascia  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal branch posterior femoral cutaneous nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal branch posterior femoral cutaneous nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Gracilis muscle Lower pointer: Adductor longus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dartos fascia covering scrotal septum (spread out in retracting testicles)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Terminal filament of posterior scrotal nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of left testis (retracted with scrotum)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Great saphenous vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia lata  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial perineal fascia (membranous layer)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal branch posterior femoral cutaneous nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiorectal fossa"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_73", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Sagittal section of left testis, viewed from medial side\n\t\t\t\t\t\t\t\t\t\tThe testis has been cut in a sagittal plane. The plane of section does not include the entire length of the epididymis due to the fact that the body of the epididymis curves away from the sectioned surface.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of epididymis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Efferent ductule of testis (one or two other efferent ductules are indistinctly visible in the image)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Mediastinum testis (rete testis not grossly visible)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of epididymis  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Connective tissue  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens (cut across, note thick muscular tunic, thin mucosal tunic and small lumen)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tail of epididymis  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Septa of testis  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lobule of testis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tunica albuginea  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tunica vaginalis testis (visceral layer)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior margin of testis  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extremity of testis"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_74", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Epididymis dissected, posterior view\n\t\t\t\t\t\t\t\t\t\tThe nerves and vessels have been removed from the specimen shown in the previous view. The epididymis has been teased apart to some extent.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial surface of testis (covered by visceral lamina of tunica vaginalis testis)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut margin of tunica vaginalis testis  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior margin testis (tunica albuginea)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior extremity of testis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior aberrant ductule  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of epididymis  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Efferent ductules  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lobules of epididymis (coni epididymidis)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Aberrant ductules  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of epididymis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Epididymal duct  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tail of epididymis (teased apart and stretched upward toward ductus deferens with which it is continuous)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_75", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Close-up view of posterior aspect of testis and epididymis\n\t\t\t\t\t\t\t\t\t\tThe testis has been rotated to expose its posterior aspect. The ductus deferens (2) has been dissected and displaced to the side for better exposure of underlying structures. The numerous testicular veins and veins of the epididymis have been cut off and the pampiniform plexus of veins has been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Testicular plexus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial surface of testis (testis has been rotated to demonstrate its posterior aspect)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Testicular artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t artery of ductus deferens  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tail of epididymis (ductus epididymidis dissected and teased apart)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Thigh (background)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of epididymis  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Efferent ductule of testis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal layer tunicae vaginalis testis (in background)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior margin testis (dissected)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Testicular veins (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of epididymis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial coverings of spermatic cord"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_76", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Contents of spermatic cord\n\t\t\t\t\t\t\t\t\t\tThe various structures which pass within the spermatic cord to the right testis have been dissected and separated. The testicle has been rotated to expose its posterior aspect. The coverings of the cord (5) have been incised and reflected. Connective tissue has been removed from the ductus deferens (4) and its associated vessels and nerves. The pampiniform plexus of veins (2) has been cut off at a high level so that the testicular plexus of nerves (3), the testicular (internal spermatic) artery (1), and the ductus deferens (4) with its artery (12) might be displayed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Testicular artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pampiniform plexus (cut away between level of pointer and testis)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Testicular plexus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial coverings of spermatic cord (reflected)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of epididymis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Testis (rotated to expose posterior aspect)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of epididymis  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tail of epididymis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery and vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial inguinal ring  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of ductus deferens  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligament of the penis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans penis"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_77", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Testis and epididymis viewed from above\n\t\t\t\t\t\t\t\t\t\tThe line along which the parietal layer of the tunica vaginalis testis reflects onto the epididymis and testis to become the visceral layer may be traced in this view of the testis seen from above.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Spermatic cord  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External spermatic fascia (reflected)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Tunica vaginalis testis (parietal layer)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Line of reflection of parietal lamina of tunica vaginalis testis onto testis and epididymis as visceral layer  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of epididymis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of epididymis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral surface of testis  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Testis (covered by visceral layer tunicae vaginalis testis)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Appendix testis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial surface of testis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior extremity of testis"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_78", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Testis and epididymis, close-up anterior view\n\t\t\t\t\t\t\t\t\t\tThe right half of the scrotal sac has been opened and the testis and spermatic cord have been elevated. The layers of the spermatic cord have been incised and reflected to reveal the testis and epididymis.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of scrotal wall  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External spermatic fascia  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Connective tissue surrounding ductus deferens, vessels and nerves of testis  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sinus of epididymidis Lower pointer: Body of epididymis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tunica vaginalis testis (lamina parietalis)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep (Buck's) fascia of penis (covering body of penis)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial penile fascia  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans penis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Appendix testis (elevated)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Head of epididymis Lower pointer: Superior ligament of the epididymidis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior margin of testis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral surface of testis (covered by visceral layer of tunica vaginalis testis)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extremity of testis"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_79", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Tela subcutanea; deep membranous layer of superficial fascia, anteroinferior view\n\t\t\t\t\t\t\t\t\t\tThe skin has been removed from the abdominal wall, the external genitalia and the perineum. The tela subcutanea has been dissected to expose the deeply placed membranous layer of superficial fascia which over the lower part of the abdominal wall is known as Scarpa's fascia (1) and over the penis, scrotum and perineum has been called Colles' fascia (19). In the scrotum this layer is blended into the tunica dartos.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Membranous layer of superficial fascia (Scarpa's fascia)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of left testis in elevated scrotum (testis atrophic)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethral surface of penis (covered by superficial penile fascia)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Raphe penis (skin removed)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans penis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of penis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of right testis in elevated scrotum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Skin of right thigh  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcutaneous fat in perineum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Skin of perineum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of anus (not visible)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Incomplete fibrous lamina in tela subcutanea  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ilioinguinal nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Line of fusion of Scarpa's fascia to fascia of thigh below and parallel to inguinal ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t External pudendal arteries  16\n\t\t\t\t\t\t.\n\t\t\t\t\t External pudendal vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia lata  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Great saphenous vein  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Membranous layer of superficial fascia overlying root of penis (Colles' fascia)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle (cut across in transecting thigh)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_80", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Penis and scrotum, anterior view\n\t\t\t\t\t\t\t\t\t\tThe subject is a young adult.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum of penis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Neck of penis Lower pointer: Head of penis  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans penis  4\n\t\t\t\t\t\t.\n\t\t\t\t\t External urethral opening  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Raphe of scrotum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Scrotum (pointer indicates location of left testis)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_81", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Pubic symphysis, sectioned\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic tubercle (sectioned)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis (no cavity present in central area of symphysis)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic arcuate ligament"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_82", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Pubic symphysis, posterior aspect\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineal ligament (ligament of Cooper)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic arcuate ligament  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator membrane (cut off near body of pubic bone)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of levator ani muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_83", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Pubic symphysis, anterior aspect\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic tubercle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineal ligament (ligament of Cooper)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of pectineus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of gracilis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator canal  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic arcuate ligament"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_84", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Sacroiliac joint opened; interosseous sacroiliac ligament, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe left ilium has been detached to display the auricular surface of the sacrum and the interosseous sacroiliac ligaments.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous sacroiliac ligament (pointer indicates only a small part of the area occupied by the numerous bands that comprise these ligaments which have been cut at their attachments to the ilium)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral sacroiliac ligament  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra L. V  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinous ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Interspinous ligament L. V - S. I (convex in shape due to compression by extension of vertebra on sacrum)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral crest  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacroiliac ligament (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac branch of iliolumbar artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of articular surface in which fibrocartilage has been damaged (remainder of auricular surface intact)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule (lined internally by synovial membrane)"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_85", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Sagittal section of lumbosacral spine; transverse section through sacroiliac joint\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the preceding view (155-7) has been cut in the median plane and the right half subsequently has been cut in a plane transverse to the sacroiliac joint and approximately at right angles to the long axis of the sacrum. The sectioned parts have been separated from each other and are viewed from in front.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intervertebral foramen Lower pointer: Dorsal sacral foramen  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous sacroiliac ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacroiliac joint (pointer on cavity and fibrocartilage covering articular surfaces of both bones)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ilium (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior (pelvic) sacral foramina  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic foramen  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ischium  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Bony ridge at site of exit of tendon of obturator internus from pelvis (note other parallel ridges)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic foramen  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral sacrococcygeal ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrococcygeal junction (articular cavity present in this specimen)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinous ligament  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine (pointer indicates facet for attachment of coccygeus muscle)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinous ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Interspinous ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Spine of vertebra L. IV  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of vertebra L. IV (facing vertebral canal)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum flavum  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anulus fibrosus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. V  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Nucleus pulposus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part of sacrum  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior limit of dural sac  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacroiliac joint (reinforced by ventral sacroiliac ligament)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse line of sacrum (note remnant of intervertebral disk in cut section)  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Hiatus sacral canal Lower pointer: Superficial dorsal sacrococcygeal ligament"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_86", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Ligaments of pelvic girdle, anterior view\n\t\t\t\t\t\t\t\t\t\tThe pubic bones have been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part of sacrum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineal ligament (ligament of Cooper)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus (cut across)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of coccyx (pointer overlies head of femur)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiofemoral ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacrococcygeal ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. V  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. V - S. I  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process vertebrae L. V  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac fossa  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacroiliac joint (covered by ventral sacroiliac ligament)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic (anterior) sacral foramina  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic foramen  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinous ligament  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic foramen  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator membrane (cut across)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_87", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Iliolumbar ligaments, anterior view\n\t\t\t\t\t\t\t\t\t\tMuscles within the pelvic cavity have been preserved. The main constituents of the sacral plexus have been left intact on the right side.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. IV (covered by anterior longitudinal ligament)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process vertebrae L. IV  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve I (ventral branch)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate line  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator fascia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous arch of levator ani muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. IV-V  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac fossa  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part of sacrum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacroiliac joint (pointer indicates ventral sacroiliac ligament)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic foramen  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inguinal ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior fascia of pelvic diaphragm  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic surface of sacrum  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_88", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Ligaments of pelvic girdle, posterior view\n\t\t\t\t\t\t\t\t\t\tMuscles, blood vessels and nerves have been removed from this specimen of a young adult male.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinous ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process of vertebra L. V  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral crest  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic foramen  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinous ligament (at attachment to ischial spine)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic foramen  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process vertebrae L. IV  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process vertebrae L. V  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala of ilium  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacroiliac ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ilium  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of coccyx  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral horn  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial dorsal sacrococcygeal ligament  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacrococcygeal ligament"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_89", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Ligaments of coccygeal region, close-up posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch of coccygeal nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch of sacral nerve V  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Connecting ioop between fifth sacral nerve and coccygeal nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (transected)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral border of sacrum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal vein (cut off)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pudendal nerve Lower pointer: Internal pudendal artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine (covered by fibers of coccygeus muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle (overlying sacrospinous ligament)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (pointer on iliococcygeus muscle)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior rectal artery Lower pointer: Perineal artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator fascia (reflected to expose perineal vessels and nerves in pudendal canal)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (pointer on pubococcygeus muscle)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral horn  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeal horn  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Aperture for dorsal ramus of fifth sacral nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial dorsal sacrococcygeal ligament  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Deep dorsal sacrococcygeal ligament Lower pointer: Sacrotuberous ligament  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (terminal segment)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate fascia  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior fascia of pelvic diaphragm  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  28\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_90", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Ligaments of sacral region, posterior view\n\t\t\t\t\t\t\t\t\t\tThe central area of the dissection shown in the preceding view is illustrated in this close-up photograph.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinous ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process vertebrae L. V (periosteum removed)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacral foramina (partially obscured by ligamentous bands note vessels and nerves emerging between bands)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery (cut off)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve (exposed by excision of piriform muscle)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinous ligament (blended with coccygeus muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebrae L. V  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint capsule  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacroiliac ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral crest  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral horn  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial dorsal sacrococcygeal ligament"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_91", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Ligaments of lumbosacral region, posterior view\n\t\t\t\t\t\t\t\t\t\tThe erector spinae and gluteus maximus muscles have been removed. On the left the gluteus medius has been cut away.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Erector spinae muscle (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinous ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertransverse ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus lumborum muscle (covered by middle layer of thoracolumbar fascia)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Left kidney (faintly visible through thoracolumbar and renal fascia)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process vertebrae L. IV  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle (cut edge)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of gluteus medius muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus minimus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve (emerging through greater sciatic foramen)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal pudendal artery Lower pointer: Pudendal nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle (tendon of insertion)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (posterior layer, reflected)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint capsule L. IV-V  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral crest  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacroiliac ligament  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiorectal fossa  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial dorsal sacrococcygeal ligament  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_92", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Coccyx, anterior view\n\t\t\t\t\t\t\t\t\t\tThis specimen consists of three segments, the terminal one of which comprises two small terminal pieces fused together.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeal horn  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for sacrum"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_93", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Sacrum, left lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of sacrum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic surface  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral crest  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral tuberosity (note accessory articular facet on posterior part of tuberosity)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral crest"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_94", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Sacrum, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Base  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacral foramen (pelvic foramen in background)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate sacral crest  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral horn  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral canal  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral tuberosity  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory articular facet (of sacroiliac joint)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral crest  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral crest  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral hiatus"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_95", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Sacrum, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of sacrum (pointer on Promontory)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior (pelvic) sacral foramina  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse lines (note lack of fusion between first and second sacral bodies in this young specimen)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of sacrum"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_96", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left coxal bone, medial aspect\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac tuberosity  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory facet of sacroiliac articulation  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic notch  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ischium  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic notch  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac fossa  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ilium  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic eminence  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Symphyseal surface  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator foramen"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_97", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated male pelvis, left lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle of iliac crest  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External lip of iliac crest  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteal surface of ilium  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ilium (pointer on inferior gluteal line)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic eminence  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fossa of acetabulum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate surface  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic tubercle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Notch of acetabulum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator foramen  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior gluteal line  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior gluteal line  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior inferior iliac spine  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrum  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic notch  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic notch  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ischium  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_98", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated male pelvis, posteroinferior view\n\t\t\t\t\t\t\t\t\t\tThe configuration of the male pelvic outlet is shown in this view and should be compared with that of the female pelvis in 154-1.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior inferior iliac spine  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala of ilium (gluteal surface)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of pubic symphysis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process of sacrum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate sacral crest  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral crest  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral hiatus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral horn  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (upper pointer indicates coccygeal horn)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic notch  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic notch"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_99", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated male pelvis, anterosuperior view\n\t\t\t\t\t\t\t\t\t\tThe shape of the superior pelvic aperture (13) and of the pelvic cavity below this line should be compared with that of the female pelvis shown in 153-7.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part of sacrum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ilium  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal lip of iliac crest  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intermediate line of iliac crest Lower pointer: External lip of iliac crest  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic eminence  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic tubercle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process of sacrum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral crest  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral canal  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of sacrum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate line (part of linea terminalis which marks superior pelvic aperture)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_100", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated male pelvis, anteroinferior view\n\t\t\t\t\t\t\t\t\t\tThe specimen is viewed from in front and slightly below in order that details of the obturator foramen may be seen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala of ilium (pointer indicates iliac fossa)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate line of ilium  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic eminence  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineal line (pubic bone)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior pubic ramus Lower pointer: Pubic tubercle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part of sacrum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior (pelvic) sacral foramen  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse line  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of sacrum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacroiliac joint  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ilium  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ischium  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator foramen  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium"}
{"_id": "stanford_medicine_male_pelvis_clean$$$corpus_101", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated male and female pelvic bones, anterior view\n\t\t\t\t\t\t\t\t\t\tThe more massive male pelvis on the left side of the view is distinguished from that of the female in several respects. It is higher and narrower and exhibits more pronounced surface markings than the female specimen. The angle between the diverging inferior rami of the pubic bones (subpubic angle) is less in the male. The obturator foramina are elongated in comparison with those of the female. Marked differences in the configuration of the superior and inferior pelvic apertures are not clearly visible in this photograph but are shown in subsequent views in this series. The view was made from in front and slightly below the horizontal plane in order to show the subpubic angle and the obturator foramina. The relations in a direct anteroposterior view are visible in the radiograph shown in 155-1.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ilium  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischium  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrum (pointer on Promontory)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacroiliac joint  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Linea terminalis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator foramen  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus"}
{"_id": "stanford_medicine_neck_clean$$$corpus_1", "text": "Hyoid bone and framework of larynx\n\t\t\t\t\t\t\t\t\t\t Cricoid and arytenoid cartilages, right anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe left arytenoid cartilage has been detached and turned to expose its medial surface.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Corniculate cartilage  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Arycorniculate synchondrosis  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of arytenoid cartilage  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Triangular fovea of arytenoid cartilage  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate crest of arytenoid cartilage  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Fovea oblonga arytenoid cartilage  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular process of arytenoid cartilage  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of arytenoid cartilage  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface arytenoid  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina of cricoid cartilage  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface thyroid (poorly defined)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Arytenoid cartilaginous neck  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vocal process of arytenoid cartilage  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface arytenoid cartilage  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tracheal cartilage (fused to cricoid cartilage)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of cricoid cartilage"}
{"_id": "stanford_medicine_neck_clean$$$corpus_2", "text": "Hyoid bone and framework of larynx\n\t\t\t\t\t\t\t\t\t\t Thyroid cartilage, posterior view\n\t\t\t\t\t\t\t\t\t\tThe periochondrium has been removed except near the midline where the hyothyroid, thyroepiglottic, cricothyroid and vocal ligaments were attached.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior thyroid incisure  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lamina thyroid cartilage  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior horn thyroid cartilage  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior horn thyroid cartilage  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid incisure  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Attachment of ligaments (see note above)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_3", "text": "Hyoid bone and framework of larynx\n\t\t\t\t\t\t\t\t\t\t Hyoid bone, inferior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater horn  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser horn  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articulation between greater horn and body (see previous view)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_4", "text": "Hyoid bone and framework of larynx\n\t\t\t\t\t\t\t\t\t\t Hyoid bone, superior view\n\t\t\t\t\t\t\t\t\t\tTwo unusual features of ossification are seen in this specimen. The greater cornu on the right is not fused to the body, although the left one is joined in the normal manner. The lesser cornua are fused to their respective greater cornua.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater horn  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Articulation between greater horn and body of hyoid bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser horn"}
{"_id": "stanford_medicine_neck_clean$$$corpus_5", "text": "Hyoid bone and framework of larynx\n\t\t\t\t\t\t\t\t\t\t Anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottic cartilage  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lesser horn hyoid bone Lower pointer: Joint capsule between minor and major horn  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater horn hyoid bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior horn thyroid cartilage  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior thyroid incisure  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina right thyroid cartilage  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior horn thyroid cartilage  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricothyroid joint capsule  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricotracheal ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tracheal cartilage  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Triticeal cartilage (within lateral thyrohyoid ligament)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle hyothyroid ligament  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior thyroid tubercle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique line thyroid cartilage  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid tubercle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cricothyroid ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cricothyroid ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Conus elasticus Lower pointer: Arch of cricoid cartilage  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Annular ligament of trachea"}
{"_id": "stanford_medicine_neck_clean$$$corpus_6", "text": "Hyoid bone and framework of larynx\n\t\t\t\t\t\t\t\t\t\t Posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottic cartilage  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater horn hyoid bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior thyroid incisure  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroepiglottic ligament  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior horn thyroid cartilage  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Arycorniculate synchondrosis Lower pointer: Apex of arytenoid cartilage  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular process of arytenoid cartilage  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Interarytenoid notch  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior horn of thyroid cartilage  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricotracheal ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Membranous wall of trachea (layer of smooth muscle visible)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser horn hyoid bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Stem of epiglottis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral thyrohyoid ligament (Triticeal cartilage embedded in ligament at site of pointer)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina right thyroid cartilage  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Corniculate cartilage  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vocal lip Lower pointer: Rima glottidis  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cricoarytenoid ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricoarytenoid joint capsule  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina of cricoid cartilage  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricoarytenoid joint capsule  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Tracheal cartilage"}
{"_id": "stanford_medicine_neck_clean$$$corpus_7", "text": "Hyoid bone and framework of larynx\n\t\t\t\t\t\t\t\t\t\t Superior view\n\t\t\t\t\t\t\t\t\t\tThe periosteum has been removed from the hyoid bone and the perichondrium scraped from the laryngeal cartilages. The elastic cone and vocal ligaments have been preserved and the articular capsules retained.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottal cartilage  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser horn hyoid bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lamina thyroid cartilage  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater horn hyoid bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior horn thyroid cartilage  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Corniculate cartilage  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of arytenoid cartilage  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Interarytenoid incisure Lower pointer: Posterior cricoarytenoid ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina of cricoid cartilage  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroepiglottic ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vocal ligament  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Rim of glottis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Conus elasticus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of cricoid cartilage  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Apex of arytenoid cartilage Lower pointer: Muscular process of arytenoid cartilage  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral thyrohyoid ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricothyroid joint capsule  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior horn thyroid cartilage  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricothyroid joint capsule"}
{"_id": "stanford_medicine_neck_clean$$$corpus_8", "text": "Sagittal section of neck\n\t\t\t\t\t\t\t\t\t\t Dissection of left half of larynx, medial view\n\t\t\t\t\t\t\t\t\t\tThe mucosa of the larynx has been cut away except for that which lines the ventricle (28) and a narrow rim which remains on the vocal (30) and ventricular folds (28). The elastic cone and the quadrangular membrane have been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Oral part pharynx  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Root of tongue  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottal cartilage  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Hyoepiglottic ligament  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Laryngeal part of pharynx  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Aryepiglotticus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior laryngeal nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Aryepiglottic fold (cuneiform cartilage not present)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Corniculate cartilage  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of arytenoid cartilage  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse arytenoid muscle (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cricoarytenoid ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vocal process of arytenoid cartilage  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina of cricoid cartilage (sectioned)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cricoarytenoid muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle (cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricotracheal ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Genioglossus muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible (sectioned)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniohyoid muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone (sectioned)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid muscle (cut across)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle hyothyroid ligament  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior laryngeal glands  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial laryngeal glands (overlying appendix ventriculi laryngis)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Left lamina thyroid cartilage Right pointer: Superficial fascia  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroepiglottic ligament  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ventricular fold Lower pointer: Laryngeal ventricle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Sesamoid cartilage  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Vocal ligament (beneath tunica mucosa of vocal cord)  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroarytenoid muscle  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage (sectioned)  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cricoarytenoid ligament  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Isthmus of thyroid gland  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of cricoid cartilage (sectioned)  36\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophageal mucosa (tunica)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_9", "text": "Sagittal section of neck\n\t\t\t\t\t\t\t\t\t\t Larynx; medial aspect viewed from right side\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual tonsil  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Laryngeal part of pharynx  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior wall of pharynx (sectioned)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Epiglottis Lower pointer: Piriform recess  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Aryepiglottic fold (upper pointer, cuneiform tubercle; lower pointer, corniculate tubercle)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body cervical vertebra IV and nucleus pulposus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse arytenoid muscle (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cricoarytenoid muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricoid cartilage (lamina)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Retropharyngeal space  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniohyoid muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Hyoepiglottic ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Mylohyoid muscle Lower pointer: Fat  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle hyothyroid ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Laryngeal vestibule Lower pointer: Ventricular fold  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Laryngeal ventricle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Vocal cord  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid gland  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Conus elasticus (covered by mucosa)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricoarytenoid ligament (middle)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of cricoid cartilage"}
{"_id": "stanford_medicine_neck_clean$$$corpus_10", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Larynx; arytenoid and posterior cricoarytenoid muscles, quadrangular membrane\n\t\t\t\t\t\t\t\t\t\tThe attachment of the cervical part of the esophagus to the cricoid cartilate (ligamentum cricopharyngeum) has been cut and the esophagus (13) sectioned transversely below the inferior margin of the cricoid cartilage. The quadrangular membrane (15) has been exposed by the removal of the aryepiglottic muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral thyrohyoid ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior laryngeal nerve (cut across)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior horn thyroid cartilage  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior laryngeal artery Lower pointer: Inferior branch of superior laryngeal nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lamina thyroid cartilage (inner surface)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique arytenoid muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse arytenoid muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomotic branch of superior laryngeal nerve with inferior laryngeal nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior laryngeal nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid gland  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Trachea Lower pointer: Esophagus (sectioned)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngoepiglottic fold  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Aryepiglottic fold Lower pointer: Quadrangular membrane  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Corniculate cartilage  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Interarytenoid incisure  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomotic branch superior laryngeal nerve with inferior laryngeal nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricoid cartilage  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cricoarytenoid muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosa of pharynx (separated from muscular tunica)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_11", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Cavity of larynx, superior view\n\t\t\t\t\t\t\t\t\t\tThe specimen is the same as that seen in reel 83-3.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottic tubercle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Laryngeal ventricle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Aryepiglottic fold  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventricular fold  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Laryngeal ventricle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior laryngeal artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Macula flava  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior laryngeal nerve (superior branch)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Glottic rim (intermembrane part )  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina right thyroid cartilage (inner surface)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Vocal cord  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior laryngeal nerve (inferior branch)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Aberrant muscular slip  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Aryepiglotticus muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Vocal process of arytenoid cartilage  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Glottic rim (intercartilaginous part)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Corniculate cartilage  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Interarytenoid notch"}
{"_id": "stanford_medicine_neck_clean$$$corpus_12", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Larynx; blood vessels and nerves\n\t\t\t\t\t\t\t\t\t\tThe mucous membrane has been removed from the piriform recesses and anterior wall of the esophagus. The right superior laryngeal nerve (22) has been retracted to expose branches of the superior laryngeal artery (20) and vein.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Salpingopharyngeus muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater horn hyoid bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal branch of external carotid artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral thyrohyoid ligament (Triticeal cartilage not present)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior laryngeal nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior horn thyroid cartilage  9\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Corniculate tubercle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform recess (mucosa removed)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid gland  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Root of tongue  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottis  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngoepiglottic fold (mucosa preserved)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Aryepiglottic fold (inner mucosal surface preserved)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Laryngeal ventricle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior laryngeal artery Lower pointer: Superior laryngeal vein  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosa of pharynx (tunica)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior laryngeal nerve (retracted slightly laterally)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricoid cartilage (covered by perichondrium)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cricoarytenoid muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophageal veins  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve VII (cut across)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular coat of esophagus (longitudinal layer)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular coat of esophagus (circular layer)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_13", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Larynx; posterior surface view\n\t\t\t\t\t\t\t\t\t\tThe wall of the pharynx and esophagus has been opened.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior laryngeal nerve (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cuneiform tubercle Lower pointer: Corniculate tubercle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lobe of thyroid gland  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X) (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Root of tongue  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Oral part pharynx  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngoepiglottic fold  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Laryngeal ventricle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Aryepiglottic fold Lower pointer: Superior horn thyroid cartilage  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Fold of laryngeal nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Interarytenoid incisure  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Piriform recess Lower pointer: Prominence produced by cricoid cartilage  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus"}
{"_id": "stanford_medicine_neck_clean$$$corpus_14", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Relation of left facial nerve to parotid gland\n\t\t\t\t\t\t\t\t\t\tThe sternocleidomastoid muscle (3) has been cut off close to its insertion and its tendon reflected laterally from the mastoid process (4) of the temporal bone. The posterior facial vein (7) has been cut off and the parotid gland dissected to expose the facial nerve as it passes between the deep (9) and superficial (10) lobes of the gland.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylomastoid foramen (opened)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid incisure  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle (tendon of insertion stripped from mastoid process)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior (temporofacial) division of facial nerve (VII)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior facial vein  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior (cervicofacial) division of facial nerve (VII)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid gland (deep lobe)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid gland (superficial lobe)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylohyoid ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylohyoid muscle (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Hypoglossal nerve (XII) (cut across) Lower pointer: External maxillary artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia (external layer)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular gland  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t External pterygoid muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process temporal bone  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Salpingopharyngeus muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ascending palatine artery Lower pointer: Stylomandibular ligament  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal constrictor muscle (pointer near origins of muscle from pterygomandibular raphe)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloglossus muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylopharyngeus muscle (cut across)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_15", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Musculature of soft palate\n\t\t\t\t\t\t\t\t\t\tThe mucous membrane has been removed from the left half of the soft palate and pharyngeal wall.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending pharyngeal artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cartilaginous auditory tube  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator veli palatini muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending palatine artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tensor veli palatini muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid hamulus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal constrictor muscle (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid gland  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatopharyngeus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylopharyngeus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylohyoid ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylohyoid muscle (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Digastric muscle (cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater horn hyoid bone  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral thyrohyoid ligament  22\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal septum  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior nasal concha  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Torus tubarius  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Salpingopharyngeal fold  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Velum of palate  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Uvular muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Uvula  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of tongue  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Vallate papilla  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sulcus terminalis Lower pointer: Foramen caecum  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual tonsil  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Oral part pharynx  36\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Epiglottic vallecula Lower pointer: Median glossoepiglottic fold  37\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottis"}
{"_id": "stanford_medicine_neck_clean$$$corpus_16", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Pharynx and esophagus; posterior aspect of larynx\n\t\t\t\t\t\t\t\t\t\tA midline incision has been made through the wall of the pharynx and cervical part of the esophagus. The cut margins have been retracted.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Torus tubarius  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal part pharynx  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process temporal bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Salpingopharyngeal fold  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatopharyngeal arch  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Oral part pharynx  7\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Laryngeal part of pharynx  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform recess  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid gland  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal septum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Choanae  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Soft palate Lower pointer: Uvula (poorly developed)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Root of tongue  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vallate papillae  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual tonsil  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Epiglottis Lower pointer: Pharyngoepiglottic fold  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Aryepiglottic fold  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Laryngeal ventricle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Prominence produced by cricoid cartilage  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (cut across)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular surface thoracic vertebrae II"}
{"_id": "stanford_medicine_neck_clean$$$corpus_17", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Muscles originating from styloid process\n\t\t\t\t\t\t\t\t\t\tThe stylopharyngeus (6) and stylohyoid (7) muscles have been retracted slightly to expose the styloid process (8), the stylomandibular ligament (11) and the styloglossus muscle (9).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid part of temporal bone (dissected)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX) (note branch to stylopharyngeus muscle (6))  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII) (note branch to stylohyoid muscle (7))  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid gland  5\n\t\t\t\t\t\t.\n\t\t\t\t\t External pterygoid muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylopharyngeus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lymph node parotid Lower pointer: Stylohyoid muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process temporal bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloglossus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Digastric muscle (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylohyoid ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery (lingual artery lies inferiorly but is obscured)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pharyngobasilar fascia Lower pointer: Pharyngeal tonsil  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital condyle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending pharyngeal artery (cut off)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid venous plexus (near junction with pharyngeal venous plexus)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal constrictor muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal raphe  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle pharyngeal constrictor muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior horn thyroid cartilage  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior laryngeal nerve"}
{"_id": "stanford_medicine_neck_clean$$$corpus_18", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Middle constrictor muscle of pharynx; pharyngeal raphe; submucosal plexus of esophageal veins\n\t\t\t\t\t\t\t\t\t\tThe inferior constrictor muscle has been partially resected on the left to expose the middle constrictor of the pharynx. The vagus nerve and sympathetic trunk have been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid gland  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery (cut across)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylopharyngeus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylohyoid muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process temporal bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending pharyngeal artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior belly of digastric muscle Lower pointer: Occipital artery (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual artery (in background)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal branch of external carotid artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid body  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid sheath  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid gland  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal tonsil (pharyngobasilar fascia removed)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital condyle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal constrictor muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Pterygoid venous plexus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal raphe  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle pharyngeal constrictor muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior horn thyroid cartilage  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle right  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle left (divided)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophageal vein"}
{"_id": "stanford_medicine_neck_clean$$$corpus_19", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Pharyngeal plexus of nerves; ascending pharyngeal artery\n\t\t\t\t\t\t\t\t\t\tBranches of the glossopharyngeal (8) and vagus (9) nerves which enter the pharyngeal plexus are visible in this close-up view of the superior portion of the dissection shown in reel 82-2.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cochlea Lower pointer: Tympanic cavity (opened)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior belly of digastric muscle Lower pointer: Styloid process temporal bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X) (retracted Iaterally)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending pharyngeal artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal branch glossopharyngeal nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal branch vagus nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Nodose ganglion of vagus nerve (retracted laterally)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII) (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cervical ganglion  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior laryngeal nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid body  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cardiac branch vagus nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Aperture of sphenoid sinus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid venous plexus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal part pharynx (cut open)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pharyngobasilar fascia Lower pointer: Pharyngeal tonsil (outer surface)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal constrictor muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Longus colli muscle (cut across) Lower pointer: Longus capitis muscle (cut across)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Middle pharyngeal constrictor muscle Lower pointer: Buccopharyngeal fascia  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior horn thyroid cartilage Lower pointer: Sympathetic trunk"}
{"_id": "stanford_medicine_neck_clean$$$corpus_20", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t General view of pharynx and esophagus\n\t\t\t\t\t\t\t\t\t\tThe remainder of the cervical spine and the first thoracic vertebrae have been removed. The prevertebral muscles on the right have been partially resected. The prevertebral and buccopharyngeal fascia remain to the right of the midline. The left internal carotid artery, internal jugular vein, hypoglossal and accessory nerves have been cut away from the central areas of the dissection. The left vagus nerve has been retracted laterally. The left pharyngeal plexus has been preserved.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pharyngobasilar fascia Lower pointer: Pharyngeal tonsil (exposed by partial resection of above fascia)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process temporal bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Nodose ganglion of vagus nerve (retracted laterally)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal branch vagus nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior laryngeal nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cervical ganglion  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior horn thyroid cartilage  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal carotid artery (cut off) Lower pointer: Internal jugular vein (cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cardiac branch vagus nerve (joined by superior cardiac nerve from sympathetic trunk)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lobe of thyroid gland  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sphenoid sinus (opened) Lower pointer: Body sphenoid bone (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital condyle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pharyngobasilar fascia Lower pointer: Superior pharyngeal constrictor muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle pharyngeal constrictor muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical part of esophagus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Brachial plexus (cervical nerve VIII) Lower pointer: Articular surface superior thoracic vertebrae II"}
{"_id": "stanford_medicine_neck_clean$$$corpus_21", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Blood vessels and nerves to left carotid body\n\t\t\t\t\t\t\t\t\t\tThe internal carotid artery and vagus nerve have been retracted posterolaterally and the superior cervical ganglion retracted posteromedially.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sternocleidomastoid muscle Lower pointer: Accessory nerve (XI)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Nodose ganglion of vagus nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X) (retracted posterolaterally)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery (retracted posterolaterally)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Carotid body Lower pointer: Carotid body (accessory)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve filaments entering wall of Internal carotid artery at site of carotid sinus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery which supplies carotid body  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle pharyngeal constrictor muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior laryngeal nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Gray rami communicantes (to cervical nerve I-II)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cervical ganglion  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerves to carotid body (branches of glossopharyngeal nerve (IX))  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal plexus vagus nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior horn thyroid cartilage  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cardiac branch vagus nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk"}
{"_id": "stanford_medicine_neck_clean$$$corpus_22", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Plexus of nerves in region of left superior cervical sympathetic ganglion\n\t\t\t\t\t\t\t\t\t\tThe left internal carotid artery and vagus nerve have been retracted medially to expose the origins of the external carotid and pharyngeal plexuses.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly of digastric muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal venous plexus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid nerve plexus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch hypoglossal nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle and superficial fascia  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid body  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular ganglion of vagus nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior rectus capitis muscle Lower pointer: Longus capitis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior arch atlas (midsagittal section)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens axis (midsagittal section)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal branch vagus nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Nodose ganglion of vagus nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cervical ganglion  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Plexus of nerves associated with superior cervical ganglion (20), pharyngeal branches of vagus nerve (18), and glossopharyngeal nerve (6)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery (retracted medially)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X) (retracted medially)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal plexus vagus nerve"}
{"_id": "stanford_medicine_neck_clean$$$corpus_23", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Pharyngeal blood vessels and nerves\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Nodose ganglion of vagus nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Gray rami communicantes (to cervical nerve IV-V, which have been cut away)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior laryngeal nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch hypoglossal nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia (deep lamina of external layer)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior horn thyroid cartilage  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Gray rami communicantes (to cervical nerve IV-V)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion cervical nerve VI  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal constrictor muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal venous plexus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle pharyngeal constrictor muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cervical ganglion  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Body cervical vertebra III (cut in midline)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal branch of external maxillary artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal plexus vagus nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion cervical nerve V  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament"}
{"_id": "stanford_medicine_neck_clean$$$corpus_24", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Relation of pharynx to cervical spine\n\t\t\t\t\t\t\t\t\t\tThe left half of the cervical spine, together with the prevertebral muscles and fascia, has been resected and the muscles of the posterior wall of the pharynx brought to view by removal of the buccopharyngeal fascia. The left carotid sheath has been cut away.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Facial nerve (VII) (pointer at stylomastoid foramen) Lower pointer: Internal jugular vein  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X) (pointer on nodose ganglion)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Accessory nerve (XI) Lower pointer: Sternocleidomastoid muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Gray rami communicantes (to cervical nerve II-III, which have been cut away)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cervical ganglion  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal plexus vagus nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior horn thyroid cartilage  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater auricular nerve (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia (deep lamina of external layer)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal ganglion cervical nerve VI  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t External jugular vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface superior thoracic vertebrae I  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cranial fossa  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum occipital bone  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior margin of foramen magnum  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle (cut across)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal constrictor muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Pharyngeal vein  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle pharyngeal constrictor muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of cervical vertebra III  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Body cervical vertebra IV (sectioned in midsagittal plane)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Trapezius muscle Lower pointer: Levator scapulae muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis cervicis muscle and multifidus muscle (cut across)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of cervical vertebra VII (cut across)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal cord"}
{"_id": "stanford_medicine_neck_clean$$$corpus_25", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Glossopharyngeal and vagus nerves in jugular foramen; origin of tympanic nerve; posterior wall of pharynx\n\t\t\t\t\t\t\t\t\t\tThe temporal bone has been dissected to expose the tympanic canaliculus (canal of Jacobson) (2) and the facial canal (1). Veins and fibrous tissue have been removed to reveal the glossopharyngeal nerve (4) in the anterior part of the jugular foramen. The apex of the petrous part of the temporal bone, the left half of the occipital bone and part of the body of the sphenoid bone have been ground away. This was done without disturbing the soft tissues of the carotid canal (14), petrooccipital fissure (15) or the thick fibrous tissue which underlies the base of the skull (17). The longus capitis and rectus capitis anterior muscles have been partially resected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Facial nerve (VII) within facial canal Lower pointer: Stapedius muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tympanic nerve within tympanic canaliculus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricular branch vagus nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Styloid process temporal bone (covered by periosteum) Lower pointer: Internal jugular vein (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly of digastric muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery left  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery left (cut across in cavernous sinus)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sphenoid sinus (opened)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteal lining of carotid canal  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Veins and connective tissue of petro-occipital fissure (bone removed)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Basal part occipital bone (sectioned in midline)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum (reinforced by anterior atlanto-occipital membrane and pharyngobasilar fascia)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular ganglion of vagus nerve (X)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (Xl)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior rectus capitis muscle (cut across)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle (cut across)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens (axis)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal[ constrictor muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Nodose ganglion of vagus nerve (X)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle pharyngeal constrictor muscle"}
{"_id": "stanford_medicine_neck_clean$$$corpus_26", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Relations of facial, vagus, accessory, hypoglossal and internal carotid nerves; internal jugular vein\n\t\t\t\t\t\t\t\t\t\tThe accessory nerve has been reflected anteriorly to show its communication with the vagus nerve.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior semicircular canal  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse sinus (sigmoid portion)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid cells  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII) emerging from stylomastoid foramen  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior bulb of jugular vein (internal surface)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal branch accessory nerve Lower pointer: External branch accessory nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Retromandibular process parotid gland  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process temporal bone (covered by periosteum)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly of digastric muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Digastric branch of facial nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of longissimus capitis muscle (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VIII)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Petro-occipital synchondrosis  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI) (reflected anteriorly)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular ganglion of vagus nerve (X)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part of occipital bone (cut across)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ascending pharyngeal artery Lower pointer: Alar fascia  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_27", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Nerve supply to longus capitis, longus colli and rectus capitis anterior muscles\n\t\t\t\t\t\t\t\t\t\tThe first three cervical nerves have been retracted laterally so that their muscular branches are visible. The muscles have been elevated.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid nerve (from superior cervical ganglion)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of cervical nerve I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Loop between first and second cervical nerves (note communications with hypoglossal nerve)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Gray ramus communicans (to cervical nerve I)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of cervical nerve II  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ganglion cervical nerve III Lower pointer: Posterior branch cervical nerve III  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Gray rami communicantes (to cervical nerves II-III)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cervical ganglion  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior arch atlas  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens axis  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior rectus capitis muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of cervical nerve I  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of cervical nerve II  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc (C. II-III)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of cervical nerve III  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus colli muscle"}
{"_id": "stanford_medicine_neck_clean$$$corpus_28", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Hypoglossal, accessory and vagus nerves; anterior rami of cervical nerves; internal carotid artery; internal jugular vein\n\t\t\t\t\t\t\t\t\t\tThe bodies of the first five cervical vertebrae have been sectioned in the midsagittal plane and the left halves removed. The cervical nerves have been retained approximately in their normal positions with the exception of the first nerve (16), which has been displaced superiorly. The anterior vertebral venous plexus (18) and longus colli and capitis muscles have been preserved.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular ganglion of vagus nerve (X)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of cervical nerve I-Il to longus capitis muscle and anterior rectus capitis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly of digastric muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Nodose ganglion vagus nerve (X)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch hypoglossal nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lesser occipital nerve Lower pointer: Unnamed cutaneous nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia (deep lamina of external layer)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI) (note communicating branches from second and third cervical nerves)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraclavicular nerves  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of cervical nerve I  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion cervical nerve II (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior rectus capitis muscle Lower pointer: Anterior vertebral venous plexus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion cervical nerve III  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intervertebral disc Lower pointer: Body cervical vertebra III  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion cervical nerve IV  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion cervical nerve V (displaced slightly inferiorly)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface superior cervical vertebra VI  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal cord"}
{"_id": "stanford_medicine_neck_clean$$$corpus_29", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Relations of left sternocleidomastoid muscle, internal jugular vein, cervical plexus and cervical spine\n\t\t\t\t\t\t\t\t\t\tThe fascia has been removed from the upper part of the sternocleidomastoid muscle, which has been pulled somewhat anteriorly. The bodies of the upper cervical vertebrae have been exposed to the left of the midline. The levator scapulae muscle has been cut from its origins and retracted medially and inferiorly to expose the cervical plexus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein (pointer at inferior margin of jugular foramen)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of insertion of longissimus capitis muscle (divided by occipital artery)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle (cut across)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of cervical nerve I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly of digastric muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle (cut across; a similar, more inferior origin is visible medial to the third cervical nerve (24))  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending cervical artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser occipital nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Greater auricular nerve and superficial cutaneous nerve Lower pointer: Supraclavicular nerves  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cervical triangle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t External jugular vein (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Foramen magnum (anterior margin) Lower pointer: Dens (axis)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Right alar ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint cavity between dens and transverse ligament of atlas  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique capitis muscle (cut across)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve III  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Arch of axis Lower pointer: Roots of cervical nerve III  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Basivertebral vein (cut off at junction with longitudinal vertebral sinus) Lower pointer: Body cervical vertebra llI  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve III  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint (between articular processes of C. III- IV)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion cervical nerve V  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Annulus fibrosus intervertebral disc (C. IV-V)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface superior cervical vertebra VI  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle (also see 8 above)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_30", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Joint cavity between transverse ligament and dens\n\t\t\t\t\t\t\t\t\t\tThe left half of the transverse ligament (21) has been divided and the cruciate ligament (15) has been reflected to the right.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Clivus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Hypoglossal canal (opened) Lower pointer: Hypoglossal nerve (Xll)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlanto-occipital joint cavity  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of cervical nerve I  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlantoaxial joint cavity  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion cervical nerve II  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots of hypoglossal nerve (XII)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tectorial membrane (cut edge)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cruciate ligament atlas (divided, lower part retracted)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous tissue and blood vessels in anterior part of foramen magnum (ligamentum apicis dentis not well defined)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar ligament (divided on left)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens axis (joint cavity between dens and transverse ligament opened)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Tectorial membrane (cut across)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse ligament atlas (divided)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlantoaxial joint capsule (opened)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of axis"}
{"_id": "stanford_medicine_neck_clean$$$corpus_31", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Relations of internal jugular vein, hypoglossal, accessory and vagus nerves to atlantooccipital joint; atlantoepistrophic joint\n\t\t\t\t\t\t\t\t\t\tThe contents of the jugular foramen (1,3,4) and hypoglossal canal (2) have been partially exposed without disturbing their relations. The capsule of the atlantoepistrophic joint (22) has been partially resected. The opposing articular surfaces of this joint are incongruous as compared to those of the atlantooccipital joint (6). A dense plexus of blood vessels (16) occupies the area between the dens and the margin of the foramen magnum. The apical ligament of the dens was not well defined.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII) (within hypoglossal canal the nerve is obscured by fibrous tissue and veins)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital condyle (cut across)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlanto-occipital articulation (opened)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular facet atlas (articular cartilage removed)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process atlas  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior branch of cervical nerve I Lower pointer: Groove in atlas for vertebral artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal ganglion cervical nerve II  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of cervical nerve II  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch cervical nerve II  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cruciate ligament atlas (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Plexus of veins (ligamentum apicis dentis absent)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Dens axis (covered by ligaments)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar ligament (cut across)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse ligament atlas (part of cruciate ligament)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Tectorial membrane (cut across)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlanto-occipital joint cavity  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlantoepistrophical joint capsule  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of axis (cut across)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_32", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Cruciate ligament; alar ligaments\n\t\t\t\t\t\t\t\t\t\tThe posterior longitudinal ligament and tectorial membrane have been resected. The posterior vertebral venous plexus has been removed from the left side of the dissection. The jugular foramen (4) and the hypoglossal canal (5) have been cut open.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior semicircular canal  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior petrosal sinus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Glossopharyngeal nerve (IX) Lower pointer: Vagus nerve (X)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior jugular venous bulb (jugular foramen opened, vein emptied of latex, and its anterior wall dissected to show artery to jugular ganglion of vagus nerve)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots of hypoglossal nerve (XII) (hypoglossal canal opened to reveal veins and fibrous tissue enclosing nerve)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital bone (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia (exposed by removal of rectus capitis lateralis muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlantooccipital cavity of articulation  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior branch of cervical nerve I Lower pointer: Groove in atlas for vertebral artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique capitis muscle (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal ganglion cervical nerve II  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous slip of longissimus cervicis muscle (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of axis (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch cervical nerve III  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigeminal nerve (V)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibulocochlear nerve (VIII)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Clivus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater encephali (cut edge)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior longitudinal ligament Lower pointer: Cruciate ligament atias  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Alar ligament (cut across on left)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of dens (axis)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of tectorial membrane  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse ligament atlas (part of cruciate ligament)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater"}
{"_id": "stanford_medicine_neck_clean$$$corpus_33", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Tectorial membrane; atlantooccipital joint\n\t\t\t\t\t\t\t\t\t\tMore of the occipital bone has been removed and the suboccipital muscles have been almost completely cut away on the left side. The capsule of the left atlantooccipital joint has been opened. Synovial folds extend into the joint cavity (4). The dura mater (15) has been reflected laterally. The part of the posterior longitudinal ligament (18) to the right of the midline has been preserved. On the left side this ligament has been cut away to expose the tectorial membrane (20).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Posterior semicircular canal (opened) Right pointer: Vestibulocochlear nerve (VIII)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Transverse sinus (sigmoid portion) Right pointer: Internal jugular vein (in jugular foramen)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Condyloid emissary within condyloid canal  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlanto-occipital articulation  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlanto-occipital joint capsule  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique capitis muscle (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior vertebral venous plexus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch cervical nerve II  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of axis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch cervical nerve III  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Petrosal part of temporal bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater (reflected)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament (left half resected, cut end visible at upper pointer)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots of hypoglossal nerve (XII)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Tectorial membrane  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots of cervical nerve II  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal branch vertebral artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal vertebral sinus"}
{"_id": "stanford_medicine_neck_clean$$$corpus_34", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Posterior longitudinal ligament\n\t\t\t\t\t\t\t\t\t\tThe posterior part of the occipital bone has been cut away to open the foramen magnum and the arches of the cervical vertebrae have been resected. The brain and spinal cord have been removed. The dura mater has been retained in the right half of the posterior cranial fossa and vertebral canal. Details of the relations of meninges and central nervous system in this area are to be found in Section I, reel 32-4 ff.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vestibulocochlear nerve (VIII) Lower pointer: Inferior petrosal sinus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus. nerve (X)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI) (spinal root)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse sinus (sigmoid portion)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior vertebral venous plexus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique capitis muscle (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch occipital artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique capitis muscle (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of axis (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater (over clivus)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Roots of hypoglossal nerve (XII)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior longitudinal ligament Lower pointer: Position of dens (axis)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of foramen magnum (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery and ventral roots of cervical nerve I  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch cervical nerve I  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas (cut across)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior vertebral venous plexus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal vertebral sinus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Roots cervical nerve II Lower pointer: Roots cervical nerve III  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of cervical vertebra III (cut across)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_35", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Ligamenta flava\n\t\t\t\t\t\t\t\t\t\tThe arches of the third, fourth and fifth cervical vertebrae have been divided. The cavities of the superior and inferior (12) intervertebral joints of the third cervical vertebrae have been opened.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique capitis muscle (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Major posterior rectus capitis muscle (cut across)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Condyloid emissary  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlanto-occipital joint capsule  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery and vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process atlas  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of cervical nerve II (note relation to vertebral artery)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch axis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular cavity  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Minor posterior rectus capitis muscle (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Border of foramen magnum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posteror tubercle atlas Lower pointer: Ligamentum flavum  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process axis  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut margins of arch of cervical vertebra III (resected)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ligamentum flavum Lower pointer: Interspinalis muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater (epidural space absent at this level)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_36", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Intervertebral joints; vertebral arches and ligaments\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique capitis muscle (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Major posterior rectus capitis muscle (cut across)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch vertebral artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior atlanto-occipital membrane  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior arch atlas Lower pointer: Inferior oblique capitis muscle (cut across)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cervical plexus (deep portion)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique capitis muscle (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum flavum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch cervical nerve V  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint capsule (C. IV-V)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Rotator brevis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scalene muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Minor posterior rectus capitis muscle (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Major posterior rectus capitis muscle (cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Interspinalis muscles  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of cervical vertebra IV  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process cervical vertebra VII (vertebra prominens)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_37", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Nerve supply to left suboccipital muscles, posterolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique capitis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid cells (dissected)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch occipital artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Facial nerve (VII)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Digastric muscle (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cervical plexus (of Cruveilhier)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process atlas  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior oblique capitis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertransverse muscle (posterior)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint capsule (C. II-III)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch cervical nerve IV  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital bone  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Minor posterior rectus capitis muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Major posterior rectus capitis muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Nuchal ligament  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch cervical nerve I  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process axis  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of axis  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis cervicis muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Multifidus muscle"}
{"_id": "stanford_medicine_neck_clean$$$corpus_38", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Suboccipital muscles; semispinalis cervicis muscle; nerve supply to semispinalis capitis muscle\n\t\t\t\t\t\t\t\t\t\tThe semispinalis capitis muscle has been reflected laterally. Dense fibrous connective tissue and fat have been removed from beneath the muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of semispinalis capitis muscle (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of splenius capitis muscle (cut across)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Obliquus capitis superior muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of occipital artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle (reflected laterally)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve (reflected with above muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch cervical nerve II (note muscular branches)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior branch cervical nerve III (note muscular branches) Lower pointer: Third occipital nerve (reflected with muscle)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior muscular branch of cervical nerve IV  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cutaneous branch of cervical nerve IV  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of origin of semispinalis capitis muscle (from transverse process thoracic vertebra II)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: External intercostal muscle Lower pointer: Rib II  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Minor posterior rectus capitis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior muscular branch of cervical nerve I  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Major posterior rectus capitis muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Nuchal ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Obliquus capitis inferior muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process of axis  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior vertebral venous plexus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Interspinalis muscles  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis cervicis muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process cervical vertebra VI  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle"}
{"_id": "stanford_medicine_neck_clean$$$corpus_39", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Nerve supply to longissimus capitis muscle\n\t\t\t\t\t\t\t\t\t\tThe muscle (9) has been reflected laterally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of splenius capitis muscle (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep cervical lymph node (superior)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Obliquus capitis superior muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of longissimus capitis muscle on mastoid process  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Aberrant muscular slip from longissimus muscle to semispinalis capitis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch occipital artery (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior muscular branches of cervical nerve II  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pterygoid muscle (in background, mandible removed)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior muscular branch of cervical nerve III  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Nuchal ligament"}
{"_id": "stanford_medicine_neck_clean$$$corpus_40", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Semispinalis capitis and cervicis muscles\n\t\t\t\t\t\t\t\t\t\tThe splenius muscles have been cut away and the fascia completely removed from the semispinalis muscles.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of insertion of splenius capitis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process (partially removed laterally)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Nuchal ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of origin of levator scapulae muscle (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus cervicis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scalene muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  14\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis cervicis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser occipital nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of origin of splenius capitis muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process cervical vertebra VI  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Interspinalis muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis cervicis muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle"}
{"_id": "stanford_medicine_neck_clean$$$corpus_41", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Nerve supply to left splenius capitis and cervicis muscles\n\t\t\t\t\t\t\t\t\t\tThe muscles have been cut from their spinal origins (the splenius capitis muscle also cut near its cranial insertion) and reflected laterally. A portion of the fascia which covered the deep surface of the splenius capitis muscle has been preserved. The fascia (15) of the semispinalis capitis muscle (16) has been retained only in a small area.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mastoid process  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior oblique capitis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Suboccipital lymph node  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle (reflected)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Aberrant muscular slip from longissimus capitis muscle to semispinalis capitis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch occipital artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of posterior branch cervical nerve II  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius cervicis muscle (reflected)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of posterior branch cervical nerve IV  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus cervicis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve right  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of semispinalis capitis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Semispinalis capitis muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve left  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle right  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Nuchal ligament  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis of origin of splenius capitis muscle (cut across)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of posterior branch cervical nerve III  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous branch of posterior branch cervical nerve IV"}
{"_id": "stanford_medicine_neck_clean$$$corpus_42", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Left splenius capitis and cervicis muscles; origin of levator scapulae muscle\n\t\t\t\t\t\t\t\t\t\tThe left rhomboid muscles have been removed and the serratus posterior superior muscle (5) reflected laterally. The left scapula has been pulled laterally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Fascia covering semispinalis capitis muscle Lower pointer: Greater occipital nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior serratus muscle (reflected laterally)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve supply to posterior superior serratus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of levator scapulae muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius cervicis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid minor muscle (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis cervicis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus capitis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsalis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Nuchal ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Band of lumbodorsal fascia (removed elsewhere)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process thoracic vertebrae II  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Spine of scapula Lower pointer: Deltoid muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle"}
{"_id": "stanford_medicine_neck_clean$$$corpus_43", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Splenius capitis and levator scapulae muscles\n\t\t\t\t\t\t\t\t\t\tThe left trapezius and sternocleidomastoid muscles have been removed. The rhomboideus major and minor muscles have been divided. The fascia of the splenius capitis muscle has been cut away with the exception of a band (6) which has been retained across the inferior part of the muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of origin of trapezius muscle left  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Nuchal ligament  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of splenius capitis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid minor muscle (cut across near origin)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus fascia  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior serratus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid major muscle (aponeurosis of origin)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of insertion of trapezius muscle into spine of scapula  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid minor muscle (cut across near insertion)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid major muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process cervical vertebra VII  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Spine of scapula"}
{"_id": "stanford_medicine_neck_clean$$$corpus_44", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Fascia colli; cervical part of trapezius muscle\n\t\t\t\t\t\t\t\t\t\tThe dissected area to the left of the midline has not been altered from the previous view. On the right side the skin and tela subcutanea have been removed and the fascia cut away from the trapezius and sternocleidomastoid muscles.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipitalis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater occipital nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser occipital nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular lymph nodes  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital lymph nodes  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle (covered by superficial fascia)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial branches of posterior rami of cervical nerve IV  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve right  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (pointer near origin from superior nuchal line)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle (pointer near insertion into superior nuchal line)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Aberrant muscular slip (unidentified)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cervical triangle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (origin from nuchal ligament)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process cervical vertebra VII  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneus branches of posterior branches cervical nerve VII"}
{"_id": "stanford_medicine_neck_clean$$$corpus_45", "text": "Dissection of head and neck from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Superficial structures; fascia colli\n\t\t\t\t\t\t\t\t\t\tThe skin has been removed and superficial nerves, blood vessels and lymphatic structures dissected on the left side.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse nuchal muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior auricular lymph nodes  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior auricular muscle Lower pointer: Lesser occipital nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Auricle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle (covered by superficial fascia)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cervical triangle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (covered by superficial fascia)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous filaments of cervical plexus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater auricular nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Platysma  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (near insertion)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Third occipital nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital artery and major occipital nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous filament of third occipital nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Occipital lymph nodes  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous filament of posterior branch cervical nerve III  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcutaneous vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia (sectioned)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Medial branches of posterior cervical nerve IV Lower pointer: Cutaneous branch of superficial cervical artery"}
{"_id": "stanford_medicine_neck_clean$$$corpus_46", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Vertebral artery; gray communicating rami of cervical sympathetic trunk, left anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe longus colli, rectus capitis anterior, rectus capitis lateralis and some of the intertransverse muscles have been cut away. In addition, the transverse processes of the atlas, epistropheus and fifth cervical vertebra have been cut so that the course of the vertebral artery (17) is visible. The artery did not pass through the transverse process of the sixth cervical vertebra in this specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal cavity (for details refer to reel 72-3)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of longus capitis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal part pharynx (for details refer to reel 78-5)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus colli muscle (transected close to insertion on anterior tubercle atlas)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cervical ganglion  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Areas of insertion of Iongus colli muscle on bodies of cervical vertebraes III-V  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Position of intervertebral disc uniting cervical vertebrae IV-V Lower pointer: Body of cervical vertebra V  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII) near hypoglossal canal  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Atlanto-occipital articulation  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of cervical nerve I (branch communicating with hypoglossal nerve cut away)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior arch of atlas  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Articulation of atlas-axis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of cervical nerve II  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Gray rami communicantes  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve III  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertransverse muscle (anterior)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch cervical nerve IV  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertransverse muscle (posterior)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of cervical nerve IV  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Gray rami communicans  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior tubercle cervical vertebra V  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve VI"}
{"_id": "stanford_medicine_neck_clean$$$corpus_47", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Prevertebral muscles (continued), left anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe longus capitis muscle has been resected close to its origins (15) from the transverse processes of the third to the sixth cervical vertebrae and also close to its insertion (1) into the occipital bone.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of longus capitis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal cavity (for details refer to reel 78-4)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Nasal part pharynx  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Oral part pharynx  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Larynx  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal carotid artery (within carotid canal) Lower pointer: Jugular foramen (opened)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus capitis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Hypoglossal nerve (XII) Lower pointer: Anterior rectus capitis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior atlanto-occipital membrane Lower pointer: Anterior arch atlas (covered by connective tissue)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process atlas  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Articulation of atlas and axis (pointers on capsule)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of cervical nerve II  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus colli muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cervical ganglion  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Origins of longus capitis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of cervical nerve III  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior intertransverse muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament (partially covered by prevertebral fascia)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cervical ganglion  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process cervical vertebra VII"}
{"_id": "stanford_medicine_neck_clean$$$corpus_48", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Cervical sympathetic trunk; vagus nerve; prevertebral muscles, anterior view\n\t\t\t\t\t\t\t\t\t\tThe tongue has been removed and the pharynx and palate have been sectioned near the midline. The prevertebral fascia has been cut away to the left of the midline.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sphenoid ridge Lower pointer: Nasal part pharynx  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Soft palate (cut in midline)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine tonsil  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Uvula  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Oral part pharynx  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniohyoid muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone (cut in midline)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vagus nerve (X) Lower pointer: Common carotid artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal carotid artery (in carotid canal) Lower pointer: Jugular foramen (opened)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral rectus capitis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Nodose ganglion Lower pointer: Hypoglossal nerve (XII)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cervical ganglion  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cardiac branch vagus nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus colli muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottis  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Origins of anterior scalene muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve VI  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scalene muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve VIII  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cervical ganglion  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Costocervical trunk"}
{"_id": "stanford_medicine_neck_clean$$$corpus_49", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Larynx; relation to oral cavity, oral and laryngeal parts of pharynx, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe left wall of the pharynx has been resected in such a way that the soft palate and left pharyngopalatine arch (20) are preserved. The left glossopalatine arch (15) has been divided and the ends separated. The lateral (attached) surface of the left palatine tonsil (23) is exposed. The hyoid bone has been resected to the midline and the epiglottic cartilage exposed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior longitudinal muscle of tongue  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Genioglossus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior longitudinal muscle of tongue  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid muscle (cut across at midline raphe)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniohyoid muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual tonsil (surface)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vallecula epiglottica left  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadrangular membrane  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Vocal cord and arytenoid cartilage  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricoid cartilage  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Levator veli palatini muscle (cut off) Lower pointer: Styloid process  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatoglossal arch (divided) containing fibers of glossopalatine muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal constrictor muscle (cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cervical ganglion  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Supratonsillar fossa Right pointer: Pharyngopalatine muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatopharyngeal arch (mucosal surface)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Uvula  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine tonsil right in tonsillar fossa  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Palatine tonsil left  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Oral part pharynx  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Epiglottis Lower pointer: Aryepiglottic fold  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Laryngeal part of pharynx  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle (cut across)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus (opened)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_50", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Larynx; vocal cord and vocal muscle; lateral and posterior cricoarytenoid muscles; left lateral view\n\t\t\t\t\t\t\t\t\t\tThe external part of the thyroarytenoid muscle has been removed and the internal part (vocal muscle) retained.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser horn hyoid bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottal cartilage  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrohyoid ligament  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Thyroepiglotticus muscle (cut across) Lower pointer: Aryepiglotticus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadrangular membrane  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Laryngeal ventricle (opened)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vocal cord  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Vocalis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cricoarytenoid muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Conus elasticus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of cricoid cartilage  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral suspensory ligament of thyroid gland (cut off)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Aryepiglottic fold  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior horn thyroid cartilage (cut across)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform recess (opened)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Arytenoid cartilage  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cricoarytenoid muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior branch inferior laryngeal nerve Lower pointer: Inferior pharyngeal constrictor muscle (cut across)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch inferior laryngeal nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of thyroid  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve VI  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of recurrent esophageal nerve  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus"}
{"_id": "stanford_medicine_neck_clean$$$corpus_51", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Larynx; relation to tongue, pharynx and hyoid bone, left anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe external part of the thyroarytenoid muscle has been cut away to expose the vocal muscle (8) and the vocal cord (7). The wall of the appendix of the ventricle, which was opened in the previous view, has been removed. The intrinsic and extrinsic muscles of the tongue have been dissected and are considered in detail in reel 70-3.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum of tongue  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible (cut across)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Genioglossus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniohyoid muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Quadrangular membrane Lower pointer: Ventricular fold  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Laryngeal ventricle Lower pointer: Vocal cord  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Thyroid cartilage Lower pointer: Vocalis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Conus elasticus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pharyngeal constrictor muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Glossopharyngeal nerve (IX)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Hyoglossus muscle (cut off)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle pharyngeal constrictor muscle (chondropharyngeus)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Greater horn hyoid bone Lower pointer: Triticeal cartilage  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior horn thyroid cartilage  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser horn hyoid bone  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform recess (opened)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Arytenoid cartilage  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cricoarytenoid muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricoid cartilage"}
{"_id": "stanford_medicine_neck_clean$$$corpus_52", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Larynx; laryngeal ventricle and piriform recess of pharynx opened, left anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe left half of the thyroid cartilage has been removed with the exception of its superior horn (15) which remains attached to the hyoid bone by the lateral hyothyroid ligament.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottic cartilage (covered by fibrous tissue)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of thyroglossal duct (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Middle laryngeal gland Lower pointer: Appendix laryngeal ventricle (opened)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Elastic laryngeal membrane (quadrangular membrane) Lower pointer: Stem of epiglottis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventricular fold (ventricle opened)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroarytenoid muscle (a few fibers pass superiorly as the thyroepiglotticus muscle )  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Aberrant fibers of cricoepiglottic muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cricoarytenoid muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Area of attachment of deep fibers of cricothyroid muscle Lower pointer: Articular surface of thyroid  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of cricoid cartilage  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater horn hyoid bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral thyrohyoid ligament (enlargement marks position of triticeal cartilage)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior horn thyroid cartilage (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle (reflected posteriorly)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Tunica of pharyngeal mucosa (external aspect)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform recess (opened)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomotic branch superior laryngeal nerve (cut off) with inferior laryngeal nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Arytenoid cartilage  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch inferior laryngeal nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cricoarytenoid muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch inferior laryngeal nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior laryngeal nerve"}
{"_id": "stanford_medicine_neck_clean$$$corpus_53", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Larynx; thyroarytenoid and lateral cricoarytenoid muscles; anastomosis of superior and inferior laryngeal nerves, left anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe left lamina of the thyroid cartilage has been cut and reflected posteriorly. The left cricothyroid joint (23) has been opened.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Hyoglossus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior laryngeal artery Lower pointer: Branches of superior laryngeal nerve to epiglottis and vestibule of larynx  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid muscle (cut across)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Hyoid bone (thick layer of fibrous tissue removed to expose bone)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fat  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle laryngeal gland  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Appendix laryngeal ventricle (outer surface of mucosa) Lower pointer: Thyroepiglotticus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lamina thyroid cartilage (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroarytenoid muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cricoarytenoid muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricoarytenoid ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Prelaryngeal lymph node  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricothyroid muscle (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior laryngeal nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle (reflected posteriorly)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior horn thyroid cartilage  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Mucosa of piriform recess (outer surface) Lower pointer: Aryepiglotticus muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomotic branch superior laryngeal nerve with inferior laryngeal nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Left lamina thyroid cartilage (cut across and reflected posteriorly) Lower pointer: Anterior branch inferior laryngeal nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricothyroid articulation (cut open)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_54", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Larynx; nerve supply to cricothyroid muscle, left anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe left inferior constrictor muscle of the pharynx has been reflected from its origin.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual gland (mandible removed)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior belly digastric muscle (turned inferiorly to expose nerve supply)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Left cartilaginous plate of thyroid  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique line of thyroid cartilage (covered by tendinous band for attachment of muscles)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Prelaryngeal lymph node  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Straight part of cricothyroid muscle Lower pointer: Oblique part of cricothyroid muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle right  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior laryngeal artery Lower pointer: External carotid artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal branch superior laryngeal nerve Lower pointer: Superior horn thyroid cartilage  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrohyoid membrane  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior thyroid artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t External branch of superior laryngeal nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle (reflected)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior horn thyroid cartilage  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior laryngeal nerve Lower pointer: Trachea"}
{"_id": "stanford_medicine_neck_clean$$$corpus_55", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Larynx, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe origin of the inferior constrictor muscle of the pharynx from the thyroid and cricoid cartilages and from an intervening tendinous arch has been preserved.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior belly digastric muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone (covered by fibrous tissue)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrohyoid muscle (reflected)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior jugular vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibers of origin of thyrohyoid muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricothyroid branch superior thyroid artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Prelaryngeal lymph node  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricothyroid muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Tendinous arch for origin of inferior pharyngeal constrictor muscle Lower pointer: Cricoid cartilage  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tracheal cartilage  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior laryngeal artery (originates from external carotid artery)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal branch of superior laryngeal nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrohyoid branch hypoglossal nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t External carotid artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrohyoid membrane  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior thyroid artery Lower pointer: External branch of superior laryngeal nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch hypoglossal nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternothyroid muscle (cut across)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch superior thyroid artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Esophageal branch inferior thyroid artery Lower pointer: Glandular branch inferior thyroid artery  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior pharyngeal constrictor muscle Lower pointer: Inferior laryngeal nerve"}
{"_id": "stanford_medicine_neck_clean$$$corpus_56", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Relations of larynx, anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe infrahyoid muscles have been cut away. The left lobe of the thyroid gland has been removed. The left common carotid artery, internal jugular vein and vagus nerve have been retracted laterally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Omohyoid muscle (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternohyoid muscle (cut across)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrohyoid muscle (divided and elevated)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut ends of fibers of thyrohyoid muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternothyroid muscle (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricothyroid muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricoid cartilage  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch superior thyroid artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Right lobe thyroid gland  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Isthmus of thyroid gland (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic trunk right (duplicated)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternothyroid muscle (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior jugular vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Thymus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cardiac branch vagus nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery (retracted laterally)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior thyroid artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X) (retracted laterally)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein (retracted laterally)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch hypoglossal nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cervical ganglion  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrocervical trunk  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cardiac nerve  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cervical ganglion  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Recurrent laryngeal nerve Lower pointer: Paratracheal lymph node  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Termination of lymphatic ducts in internal jugular vein  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian vein  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia extending into mediastinum from carotid sheath"}
{"_id": "stanford_medicine_neck_clean$$$corpus_57", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Right phrenic nerve; innominate artery and branches, anterior view\n\t\t\t\t\t\t\t\t\t\tThe innominate veins have been cut off close to the superior vena cava and the right subclavian and first part of the right axillary vein removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery and vagus nerve (X)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cervical triangle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superficial cervical artery Lower pointer: Brachial plexus (pointer on superior trunk; roots lie medial, divisions lie lateral to pointer)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Phrenic nerve Lower pointer: Anterior scalene muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle and subclavius muscle (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Transversa colli artery Lower pointer: Transverse scapular artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial plexus (pointer on proximal portion of medial cord)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery (first portion)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary vein (cut off)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic vein right  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis minor muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Axilla  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery and vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery left  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ansa subclavia  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vertebral artery right Lower pointer: Subclavian artery right  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery left  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle right cardiac nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior mediastinal lymph node  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cardiac branch of vagus nerve  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic vein left (cut off)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Pleura (of left lung)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Pleura (of right lung)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_58", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Lymphatic ducts of right side of neck; thymus; innominate artery and veins, anterior view\n\t\t\t\t\t\t\t\t\t\tThe superior mediastinal space has been opened by removal of the manubrium and upper part of the body of the sternum, and parts of the first and second costal cartilages.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Thyroid cartilage (left lamina resected) Lower pointer: Cricoid cartilage  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t External jugular vein (cut across)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle and clavicle (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Right lymphatic duct  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery right  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Axillary artery Lower pointer: Axillary vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian trunk  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Bronchiomediastinal trunk right Lower pointer: Brachiocephalic vein right  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis minor muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior vena cava Lower pointer: Costal pleura right  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal mammary lymph nodes  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vocal ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus colli muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cervical ganglion  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery left  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic vein left  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic artery  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Thymus  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery and vein  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta (covered by fibrous layer of pericardium)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II"}
{"_id": "stanford_medicine_neck_clean$$$corpus_59", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Relations of cupula of pleura, left anterolateral view\n\t\t\t\t\t\t\t\t\t\tA portion of the left innominate vein has been resected. Fascia which covered the pleura (24) has been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricothyroid muscle(partially resected)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vertebral artery Lower pointer: Inferior cervical ganglion  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Isthmus of thyroid gland  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic duct (cut across and reflected anteriorly)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternothyroid muscle (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery left  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pretracheal lymph node Lower pointer: Suprasternal lymph node  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Thymus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve VI  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cervical ganglion  17\n\t\t\t\t\t\t.\n\t\t\t\t\t (Gray) rami communicantes (to cervical nerve VII, VIII)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral vein  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse superficial artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrocervical trunk  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle (cut across)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Cupula pleurae  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic (mammary) artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic vein left (cut off)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_60", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Relations of inferior cervical ganglion, anterior view\n\t\t\t\t\t\t\t\t\t\tThe left common carotid artery and left internal jugular vein have been resected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricoid cartilage  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior laryngeal nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprasternal space  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cervical ganglion  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sympathetic trunk Lower pointer: Vertebral vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending cervical artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cervical ganglion  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve (displaced posterior to brachiocephalic vein)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrocervical trunk  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic duct  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein (cut off)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep cervical vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian vein  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic vein left  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Thymus"}
{"_id": "stanford_medicine_neck_clean$$$corpus_61", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Thoracic duct; structures related to cupula of pleura, left anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe internal jugular vein has been cut off and the left innominate vein retracted anteromedially.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricoid cartilage  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Isthmus of thyroid gland (cut across)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid vein right  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternothyroid muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternal extremity of clavicle (covered by joint capsule)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Thymus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of manubrium of sternum for left clavicle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Manubrium of sternum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending cervical artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial cervical artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cervical ganglion  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrocervical trunk  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic duct  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse scapular artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Cupula pleurae  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic (mammary) artery (note internal mammary nerve plexus)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior and posterior bronchomediastinal lymphatic trunks  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Left internal mammary lymphatic vessels  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anonymous vein left (retracted anteromedially) Lower pointer: Costoclavicular ligament"}
{"_id": "stanford_medicine_neck_clean$$$corpus_62", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Fascial relations at apex of parietal pleura, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe subclavian vein has been retracted anteriorly and areolar connective tissue has been removed posterior to the vein. The fascia (24) which extends medially from the anterior border of the anterior scalene muscle toward the internal mammary artery (23) covers the cupula of the pleura.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral suspensory ligament of thyroid gland (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve (split into several trunks)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch superior thyroid artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Principal termination of lymphatic trunks in internal jugular vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Secondary termination of lymphatic trunks in subclavian vein  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian vein (retracted anteriorly)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid vein (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Thymus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic vein left  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternohyoid muscle (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending cervical artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial cervical artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial plexus (anterior and posterior divisions of superior trunk)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrocervical trunk  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse scapular artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral vein  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic (mammary) artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia covering cupula pleurae  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Costoclavicular ligament"}
{"_id": "stanford_medicine_neck_clean$$$corpus_63", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Left common carotid artery, vagus nerve and thoracic duct, anterior view\n\t\t\t\t\t\t\t\t\t\tThe left lobe of the thyroid gland has been removed, most of the carotid sheath has been cut away and the internal jugular vein has been retracted laterally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Hyoid bone (covered by fibrous tissue)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sternocleidomastoid muscle (cut across) Lower pointer: External jugular vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein (within carotid sheath)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricoid cartilage  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Omohyoid muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea (pointer on first tracheal ring)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Right lobe of thyroid gland  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve left  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph vessels  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of origin of sternocleidomastoid muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery (pointer at bifurcation)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrohyoid muscle (cut and reflected)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior thyroid artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve (X)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus capitis muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Middle cervical ganglion Lower pointer: Ascending cervical artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cervical ganglion  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial plexus (cut across distal to trunks)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic duct  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian vein  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower part of carotid sheath  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Thymus"}
{"_id": "stanford_medicine_neck_clean$$$corpus_64", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Relation of subclavian artery and vein to scalene muscles and brachial plexus, lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal jugular vein Lower pointer: Common carotid artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ansa hypoglossi  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending cervical artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch superior thyroid artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid gland  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse scapular artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymphatic trunks terminating in internal jugular vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid vein left  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternohyoid muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sternoclavicular joint capsule Lower pointer: Costoclavicular ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Nerves to levator scapulae muscle Lower pointer: Levator scapulae muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial cervical artery (posterior end displaced)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior scalene muscle Lower pointer: Transversa colli artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Long thoracic nerve (plexiform)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial plexus (pointer on divisions of superior trunk)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial plexus (pointer on divisions of middle trunk)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial plexus (pointer on divisions of inferior trunk)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle (pointer near origin of muscle from first rib)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian vein"}
{"_id": "stanford_medicine_neck_clean$$$corpus_65", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Levator scapulae and scalene muscles, lateral view\n\t\t\t\t\t\t\t\t\t\tThe prevertebral fascia has been removed and the clavicle partially resected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible and inferior alveolar nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior belly digastric muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Hyoid bone (covered by fibrous tissue)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Common carotid artery Lower pointer: Internal jugular vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrohyoid muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ansa hypoglossi  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid gland  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprascapular nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Transverse scapular artery Lower pointer: Phrenic nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial plexus (upper trunk)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternoclavicular articular disc (clavicle removed)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian vein  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Glenohumeral joint  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior belly of digastric muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater auricular nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI) (cut across)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial cutaneous nerve (cut off)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraclavicular nerves (cut off)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial cervical artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascicle of levator scapulae muscle which joins serratus anterior muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior scalene muscle Lower pointer: transverse colli artery  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus muscle  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus muscle"}
{"_id": "stanford_medicine_neck_clean$$$corpus_66", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Relations of thyroid gland to larynx and trachea, anterior view\n\t\t\t\t\t\t\t\t\t\tThe isthmus (13) of the thyroid gland has been divided and the left lobe retracted laterally. The fascial attachment (9) of the gland to the upper part of the trachea is shown.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternohyoid muscle right (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrohyoid muscle right  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Aberrant muscular slip of cricothyroid muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Prelaryngeal lymph node  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricothyroid muscles  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of cricoid cartilage  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of superior thyroid artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral suspensory ligament of thyroid gland  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Right lobe of thyroid gland  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Isthmus of thyroid gland (divided)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid vein right and tributaries  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternohyoid muscle (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid vein left  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrohyoid muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricothyroid branch superior thyroid artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternothyroid muscle (cut across)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch superior thyroid artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch superior thyroid artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pharyngeal constrictor muscle (m. cricopharyngeus)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lobe of thyroid gland (posteromedial surface)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch from ansa hypoglossi to sternohyoid muscle  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Termination of lymphatic trunks in internal jugular vein  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternothyroid muscle and sternohyoid muscle"}
{"_id": "stanford_medicine_neck_clean$$$corpus_67", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Thyroid gland retracted anteriorly; recurrent laryngeal nerve, left anterolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternohyoid muscle (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of thyroglossal duct (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cricothyroid branch superior thyroid artery Lower pointer: Superior thyroid vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Thyrohyoid muscle Lower pointer: Sternothyroid muscle (cut off)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch superior thyroid artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramidal lobe of thyroid gland  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lobe of thyroid gland (retracted anteriorly)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Right brachiocephalic trunk right (duplicated)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea (pointer on annular ligament)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternothyroid muscle (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternoclavicular ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Filament of superior thyroid nerve plexus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior thyroid artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior thyroid artery Lower pointer: Filament of inferior thyroid nerve plexus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Muscular branch of superior thyroid artery Lower pointer: Fascial layer which covered posterior surface of of thyroid gland  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial cervical artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Chain of lymph nodes along recurrent nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse scapular artery  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian vein"}
{"_id": "stanford_medicine_neck_clean$$$corpus_68", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Thyroid and parathyroid glands, posterior view\n\t\t\t\t\t\t\t\t\t\tA right superior parathyroid gland was not identified.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramidal lobe  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch superior thyroid artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lobe  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior parathyroid gland left  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior parathyroid gland left  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle thyroid vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid artery left  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid vein left  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior thyroid vein right  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch superior thyroid artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch superior thyroid artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Right lobe  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Isthmus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid artery right  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery to inferior parathyroid gland right  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior parathyroid gland right  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid vein right"}
{"_id": "stanford_medicine_neck_clean$$$corpus_69", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Thyroid gland, anterior view\n\t\t\t\t\t\t\t\t\t\tLocalized enlargements at the sites of valves occur at several places along the thyroid veins.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior thyroid vein right  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of superior thyroid artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right lobe  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid artery right  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid vein right  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramidal lobe  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior thyroid vein left  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch superior thyroid artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lobe  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Isthmus (covered by vein)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid vein left"}
{"_id": "stanford_medicine_neck_clean$$$corpus_70", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Infrahyoid region, anterosuperior close-up view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternothyroid muscle right (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricothyroid muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Prelaryngeal lymph node Lower pointer: Cricoid cartilage (covered by perichondrium)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein right  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch anterior superior thyroid artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Right lobe of thyroid gland  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of ansa hypoglossi to sternohyoid muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic trunk right (duplicated)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid vein right  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid vein left  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pretracheal lymph node  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior jugular vein (cut off)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternoclavicular ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprasternal space  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Manubrium of sternum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramidal lobe of thyroid gland  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein left  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lobe of thyroid gland  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscle fascicle from sternothyroid muscle to carotid sheath  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of ansa hypoglossi to sternohyoid muscle and sternothyroid muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Termination of lymphatic trunks in internal jugular vein  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternothyroid muscle (cut off and reflected anteriorly)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian vein  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lymphatic trunk from anterior mediastinal lymph nodes Lower pointer: Internal mammary lymphatic trunk  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternohyoid muscle (lower pointer indicates clavicular origin)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sternoclavicular ligament Lower pointer: Sternoclavicular articular disc  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Costoclavicular ligament  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternoclavicular joint (medial cavity)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_71", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Relations of thyroid gland, anterior view\n\t\t\t\t\t\t\t\t\t\tThe sternocleidomastoid and infrahyoid muscles of the right side have been partially cut away. The left clavicle has been removed. The left subclavian artery, the trunks of the brachial plexus and the junction of the subclavian vein with the internal jugular vein are visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia (external layer)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External jugular vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle (cut across)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superficial fascia (middle layer) Lower pointer: Sternohyoid muscle and omohyoid muscle (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Remnant of thyroglossal duct Lower pointer: Thyroid cartilage  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternothyroid muscle (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein right  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Omohyoid muscle (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Right and left lobe of thyroid gland  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Right lymphatic duct  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Trachea Lower pointer: Inferior thyroid vein right  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicular part pectoralis major muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointers: Sternothyroid muscles (cut across) Lower pointers: Sternohyoid muscles (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Mandible Lower pointer: Anterior belly digastric. muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery (pointer at bifurcation)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve III  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve IV  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrohyoid muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial cervical artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ansa hypoglossi  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricothyroid muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper trunk of brachial plexus  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle trunk of brachial plexus  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Axillary lymph node (subclavian node) Lower pointer: Tributary to subclavian trunk  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian vein  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lymphatic trunk from anterior mediastinal lymph nodes Lower pointer: Internal mammary lymphatic trunk  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicular origin of sternohyoid muscle (clavicle removed)  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Costoclavicular ligament (cut across)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_72", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Left lobe of thyroid gland in situ, anterior view\n\t\t\t\t\t\t\t\t\t\tThe sternothyroid muscle has been divided and reflected to expose the isthmus and left lobe of the thyroid gland. A thin layer of fascia (pretracheal fascia) is adherent to the gland.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Depressor anguli oris muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Submental lymph node  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone (covered by fibrous tissue)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator muscle of thyroid gland  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternohyoid muscle right  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramidal lobe of thyroid gland  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Prelaryngeal lymph node  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lobe of thyroid gland  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Isthmus of thyroid gland  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle layer of superficial fascia  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternal origin of sternocleidomastoid muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal carotid artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch hypoglossal nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior thyroid artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Omohyoid muscle (cut off)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternohyoid muscle (cut off)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrohyoid muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ansa hypoglossi  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of sternothyroid muscle (cut across)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial cervical artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascicle of sternothyroid muscle attaching to carotid sheath  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular trunk  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternothyroid muscle (cut across near origin)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternohyoid muscle (cut across)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle"}
{"_id": "stanford_medicine_neck_clean$$$corpus_73", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Nerve supply to sternohyoid and sternothyroid muscles, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternohyoid muscle (cut across near insertion)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior jugular vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage (covered by membrane)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Levator muscle of thyroid gland Lower pointer: Fibrous-remnant of thyroglossal duct  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternohyoid muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Prelaryngeal lymph nodes  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of superficial cutaneous nerve (displaced inward at termination)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Isthmus of thyroid gland  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle layer of superficial fascia  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior jugular veins (connected by jugular venous arch)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior thyroid artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrohyoid muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricothyroid branch superior thyroid artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of oblique line thyroid cartilage  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ansa hypoglossi  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramidal lobe of thyroid gland  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternothyroid muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Aberrant muscle fascicle attaching to carotid sheath  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerves to sternothyroid muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Site of entry into internal jugular vein of jugular, subclavius and anterior mediastinal trunks  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Nerves entering sternohyoid muscle Lower pointer: Sternohyoid muscle (divided and reflected anteriorly)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternoclavicular ligament and clavicle"}
{"_id": "stanford_medicine_neck_clean$$$corpus_74", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Deep layers of infrahyoid muscles, anterior view\n\t\t\t\t\t\t\t\t\t\tThe bellies of the left sternohyoid and omohyoid muscles have been removed. The left sternoclavicular joint has been opened.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Depressor anguli oris muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Platysma  3\n\t\t\t\t\t\t.\n\t\t\t\t\t External jugular vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternohyoid muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior supraclavicular nerves  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltopectoral triangle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicular part pectoralis major muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pyramidal lobe of thyroid gland  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprasternal space  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior belly digastric muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch hypoglossal nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery (within carotid sheath)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Sternohyoid muscle (cut off) Right pointer: Omohyoid muscle (cut off)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrohyoid muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ansa hypoglossi  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternothyroid muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia covering scalene muscles  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Jugular trunk Lower pointer: Lymphatic trunk from inferior deep cervical lymph nodes  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavius muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery and vein  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternoclavicular ligament  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternoclavicular joint (medial and lateral cavities)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Interclavicular ligament (partially removed)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_75", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Thyrohyoid muscle, anterior view\n\t\t\t\t\t\t\t\t\t\tThe sternohyoid and omohyoid muscles (5) have been detached from the hyoid bone and turned inferiorly. The thin fascia of the thyrohyoid muscle (9) has been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of mandible  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior belly digastric muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone (covered by fibrous tissue)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Omohyoid muscle (cut-off) Lower pointer: Sternohyoid muscle (cut-off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior jugular vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage (covered by fascia)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous remnant of thyroglossal duct (note accompanying Ievator glandulae thyroideae muscle)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Thyrohyoid muscle left Lower pointer: Cricothyroid branch superior thyroid artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternohyoid muscle right  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle right  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Prelaryngeal lymph nodes and medial superior thyroid lymphatic vessels  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternohyoid muscle (reflected inferiorly)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Veins of submandibular gland  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Bifurcation of common carotid artery (covered by carotid sheath)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior thyroid artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch hypoglossal nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve IV  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Hyoid branch lingual artery Right pointer: Thyrohyoid branch hypoglossal nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of descending branch hypoglossal nerve to sternohyoid muscle and superior belly omohyoid muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid branch superior thyroid artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of superior thyroid artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Ansa hypoglossi  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior belly omohyoid muscle (reflected inferiorly)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternothyroid muscle"}
{"_id": "stanford_medicine_neck_clean$$$corpus_76", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Inferior deep cervical lymph nodes; lymphathic vessels entering left internal jugular vein, anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe middle layer of cervical fascia has been removed and the omohyoid muscle retracted superiorly. The thoracic duct is not visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior belly omohyoid muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ansa hypoglossi  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph node of chain posterior to internal jugular vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of superior thyroid artery to sternothyroid muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior deep cervical lymph nodes  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternothyroid muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Aberrant slip of sternothyroid muscle attached superiorly to carotid sheath  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular trunk left  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sternohyoid muscle Lower pointer: Nerve entering sternohyoid muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Site of entry of lymphatic trunks into internal jugular vein Lower pointer: Lymphatic trunk from anterior mediastinal lymph nodes  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to inferior belly omohyoid muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial cervical artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior deep cervical lymph node  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior belly omohyoid muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t External jugular vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial transverse vein  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Subclavian trunk Right pointer: Transverse scapular artery"}
{"_id": "stanford_medicine_neck_clean$$$corpus_77", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Close-up view of clavicular attachment of middle layer of cervical fascia; inferior deep cervical lymphatics, anterosuperior view\n\t\t\t\t\t\t\t\t\t\tThe left clavicle crosses the lower part of the view. The sling-like thickening of fascia (5) which invests the intermediate tendon of the omohyoid muscle has been divided to expose the tendon. The lympathic structures visible at 11 lie in a natural opening in the fascia.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial cervical artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to inferior belly omohyoid muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior belly omohyoid muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior deep cervical lymph nodes and lymph vessels  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia (middle layer)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia  7\n\t\t\t\t\t\t.\n\t\t\t\t\t External jugular vein (cut off)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial transverse vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior belly omohyoid muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t External jugular vein near junction with transverse scapular vein (covered by fascia)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior deep cervical lymph node  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia (middle layer, near clavicular attachment)"}
{"_id": "stanford_medicine_neck_clean$$$corpus_78", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Infrahyoid muscles, anterior view\n\t\t\t\t\t\t\t\t\t\tThe middle layer of cervical fascia has been partially removed from the left side to expose the sternohyoid and omohyoid muscles. On the right side the middle layer of cervical fascia (7) has been reflected to expose a thin, intrinsic fascia over the sternohyoid muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid muscle left  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Platysma  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Submental lymph node  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia (external layer)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t External jugular vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia (middle layer)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intrinsic fascia of sternohyoid muscle Lower pointer: Sternohyoid muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraclavicular nerves  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle right  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicular part pectoralis major muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of mandible  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior belly digastric muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular gland  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Hyoid bone (covered by dense fibrous tissue)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch hypoglossal nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle (reflected)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Omohyoid muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternohyoid muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia (middle layer)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle left  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternoclavicular ligament  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Manubrium of sternum"}
{"_id": "stanford_medicine_neck_clean$$$corpus_79", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Contents of left posterior cervical triangle; superficial cervical lymphatics, lateral view\n\t\t\t\t\t\t\t\t\t\tThe external layer of cervical fascia has been removed from the left side of the neck except from the lower part of the posterior triangle. In this region the lamina of this fascia which passes deep to the sternocleidomastoid and trapezius muscles remains in place. This layer has openings for lymphatic vessels (20) and veins, but can be traced superiorly to the midpart of the view where it becomes continuous with the prevertibral fascia (13). The left shoulder occupies the midforeground of the view.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Parotid gland Lower pointer: Parotid-masseteric fascia  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical branch of facial nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandibular marginal branch of facial nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomosis of cervical cutaneus nerve with facial nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Platysma (reflected anteriorly)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t External jugular vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneus colli nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior supraclavicular nerves  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial supraclavicular nerves  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Clavicle (acromial end) Lower pointer: Deltoid muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Great auricular nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Minor occipital nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Borders of posterior cervical triangle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior supraclavicular nerves  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial cervical lymph glands  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial lymphatic vessel passing through cervical fascia  *\n\t\t\t\t\t\t.\n\t\t\t\t\t [Legend above restored translation from Latin]"}
{"_id": "stanford_medicine_neck_clean$$$corpus_80", "text": "Dissection of anterior and lateral regions of neck\n\t\t\t\t\t\t\t\t\t\t Suprasternal space, anterior view\n\t\t\t\t\t\t\t\t\t\tThe sternal and clavicular origins of the sternocleidomastoid muscles are visible. The pectoral fascia has been removed bilaterally and the external layer of cervical fascia cut away to the right of the midline. On the left the cervical fascia covers the sternocleidomastoid muscle and extends partially across the suprasternal space.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia colli (middle layer over infrahyoid muscles)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right external jugular vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Terminal branch of cutaneus colli nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior jugular vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicula  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicular origin of sternocleidomastoid muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicular part of pectoralis major muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternal origin of sternocleidomastoid muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocostal part of pectoralis major muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tela subcutanea  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia colli (external layer, cut in a manner to show its continuity around the medial border of ther sternocleidomastoid muscle with the deep lamina of this fascia, as well as its extension  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous medial border of sternocleidomastoid muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Fat and fascia in depths of suprasternal space (of Burns)  *\n\t\t\t\t\t\t.\n\t\t\t\t\t [Legend above restored translation from Latin]"}
{"_id": "stanford_medicine_neck_clean$$$corpus_81", "text": "Dissection of oral region\n\t\t\t\t\t\t\t\t\t\t Relation of sublingual gland to tongue, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe mylohyoid and digastric muscles have been reflected inferiorly to demonstrate the relations of the tongue, sublingual gland, lingual and hypoglossal nerves, and geniohyoid muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior labial artery (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum linguae  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fimbriated fold (of tongue)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual fold  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual gland  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sublingual lymph nodes and lymphatic vessels  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Geniohyoid muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Submental artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior belly digastric muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Parotid duct  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pterygoid muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Buccinator muscle (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingual nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylohyoid ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular ganglion  17\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery (cut off)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of digastric muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular duct  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypoglossal nerve (XII)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid muscle"}
{"_id": "stanford_medicine_neck_clean$$$corpus_82", "text": "Dissection of left submaxillary (submandibular) gland and related structures\n\t\t\t\t\t\t\t\t\t\t Medial relations of submaxillary duct, anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe submaxillary gland has been resected although the principal branches of its duct (4), as well as nerves and blood vessels, remain in situ. Structures which lie medial to the gland are visible through their fascial coverings.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of mandible  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular lymph node  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Mylohyoid muscle (posterior border)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular duct  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial sling for tendon of digastric muscle (continuous with the fascia which surrounded submandibular gland)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Stylohyoid muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior laryngeal artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Body hyoid bone (covered by fascia)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrohyoid branch of hypoglossal nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrohyoid muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular branches of submandibular ganglion  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Common facial vein  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Glandular branch external maxillary artery (note accompanying plexus of veins)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Artery to lymph node Lower pointer: Superior deep cervical lymph node  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery (covered by carotid sheath)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch hypoglossal nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Prevertebral fascia  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior thyroid artery"}
{"_id": "stanford_medicine_neck_clean$$$corpus_83", "text": "Dissection of left submaxillary (submandibular) gland and related structures\n\t\t\t\t\t\t\t\t\t\t Intrinsic nerves and blood vessels, inferolateral view\n\t\t\t\t\t\t\t\t\t\tThe lobules of the gland have been separated and some of them removed. The submaxillary duct has not been exposed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Platysma (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of mandible and submandibular lymph node  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia covering anterior belly digastric muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia which extends medial to submandibular gland (continuous with external layer of cervical fascia)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Hyoid bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrohyoid muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Masseteric branch of external maxillary artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t External maxillary artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph vessel and submandibular lymph node  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Submental vein (cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular branches of submandibular ganglion  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Glandular branch external maxillary artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular gland  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch hypoglossal nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior deep cervical lymph node  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Carotid sheath covering external carotid artery Lower pointer: Superior thyroid artery"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_1", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Membranous layer of superficial fascia in urogenital triangle\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in view 165-2 is further explored in this preparation and in subsequent dissections of this series. The subcutaneous fat has been removed from the ischiorectal fossa. On the right side of the specimen an opening (6) has been made in the membranous layer of superficial fascia to expose some of the branches of the posterior scrotal artery and nerve. The scrotum has been retracted upward.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of penis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dartos fascia (covering right testis)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery and vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scrotal nerves  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scrotal branch internal pudendal artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of window cut through membranous layer of superficial fascia  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal branch posterior femoral cutaneous nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal branch posterior femoral cutaneous nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Gracilis muscle Lower pointer: Adductor longus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dartos fascia covering scrotal septum (spread out in retracting testicles)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Terminal filament of posterior scrotal nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of left testis (retracted with scrotum)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Great saphenous vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia lata  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial perineal fascia (membranous layer)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal branch posterior femoral cutaneous nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiorectal fossa"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_2", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Sagittal section of left testis, viewed from medial side\n\t\t\t\t\t\t\t\t\t\tThe testis has been cut in a sagittal plane. The plane of section does not include the entire length of the epididymis due to the fact that the body of the epididymis curves away from the sectioned surface.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of epididymis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Efferent ductule of testis (one or two other efferent ductules are indistinctly visible in the image)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Mediastinum testis (rete testis not grossly visible)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of epididymis  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Connective tissue  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens (cut across, note thick muscular tunic, thin mucosal tunic and small lumen)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tail of epididymis  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Septa of testis  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lobule of testis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tunica albuginea  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tunica vaginalis testis (visceral layer)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior margin of testis  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extremity of testis"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_3", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Epididymis dissected, posterior view\n\t\t\t\t\t\t\t\t\t\tThe nerves and vessels have been removed from the specimen shown in the previous view. The epididymis has been teased apart to some extent.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial surface of testis (covered by visceral lamina of tunica vaginalis testis)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut margin of tunica vaginalis testis  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior margin testis (tunica albuginea)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior extremity of testis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior aberrant ductule  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of epididymis  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Efferent ductules  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lobules of epididymis (coni epididymidis)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Aberrant ductules  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of epididymis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Epididymal duct  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tail of epididymis (teased apart and stretched upward toward ductus deferens with which it is continuous)"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_4", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Close-up view of posterior aspect of testis and epididymis\n\t\t\t\t\t\t\t\t\t\tThe testis has been rotated to expose its posterior aspect. The ductus deferens (2) has been dissected and displaced to the side for better exposure of underlying structures. The numerous testicular veins and veins of the epididymis have been cut off and the pampiniform plexus of veins has been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Testicular plexus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial surface of testis (testis has been rotated to demonstrate its posterior aspect)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Testicular artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t artery of ductus deferens  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tail of epididymis (ductus epididymidis dissected and teased apart)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Thigh (background)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of epididymis  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Efferent ductule of testis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal layer tunicae vaginalis testis (in background)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior margin testis (dissected)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Testicular veins (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of epididymis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial coverings of spermatic cord"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_5", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Contents of spermatic cord\n\t\t\t\t\t\t\t\t\t\tThe various structures which pass within the spermatic cord to the right testis have been dissected and separated. The testicle has been rotated to expose its posterior aspect. The coverings of the cord (5) have been incised and reflected. Connective tissue has been removed from the ductus deferens (4) and its associated vessels and nerves. The pampiniform plexus of veins (2) has been cut off at a high level so that the testicular plexus of nerves (3), the testicular (internal spermatic) artery (1), and the ductus deferens (4) with its artery (12) might be displayed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Testicular artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pampiniform plexus (cut away between level of pointer and testis)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Testicular plexus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Ductus deferens  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial coverings of spermatic cord (reflected)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of epididymis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Testis (rotated to expose posterior aspect)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of epididymis  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tail of epididymis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery and vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial inguinal ring  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery of ductus deferens  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligament of the penis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans penis"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_6", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Testis and epididymis viewed from above\n\t\t\t\t\t\t\t\t\t\tThe line along which the parietal layer of the tunica vaginalis testis reflects onto the epididymis and testis to become the visceral layer may be traced in this view of the testis seen from above.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Spermatic cord  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External spermatic fascia (reflected)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Tunica vaginalis testis (parietal layer)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Line of reflection of parietal lamina of tunica vaginalis testis onto testis and epididymis as visceral layer  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of epididymis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of epididymis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral surface of testis  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Testis (covered by visceral layer tunicae vaginalis testis)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Appendix testis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial surface of testis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior extremity of testis"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_7", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Testis and epididymis, close-up anterior view\n\t\t\t\t\t\t\t\t\t\tThe right half of the scrotal sac has been opened and the testis and spermatic cord have been elevated. The layers of the spermatic cord have been incised and reflected to reveal the testis and epididymis.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of scrotal wall  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External spermatic fascia  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Connective tissue surrounding ductus deferens, vessels and nerves of testis  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sinus of epididymidis Lower pointer: Body of epididymis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tunica vaginalis testis (lamina parietalis)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep (Buck's) fascia of penis (covering body of penis)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial penile fascia  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans penis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Appendix testis (elevated)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Head of epididymis Lower pointer: Superior ligament of the epididymidis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior margin of testis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral surface of testis (covered by visceral layer of tunica vaginalis testis)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior extremity of testis"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_8", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Tela subcutanea; deep membranous layer of superficial fascia, anteroinferior view\n\t\t\t\t\t\t\t\t\t\tThe skin has been removed from the abdominal wall, the external genitalia and the perineum. The tela subcutanea has been dissected to expose the deeply placed membranous layer of superficial fascia which over the lower part of the abdominal wall is known as Scarpa's fascia (1) and over the penis, scrotum and perineum has been called Colles' fascia (19). In the scrotum this layer is blended into the tunica dartos.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Membranous layer of superficial fascia (Scarpa's fascia)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of left testis in elevated scrotum (testis atrophic)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethral surface of penis (covered by superficial penile fascia)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Raphe penis (skin removed)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans penis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of penis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of right testis in elevated scrotum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Skin of right thigh  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcutaneous fat in perineum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Skin of perineum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of anus (not visible)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Incomplete fibrous lamina in tela subcutanea  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ilioinguinal nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Line of fusion of Scarpa's fascia to fascia of thigh below and parallel to inguinal ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t External pudendal arteries  16\n\t\t\t\t\t\t.\n\t\t\t\t\t External pudendal vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia lata  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Great saphenous vein  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Membranous layer of superficial fascia overlying root of penis (Colles' fascia)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle (cut across in transecting thigh)"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_9", "text": "Male external genitalia and perineum\n\t\t\t\t\t\t\t\t\t\t Penis and scrotum, anterior view\n\t\t\t\t\t\t\t\t\t\tThe subject is a young adult.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsum of penis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Neck of penis Lower pointer: Head of penis  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans penis  4\n\t\t\t\t\t\t.\n\t\t\t\t\t External urethral opening  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Raphe of scrotum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Scrotum (pointer indicates location of left testis)"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_10", "text": "Embryo, placenta and fetal membranes\n\t\t\t\t\t\t\t\t\t\t Placenta at four and one-half months of gestation\n\t\t\t\t\t\t\t\t\t\tThe umbilical arteries have been injected with red latex and the umbilical vein has been filled with blue latex.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Placenta  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Amnion  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Chorion (left side)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Cotyledon  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Umbilical vein (within umbilical cord)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Umbilical arteries"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_11", "text": "Embryo, placenta and fetal membranes\n\t\t\t\t\t\t\t\t\t\t Three-month-old fetus in situ within fetal membranes\n\t\t\t\t\t\t\t\t\t\tThe uterus of this surgical specimen has been opened by means of a longitudinal incision. The chorion has been cut and reflected from the amnion.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Chorion (cut and reflected from amnion)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Placenta (lower portions of the placenta are visible through the amniotic sac)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Umbilical cord  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Amniotic sac  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Myometrium  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervix of uterus (supravaginal part)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervix of uterus (vaginal part)"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_12", "text": "Embryo, placenta and fetal membranes\n\t\t\t\t\t\t\t\t\t\t Two-month-old embryo within amniotic sac\n\t\t\t\t\t\t\t\t\t\tThe chorion of this fresh surgical specimen has been opened to expose the amniotic sac (1) and yolk sac (3), both of which have been displaced to reveal the fetal surface of the placenta (9). The yolk sac remains attached to the umbilical cord by a slender stalk containing blood vessels which are visible in the photograph.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Amniotic sac (enclosing fetus within amniotic fluid)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Umbilical arteries (distinguished by thicker, white walls and smaller lumen than those of umbilical vein)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Yolk sac  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Yolk stalk (note vitelline artery within stalk)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of chorion  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Umbilical cord (note spiraling course of umbilical arteries within cord)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Umbilical vein  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Chorionic VIII  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Placenta"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_13", "text": "Uterus and adnexae\n\t\t\t\t\t\t\t\t\t\t Cavity of uterus; ovary sectioned transversely\n\t\t\t\t\t\t\t\t\t\tThe uterine cavity has been opened by means of a T-shaped incision through the anterior wall of the uterus. The right ovary has been sectioned transversely. The sectioned surface of the ovary exhibits a vesicular follicle, a fresh corpus luteum, a regressing corpus luteum and a corpus albicans. The specimen is viewed from in front.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fundus of uterus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cavity of uterus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus albicans (sectioned)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesicular follicle (unopened)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus luteum (recent)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus luteum (regressing)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Perimetrium (tunica serosa) Lower pointer: Myometrium (muscular tunic)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Endometrium (mucosal tunic)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Isthmus of uterus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervix of uterus (supravaginal part)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior wall of vagina (cut and retracted)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervix of uterus (vaginal part)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Opening of uterus (note junction of cervical and vaginal mucosa)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior labium uterine opening  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Opening of uterine tube  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ovary (elevated)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine tube  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres (of uterus)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Broad ligament of uterus"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_14", "text": "Uterus and adnexae\n\t\t\t\t\t\t\t\t\t\t Uterus, uterine tubes and ovaries, posterior aspect\n\t\t\t\t\t\t\t\t\t\tThe specimen shown previously has been turned to expose its posterior aspect. The right ovary has been elevated.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fundus of uterus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of uterus (covered by peritoneum)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper ovarian ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Isthmus of uterine tube  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres (of uterus) (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Mesovarium  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Mesosalpinx  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ampulla of uterine tube  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Abdominal opening of uterine tube  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Free margin of ovary  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior wall of vagina  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervix of uterus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Corpus luteum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovary  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligament of ovary  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovarian fimbria (see previous view label no. 6)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Broad ligament of uterus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Right margin of uterus"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_15", "text": "Uterus and adnexae\n\t\t\t\t\t\t\t\t\t\t Uterus, uterine tubes and ovaries, anterior aspect\n\t\t\t\t\t\t\t\t\t\tThe specimen, from an 18-year old girl, is viewed from in front. The ovaries have been elevated. The peritonealized parts of the specimen can be distinguished from the non-peritonealized lower portions by tracing the cut margin of peritoneum indicated in the drawing at 11.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fundus of uterus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine extremity of ovary  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovary  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovarian follicle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Infundibulum of uterine tube (pointers also indicate tubal fimbriae)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovarian fimbria  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubal extremity of ovary  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Mesosalpinx  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres (of uterus) (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of uterus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut margin of peritoneum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior wall of vagina (note vaginal rugae)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior wall of vagina  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervix of uterus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Isthmus of uterine tube  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Abdominal opening of uterine tube  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ampulla of uterine tube (indicated by two pointers, it tapers abruptly medially into the isthmus (15)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Mesovarium  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Broad ligament of uterus (parametrium)"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_16", "text": "Pelvic peritoneal cavity of female\n\t\t\t\t\t\t\t\t\t\t Left ovarian fossa, close-up view\n\t\t\t\t\t\t\t\t\t\tThe left wall of the pelvic cavity is viewed here with the specimen turned slightly to demonstrate the position of the ovary in the ovarian fossa and to show its relations to neighboring structures. The same specimen is also shown in view 161-4 and in subsequent views of that series.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Appendix epiploica  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid colon  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fimbria of uterine tube  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectouterine fold  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of ureter (faintly visible through peritoneum)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovarian fossa  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Fundus of uterus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Peritoneum overlying iliac vessels  10\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac vein (visible as bluish discoloration beneath peritoneum)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Peritoneum of anterior abdominal wall (reflected)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Mesosalpinx  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovary  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper ovarian ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine tube  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres (of uterus)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterovesical pouch"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_17", "text": "Pelvic peritoneal cavity of female\n\t\t\t\t\t\t\t\t\t\t Pelvic peritoneal relations with bladder deflated, close-up anterior view\n\t\t\t\t\t\t\t\t\t\tThe bladder has been deflated to reveal the depth of the vesicouterine pouch and to demonstrate the transverse peritoneal fold of the bladder. The view is directed horizontally from in front.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fimbriae of uterine tube  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pararectal fossa  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectouterine fold  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse fold of bladder  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fundus of uterus (note oval depression from which a small fibroma was removed)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterovesical pouch  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder (empty)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid colon  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral flexure of rectum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Rectum Right pointer: Rectouterine space  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ampulla of uterine tube Lower pointer: Ovary  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Mesosalpinx  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine tube  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres (of uterus)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Broad ligament of uterus"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_18", "text": "Pelvic peritoneal cavity of female\n\t\t\t\t\t\t\t\t\t\t Lower abdominal and pelvic peritoneum, anterior view\n\t\t\t\t\t\t\t\t\t\tThe small intestine has been detached from its mesentery and removed from the specimen. The descending colon has been divided at its confluence with the sigmoid colon and has also been detached along the lines of its peritoneal reflections onto the abdominal wall to permit its removal. A small fibroma has been taken away from the uterus leaving an oval depression on the surface of the fundus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal peritoneum (overlying iliac vessels)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Mesentery (cut along attachment to small intestine)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Rectum (sacral flexure lies just above level of pointer) Left pointer: Pararectal fossa  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres (of uterus)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterovesical pouch  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder (inflated)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal peritoneum (of anterior abdominal wall)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edges of peritoneum at lines of reflection onto descending colon  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid colon (transected at junction with descending colon)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ampulla of uterine tube Lower pointer: Ovary  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectouterine fold (bordering rectouterine space)"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_19", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Interior of left side of pelvic cavity; sacral plexus; pelvic diaphragm\n\t\t\t\t\t\t\t\t\t\tThe pelvic blood vessels have been resected to reveal the component parts of the sacral plexus. The origin of the pelvic diaphragm in this specimen extends nearly to the pelvic brim with the result that there is no tendinous arch such as the one shown in 174-7. The larger divisions of the levator ani muscle that are usually described as distinct muscles (m. puborectalis, m. pubococcygeus and m. iliococcygeus) are not clearly separable here.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk (pointer on branch from lumbar nerve V)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus communicans  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral venous plexus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic surface of sacrum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve I  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve II  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve IV  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve III  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of sacral nerve IV to levator ani muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral plexus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Internal pudendal artery (cut off) Right pointer: Inferior gluteal artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliococcygeus muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubococcygeus muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Puborectalis muscle (16-18 comprise the levator ani muscle)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethra  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar vein (note accompanying artery)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac fascia  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Ilium (covered by periosteum)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery and vein  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator artery  27\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac vein (approaching vascular lacuna deep to inguinal ligament)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineal ligament  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_20", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Interior of left side of pelvic cavity; parietal blood vessels; sacral plexus; pelvic diaphragm\n\t\t\t\t\t\t\t\t\t\tThe pelvic organs have been cut across at the pelvic outlet and have been removed to expose the pelvic diaphragm and the major blood vessels and nerves of the lateral wall of the pelvic cavity.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Ganglion of sympathetic trunk (note ramus communicans) Left pointer: Sacral nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Left piriform muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve II (note ramus communicans from sympathetic trunk)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve III  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve IV  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery and vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior gluteal artery Lower pointer: Pelvic diaphragm  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anal canal  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagina  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethra  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium minus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans of clitoris  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Common iliac artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Internal iliac artery Right pointer: External iliac artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Transversus abdominis muscle (covered by transversalis fascia)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine artery (cut off)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of obturator artery to iliopsoas muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve (at entrance to obturator canal)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_21", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Blood vessels and nerves of uterus, vagina and neck of bladder, anterior view\n\t\t\t\t\t\t\t\t\t\tThe bladder has been transected close to the internal urethral opening and has been removed, together with the ureter, from the dissection. The anterior surfaces of the uterus and vagina are exposed to view.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left sympathetic trunk  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. V - S. I  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Right sympathetic trunk  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve IV  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic diaphragm (right half, cut close to sacral and coccygeal attachment)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine venous plexus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic ganglion  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vaginal venous plexus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagina  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical venous plexus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervix of urinary bladder  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vesical artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic branch of obturator artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineal ligament  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior hypogastric plexus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Common iliac artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac artery and vein  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral umbilical ligament  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Internal pudendal artery Right pointer: Inferior gluteal artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Vaginal artery  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine artery  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic diaphragm  29\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery and vein  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres (of uterus)"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_22", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Blood vessels and nerves of uterus, vagina and bladder, medial view\n\t\t\t\t\t\t\t\t\t\tThe uterus and vagina have been retracted posteriorly and the bladder has been drawn forward to expose the vessels and nerves as they approach the left borders of these organs.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter:  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine artery (note vaginal artery branching off slightly below level of pointer)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior hypogastric plexus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine veins  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior hypogastric plexus (pelvic plexus)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal pelvic fascia  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine venous plexus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vaginal venous plexus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagina  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesicovaginal septum (cut edge)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Wall of vagina (cut in median plane)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anal canal  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethra  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical venous plexus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal vein of clitoris  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of clitoris  18\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery and vein  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator artery and vein  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pelvic diaphragm Lower pointer: Pelvic ganglion  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres (of uterus) (cut across)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vesical artery (branch of uterine artery)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter (at junction with wall of bladder)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical nerve plexus  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_23", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Blood vessels and nerves of uterus, vagina and bladder, anterior view\n\t\t\t\t\t\t\t\t\t\tIn this dissection the relations of blood vessels and nerves are shown as these approach the pelvic urogenital organs from the pelvic wall on the left side. The ureter (14) lies in situ. The left lateral umbilical ligament (20), representing the obliterated umbilical artery, has been dissected free of connective tissue. It is noteworthy that in this body there is no vesical artery branching from the proximal part of the umbilical artery. Instead, the left half of the bladder is supplied by two branches from the uterine artery and a small branch from the obturator artery.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunks  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic surface of sacrum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine venous plexus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical venous plexus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical arteries  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Umbilicovesical fascia  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior hypogastric plexus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Common iliac artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ureteral branch of internal iliac artery Lower pointer: Internal iliac vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery and vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vaginal artery Lower pointer: Uterine artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral umbilical ligament  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Tendinous arch of pelvic fascia Lower pointer: Superior fascia of pelvic diaphragm  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres (of uterus) (cut off)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior epigastric artery and vein (covered by transversalis fascia)"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_24", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Nerves and vessels related to pelvic surface of sacrum\n\t\t\t\t\t\t\t\t\t\tThe specimen has been placed in a supine position. The view into the pelvic cavity is directed from below and to the right. The uterus and vagina have been retracted toward the pubic symphysis.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Common iliac artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. V - S. I  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic surface of sacrum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral plexus (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion of sympathetic trunk  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior (pelvic) sacral foramen II  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral splanchnic nerve (sympathetic)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve IV  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior fascia of pelvic diaphragm  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior hypogastric plexus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac vein  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter  22\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac vein  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lateral sacral artery Lower pointer: Ramus communicans (gray)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sacral nerve I Lower pointer: Piriform muscle (covered by parietal pelvic fascia)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic splanchnic nerve (from sacral nerve II)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic splanchnic nerve (from sacral nerve III)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagina"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_25", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Pelvic plexus and ganglion; vaginal artery\n\t\t\t\t\t\t\t\t\t\tThe uterus and vagina have now been deflected anteriorly. The uterosacral and cardinal ligaments, which are shown in 162-2, have been dissected so that the pelvic plexus and the vaginal and uterine blood vessels are exposed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac artery and vein  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior hypogastric plexus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ganglion of sympathetic trunk  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic splanchnic nerves  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic ganglion  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior hypogastric plexus (pelvic plexus)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Vaginal artery (branch of uterine artery)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior fascia of pelvic diaphragm  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic diaphragm (sectioned near midline)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagina  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethra  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter  17\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery and vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine veins  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral umbilical ligament  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres (of uterus)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterus"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_26", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Interior of left side of pelvic cavity.\n\t\t\t\t\t\t\t\t\t\tRemoval of the left ovary and uterine tube has exposed the structures that lie immediately lateral to the ovarian fossa. Lymphatic vessels (21) can be seen passing to the external iliac nodes from the uterus and vagina. The obliterated part of the umbilical artery (16) lies lateral to these vessels against the pelvic wall.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac lymph nodes  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: External iliac artery (cut off) Left pointer: Internal iliac artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior hypogastric plexus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal pelvic fascia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectouterine muscle (uterosacral ligament)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac lymph node  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle (covered by fascia)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral umbilical ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery and vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac lymph node  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac lymph node  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres (of uterus)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph vessel (from uterus and vagina)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine tube (cut across)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper ovarian ligament (cut off)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine artery"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_27", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Interior of left side of pelvic cavity.\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the preceding photograph has been turned so that it is now viewed from in front and slightly to the right. The ovary, ovarian vessels and uterine tube have been pulled anteriorly.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior hypogastric plexus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory (pointer on intervertebral disc L. V - S. I)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Common iliac artery (pointer at level of bifurcation into internal and external iliac arteries)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac lymph node  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic surface of sacrum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal pelvic fascia  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectouterinus muscle (uterosacral ligament)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac lymph node  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovarian artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal iliac vein (pointer indicates level at which vein originates from common iliac vein) Lower pointer: Ureteral branch of internal iliac artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle (covered by fascia)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac fascia  17\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac lymph node  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovary  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Uterine artery Lower pointer: Ovarian branch of uterine artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine venous plexus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Fundus of uterus"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_28", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Interior of left side of pelvic cavity.\n\t\t\t\t\t\t\t\t\t\tThe peritoneum has been removed from the posterior and left lateral walls of the pelvic cavity. The fascial investments of extraperitoneal structures have been stripped away. A large ureteric artery (22), which originates from the internal iliac artery, supplies the lower part of the ureter and communicates inferiorly with the ovarian branch of the uterine artery.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior hypogastric plexus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk (pointer on ganglion)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrum (upper pointer, articular surface; lower pointer, lateral crest)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectouterinus muscle (uterosacral ligament)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagina  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac lymph node  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovarian artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac artery and vein  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac lymph node  15\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery and vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Fimbria of uterine tube  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovary  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac lymph node (note associated lymphatic vessels)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac lymph node  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral umbilical ligament  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureteral branch of internal iliac artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine vein"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_29", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Uterosacral ligament and cardinal ligament of uterus, medial view\n\t\t\t\t\t\t\t\t\t\tThe peritoneal covering of the rectouterine fold previously illustrated (161-4) has now been removed. The uterus and vagina have been pulled anteriorly to expose the smooth muscle and fibrous tissue (4) that occupies this fold and extends from the uterus and vaginal wall to the lateral and posterior walls of the pelvic cavity. Although it appears as a continuous sheet, this tissue has usually been subdivided into uterosacral and cardinal (or lateral cervical) ligaments. The former is also identified as the m. rectouterinus and the latter as Mackenrodt's ligament. In subsequent dissections of this series it may be seen that the pelvic plexus of nerves as well as several blood vessels are incorporated within these ligaments.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic diaphragm  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior rectal artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Rectouterinus muscle (uterosacral ligament) Lower pointer: Cardinal ligament (of Mackenrodt)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal muscle of anal canal  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule of vagina  10\n\t\t\t\t\t\t.\n\t\t\t\t\t External urethral opening  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior hypogastric plexus (note that these fibers become incorporated below in the uterosacral ligament)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter  15\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac lymph node  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovary (retracted anteriorly)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior wall of vagina  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagina"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_30", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Interior of anal canal and lower part of rectum, close-up view\n\t\t\t\t\t\t\t\t\t\tThe lower part of the dissection shown in the preceding photograph is shown in more detail in this close-up view centered on the anal canal.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosal tunic of rectum (note numerous small depressions or pits in mucosa marking the sites of lymphatic nodules (folliculi Iymphatici))  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anal columns  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectinate line  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anal verge  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Hemorrhoidal zone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal anal sphincter muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Plicae transversales of rectum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Opening of uterus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior labium  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior wall of vagina  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagina  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior wall of vagina Lower pointer: Vesicovaginal septum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular tunic of urinary bladder  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical sphincter muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior vaginal wall posterior  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Hymenal caruncles  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule of vagina  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (puborectalis muscle, inserting into wall of anal canal)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_31", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Interior of rectum and anal canal, general view\n\t\t\t\t\t\t\t\t\t\tA longitudinal incision has been made through the anterior wall of the anal canal and rectum from the anus to the level of the sacral flexure. The wall to the right of the incision has been pulled aside to reveal the lumen of the lower end of the intestinal tract.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal pelvic fascia  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral flexure of rectum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal layer of muscular tunic of rectum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Circular layer of muscular tunic of rectum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Mucosal tunic of rectum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Terminal segment of coccyx  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse fold of rectum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagina  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal flexure of rectum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anal column  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anal valve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anal bend  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal anal sphincter muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle (cut across, slightly to right of midline)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule of vagina  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid colon  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Mesosigmoid colon  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectouterine fold  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ovary Lower pointer: Uterine tube  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterus  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethra  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Clitoris"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_32", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Rectum viewed from right side\n\t\t\t\t\t\t\t\t\t\tThe peritoneal covering of the rectum (16) has been elevated. The uterus, vagina and bladder have been pulled anteriorly. The fascia of the rectum has been removed to expose the longitudinal layer of muscle of the rectal wall. Note the fluted infolding of this layer at the site of the lowest transverse rectal fold (5).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal pelvic fascia  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse fold of rectum (external aspect)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior branches rectal artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior fascia of pelvic diaphragm  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubococcygeus muscle (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle (divided)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Puborectalis muscle (cut off near junction with wall of anal canal)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anal canal  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal flexure of rectum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule of vagina  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal peritoneum (reflected from anterior wall of rectum)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectouterine fold  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovary  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterovesical pouch (pointer on reflection of peritoneum from uterus to wall of bladder)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vesicovaginal septum Lower pointer: Vagina  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethra"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_33", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Arteries and nerves of sigmoid colon and rectum, right anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe sigmoid mesocolon has been dissected and the rectum and sigmoid colon have been retracted anteriorly and to the left. Peritoneum has been removed from the right surface of the rectum.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior rectal artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Strand of inferior mesenteric plexus (note other nerve filaments interlaced among branches of arteries)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  4\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery (cut off)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior hypogastric plexus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal pelvic fascia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior branches rectal artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum (longitudinal layer of muscular tunic)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ampulla of rectum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagina  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia overlying external iliac vessels and lymph nodes  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid colon"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_34", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Interior of left side of pelvic cavity with peritoneum intact\n\t\t\t\t\t\t\t\t\t\tThe uterus and bladder have been retracted toward the pubic symphysis to reveal the peritoneum lining the left half of the pelvic cavity. The rectouterine fold (5) is clearly visible extending laterally and superiorly from the uterus toward the sacrum. The ridge produced by the ureter (2) blends with the lateral part of the rectouterine fold.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal iliac artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of left ureter (indicated by raised fold of peritoneum)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectouterine fold (continuous inferiorly with broad ligament (11))  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum (longitudinal layer of muscle exposed)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal pelvic fascia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Opening of uterus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagina  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Broad ligament of uterus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Fundus of uterus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid colon  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Mesosigmoid colon  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Fimbria of uterine tube  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligament of ovary (covered by peritoneum)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ampulla of uterine tube  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of external iliac vein (indicated on specimen by bluish area of peritoneum)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Ovary Right pointer: Mesovarium  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovarian fossa  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres (of uterus)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Uterine tube Lower pointer: Proper ovarian ligament"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_35", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Median section of bladder, urethra, uterus and vagina, right lateral view\n\t\t\t\t\t\t\t\t\t\tThe bladder, urethra, uterus and vagina have been sectioned in the median plane. The rectum and anal canal have been exposed but not opened. Peritoneum remains intact in the left half of the pelvic cavity.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectouterine fold  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral crest  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine cavity  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (cut off)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior labium uterine opening Middle pointer: Opening of uterus Lower pointer: Anterior labium uterine opening  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagina  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Lamina of connective tissue forming vesicovaginal septum Right pointer: Internal urethral opening  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Posterior wall of vagina Right pointer: Anterior wall of vagina  9\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anal canal (pointer on muscular tunic)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule of vagina  13\n\t\t\t\t\t\t.\n\t\t\t\t\t External urethral opening  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium minus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid colon  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Fimbria of uterine tube Right pointer: Suspensory ligament of ovary  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ampulla of uterine tube  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Ovarian fossa Right pointer: Ovary  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Mesosigmoid colon  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Appendices epiploicae  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Fundus of uterus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres (of uterus)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of urinary bladder  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of urinary bladder  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vesical sphincter muscle Lower pointer: Urethra  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Clitoris"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_36", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Interior of bladder, right anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe bladder has been opened by a sagittal cut placed just lateral to the point of entrance of the right ureter into the bladder wall.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Parametrium  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Fundus of urinary bladder  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine opening  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Interureteric fold Lower pointer: Trigone of urinary bladder  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagina (opened)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal urethral opening  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethra (surrounded by vesical sphincter muscle)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of obturator artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vesical venous plexus Lower pointer: Dorsal vein of clitoris  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Retropubic space  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum (covered by peritoneum)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres (of uterus) (cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Fundus of uterus (depressed area close to pointer was occupied by small fibroma)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovary  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine tube  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper ovarian ligament  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres (of uterus)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterovesical pouch  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of urinary bladder  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal peritoneum  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Transversalis fascia"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_37", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Interior of vagina, viewed from right side\n\t\t\t\t\t\t\t\t\t\tThe vagina has been opened along its right border. Its walls have been separated to permit a view of the interior.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fornix of vagina  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle rectal artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Opening of uterus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior wall of vagina  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior fascia of pelvic diaphragm  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Vaginal venous plexus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (cut off)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle (superficial and deep portions, partially removed)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Urethral carina Lower pointer: Posterior neck fold  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular tunic of anal canal (longitudinal layer)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle (subcutaneous part)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Hymenal caruncles  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule of vagina  16\n\t\t\t\t\t\t.\n\t\t\t\t\t External urethral opening  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Urogenital diaphragm  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium minus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium majus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Vaginal artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vesical artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior labium uterine opening  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior labium uterine opening  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Posterior vaginal wall anterior Right pointer: Anterior wall of vagina  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical venous plexus  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical sphincter muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic arcuate ligament (cut in midline)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal vein of clitoris  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Commissure of vestibular bulb  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of clitoris  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans of clitoris"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_38", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Rectum, vagina, bladder and ureter, right lateral view\n\t\t\t\t\t\t\t\t\t\tThe uterosacral and lateral cervical ligaments have been resected along with parts of the pelvic plexus to expose the vagina and rectum.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum (sacral flexure)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Vaginal artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior vesical artery Lower pointer: Vagina (external aspect)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle rectal artery (note vaginal branch)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic plexus (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum (perineal flexure)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Levator ani muscle (note continuity with longitudinal muscle of anal canal) Lower pointer: Longitudinal layer of muscular tunic of anal canal  13\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle (partially resected)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Major vestibular gland  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Urogenital diaphragm  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule of vagina  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid colon  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervix of bladder  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Clitoris"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_39", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Interior of pelvic cavity with uterus and bladder in situ, right anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe right ovary, uterine tube and round ligament have been detached and removed. The uterine artery (10) has been elevated slightly to demonstrate its passage across the ureter as it approaches the lateral border of the uterus. The uterosacral and lateral cervical (cardinal) ligaments have been dissected to reveal the pelvic plexus and ganglia (11).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral umbilical ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Uterine tube (cut across) Lower pointer: Ligamentum teres (of uterus) (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectum (covered by peritoneum)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic plexus (pointer on pelvic ganglion)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder (reflected downward)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid colon  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Suspensory ligament of ovary Lower pointer: Infundibulum of uterine tube  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic cavity (pointer on rectouterine fold)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovary  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres (of uterus)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterovesical pouch  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Broad ligament of uterus (dissected)"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_40", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Lateral view of ligaments, vessels and nerves of right ovary\n\t\t\t\t\t\t\t\t\t\tThe peritoneum has been removed from the lateral pelvic wall. The hilum of the ovary (26) and the broad ligament of the uterus (36) have been dissected. The ovary has been elevated for better exposure of the dissection.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sigmoid colon  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior gluteal vein Lower pointer: Obturator artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral umbilical ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior gluteal artery (internal pudendal artery was a branch of this trunk) Lower pointer: Coccygeal branch of inferior gluteal artery (see 159-1)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine artery (note vesicular branches)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine vein  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vesical arteries  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vesical artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical venous plexus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical nerve plexus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterosacral ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac vein  21\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovarian nerve plexus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovarian artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligament of ovary  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Fimbria of uterine tube  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Right ovary (elevated) Lower pointer: Hilus of ovary (dissected)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Peritoneum lining pelvic cavity (in background)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Infundibulum of uterine tube (in background)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ovary (in background)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres (of uterus) (elevated)  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper ovarian ligament  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres (of uterus) (in background)  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Left uterine tube (in background)  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Ovarian branch of uterine artery  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterus  36\n\t\t\t\t\t\t.\n\t\t\t\t\t Broad ligament of uterus (dissected)"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_41", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Relations of blood vessels and nerves at ureterovesical junction\n\t\t\t\t\t\t\t\t\t\tThe levator ani muscle (15) has been cut off near its insertion and the adjacent superior fascia of the pelvic diaphragm (17) has been partially removed to expose the mass of smooth muscle and fibrous tissue (14) that comprises the uterosacral ligament and the lateral cervical ligament or cardinal ligament of the uterus (of Mackenrodt). The pelvic plexus lies enmeshed in these ligaments. Branches from the plexus (11) are visible passing to the terminal part of the ureter and base of the bladder.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical artery (2 and 3 are branches of uterine artery)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery (cut off)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral plexus (pointer on junction of 2nd and 3rd sacral nerves)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic splanchnic nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to Levator ani muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureter  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical vein (plexiform)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Plexus vesical nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle (reflected)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ureterovesical junction (note longitudinal smooth muscle of bladder continuing upward onto ureter)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Smooth muscle and fibrous tissue of uterosacral and lateral cervical ligaments of uterus (rectouterinus muscle)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (cut off)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior fascia of pelvic diaphragm (continuous posteriorly with fascia on coccygeus muscle (12))  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of nerve to levator ani muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of pelvis plexus to vaginal wall  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical venous plexus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator artery (cut off)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine artery and vein  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral umbilical ligament  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal peritoneum  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of obturator artery  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_42", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Vaginal and urethral orifices, close-up view through vestibule of vagina\n\t\t\t\t\t\t\t\t\t\tThe labia of the right side have been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t External urethral opening  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule of vagina  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Urethral carina  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vaginal opening  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Wall of vagina (cut across) Lower pointer: Opening of duct of greater vestibular (Bartholin's) gland (7)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Hymenal caruncle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater vestibular (Bartholin's) gland  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior neck fold  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium minus (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium minus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium majus"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_43", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Vestibule of vagina, opened and viewed from right side\n\t\t\t\t\t\t\t\t\t\tThe labia have been removed from the right side. The view is from below and to the right.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pubic symphysis (cut through) Lower pointer: Urinary bladder  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of clitoris (note branches of deep artery of clitoris on cut section of ems)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical venous plexus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal vein of clitoris  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of obturator artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t External urethral opening  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal pelvic fascia (continuous anteriorly with transversalis fascia)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Vaginal opening  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal membrane (inferior fascia of urogenital diaphragm)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater vestibular (Bartholin's) gland  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Hymenal caruncles  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior labial commissure  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of clitoris  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans of clitoris  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium majus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium minus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule of vagina (opened by removal of right labia)"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_44", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Fascial layers related to bladder, close-up view\n\t\t\t\t\t\t\t\t\t\tThe fascial layers associated with the anteroinferior aspect of the bladder have been separated from each other. The umbilicovesical fascia (14) divides to cover both surfaces of the bladder. Superiorly this layer is related to the subserosa of the peritoneum and extends laterally to the lateral umbilical ligament (11). An intermediate fascial plane, the umbilical prevesical fascia (15), intervenes between the umbilicovesical fascia behind the transversalis fascia (13) in front. The bladder in this specimen has a large posterolateral recess that has been infolded to permit display of nearby structures in the photograph.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vesical artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Uterine artery (uncolored)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vesical vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectouterinus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder (see text above)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (reflected)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal artery of clitoris (cut off)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal peritoneum (pointer on tela subserosa)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres (of uterus)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral umbilical ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Fibrous cord connecting lateral umbilical ligament with a branch of obturator artery Lower pointer: Branch of obturator artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transversalis fascia  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Umbilicovesical fascia  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Umbilical prevesical fascia  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_45", "text": "Dissection of female pelvis froma lateral approach\n\t\t\t\t\t\t\t\t\t\t General view of pelvic contents with right hip bone removed\n\t\t\t\t\t\t\t\t\t\tThe entire right hip bone has been removed from the specimen. The pelvic diaphragm has been split and reflected downward. The pelvic peritoneum (17, 19) remains intact on the right side and is seen from its external aspect.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Iliacus muscle Lower pointer: Psoas major muscle (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Impression remaining after removal of posterior part of ilium (pointer on periosteum)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral nerve (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior gluteal artery Lower pointer: Piriform muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinous ligament (reflected posteriorly)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vesical artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectouterine muscle (uterosacral and cardinal ligaments, consisting of smooth muscle intermingled with fibrous tissue and pelvic plexus of nerves)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (reflected)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Urinary bladder (redundant pocket which extended posterolaterally has been pulled downward and partly invaginated into bladder)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ileocolic artery (cut off in margin of mesentery)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Root of mesentery (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t External iliac artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal peritoneum (pointer on tela subserosa)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal peritoneum (interior of anterior abdominal wall, pointer on tunica serosa)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ligamentum teres (of uterus) Lower pointer: Parietal peritoneum (external aspect)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral umbilical ligament  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Obturator nerve Lower pointer: Obturator artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of clitoris  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium minus"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_46", "text": "Dissection of female pelvis froma lateral approach\n\t\t\t\t\t\t\t\t\t\t Sphincter ani externus muscle, close-up view\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the previous view is here seen in a close-up centered on the sphincter ani externus muscle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (pointer on puborectalis muscle)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal artery (small branch cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of communication between ischiorectal fossae of two sides  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep part  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial part  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcutaneous part (6-8 refer to the external anal sphincter)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal muscle layer of anal wall  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Vaginal wall  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule of vagina (opened by removal of labia on right side)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiorectal fossa (remnant of anterior recess)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator fascia  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal artery of clitoris  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of clitoris  18\n\t\t\t\t\t\t.\n\t\t\t\t\t artery of vestibular bulb  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibular bulb  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Major vestibular gland"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_47", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Levator ani and coccygeus muscles; sphincter ani externus, lateral view\n\t\t\t\t\t\t\t\t\t\tThe pudendal vessels and nerves have been cut away to reveal the lateral aspect of the levator ani muscle, the sacrospinous ligament and the coccygeus muscle. The component parts of the sphincter ani externus (13, 14, 15) are also visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cluneal nerve (from dorsal branch of 2nd sacral nerve)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (periosteum removed)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinous ligament (coccygeus muscle fused with ligament, the latter rather indistinct)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (tip)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (pointer on pubococcygeal part of muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep part  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial part  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcutaneous part (1315 refer to the external anal sphincter)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Longitudinal muscle of anal canal  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Lymph node Right pointer: Margin of greater sciatic notch  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala of ilium  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of rectus femoris muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous arch of levator ani muscle (indistinct, see discussion with 158-7)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (pointer on puborectalis muscle)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone (partially removed)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator fascia  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of clitoris  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibular bulb  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Major vestibular gland  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_48", "text": "Dissection of female pelvis froma lateral approach\n\t\t\t\t\t\t\t\t\t\t Pelvic diaphragm, lateral view with pudendal vessels and nerves in situ\n\t\t\t\t\t\t\t\t\t\tIn an earlier view of this specimen (158-7) the pelvic diaphragm was partially visible through a window cut in the lateral pelvic wall. The exposure of the diaphragm has been increased by resection of more of the ischium. The pudendal vessels and nerves have been retained in place, although the fascia (25) that formed the walls of the pudendal canal has been nearly completely removed from around them.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic notch  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal nerve (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery and vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pudendal nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal artery of clitoris  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater vestibular (Bartholin's) gland  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibular bulb  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule of vagina  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous arch of levator ani muscle (atypical, see discussion of 158-7)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum (remnant)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral vein  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Inguinal ligament  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone (partially cut away)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator fascia (forming medial wall of pudendal canal)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of clitoris"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_49", "text": "Dissection of female pelvis froma lateral approach\n\t\t\t\t\t\t\t\t\t\t Close-up view of clitoris\n\t\t\t\t\t\t\t\t\t\tThe structure and relations of the clitoris are shown in this close-up view of the specimen illustrated in the previous photograph. The ischiocavernosus and bulbospongiosus muscles have been removed from the dissection. The right crus, body and glans of the clitoris are exposed. A fibrous commissural extension (4) from the pars intermedia of the vestibular bulb, joined by its fellow of the opposite side, passes forward to fuse with the clitoris.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of clitoris  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibular bulb (cavernous spaces within erectile tissue filled with blue latex)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate part of bulb of vestibule  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Commissure of vestibular bulb (joined anteriorly with body of clitoris)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium minus (dissected)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibule of vagina  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium minus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Frenulum of clitoris  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans of clitoris  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic bone (partially resected)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of origin of gracilis muscle (cut off)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal nerve of clitoris  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous branch of dorsal nerve of clitoris  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal artery of clitoris  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligament of clitoris  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of clitoris  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Skin of mons pubis  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Prepuce of clitoris"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_50", "text": "Dissection of female pelvis froma lateral approach\n\t\t\t\t\t\t\t\t\t\t Pudendal nerve and branches in situ\n\t\t\t\t\t\t\t\t\t\tThe course of the pudendal nerve is shown in this close-up view of the pudendal canal.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of coccyx (covered by ligaments)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pudendal nerve (passing through lesser sciatic foramen; inferior rectal nerve lying medially is shown in view 159-4)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Dorsal nerve of clitoris (in pudendal canal) Lower pointer: Perineal nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Obturator fascia Lower pointer: Periosteum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior labial nerves  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Major vestibular gland  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibular bulb  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Crus of clitoris Lower pointer: Intermediate part and commissure of vestibular bulb  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium minus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery and vein (in pudendal canal)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of pudendal nerve passing to region of mons pubis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle (remnant of origin of muscle, cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve (in obturator canal)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral vein  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus (area of origin of pectineus muscle)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone (partially resected)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligament of clitoris  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal nerve of clitoris  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal artery of clitoris  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of clitoris  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans of clitoris"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_51", "text": "Dissection of female pelvis froma lateral approach\n\t\t\t\t\t\t\t\t\t\t Contents of greater sciatic foramen, close-up lateral view\n\t\t\t\t\t\t\t\t\t\tThe specimen has been rotated slightly and is viewed here from a somewhat posterolateral direction.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral crest  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (emerging through greater sciatic foramen)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal veins  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Nerve to obturator internus muscle (cut off) Lower pointer: Inferior gluteal nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Middle cluneal nerve (traced from dorsal ramus of 2nd sacral nerve) Right pointer: Coccygeal branch of inferior gluteal artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Sacrotuberous ligament Right pointer: Sacrospinous ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pudendal nerve (passing through lesser sciatic foramen)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal vein  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal pelvic fascia (completing closure of greater sciatic foramen)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve (upper pointer, tibial nerve; lower pointer, common peroneal nerve)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of greater sciatic foramen  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabular labrum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of lesser sciatic foramen"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_52", "text": "Dissection of female pelvis froma lateral approach\n\t\t\t\t\t\t\t\t\t\t Pudendal canal; obturator fascia; pelvic diaphragm\n\t\t\t\t\t\t\t\t\t\tThe obturator internus muscle, shown in view 158-4, has been completely removed from the field of dissection. The obturator fascia (9) which covered the medial surface of the muscle has been excised to open the pudendal canal (Alcock's canal). The pudendal nerve (6) and the internal pudendal artery and vein (8) lie within the canal. Part of the obturator fascia above and anterior to the pudendal canal has been cut away to expose the levator ani muscle. The origin of the levator ani in this case is closer to the terminal line of the pelvis than usual and the tendinous arch usually associated with this origin is indistinct. View 163-5 demonstrates a similar arrangement on the opposite side of the pelvis.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve (upper pointer, tibial nerve; lower pointer, common peroneal nerve)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pudendal nerve (passing anteriorly through lesser sciatic foramen to enter pudendal canal)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery and vein (within pudendal canal)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Obturator fascia Lower pointer: Periosteum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala of ilium  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of acetabulum (pointer on acetabular labrum)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle (cut off)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Inguinal ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal nerve of clitoris  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of clitoris  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium minus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium majus"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_53", "text": "Dissection of female pelvis froma lateral approach\n\t\t\t\t\t\t\t\t\t\t Superficial perineal space, close-up lateral view\n\t\t\t\t\t\t\t\t\t\tThe membranous layer of the superficial fascia (shown in view 158-3) has been cut off at the labium majus (17) and removed. The underlying deep perineal fascia has also been trimmed away to expose structures within the superficial perineal space. A margin of the fascia remains anteriorly (15). The contents of the superficial space include the ischiocavernosus and bulbospongiosus muscles (14), the crus of the clitoris (not visible), the bulb of the vestibule (16), the greater vestibular gland (6), the superficial transverse perineal muscle (3) and branches of the pudendal nerve and vessels (6, 8). The posterior labial veins are somewhat dilated and plexiform in appearance.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ramus of ischium Lower pointer: Obturator fascia (pointer indicates location of pudendal canal, note branch of obturator vein passing through this fascia to join internal pudendal vein)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal nerves  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial transverse perineal muscle (poorly developed)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle (covered by fascia)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Posterior labial branch internal pudendal artery Right pointer: Major vestibular gland  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior labial nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic bone (partially resected)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of origin of gracilis m:  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligament of clitoris  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ischiocavernosus muscle Lower pointer: Bulbospongiosus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep perineal fascia (removed posteriorly to expose contents of superficial space of perineum)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibular bulb  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial perineal fascia (membranous layer or Colles' fascia)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium majus"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_54", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Superficial perineal space; obturator internus muscle; contents of obturator canal\n\t\t\t\t\t\t\t\t\t\tThe contents of the superficial space of the perineum have been exposed by excision of the membranous layer of superficial fascia (Colles' fascia) and of part of the deep perineal fascia (24). The obturator internus muscle, together with branches of the obturator vessels, has been uncovered in situ by removal of the obturator membrane and portions of the pubic and ischial bones that bordered the obturator foramen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ischium (dissected)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve (note emergence of tibial portion through piriform muscle)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of obturator internus muscle (elevated from lesser sciatic notch and cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle (exposed by removal of obturator membrane and parts of ischium and pubic bone)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of obturator artery to obturator internus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  10\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle (muscle fibers indistinct)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior labial branch internal pudendal artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior labial nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior labial vein (plexiform)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Major vestibular gland  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve, artery, and vein (emerging from pelvis through obturator canal)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery and vein (surrounded by femoral sheath)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Inguinal ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of pectineus muscle from superior pubic ramus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic tubercle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone (partially cut away)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  22\n\t\t\t\t\t\t.\n\t\t\t\t\t suspensory ligament of clitoris (note continuation of tendons of ischiocavernosus and bulbospongiosus muscles into this area)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiocavernosus muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep perineal fascia (partially removed)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t bulbospongiosus muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium majus  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Vestibular bulb"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_55", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Right obturator internus muscle, general lateral view\n\t\t\t\t\t\t\t\t\t\tThe obturator membrane and neighboring parts of the pubic and ischial bones have been resected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus minimus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve (upper pointer, tibial nerve; lower pointer, common peroneal nerve)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of obturator internus muscle (cut off close to lesser sciatic foramen gemelli muscles removed)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle (exposed in situ area of origin from bone lies anterior to muscular branches of obturator vessels)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity (partially cut away)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior labial branch internal pudendal artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ilium  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine (origin of rectus femoris visible)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabular labrum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Iliopsoas muscle Lower pointer: Inguinal ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium majus"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_56", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Pubis, ischium and external genitalia, close-up view of right lateral aspect\n\t\t\t\t\t\t\t\t\t\tThe lower portion of the dissection shown in the preceding view is displayed in this close-up photograph. The superficial fascia of the perineum has been dissected. The membranous layer of the fascia (25) consists in part of a fan-like series of fibrous bands which radiate into the labium majus from a bony attachment along the inferior ramus of the pubic bone.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum teres femoris (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum transversum of acetabulum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch of obturator artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity (tendons of hamstring muscles divided close to bone)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (covered by ligaments)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of inferior rectal artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle (covered with fascia)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral vein  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of obturator nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch of obturator nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic tubercle (covered by fibers of inguinal ligament)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of obturator artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator membrane (obturator internus muscle visible through membrane)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of pubic symphysis  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of gracilis muscle (cut off)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial perineal fascia (membranous layer or Colles' fascia; note the radiating fibers firmly attached to the inferior ramus of pubis)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium majus  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium minus (redundant)"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_57", "text": "Dissection of female pelvis from a lateral approach\n\t\t\t\t\t\t\t\t\t\t Exterior of pelvis with femur removed, right lateral view\n\t\t\t\t\t\t\t\t\t\tThe right thigh has been detached by disarticulating the femur at the hip joint. Muscles of the gluteal region have been cut off in various ways to demonstrate their interrelations. The obturator externus and pectineus muscles have been completely removed. The periosteum has been stripped from the rami of the pubis and ischium. In succeeding views of this sequence the dissection of the specimen is continued into the interior of the pelvis.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle (cut off)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t External oblique muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus minimus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Aponeurosis External oblique muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus femoris muscle (origin, cut off)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopsoas muscle (cut off)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of coccyx  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral artery and vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum (pointer on ligamentum teres)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic bone  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator membrane  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial perineal fascia (membranous layer)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium majus"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_58", "text": "Female perineum\n\t\t\t\t\t\t\t\t\t\t Inferior aspect of levator ani muscle\n\t\t\t\t\t\t\t\t\t\tThe left half of the urogenital diaphragm has been resected to open the anterior recess of the ischiorectal fossa and to display the levator ani muscle. The inferior fascia of the pelvic diaphragm (anal fascia) has been stripped from the levator ani. Portions of the obturator fascia (13) are visible in the deep part of the dissected area.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium minus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External urethral opening  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal nerve of clitoris  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagina  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (pointer on puborectalis muscle)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of perineum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Clitoris  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Femoral vein (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator fascia  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator externus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Deep artery of clitoris Lower pointer: Internal pudendal vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus femoris muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal nerve (other branches previously removed)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament (cut across  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (pointer on pubococcygeus muscle)"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_59", "text": "Female perineum\n\t\t\t\t\t\t\t\t\t\t Superficial perineal space (continued).\n\t\t\t\t\t\t\t\t\t\tThe bulbospongiosus and ischiocavernosus muscles have been removed on the left side of the specimen. The left bulb of the vestibule has been slightly retracted from its position against the wall of the vestibule. Several small, aberrant bundles of muscle (18) pass across the superficial perineal space in close apposition to the inferior surface of the perineal membrane.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of clitoris  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Glans of clitoris  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Prepuce of clitoris  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium minus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t External urethral opening  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vaginal opening  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiorectal fossa  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligament of clitoris  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of clitoris  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor brevis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle (cut off)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineus muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbus vestibuli  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Wall of vagina (cut across) Lower pointer: Duct of greater vestibular gland  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Greater vestibular gland Lower pointer: Aberrant muscle fasciculus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal membrane  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial transverse perineal muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_60", "text": "Female perineum\n\t\t\t\t\t\t\t\t\t\t Superficial perineal space (continued).\n\t\t\t\t\t\t\t\t\t\tThe bulbospongiosus and ischiocavernosus muscles have been elevated to display perineal branches of the pudendal nerve that enter the deep surfaces of the muscles.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Vaginal opening  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep perineal fascia  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater vestibular (Bartholin's) gland  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal raphe  5\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial transverse perineal muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal artery (cut off)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  10\n\t\t\t\t\t\t.\n\t\t\t\t\t prepuce of clitoris  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium minus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiocavernosus muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Crus of clitoris  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus (covered by fibrous tissue)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Bulbospongiosus muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerves entering bulbospongiosus muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior fascia of urogenital diaphragm (perineal membrane)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve entering ischiocavernosus muscle"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_61", "text": "Female perineum\n\t\t\t\t\t\t\t\t\t\t Superficial perineal space.\n\t\t\t\t\t\t\t\t\t\tThe ischiocavernosus (9), bulbospongiosus (10) and superficial transverse perineal muscles (12) have been exposed within the superficial perineal space, or compartment, by the removal of the fascial investment of these muscles shown in the preceding view.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Labia minora  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep perineal fascia (intact)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiorectal fossa (pointer indicates lunate fascia)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendons of insertion of bulbospongiosus muscle and ischiocavernosus muscle blending with suspensory ligament of clitoris  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Crus clitoridis Lower pointer: Ischiocavernosus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: bulbospongiosus muscle Lower pointer: Labium majus (partially cut away)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior labial artery and nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial transverse perineal muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_62", "text": "Female perineum\n\t\t\t\t\t\t\t\t\t\t Posterior labial nerves and vessels\n\t\t\t\t\t\t\t\t\t\tThe deep perineal fascia has been resected from the left half of the dissection. The major branches of the posterior labial nerves and vessels (12) that lay deep to this layer have been freed of their connective tissue investments. Still remaining in place is a layer of fascia (14) that covers the ischiocavernosus, bulbospongiosus and superficial transverse perineal muscles.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Prepuce of clitoris  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium minus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium majus (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vaginal opening Lower pointer: Deep perineal fascia  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligament of clitoris  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial perineal fascia (cut edge)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t posterior labial nerves (accompanied by posterior labial arteries)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep perineal fascia (cut edge)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep layer of deep perineal fascia  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_63", "text": "Female perineum\n\t\t\t\t\t\t\t\t\t\t Deep perineal fascia\n\t\t\t\t\t\t\t\t\t\tThe superficial fascia has been removed from the perineum. A narrow remnant of the membranous layer of the superficial fascia (16) has been retained along the line of its fusion with the fascia lata close to the ischiopubic rami. The deep perineal fascia (17) appears as a distinct membranous layer that covers the main trunks of the posterior labial nerves in this specimen. In the following view this layer is dissected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium minus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vestibule of vagina Lower pointer: External urethral opening  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Labium majus Lower pointer: Vaginal opening  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium (covered by fibrous tissue)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor magnus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiorectal fossa (pointer indicates posterior recess)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus maximus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior fascia of pelvic diaphragm  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Prepuce of clitoris  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor longus muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of superficial perineal fascia (Colles' fascia)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep perineal fascia  18\n\t\t\t\t\t\t.\n\t\t\t\t\t posterior perineal branches femoral cutaneous nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anus Lower pointer: External anal sphincter muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal artery (cut off)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_64", "text": "Female perineum\n\t\t\t\t\t\t\t\t\t\t Female external genitalia; superficial fascia\n\t\t\t\t\t\t\t\t\t\tThe skin and subcutaneous tissue have been removed from both thighs and from the left half of the perineum. The labia have been retracted to expose the vestibule of the vagina.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior labial commissure  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Frenulum of clitoris  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Gracilis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vaginal opening (in depth of vestibule of vagina)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Skin overlying right side of perineum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Hymenal caruncle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior labial commissure  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia lata  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium majus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium minus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External urethral opening  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial perineal fascia (membranous layer or Colles' fascia)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal branch posterior femoral cutaneous nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior labial nerve"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_65", "text": "Female perineum\n\t\t\t\t\t\t\t\t\t\t Female external genitalia\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior labial commissure  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mons pubis  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium majus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Labium minus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Frenulum labiorum pudendi  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior labial commissure  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Perineal raphe  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_66", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Pubic symphysis, sectioned\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic tubercle (sectioned)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis (no cavity present in central area of symphysis)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic arcuate ligament"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_67", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Pubic symphysis, posterior aspect\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineal ligament (ligament of Cooper)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic arcuate ligament  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator membrane (cut off near body of pubic bone)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of levator ani muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_68", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Pubic symphysis, anterior aspect\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic tubercle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineal ligament (ligament of Cooper)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium (cut across)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of pectineus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of gracilis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator canal  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic arcuate ligament"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_69", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Sacroiliac joint opened; interosseous sacroiliac ligament, left lateral view\n\t\t\t\t\t\t\t\t\t\tThe left ilium has been detached to display the auricular surface of the sacrum and the interosseous sacroiliac ligaments.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous sacroiliac ligament (pointer indicates only a small part of the area occupied by the numerous bands that comprise these ligaments which have been cut at their attachments to the ilium)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of sacrum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral sacroiliac ligament  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebra L. V  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinous ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Interspinous ligament L. V - S. I (convex in shape due to compression by extension of vertebra on sacrum)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral crest  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacroiliac ligament (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac branch of iliolumbar artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of articular surface in which fibrocartilage has been damaged (remainder of auricular surface intact)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule (lined internally by synovial membrane)"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_70", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Sagittal section of lumbosacral spine; transverse section through sacroiliac joint\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the preceding view (155-7) has been cut in the median plane and the right half subsequently has been cut in a plane transverse to the sacroiliac joint and approximately at right angles to the long axis of the sacrum. The sectioned parts have been separated from each other and are viewed from in front.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intervertebral foramen Lower pointer: Dorsal sacral foramen  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous sacroiliac ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacroiliac joint (pointer on cavity and fibrocartilage covering articular surfaces of both bones)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ilium (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior (pelvic) sacral foramina  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic foramen  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ischium  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Bony ridge at site of exit of tendon of obturator internus from pelvis (note other parallel ridges)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic foramen  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventral sacrococcygeal ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrococcygeal junction (articular cavity present in this specimen)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinous ligament  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine (pointer indicates facet for attachment of coccygeus muscle)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinous ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Interspinous ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Spine of vertebra L. IV  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Arch of vertebra L. IV (facing vertebral canal)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum flavum  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anulus fibrosus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. V  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Nucleus pulposus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part of sacrum  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior limit of dural sac  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacroiliac joint (reinforced by ventral sacroiliac ligament)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse line of sacrum (note remnant of intervertebral disk in cut section)  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Hiatus sacral canal Lower pointer: Superficial dorsal sacrococcygeal ligament"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_71", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Ligaments of pelvic girdle, anterior view\n\t\t\t\t\t\t\t\t\t\tThe pubic bones have been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part of sacrum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineal ligament (ligament of Cooper)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus (cut across)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of coccyx (pointer overlies head of femur)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiofemoral ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacrococcygeal ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. V  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. V - S. I  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process vertebrae L. V  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac fossa  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacroiliac joint (covered by ventral sacroiliac ligament)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic (anterior) sacral foramina  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic foramen  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinous ligament  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic foramen  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator membrane (cut across)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_72", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Iliolumbar ligaments, anterior view\n\t\t\t\t\t\t\t\t\t\tMuscles within the pelvic cavity have been preserved. The main constituents of the sacral plexus have been left intact on the right side.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. IV (covered by anterior longitudinal ligament)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process vertebrae L. IV  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbosacral trunk  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral nerve I (ventral branch)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate line  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator fascia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous arch of levator ani muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. IV-V  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac fossa  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part of sacrum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacroiliac joint (pointer indicates ventral sacroiliac ligament)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic foramen  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inguinal ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior fascia of pelvic diaphragm  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic surface of sacrum  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_73", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Ligaments of pelvic girdle, posterior view\n\t\t\t\t\t\t\t\t\t\tMuscles, blood vessels and nerves have been removed from this specimen of a young adult male.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinous ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process of vertebra L. V  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral crest  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic foramen  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinous ligament (at attachment to ischial spine)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic foramen  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process vertebrae L. IV  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process vertebrae L. V  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala of ilium  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacroiliac ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ilium  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of coccyx  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral horn  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial dorsal sacrococcygeal ligament  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacrococcygeal ligament"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_74", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Ligaments of coccygeal region, close-up posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch of coccygeal nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch of sacral nerve V  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Connecting ioop between fifth sacral nerve and coccygeal nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (transected)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral border of sacrum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal vein (cut off)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pudendal nerve Lower pointer: Internal pudendal artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior rectal nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine (covered by fibers of coccygeus muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeus muscle (overlying sacrospinous ligament)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (pointer on iliococcygeus muscle)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior rectal artery Lower pointer: Perineal artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator fascia (reflected to expose perineal vessels and nerves in pudendal canal)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator ani muscle (pointer on pubococcygeus muscle)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral horn  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeal horn  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Aperture for dorsal ramus of fifth sacral nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial dorsal sacrococcygeal ligament  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Deep dorsal sacrococcygeal ligament Lower pointer: Sacrotuberous ligament  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (terminal segment)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate fascia  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior fascia of pelvic diaphragm  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Anococcygeal ligament  28\n\t\t\t\t\t\t.\n\t\t\t\t\t External anal sphincter muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Anus"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_75", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Ligaments of sacral region, posterior view\n\t\t\t\t\t\t\t\t\t\tThe central area of the dissection shown in the preceding view is illustrated in this close-up photograph.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinous ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process vertebrae L. V (periosteum removed)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacral foramina (partially obscured by ligamentous bands note vessels and nerves emerging between bands)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior gluteal artery (cut off)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve (exposed by excision of piriform muscle)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior gluteal artery (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal pudendal artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinous ligament (blended with coccygeus muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebrae L. V  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint capsule  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacroiliac ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral crest  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral horn  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial dorsal sacrococcygeal ligament"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_76", "text": "Ligaments and joints of lumbosacral spine and pelvic girdle\n\t\t\t\t\t\t\t\t\t\t Ligaments of lumbosacral region, posterior view\n\t\t\t\t\t\t\t\t\t\tThe erector spinae and gluteus maximus muscles have been removed. On the left the gluteus medius has been cut away.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Erector spinae muscle (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinous ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertransverse ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus lumborum muscle (covered by middle layer of thoracolumbar fascia)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Left kidney (faintly visible through thoracolumbar and renal fascia)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process vertebrae L. IV  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle (cut edge)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliolumbar ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of gluteus medius muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus minimus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sciatic nerve (emerging through greater sciatic foramen)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal pudendal artery Lower pointer: Pudendal nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator internus muscle (tendon of insertion)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater trochanter  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (posterior layer, reflected)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint capsule L. IV-V  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral crest  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteus medius muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacroiliac ligament  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Piriform muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrotuberous ligament  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischiorectal fossa  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial dorsal sacrococcygeal ligament  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_77", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Anteroposterior radiograph of female pelvis\n\t\t\t\t\t\t\t\t\t\tThis film was obtained through the courtesy of Dr. Grant Melvin Stevens of the Palo Alto Clinic.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra L. IV  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacroiliac joint  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ilium  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part of sacrum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior (pelvic) sacral foramen  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischium  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic symphysis"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_78", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Coccyx, anterior view\n\t\t\t\t\t\t\t\t\t\tThis specimen consists of three segments, the terminal one of which comprises two small terminal pieces fused together.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeal horn  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for sacrum"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_79", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Sacrum, left lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of sacrum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Promontory  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pelvic surface  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral crest  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral tuberosity (note accessory articular facet on posterior part of tuberosity)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral crest"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_80", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Sacrum, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Base  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal sacral foramen (pelvic foramen in background)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate sacral crest  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral horn  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral canal  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral tuberosity  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory articular facet (of sacroiliac joint)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral crest  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral sacral crest  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral hiatus"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_81", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Sacrum, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of sacrum (pointer on Promontory)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior (pelvic) sacral foramina  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse lines (note lack of fusion between first and second sacral bodies in this young specimen)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of sacrum"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_82", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Left coxal bone, medial aspect\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac tuberosity  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory facet of sacroiliac articulation  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic notch  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ischium  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic notch  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac fossa  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ilium  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic eminence  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Symphyseal surface  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator foramen"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_83", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated female pelvis, left lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteal surface of ilium  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate surface  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fossa of acetabulum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic eminence  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Notch of acetabulum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator foramen  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior inferior iliac spine  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic notch  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic notch  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_84", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated female pelvis, posteroinferior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior inferior iliac spine  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala of ilium  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic notch  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic notch  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Lateral sacral crest Right pointer. Pelvic surface of sacrum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral horn  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral hiatus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccygeal horn  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Minor pelvis (viewed through inferior pelvic aperture)"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_85", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated female pelvis, anterosuperior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala of ilium  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Nutrient foramen  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate line  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ilium  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic eminence  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anomalous articular facet for transverse process of fifth lumbar vertebra  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (in background)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral canal  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of sacrum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac tuberosity  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal lip of iliac crest  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate line of iliac crest  18\n\t\t\t\t\t\t.\n\t\t\t\t\t External lip of iliac crest"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_86", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated female pelvis, anteroinferior view\n\t\t\t\t\t\t\t\t\t\tThe view is directed slightly upward in order that the obturator foramina may be more clearly visualized.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac fossa  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic eminence  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineal line (pubic bone)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior pubic ramus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Pubic tubercle Right pointer: Symphyseal surface  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part of sacrum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of sacrum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator sulcus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ischium  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator foramen  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_87", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated male pelvis, left lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle of iliac crest  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External lip of iliac crest  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Gluteal surface of ilium  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ilium (pointer on inferior gluteal line)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic eminence  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fossa of acetabulum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate surface  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic tubercle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Notch of acetabulum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator foramen  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior gluteal line  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior gluteal line  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior inferior iliac spine  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrum  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic notch  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic notch  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ischium  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_88", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated male pelvis, posteroinferior view\n\t\t\t\t\t\t\t\t\t\tThe configuration of the male pelvic outlet is shown in this view and should be compared with that of the female pelvis in 154-1.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior iliac spine  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior inferior iliac spine  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala of ilium (gluteal surface)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of pubic symphysis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process of sacrum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermediate sacral crest  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral crest  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral hiatus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral horn  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx (upper pointer indicates coccygeal horn)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater sciatic notch  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser sciatic notch"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_89", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated male pelvis, anterosuperior view\n\t\t\t\t\t\t\t\t\t\tThe shape of the superior pelvic aperture (13) and of the pelvic cavity below this line should be compared with that of the female pelvis shown in 153-7.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part of sacrum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ilium  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal lip of iliac crest  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intermediate line of iliac crest Lower pointer: External lip of iliac crest  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic eminence  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic tubercle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process of sacrum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle sacral crest  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacral canal  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of sacrum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate line (part of linea terminalis which marks superior pelvic aperture)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Coccyx  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_90", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated male pelvis, anteroinferior view\n\t\t\t\t\t\t\t\t\t\tThe specimen is viewed from in front and slightly below in order that details of the obturator foramen may be seen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ala of ilium (pointer indicates iliac fossa)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate line of ilium  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliopubic eminence  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectineal line (pubic bone)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior pubic ramus Lower pointer: Pubic tubercle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of pubic bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral part of sacrum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior (pelvic) sacral foramen  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse line  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of sacrum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacroiliac joint  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ilium  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ischium  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator foramen  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus of ischium"}
{"_id": "stanford_medicine_pelvis_clean$$$corpus_91", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated male and female pelvic bones, anterior view\n\t\t\t\t\t\t\t\t\t\tThe more massive male pelvis on the left side of the view is distinguished from that of the female in several respects. It is higher and narrower and exhibits more pronounced surface markings than the female specimen. The angle between the diverging inferior rami of the pubic bones (subpubic angle) is less in the male. The obturator foramina are elongated in comparison with those of the female. Marked differences in the configuration of the superior and inferior pelvic apertures are not clearly visible in this photograph but are shown in subsequent views in this series. The view was made from in front and slightly below the horizontal plane in order to show the subpubic angle and the obturator foramina. The relations in a direct anteroposterior view are visible in the radiograph shown in 155-1.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ilium  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior superior iliac spine  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior inferior iliac spine  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Acetabulum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pubic bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischium  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrum (pointer on Promontory)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacroiliac joint  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Linea terminalis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial spine  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Obturator foramen  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ischial tuberosity  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior pubic ramus"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_1", "text": "Dissection of thorax from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Thoracic viscera.\n\t\t\t\t\t\t\t\t\t\tThe esophagus has been divided at the lower border of the second thoracic vertebra and again just above the diaphragm. The intervening portion of the esophagus has been removed to expose the trachea and pericardium. The latter has been opened to the margins of the oblique sinus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc Th. II-III  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Left subclavian artery Lower pointer: Left common carotid artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch (cut off at junction with descending aorta)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vagus nerve left (cut off) Lower pointer: Left main bronchus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lung left  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left inferior pulmonary vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrium (exposed by removing pericardium from posterior wall of oblique sinus)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium (cut margin)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophageal veins  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Esophagus cut off) Lower pointer: Margin of esophageal hiatus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Thoracic aorta (cut off) Right pointer: Thoracic duct (cut off)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic trunk  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Right vagus nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Right brachiocephalic vein  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein (cut off)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Right main bronchus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchial branches thoracic aorta (cut off)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Right superior pulmonary vein Lower pointer: Right inferior pulmonary vein  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Right lung  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Greater splanchnic nerve Lower pointer: Intervertebral disc Th. XI-XII"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_2", "text": "Dissection of thorax from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Thoracic viscera.\n\t\t\t\t\t\t\t\t\t\tThe esophageal wall has been dissected in the mid-thoracic region. The area of this close-up view can be determined by reference to the previous view of this specimen. The bronchi and the cut end of the aortic arch can readily be compared in the two views.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch (cut off at junction with descending aorta)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchial branch of aorta (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve left  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Left main bronchus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophageal veins  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchial glands  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous band connecting left main bronchus to pericardium  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve left  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchial branch of aorta (cut end displaced behind esophagus)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Right main bronchus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Bifurcation of trachea  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus (pointer indicates lumen)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular mucosa of esophagus (note esophageal glands in this layer)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophageal branch of bronchial artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Right vagus nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophageal submucosa (note small arteries and veins in this layer)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular coat of esophagus (inner circular layer)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular coat of esophagus (outer longitudinal layer)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_3", "text": "Dissection of thorax from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Thoracic viscera.\n\t\t\t\t\t\t\t\t\t\tThe thoracic aorta and the azygos and hemiazygos veins have been removed to display the thoracic duct and the esophagus. Delicate connective tissue has been stripped from the esophageal wall. Numerous, small veins were present near the lower end of the esophagus, most of which have been cut away. The lungs are deflated.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior intercostal vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch (cut across at junction with thoracic aorta)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Left pulmonary artery Right pointer: Recurrent laryngeal nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left main bronchus (note bronchial artery cut off near its source from thoracic aorta)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic duct  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Left inferior pulmonary vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve left  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower lobe left lung  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary ligament  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Subpericardial space (adipose tissue, veins and lymphatic structures removed)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe left lung  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc Th. II-III  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve right  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe right lung  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Right brachiocephalic vein  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchial branch of thoracic aorta  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein (cut off)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Right main bronchus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Right inferior pulmonary vein  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior lobe right lung  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophageal hiatus  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Thoracic aorta (cut off) Lower pointer: Intervertebral disc Th. XI-XII  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Pleura (cut at line of reflection from diaphragm to mediastinum)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_4", "text": "Dissection of thorax from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Thoracic viscera.\n\t\t\t\t\t\t\t\t\t\tThe posterior half of the costal pleura has been removed. The superior and posterior parts of the mediastinum have been dissected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe left lung  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique fissure  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic duct  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal artery II  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower lobe left lung  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory hemiazygos vein  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic aorta (note origins of paired posterior intercostal arteries)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pulmonary ligament Lower pointer: Hemiazygos vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater splanchnic nerves (cut off)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib IX  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc Th. XI-XII  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal cord  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Cupula pleurae  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc Th. II- III  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe right lung  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique fissure  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein (passing anteriorly to join superior vena cava)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Right main bronchus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Right inferior pulmonary vein  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Right vagus nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior lobe right lung  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium enclosing inferior vena cava  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Mediastinal pleura"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_5", "text": "Dissection of thorax from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Ligamentous attachment of mediastinal structures to vertebral column\n\t\t\t\t\t\t\t\t\t\tThe upper part of the specimen shown in 131-7 is presented in a close-up view with the anterior longitudinal ligament (14) retracted to the right to expose a heavy, ligamentous band which extends down to the aorta from the level of the third and fourth thoracic vertebral bodies. The vertebral attachments of this band blend with the anterior longitudinal ligament near the midline. Inferiorly the ligament blends with the adventitia of the posterior part of the aortic arch and the upper thoracic aorta. It can also be traced forward to where it blends with fascia of the esophagus and trachea, although this arrangement is not visible in this view. This suspensory structure is shown elsewhere in the dissection of another specimen (128-1).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic duct  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of superior mediastinal space  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior intercostal vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Left sympathetic trunk  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentous band (see description above)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve V  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic aorta  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal facet vertebra Th. II  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anulus fibrosus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Nucleus pulposus (12-13 comprise the intervertebral disc)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve III  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Veins surrounding nerve roots in intervertebral foramen (bones removed)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Right sympathetic trunk Right pointer: Ramus communicans  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anulus fibrosus (remnant)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal vein V  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal artery V  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum capitis costae radiatum (preserved with periosteum of rib)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_6", "text": "Dissection of thorax from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Left fifth thoracic nerve; intervertebral course and meningeal branches\n\t\t\t\t\t\t\t\t\t\tThe fifth rib has been removed from the left side. The vertebral canal has been opened by laminectomy and the pedicle of the fifth thoracic vertebra has been cut off on the left to expose the component parts of the corresponding spinal nerve. A plexus of vertebral branches (11) of this nerve, including meningeal filaments, can be seen to extend medially through the intervertebral foramen anterior to the nerve roots which have been elevated somewhat out of their usual position.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic ganglion  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal facet vertebra Th. V  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle of vertebral arch Th. V (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Dorsal branch thoracic nerve V Lower pointer: Spinal ganglion thoracic nerve V  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Rami communicantes  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal vein V  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve V  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal artery V  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Meningeal branches thoracic nerve V  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of rib (costal crest visible on upper margin of rib above pointer)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process vertebra Th. VI  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal cord  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Denticulate ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal vertebral venous plexus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Ventral root thoracic nerve V Right pointer: Dorsal root thoracic nerve V  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Dura mater  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramen  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface superior articular process"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_7", "text": "Dissection of thorax from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Right tenth thoracic nerve within vertebral canal and intervertebral foramen\n\t\t\t\t\t\t\t\t\t\tThe vertebral canal has been opened by laminectomy and the tenth intervertebral foramen (6) has been opened on the right side by excision of the inferior articular process of the tenth thoracic vertebra. The dorsal and ventral roots of the corresponding nerve have been exposed. The roots penetrate the dura separately in this specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal cord  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Denticulate ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Dorsal root thoracic nerve X Lower pointer: Ventral root thoracic nerve X  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal spinal branch posterior intercostal artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Arachnoid and dura mater  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramen (opened venous plexus partially resected)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Protrusion of intervertebral disc  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior internal vertebral venous plexus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle of vertebral arch Th. XI  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular cavity of intervertebral joint  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertransverse thoracis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Longissimus thoracis muscle Right pointer: Iliocostalis thoracis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior articular process vertebra Th. IX Lower pointer: Superior articular process vertebra Th. X  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Transverse process vertebra Th. X Right pointer: Levator costarum brevis muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal ganglion thoracic nerve X  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior costotransverse ligament  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ramus communicans Lower pointer: Dorsal branch thoracic nerve X  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertransverse ligament  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracus muscle (tendon of insertion)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_8", "text": "Dissection of thorax from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Intercostal nerves, vessels and muscles; costal pleura; thoracic aorta\n\t\t\t\t\t\t\t\t\t\tRibs and vertebral bodies have been resected bilaterally between the second and the ninth thoracic segments. The periosteum (6) which covered the inner surfaces of the ribs have been preserved in most areas. The anterior longitudinal ligament (23), with remnants of the intervertebral discs attached, has also been retained in part. The lungs have been inflated and are visible through the intact costal pleura. The proximal parts of the III-VII spinal nerves have been positioned on the pleura in such a way that their dorsal and ventral roots, dorsal rami and communications with the sympathetic trunks are visible. These components are labeled for the left seventh thoracic nerve (8, 9, 10). The intercostal arteries and veins have been cut off in various ways.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve II  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib III (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum of sixth rib  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic aorta  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Intercostal nerve VII Right pointer: Ramus communicans  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch thoracic nerve VII  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Spinal ganglion and dorsal root Right pointer: Ventral root  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Innermost intercostal muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator costarum brevis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal intercostal membrane  14\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process vertebra Th. II  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc Th. II-III  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Veins of third intervertebral foramen (bones removed)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentous band extending from vertebrae to thoracic aorta  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anulus fibrosus vertebra Th. V- VI  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal artery and vein VI  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum capitis costae radiatum (preserved with periosteum of rib)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal cord  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib IX"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_9", "text": "Dissection of thorax from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Ligaments of costotransverse articulations in mid-thoracic region\n\t\t\t\t\t\t\t\t\t\tThe dorsal muscles have been removed from the central area of the dissection.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle (tendon of insertion)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertransverse ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator costarum brevis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior costotransverse ligament (upper pointer on anterior division, lower pointer on posterior division)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal tubercle VI  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of rib VI (pointer on tendon of insertion of one slip of iliocostalis thoracis muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral costotransverse ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch posterior intercostal artery V  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch thoracic nerve V  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Neck of rib Lower pointer: Costotransverse ligament (occupying foramen costotransversarium)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral joint capsule Th. V-VI  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process Th. vertebra VI  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina of vertebral arch Th. VI  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebrae Th. VI  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to levator costarum brevis muscle (branch of dorsal branch)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Rotator brevis muscle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_10", "text": "Dissection of thorax from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Deep musculature.\n\t\t\t\t\t\t\t\t\t\tThe trapezius and latissimus dorsi muscles have been preserved on the right side. These muscles have been removed on the left and the shoulder girdle has been pulled aside. The posterior serratus muscles have been cut away and the thoracolumbar fascia has been removed to display the erector spinae muscles to the left of the midline. The more delicate, intrinsic fascia of the erector spinae has also been cut away.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Scapula (retracted laterally)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus posterior superior muscle (reflected)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia related to serratus anterior muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis thoracis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinalis thoracis muscle (6-8 make up the erector spinae muscle)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch thoracic nerve X (lateral cutaneous branch)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal abdominal oblique muscle (reflected anteriorly)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (cut margin of layer which covered erector spinae)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebrae Th. II  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (intact)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t External abdominal oblique muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_11", "text": "Dissection of thorax from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Deep musculature.\n\t\t\t\t\t\t\t\t\t\tThe serratus posterior inferior has been severed near the midline where its origin blends with the thoracolumbar fascia. Its four component muscle bands (2) have been reflected upward close to their costal insertions. The branches of intercostal nerves to the two central portions of the muscle have been dissected, while those to the upper and lower fascicles are not shown.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib X  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus posterior inferior muscle (four pointers indicate individual costal insertions of this muscle)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of intercostal nerve X (to serratus posterior inferior muscle)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch intercostal artery X  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII  7\n\t\t\t\t\t\t.\n\t\t\t\t\t External abdominal oblique muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebrae Th. XII  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch thoracic nerve X (lateral cutaneous branch)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis lumborum muscle (covered by intrinsic muscle fascia)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_12", "text": "Dissection of thorax from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Deep musculature.\n\t\t\t\t\t\t\t\t\t\tThe latissimus dorsi muscle has been removed from the left side of the dissection.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib VIII  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Erector spinae muscle (covered by thoracolumbar fascia)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus posterior inferior muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XI  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII  7\n\t\t\t\t\t\t.\n\t\t\t\t\t External abdominal oblique muscle (cut off)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal abdominal oblique muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branches thoracic nerves VII and VIII (medial cutaneous branches)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branches thoracic nerves IX and X (lateral cutaneous branches)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebrae L. II  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_13", "text": "Dissection of thorax from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Deep musculature.\n\t\t\t\t\t\t\t\t\t\tThe serratus posterior superior has been reflected laterally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse colli artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus posterior superior muscle (reflected)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial scapular margin  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid minor muscle (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scalene muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of thoracic nerve I, II and III (to serratus posterior superior muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  9\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis thoracis muscle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_14", "text": "Dissection of thorax from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Deep musculature.\n\t\t\t\t\t\t\t\t\t\tThe left shoulder girdle has been freed by removal of the trapezius, latissimus dorsi and rhomboid muscles and has been pulled forward. The serratus anterior muscle (10) remains intact. The rather thick, elastic layer of fascia (11) between this muscle and the rib cage has been partially resected to reveal the serratus posterior superior muscle (5).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator scapulae muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal scapular nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse colli artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus posterior superior muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib III  7\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial scapular margin  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid major muscle (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle (elevated)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial layer between serratus anterior and thoracic wall  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliocostalis thoracis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Longissimus thoracis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia infraspinata  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_15", "text": "Dissection of thorax from a posterior approach\n\t\t\t\t\t\t\t\t\t\t Superficial structures of upper part of back; external layer of muscles\n\t\t\t\t\t\t\t\t\t\tOn the left side of the specimen the skin has been cut away and the tela subcutanea has been dissected to expose cutaneous nerves and vessels. On the right side of the skin, tela subcutanea and fascia have been removed to display muscles related to the shoulder girdle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Nuchal fascia  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cutaneous branch of dorsal branch thoracic nerve III  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostobrachial nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Triangle of auscultation  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia covering latissimus dorsi muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous branch intercostal nerve V (posterior branch)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process of vertebra C. VII  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Spine of scapula  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus fascia  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_16", "text": "Dissection of diaphragm\n\t\t\t\t\t\t\t\t\t\t Diaphragm viewed from below\n\t\t\t\t\t\t\t\t\t\tThe peritoneum and the abdominal viscera have been removed from the body. The inferior surface of the diaphragm has been cleared of fascia. The psoas fascia and the fascia which covered the left quadratus lumborum muscle have been cut away. The view is from below and in front.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Xiphoid process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of diaphragm (three parts, central, right and left. each have a surface layer of muscle or aponeurotic fibers coursing at right angles to deeper tendinous fibers)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Line of attachment of falciform ligament of liver  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Hepatic vein (cut off)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vena caval foramen Lower pointer: Inferior vena cava (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches right phrenic nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic arteries  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Duodenal suspensory muscle (cut off near attachment to right crus of diaphragm) Left pointer: Greater splanchnic nerve (celiac ganglion removed)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Right crus lumbar part diaphragm Left pointer: Lumbocostal arch (arcuate ligament)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc L. II-III  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Costal pleura (fascia in vertebrocostal triangle removed) Lower pointer: Fascia forming lateral lumbocostal arch  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic branch of intercostal artery XI  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracolumbar fascia (anterior layer)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal cartilage VIII  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of branches of phrenic nerve left (not visible in view)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus (cut off)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophageal hiatus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Celiac trunk Lower pointer: Superior mesenteric artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Aortic hiatus Lower pointer: Left crus lumbar part diaphragm  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Left renal artery Lower pointer: Abdominal aorta  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal part of diaphragm  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII (covered by periosteum)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intercostal nerve XII (subcostal nerve) Lower pointer: Subcostalis artery  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadratus lumborum muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Psoas major muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Iliac crest"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_17", "text": "Dissection of diaphragm\n\t\t\t\t\t\t\t\t\t\t Sternal attachment of diaphragm.\n\t\t\t\t\t\t\t\t\t\tThe fascia which covered the sternal and medial costal origins of the diaphragm has been removed. The transverse thoracic muscle has also been stripped of its fascial covering. The gap between the sternal and costal origins of the diaphragm, known as the sternocostal triangle (9), has been exposed. This space is occasionally the site of a hernia. In this specimen a small lobule of fat (9) occupied this triangle on the left side and this has been retracted upward.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lung  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Fat lobule  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal part of diaphragm  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Xiphoid process  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Transversus thoracis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Heart  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardial cavity  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternal part of diaphragm  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lobule of fat which occupied sternocostal triangle Lower pointer: Sternocostal triangle (external aspect of parietal peritoneum visible below opening)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_18", "text": "Dissection of diaphragm\n\t\t\t\t\t\t\t\t\t\t Sternal attachment of diaphragm.\n\t\t\t\t\t\t\t\t\t\tThe lower part of the sternum and attached costal cartilages have been pulled forward.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lung  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm (covered by pleura)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lobule of fat  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Transversus thoracis muscle (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Xiphoid process  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of sternum (cut above attachment of sixth costal cartilage)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of heart  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium (cut edge)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternal part of diaphragm (covered by fascia)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery (cut off)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_19", "text": "Dissection of diaphragm\n\t\t\t\t\t\t\t\t\t\t Right phrenic nerve and phrenic lymphatic plexus viewed from above and in front\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve right (stretched to display branches)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon (right and central divisions)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic lymph node  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal part of diaphragm  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Mediastinal pleura (cut along right pulmonary ligament)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vagus nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior mediastinal lymph node  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenicoesophageal membrane  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph vessel"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_20", "text": "Dissection of diaphragm\n\t\t\t\t\t\t\t\t\t\t Left phrenic view, phrenic lymphatic plexus, esophageal hiatus and phrenicoesophageal membrane viewed from above\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenicoesophageal membrane  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph vessel (vessel indicated by right pointer penetrates central tendon)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of diaphragm  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternal part of diaphragm  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Xiphoid process (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragmatic pleura (remnant)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophageal hiatus diaphragm (pointer indicates left margin)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve left (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Musculophrenic artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal cartilage VI"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_21", "text": "Dissection of diaphragm\n\t\t\t\t\t\t\t\t\t\t Diaphragm viewed from above, pleura removed\n\t\t\t\t\t\t\t\t\t\tThe lungs have been removed and the tracheobronchial tree has been pulled posteriorly to provide an unobstructed view of the diaphragm. A narrow band of pericardium has been preserved along the margin of its diaphragmatic attachment. Lymphatic structures have been dissected on the upper surface of the diaphragm.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve right  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of diaphragm  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph vessel  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Musculophrenic artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left main bronchus (retracted)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib VII (cut off)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior mediastinal lymph node  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vagus nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenicoesophageal membrane  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve left (cut off)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Musculophrenic artery"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_22", "text": "Dissection of diaphragm\n\t\t\t\t\t\t\t\t\t\t Diaphragm viewed from above, pleura and diaphragmatic part of pericardium intact\n\t\t\t\t\t\t\t\t\t\tThe heart and the anterior part of the pericardium have been removed. The upper lobes of the lungs have been cut away and the lower lobes have been dissected. The right phrenic nerve is stretched upward approximately in its normal course, while the left nerve has been cut off.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrium  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left inferior pulmonary vein (cut off at entrance into left atrium)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior lobe right lung  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Right phrenic nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava (cut off at entrance into right atrium)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm (pointers on right and left divisions of central tendon)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm (muscular portion)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal cartilage VII  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower lobe left lung  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve left  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Xiphoid process (cut off)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_23", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Radiograph of esophagus, right anterior oblique view\n\t\t\t\t\t\t\t\t\t\tThe esophagus has been outlined with barium sulfate paste in this young female subject. The normal folds of the mucosa of the esophagus are indicated in several areas by vertical striation of the barium mass. The upper margin of the aortic arch (7) is faintly visible opposite the upper border of the fifth thoracic vertebral body. A small calcified area, apparently the result of an old infection, is visible in the lower posterior part of the right lung field.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus (pointer indicates part of esophagus deflected posteriorly by aortic arch, above pointer, and right main bronchus, below pointer)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra Th. X  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral margin of right breast (in foreground)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior margin of aortic arch (in background)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Right margin of ascending aorta Right pointer: Conus arteriosus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Left margin of heart  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Fluid level in stomach surmounted by air bubble"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_24", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Thoracic spine; anterior longitudinal ligament; thoracic sympathetic trunks\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cervical ganglion (unusually large)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial plexus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra Th. I (covered by anterior longitudinal ligament)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Right superior intercostal vein (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament (pointer on body of vertebra Th. IV)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Endothoracic fascia  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc Th. IX-X  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater splanchnic nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Azygos vein Lower pointer: Inferior vena cava  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus colli muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Stellate ganglion  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I (cut off)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib III  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal artery and vein VII  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve VII  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic aorta"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_25", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Esophagus in relation to posterior thoracic wall and spine\n\t\t\t\t\t\t\t\t\t\tThe trachea has been removed. The left halves of the larynx and pharynx have been cut away and the esophagus has been opened a short distance below its junction with the pharynx.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible (sectioned in midline)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Laryngeal cavity  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve right  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Filaments of esophageal plexus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve right  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intervertebral disc Th. IX-X Lower pointer: Body of vertebra Th. X  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiglottis (sectioned vertically)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Laryngeal part of pharynx  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus (lumen visible)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus colli muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve left  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve left  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Left recurrent laryngeal nerve Lower pointer: Ligamentum arteriosum  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib VII  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic aorta  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of esophageal hiatus"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_26", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Esophageal plexus; pulmonary plexus; left recurrent laryngeal nerve\n\t\t\t\t\t\t\t\t\t\tThe trachea and bronchi have been elevated. The aortic arch has been cut across and turned somewhat to the left to expose branches of the left recurrent laryngeal nerve.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial plexus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic trunk  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve right  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tracheal and esophageal branches of recurrent laryngeal nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Main bronchi  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophageal plexus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus colli muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Stellate ganglion  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Communication between stellate ganglion and recurrent laryngeal nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Left recurrent laryngeal nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vagus nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchial branch of aorta  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophageal branch of aorta  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic aorta"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_27", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Esophagus and esophageal plexus, anterior view of lower part\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left main bronchus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior tracheobronchial lymph node  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right principal bronchus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophageal plexus right vagus nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura (pointer on ninth intercostal artery)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Right phrenic nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic lymph node  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Central tendon of diaphragm  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vagus nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophageal branch of aorta  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic aorta  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior mediastinal lymph node  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary ligament (cut edge of pleura)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenicoesophageal membrane  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph vessel  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of esophageal hiatus"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_28", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Relations of tracheobronchial tree, aorta and esophagus, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Larynx  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve right  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchus of upper right lobe  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior tracheobronchial lymph nodes  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchus of middle right lobe  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Right inferior lobe bronchus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior mediastinal lymph node  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral column (covered by pleura)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Vocal fold  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus (cut across near pharyngeal junction)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scalene muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Stellate ganglion  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic duct (cut off)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve left  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Main bronchi  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Left upper lobe bronchus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lower lobe bronchus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic aorta  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenicoesophageal membrane  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium (remnant)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_29", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Esophagus\n\t\t\t\t\t\t\t\t\t\tThe esophagus has been exposed by removing the trachea, the right pulmonary artery and part of the pericardium from the specimen shown previously.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Chin  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Digastric muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Larynx  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior laryngeal nerve Lower pointer: Trachea (cut off below first tracheal cartilage)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Stellate ganglion  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Right vagus nerve Lower pointer: Recurrent laryngeal nerve right (note esophageal branches)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus colli muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Right lung  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Right main bronchus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary veins  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Common carotid artery Lower pointer: Internal jugular vein  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve left  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve left  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial plexus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Lung left  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Aortic arch Lower pointer: Ligamentum arteriosum (cut off)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Left main bronchus  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary artery  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary veins  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic aorta  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Filament of esophageal plexus  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternum"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_30", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Relations of pulmonary vessels, pericardium, trachea and esophagus, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve right  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe right lung  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Bifurcation of trachea  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Right superior pulmonary vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Right inferior pulmonary vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve right  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle lobe right lung  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic duct  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch (cut off)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Main bronchi  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve left  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve left  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior pulmonary vein  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic aorta  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Left inferior pulmonary vein  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_31", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Right first and second intercostal spaces; stellate ganglion; costocervical trunk\n\t\t\t\t\t\t\t\t\t\tThe view is from below and in front.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending cervical artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse colli artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle (cut off note remnant of insertion of this muscle on first rib slightly lower in view)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of costocervical trunk (upper pointer, deep cervical artery; lower pointer, supreme intercostal artery)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior trunk brachial plexus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I (cut off)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Rami intercostal nerve I  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus communicans  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve II  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Innermost intercostal muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cervical ganglion  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve right  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrocervical trunk  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal thoracic artery (cut off) Lower pointer: Ansa subclavia  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Stellate ganglion  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior mediastinal lymph node  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic cardiac nerve  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch posterior intercostal artery (to esophagus, trachea)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal vein III"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_32", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Upper thoracic part of right sympathetic trunk; intercostal vessels; azygos vein; right vagus nerve; pulmonary and esophageal plexuses\n\t\t\t\t\t\t\t\t\t\tThe tracheobronchial tree has been pulled forward and to the left and the esophagus has been rotated slightly to the left.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior mediastinal lymph node  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib III  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus communicans (aberrant rami similar to this, which cross a rib to the next lower intercostal nerve, are present in several places on both sides of this specimen)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic ganglion  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus communicans  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph vessel  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal artery and vein VI  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater splanchnic nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve right (several esophageal and tracheal branches visible along course of nerve)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic trunk  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic cardiac nerve (these nerves also send branches into pulmonary plexus)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary plexus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior tracheobronchial lymph node  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic aorta"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_33", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Superior mediastinum.\n\t\t\t\t\t\t\t\t\t\tThe view is from the right side. The pleura (6) has been cut away to display the vagus nerve (12) and the lymphatic structures (16, 18) along the trachea. The right lung has been dissected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cupula pleurae  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of lung  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk (covered by pleura)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Mediastinal pleura (cut edge)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cardiac branch vagus nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Apical segmental bronchus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Filament of pulmonary plexus Lower pointer: Right pulmonary artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve right  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic trunk  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph vessel  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Right brachiocephalic vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Tracheal lymph nodes  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_34", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Left first intercostal space; stellate ganglion and connections; costocervical trunk\n\t\t\t\t\t\t\t\t\t\tThe subclavian artery (10) and the vertebral artery (7) have been pulled forward and slightly downward.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve left  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical fascia (prevertebral part)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus (opened)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus colli muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Stellate ganglion  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cervical cardiac nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrocervical trunk (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery (cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery (cut off)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ansa subclavia  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic duct  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of rib II  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic cardiac nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cervical ganglion  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk (two strands)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve VII  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus communicans  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve VIII  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus communicans  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior trunk brachial plexus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic nerve I (note intercostal branches)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic ganglion  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Costocervical trunk  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Rami communicantes  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve II"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_35", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Upper thoracic part of left sympathetic trunk; intercostal vessels; ligamentous band between vertebrae and mediastinal structures\n\t\t\t\t\t\t\t\t\t\tThe aortic arch and thoracic aorta have been pulled forward. The tracheobronchial tree has been retracted to the right. A ligamentous band (9), firmly attached to the anterior longitudinal ligament over the fourth and fifth thoracic vertebrae, can be seen extending downward and anteriorly to blend with the fascia which covers the esophagus, trachea and aorta. A similar ligament is also shown in another specimen (132-3).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ansa subclavia  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Brachiocephalic trunk Lower pointer: Left common carotid artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal artery III  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vagus nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tracheobronchial lymph node  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentous band extending from vertebrae to mediastinal structures  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left main bronchus (retracted to the right)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchial branch of thoracic aorta  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Stellate ganglion  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior trunk brachial plexus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Costocervical trunk  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Aberrant ramus communicans  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic ganglion  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve V  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Rami communicantes  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament (pointer on vertebra Th. V)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory hemiazygos vein  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic aorta  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_36", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Bronchial and esophageal arteries viewed from left side\n\t\t\t\t\t\t\t\t\t\tThe tracheobronchial tree has been retracted anteriorly in order to stretch the bronchial arteries (15). Delicate lymphatic tissue (19) has been partially preserved in the intercostal spaces and along the vertebral bodies.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Left main bronchus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchial branch of vagus nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Left upper lobe bronchus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchopulmonary lymph node (partially removed)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lower lobe bronchus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior tracheobronchial lymph node  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic duct (dark amber color)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph vessel  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vagus nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum arteriosum (cut off)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper and middle pointers: Bronchial branches thoracic aorta Lower pointer: Esophageal branch thoracic aorta  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib V  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve V  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intercostal lymph node Lower pointer: Lymph vessel (a considerable plexus of lymphatic vessels is visible along the sides of the vertebrae and heads of ribs and in the intercostal spaces. Only in this area of the drawing is this plexus included and labeled.)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic ganglion  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Endothoracic fascia  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal artery VI  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory hemiazygos vein  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophageal branch of sympathetic trunk  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic aorta  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary ligament (cut)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_37", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Superior mediastinum.\n\t\t\t\t\t\t\t\t\t\tThe lymphatic structures have been removed from along the trachea so that the cardiac and pulmonary nerves can be more readily visualized. Filaments of the cardiac plexus have been cut off and laid across the pulmonary artery in such a way that their various connections are more clearly visible. The pulmonary arteries have been retracted downward.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right subclavian artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right vagus nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cervical cardiac nerve (this filament can be traced upward between the arteries to a point where it joins the cervical sympathetic trunk above the stellate ganglion)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior cardiac branch of vagus nerve Lower pointer: Bronchial branch vagus nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Cardiac plexus (deep portion)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary plexus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Right main bronchus Right pointer: Tracheobronchial lymph node inferior  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Cricoid cartilage  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve VII  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Stellate ganglion  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical cardiac nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cervical cardiac nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Left common carotid artery Right pointer: Subclavian artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vagus nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Recurrent laryngeal nerve Lower pointer: Ligamentum arteriosum  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Left main bronchus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Filament of pulmonary plexus"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_38", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Superior mediastinum.\n\t\t\t\t\t\t\t\t\t\tThe aortic arch has been elevated and the pulmonary arteries have been retracted downward.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse scapular artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right vagus nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic trunk  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tracheobronchial lymph nodes  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cardiac plexus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein (cut off)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Right main bronchus (note filaments of pulmonary plexus along bronchus)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchus of upper right lobe  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior tracheobronchial lymph node  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Stellate ganglion  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve VIII  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Cupula pleurae  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Left common carotid artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch (elevated)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve left  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Tracheal bifurcation  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior tracheobronchial lymph nodes Lower pointer: Ligamentum arteriosum  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Left main bronchus  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk (retracted downward)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_39", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Superior mediastinum.\n\t\t\t\t\t\t\t\t\t\tThe lymph nodes and vessels which were shown in the previous view have been removed from the dissection.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve right  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cervical cardiac vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cardiac branch of vagus nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right brachiocephalic vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic trunk  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior mediastinal lymph node  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Filaments of cardiac plexus (two pointers encompass plexus)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Right coronary artery (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Right superior pulmonary vein (at entrance into left atrium)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Trachea Right pointer: Esophagus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Stellate ganglion  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cervical cardiac nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic duct (cut off)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cardiac branch vagus nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve left  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Cardiac ganglion  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Left coronary artery"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_40", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Superior mediastinum.\n\t\t\t\t\t\t\t\t\t\tThe thymus has been removed. Much of the lymphatic tissue in the anterior part of the superior mediastinum has been cut away. The nodes which remain retain their connections with posterior mediastinal nodes. Several lymphatic vessels from the pericardium have been preserved. The pericardial and pleural cavities have been opened. The lung is partially collapsed and has been dissected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic trunk  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vertebral artery (unusual origin from aortic arch)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Left common carotid artery (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior mediastinal lymph node (elevated)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cardiac plexus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymphatic vessels from pericardium  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Thoracic duct (cut off) Lower pointer: Costocervical trunk  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cupula pleurae  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I (cut across)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery (note plexus of nerves along artery)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vagus nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior mediastinal lymph node  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe left lung  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Apical branch left pulmonary artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Tracheobronchial lymph node  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior apical segmental bronchus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior pulmonary vein"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_41", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Superior mediastinum.\n\t\t\t\t\t\t\t\t\t\tThe right subclavian and internal jugular veins have been removed. The left brachiocephalic vein has been resected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery and vagus nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cervical triangle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superficial cervical artery Lower pointer: Brachial plexus (pointer on superior trunk)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Right phrenic nerve Lower pointer: Anterior scalene muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle and subclavius muscle (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Transverse colli artery Lower pointer: Suprascapular artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial cord brachial plexus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary vein (cut off)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cupula pleurae Lower pointer: Right brachiocephalic vein (cut oft)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis minor muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Axilla  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery and vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vertebral artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ansa subclavia  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Right vertebral artery Lower pointer: Right subclavian artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Left common carotid artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cervical cardiac nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic trunk  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior mediastinal lymph nodes  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Left phrenic nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cardiac branch vagus nerve  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Left brachiocephalic vein (cut off)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Left mediastinal pleura  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Right costal pleura"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_42", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Superior mediastinum.\n\t\t\t\t\t\t\t\t\t\tThe superior mediastinum has been opened by removing the manubrium and the upper part of the body of the sternum, together with parts of the first and second costal cartilages.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Thyroid cartilage (left lamina resected) Lower pointer: Cricoid cartilage  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t External jugular vein (cut across)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle and clavicle (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymphatic duct right  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Right subclavian artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Axillary artery Lower pointer: Axillary vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian trunk  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Right bronchomediastinal trunk Lower pointer: Right brachiocephalic vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis minor muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior vena cava Lower pointer: Costal pleura  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternal lymph nodes  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve left  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vocal ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus colli muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Stellate ganglion  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Left brachiocephalic vein  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic trunk  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Thymus  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery and vein  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta (covered by fibrous layer of pericardium)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_43", "text": "Views of segmental bronchi, azygos system of veins, sympathetic trunks and costovertebral joints\n\t\t\t\t\t\t\t\t\t\t Costovertebral articulation of left tenth rib opened from in front\n\t\t\t\t\t\t\t\t\t\tThe left tenth rib has been removed from the specimen with care to preserve the ligaments, joint capsules and articular surfaces of the costovertebral articulations. The view is directed inward from in front and to the left.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Intercostal nerve IX Lower pointer: Spinal ganglion (lying within intervertebral foramen)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Costotransverse ligament (attached posteriorly to transverse process of vertebra Th. X)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint of head of rib (pointers indicate facets on adjacent vertebral bodies, the cleft between being occupied by the delicate intraarticular ligament)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Radiating ligament of head of rib (cut through)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament (pointer also indicates vertebral body Th. X)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc Th. X-XI  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Hemiazygos vein (note small veins draining vertebral bodies at higher levels)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal vein VIII  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal artery VIII  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk (cut off, also see 24)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint of head of rib IX (intact)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve VIII  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib IX  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior costotransverse ligament (upper pointer, anterior division; lower pointer, posterior division)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of ninth intercostal nerve to elevator muscle of rib  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral costotransverse ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Elevator muscle of rib  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Borders of area occupied by tenth rib  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse costal fovea (covered with articular cartilage)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Innermost intercostal muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve X (cut off)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Sympathetic trunk (cut off, also see 11) Right pointer: Ramus communicans  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk ganglion  *\n\t\t\t\t\t\t.\n\t\t\t\t\t [Legend above restored translation from Latin]"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_44", "text": "Views of segmental bronchi, azygos system of viens, sympathetic trunks and costovertebral joints\n\t\t\t\t\t\t\t\t\t\t Sympathetic trunk, rami communicantes and splanchnic nerves in lower thoracic region, left anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the previous view has been turned to expose its left anterolateral aspect in this close-up view of the lower thoracic and upper lumbar part of the spine.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory hemiazygos vein  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Body of vertebra Th. VIII (pointer on anterior longitudinal ligament)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vein draining body of vertebra  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal arteries IX-X  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Major splanchnic nerve (lower pointer on splanchnic ganglion)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Minor splanchnic nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Smallest splanchnic nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar part of diaphragm (upper pointer: left crus; lower pointer: right crus)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Hemiazygos vein Right pointer: Posterior intercostal vein VIII  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib VIII  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk (lower pointer on sympathetic trunk ganglion)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Communicating branches  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve XI  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of rib XII  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcostal nerve (note large communicating branch)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lumbar quadratic muscle Lower pointer: Psoas major muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending lumbar vein  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process of vertebra L. II  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbar nerve I (passing downward to join lumbar plexus)  *\n\t\t\t\t\t\t.\n\t\t\t\t\t [Legend above restored translation from Latin]"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_45", "text": "Views of segmental bronchi, azygos system of veins, sympathetic trunks and costovertebral joints\n\t\t\t\t\t\t\t\t\t\t Azygos veins, intercostal vessels and sympathetic trunks in relation to vertebral column\n\t\t\t\t\t\t\t\t\t\tIn this specimen the thoracic viscera have been removed and the azygos system of veins has been dissected to show the relations of its parts to the intercostal arteries and nerves, the sympathetic trunks, and the vertebral column and ribs.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Manubrium sterni (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic veins  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Trachea Lower pointer: Esophagus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal arteries  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Major splanchnic nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior intercostal vein  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory hemiazygos vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Hemiazygos vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior longitudinal ligament Lower pointer: Intervertebral disc Th. X-XI  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve XI  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII  *\n\t\t\t\t\t\t.\n\t\t\t\t\t [Legend above restored translation from Latin]"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_46", "text": "Views of segmental bronchi, azygos system of veins, sympathetic trunks and costovertebral joints\n\t\t\t\t\t\t\t\t\t\t Segmental bronchi of left lung, lateral view\n\t\t\t\t\t\t\t\t\t\tThe left pulmonary artery (10) has been cut across at the hilum of the lung to permit the removal of its peripheral branches. The left pulmonary veins, similarly cut off at the hilum, are partially obscured by the bronchi.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior segmental bronchus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Left superior lobar bronchus Lower pointer: Left superior pulmonary vein (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior lingular bronchus Lower pointer: Inferior lingular bronchus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial basal segmental bronchus (4. & 5. originating from a common stem in this specimen)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior basal segmental bronchus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior basal segmental bronchus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior intercostal vein (covered by pleura)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch (covered by pleura)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Apicoposterior segmental bronchus (note unusual origin of posterior ramus of posterior subsegmental bronchus from anterior segmental bronchus)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Left pulmonary artery (cut off) Lower pointer: Left principal bronchus (emerging from mediastinum)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left inferior lobar bronchus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior segmental bronchus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Subsuperior segmental bronchus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral basal segmental bronchus  *\n\t\t\t\t\t\t.\n\t\t\t\t\t [Legend above restored translation from Latin]"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_47", "text": "Views of segmental bronchi, azygos system of veins, sympathetic trunks and costovertebral joints\n\t\t\t\t\t\t\t\t\t\t Segmental bronchi of left lung in relation to branches of pulmonary artery, lateral view\n\t\t\t\t\t\t\t\t\t\tThe dissection has been prepared, in a manner similar to that for the right lung (126A-1), to demonstrate the relations of the pulmonary artery and the bronchi in the left lung. In the following view (126-4) the segmental divisions of the bronchi are shown after removal of the left pulmonary artery.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch left pulmonary artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior segmental bronchus Lower pointer: Superior lobar bronchus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior lingular branch left pulmonary artery Lower pointer: Superior lingular bronchus left pulmonary artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior lingular branch left pulmonary artery Lower pointer: Inferior lingular bronchus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of left phrenic nerve (covered by pleura)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Apical branch left pulmonary artery Lower pointer: Apicoposterior segmental bronchus (Note: the posterior ramus of the posterior subsegmental bronchus (no. 8, lower pointer) has an aberrant origin from the anterior segmental bronchus in this specimen)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior branch left pulmonary artery Lower pointer: Posterior branch of posterior subsegmental branch of segmental bronchus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Interlobar part left pulmonary artery Lower pointer: Superior branch of inferior left pulmonary artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Basal part left pulmonary artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left inferior lobar bronchus  *\n\t\t\t\t\t\t.\n\t\t\t\t\t [Legend above restored translation from Latin]"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_48", "text": "Views of segmental bronchi, azygos system of veins, sympathetic trunks and costovertebral joints\n\t\t\t\t\t\t\t\t\t\t Segmental bronchi of right lung, lateral view\n\t\t\t\t\t\t\t\t\t\tThe branches of the right pulmonary artery have been cut away from the specimen shown in the previous photograph to expose the segmental divisions of the right bronchus. The upper lobar bronchus (2) divides into apical, posterior and anterior segmental bronchi (1, 11). The middle lobar bronchus (13) divides into lateral and medial segmental bronchi (15). The inferior lobar bronchus (4) gives off a superior segmental bronchus (3) and continues downward to divide into four basal segmental bronchi (4, 6, 7, 8). In this specimen it is apparent that the lateral ramus (5) of the anterior basal segmental bronchus has a high origin from the lobar bronchus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Apical segmental bronchus Lower pointer: Posterior segmental bronchus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior lobar bronchus Lower pointer: Bronchial branch of thoracic aorta  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior segmental bronchus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior lobar bronchus Lower pointer: Medial basal segmental bronchus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior basal segmental bronchus (lateral branch, originating abnormally high)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior basal segmental bronchus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral basal segmental bronchus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior basal segmental bronchus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein (covered by pleura)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Apical branch of right pulmonary artery (cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior segmental bronchus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial lobar bronchus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Right superior pulmonary vein (cut off)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lateral segmental bronchus Lower pointer: Medial segmental bronchus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Right inferior pulmonary veins  *\n\t\t\t\t\t\t.\n\t\t\t\t\t [Legend above restored translation from Latin]"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_49", "text": "Views of segmental bronchi, azygos system of veins, sympathetic trunks and costovertebral joints\n\t\t\t\t\t\t\t\t\t\t Segmental bronchi of right lung in relation to branches of pulmonary artery, lateral view\n\t\t\t\t\t\t\t\t\t\tThe right pleural cavity has been opened. The parenchyma of the lung has been removed. The segmental bronchi with the accompanying branches of the right pulmonary artery have been preserved. The abbreviation \"a.p.d.\" is used in the legend below to indicate the \"arteria pulmonalis dextra\". The right pulmonary veins have been completely resected. The basal part (5) of the pulmonary artery has been pulled slightly posteriorly to permit better visualization of the lower lobe bronchus. In the following view (126A-2) the segmental bronchi are displayed after the arteries have been entirely removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Apical branch right pulmonary artery (pointers on apical and anterior branches)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Apical segmental bronchus Left pointer: Posterior descending branch right pulmonary artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior segmental bronchus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior ascending branch right pulmonary artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior branch of inferior lobe right pulmonary artery Lower pointer: Basal part right pulmonary artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Basal lateral branch right pulmonary artery Lower pointer: Anterior basal branch right pulmonary artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior basal branch right pulmonary artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Apical branch right pulmonary artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava (covered by mediastinal pleura)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior branch right pulmonary artery Lower pointer: Anterior segmental bronchus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Interlobar part right pulmonary artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lateral branch of medial lobe right pulmonary artery Lower pointer: Medial branch of medial lobe right pulmonary artery (inferior branch)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lateral segmental bronchus Lower pointer: Medial segmental bronchus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial branch of medial lobe right pulmonary artery (superior branch)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of right atrium (covered by pleura and pericardium)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Medial basal segmental bronchus Left pointer: Medial basal branch right pulmonary artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior basal segmental bronchus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral basal segmental bronchus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior basal segmental bronchus  *\n\t\t\t\t\t\t.\n\t\t\t\t\t [Legend above restored translation from Latin]"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_50", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Contents of thoracic inlet viewed from below\n\t\t\t\t\t\t\t\t\t\tThe thoracic cavity has been opened from behind. The thoracic viscera have been excised with the exception of the structures which pass through the superior thoracic aperture (thoracic inlet). Lymphatic structures and connective tissue have been removed from the area.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process vertebrae Th. II  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Stellate ganglion  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic nerve I  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Costocervical trunk  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vertebral artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ansa subclavia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve I  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Esophagus Lower pointer: Trachea  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Left phrenic nerve Lower pointer: Left subclavian vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Left common carotid artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal cartilage I  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Recurrent laryngeal nerve Lower pointer: Ligamentum arteriosum  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternothyroid muscle (origin from sternum)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery and vein  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinal ganglion nerve Th. II  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior longitudinal ligament (crossing vertebra Th. II)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral disc Th. II-III  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Costotransverse ligament  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior costal facet  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic nerve I  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve VIII  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Costocervical trunk Right pointer: Inferior trunk brachial plexus  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Right vertebral artery and vein  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Right subclavian artery  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Right phrenic nerve  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Right subclavian vein  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Right vagus nerve Lower pointer: Right brachiocephalic vein  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Brachiocephalic trunk Right pointer: Inferior thyroid vein  36\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Left brachiocephalic vein Lower pointer: Azygos vein  37\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  38\n\t\t\t\t\t\t.\n\t\t\t\t\t Manubrium of sternum (covered by sternal membrane)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_51", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Mediastinal contents viewed from left side\n\t\t\t\t\t\t\t\t\t\tThe pleura has been removed from the left side of the mediastinum and from the paravertebral area. The pericardial cavity has been opened.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavius muscle (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery and vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic duct  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I (periosteum removed)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery and vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardiacophrenic artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Left brachiocephalic vein (in background)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch (covered by fibrous tissue)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Thymus (covered by fascia)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary veins (filled with red latex)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve left (band of pericardium preserved along nerve)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardial cavity  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal cartilage V  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium (opened)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus colli muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve II  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Supreme intercostal vein  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Left subclavian artery Lower pointer: Esophagus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior intercostal vein  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve left  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal artery IV  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary artery (filled with blue latex)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Left main bronchus  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory hemiazygos vein  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic ganglion  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater splanchnic nerve  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Hemiazygos vein  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic aorta  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_52", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Mediastinal pleura viewed from left side\n\t\t\t\t\t\t\t\t\t\tThe upper limb has been detached. The left pleural cavity has been opened and the lung has been excised.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial plexus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery and vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle (clavicular part, cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I (intact)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Line of reflection of mediastinal pleura onto lung  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches left upper pulmonary vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle (sternal part, cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal cartilage ill (cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Transversus thoracis muscle (cut across)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Costomediastinal recess  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Mediastinal pleura (pointer indicates location of phrenic nerve in its course across left border of heart and pericardium)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lobule of fat  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Costodiaphragmatic recess  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib III (cut off)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Cupula pleurae  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch (covered by pleura)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary artery (filled with blue latex)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Left main bronchus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Left inferior pulmonary vein  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic aorta (covered by pleura)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary ligament  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib X (periosteum removed)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_53", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Mediastinal contents viewed from right side\n\t\t\t\t\t\t\t\t\t\tThe pleura which covered the right side of the mediastinum and the paravertebral area has been removed from the specimen shown in the preceding view. The pericardial cavity has been opened. The endothoracic fascia has been cleared away.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic ganglion  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Longus colli muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib IV (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Cardiac thoracic nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Right superior intercostal vein Lower pointer: Azygos vein (pointer indicates location of a valve within vein)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Right main bronchus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch right pulmonary artery (filled with blue latex)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary veins (filled with red latex)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum capitis costae radiatum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ramus communicans Lower pointer: Thoracic ganglion  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater splanchnic nerve (two strands indicated by pointers join at a lower level)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal artery and vein  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior longitudinal ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavius muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial plexus (pointer indicates one of several components)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Right subclavian artery and vein  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicular part pectoralis major muscle (cut off at origin)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I (periosteum removed)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Right vagus nerve Right pointer: Right brachiocephalic vein  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cardiac branch of vagus nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery and vein  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Right phrenic nerve  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardiacophrenic artery (cut off)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia covering thymus  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardial cavity  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Musculophrenic artery and vein  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocostal part pectoralis major muscle (cut off)  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium (cut margins)  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  36\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve right (note filaments of esophageal plexus above pointer)  37\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava (covered by pericardium)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_54", "text": "Dissection of mediastinum and paravertebral structures\n\t\t\t\t\t\t\t\t\t\t Mediastinal pleura viewed from right side\n\t\t\t\t\t\t\t\t\t\tThe upper limb has been detached. The right pleural cavity has been opened and the right lung has been excised.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle (upper portion)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Depression formed by vertebral border of scapula  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib III (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Cupula pleurae  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein (covered by mediastinal pleura)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Bronchus of upper right lobe Lower pointer: Right main bronchus (to middle and lower lobes)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchopulmonary lymph node  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrium (right superior pulmonary vein cut off above pointer, right inferior pulmonary vein cut off below pointer)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Right vagus nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavius muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery and vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle (cut off)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal cartilage III  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Line of reflection of mediastinal pleura onto lung  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Costomediastinal recess  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium (covered by pericardium and mediastinal pleura)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Transversus thoracis muscle (cut across)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus abdominis muscle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_55", "text": "Dissection of lungs in situ\n\t\t\t\t\t\t\t\t\t\t Left lung.\n\t\t\t\t\t\t\t\t\t\tBranches of the pulmonary artery and vein have been removed to demonstrate the segmental bronchi (12, 13, 16, 19, 20, 22) of the lower lobe. The view is directed medially.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left main bronchus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior lingular bronchus (in foreground) Lower pointer: Inferior lingular bronchus (in foreground)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Left inferior pulmonary vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior mediastinal lymph node  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary artery (cut off)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior apical segmental bronchus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Interlobar surface lower lobe  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior segmental bronchus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior segmental bronchus (pointer on superior branch)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior segmental bronchus (pointer on lateral branch)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior and lateral basilar branches left pulmonary artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Left lower lobe bronchus Lower pointer: Bronchial branch of aorta  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior basal segmental bronchus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral branch of no. 16  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Basal branch of no.16  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial basal segmental bronchus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral basal segmental bronchus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anteromedial branch of no. 19 Lower pointer: Anterolateral branch of no. 19  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior basal segmental bronchus (division of this bronchus into laterobasal and mediobasal branches is visible below pointer)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_56", "text": "Dissection of lungs in situ\n\t\t\t\t\t\t\t\t\t\t Left lung.\n\t\t\t\t\t\t\t\t\t\tThe lower lobe has been dissected to expose the medial basal segmental bronchus (19), the distribution of the pulmonary artery to the anterior area of the lobe and tributaries to the lower left pulmonary vein. The view is directed obliquely upward and medially.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right superior pulmonary vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrium  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tributary to right superior pulmonary vein (inverted into atrium)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Right inferior pulmonary vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior mediastinal lymph node  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior pulmonary vein (cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior apical segmental bronchus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior segmental bronchus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Intersegmental lingular veins  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior lingular bronchus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior lingular bronchus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar part left pulmonary artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lower lobe bronchus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Left, inferior pulmonary vein  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial basal segmental bronchus"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_57", "text": "Dissection of lungs in situ\n\t\t\t\t\t\t\t\t\t\t Left lung.\n\t\t\t\t\t\t\t\t\t\tThe left upper lobe has been retracted anteriorly and toward the right. The pleura in the depths of the oblique fissure has been cut to expose the interlobar parts of the left pulmonary artery, the pulmonary plexus of nerves and bronchopulmonary lymph nodes and vessels. Unlike the situation in the right lung (124-7), there is no area of fusion of upper and lower lobes on the left.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vertebral artery (unusual origin from aortic arch)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Left common carotid artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic trunk  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vagus nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum arteriosum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe (retracted)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Interlobar surface upper lobe  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branches left pulmonary artery (entering upper lobe)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior mediastinal lymph node  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura (pointer on third rib)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Recurrent laryngeal nerve Lower pointer: Thoracic aorta  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vagus nerve Lower pointer: Branch entering pulmonary plexus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Line of reflection of pleura between lobes of lung  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchopulmonary lymph nodes  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lower lobe bronchus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Interlobar surface lower lobe"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_58", "text": "Dissection of lungs in situ\n\t\t\t\t\t\t\t\t\t\t Left lung.\n\t\t\t\t\t\t\t\t\t\tBranches of the left pulmonary artery have been cut away to reveal the more posterior subsegmental bronchi. The pulmonary plexus of nerves (5) has been more fully exposed. A branch of the bronchial artery (6) is visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vagus nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Recurrent laryngeal nerve Lower pointer: Ligamentum arteriosum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Left pulmonary artery Left pointer: Pulmonary trunk  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary plexus (note other unlabeled nerve filaments inferiorly)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchial branch of aorta  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Left upper lobe bronchus (note division into upper and lower parts)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior pulmonary vein (retracted medially)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior lingular bronchus Lower pointer: Inferior lingular bronchus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium (retracted medially)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe left lung  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch of apical subsegmental bronchus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Apical branch of apical subsegmental bronchus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Apical subsegmental bronchus Lower pointer: Posterior subsegmental bronchus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior apical segmental bronchus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior segmental bronchus (note posterior branch close to origin of this bronchus)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior lingular bronchus (upper pointer, anterior branch; lower pointer, posterior branch)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Intersegmental lingular veins  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower lobe left lung"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_59", "text": "Dissection of lungs in situ\n\t\t\t\t\t\t\t\t\t\t Left lung.\n\t\t\t\t\t\t\t\t\t\tThe upper division of the left superior pulmonary vein (10) has been severed. Its branches have been cut off at varying distal points and the main stem of the vein has been retracted anteromedially. This procedure has served to expose the upper part of the left pulmonary artery, parts of the bronchial tree, filaments of the pulmonary plexus of nerves and bronchopulmonary lymphatic nodes and vessels.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve left  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cardiac plexus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchopulmonary lymph nodes  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Filament of pulmonary plexus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior pulmonary vein (retracted anteromedially)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior intersegmental and lingular veins  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial surface of left lung  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of lung  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Apical branch left pulmonary artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior apical segmental bronchus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch posterior left pulmonary artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lateral branch left pulmonary artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior segmental bronchus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior descending branch left pulmonary artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior lingular bronchus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior lingular bronchus"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_60", "text": "Dissection of lungs in situ\n\t\t\t\t\t\t\t\t\t\t Left lung.\n\t\t\t\t\t\t\t\t\t\tThe upper lobe has been dissected from its medial aspect and has been retracted laterally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior pulmonary vein (note anterior intersegmental branches to upper lobe)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Left auricle Lower pointer: Latex cast in left inferior pulmonary vein at entrance into left atrium)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrium (interior visible through openings cut in wall)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Left phrenic nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of lung  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior intercostal vein (not tributary accompanying left phrenic nerve)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior mediastinal lymph node  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Apical branch left pulmonary artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior apical segmental bronchus (apical subsegmental branch)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lateral branch left pulmonary artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior segmental bronchus Lower pointer: Lingular branch superior left pulmonary artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior descending branch left pulmonary artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches superior lingular bronchi  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Intersegmental vein  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe left lung  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique fissure  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingula of left lung  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower lobe left lung"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_61", "text": "Dissection of lungs in situ\n\t\t\t\t\t\t\t\t\t\t Left lung.\n\t\t\t\t\t\t\t\t\t\tThe pleura has been divided at the hilus and has been removed from the nearby area of the mediastinum. The partially deflated upper lobe of the lung has been retracted laterally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vagus nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Left common carotid artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Left phrenic nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery (note plexus of nerves from inferior cervical ganglion along proximal part of artery)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Mediastinal pleura  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior mediastinal lymph node (note other nodes and plexus of lymphatic vessels in this area)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tracheobronchial lymph node (note lymphatic vessels entering node from lung and inferior part of mediastinum)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle (cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Cupula pleurae  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of lung  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Mediastinal surface upper lobe  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal surface upper lobe  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior pulmonary vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchopulmonary lymph node"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_62", "text": "Dissection of lungs in situ\n\t\t\t\t\t\t\t\t\t\t Right lung.\n\t\t\t\t\t\t\t\t\t\tThe five segmental bronchi in the lower lobe (5, 7, 8, 9, 15) have been exposed by the removal of lung parenchyma, smaller bronchi and vessels. The medial basal bronchus (7) has been retracted laterally to expose the posterior basal bronchus (15). The middle lobe bronchus (3) has also been retracted laterally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right main bronchus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchus of middle right lobe (retracted laterally)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right inferior lobe bronchus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior segmental bronchus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Interlobar surface lower lobe  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial basal segmental bronchus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior basal segmental bronchus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral basal segmental bronchus (pointers on lateral and basal branches)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial basal segmental bronchus (left pointer, anterior branch; right pointer, medial branch)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragmatic surface lower lobe  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchopulmonary lymph node  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior pulmonary vein  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrium  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior basal segmental bronchus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Left inferior pulmonary vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Right inferior pulmonary vein (note upper and lower branches into lower lobe)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_63", "text": "Dissection of lungs in situ\n\t\t\t\t\t\t\t\t\t\t Right lung.\n\t\t\t\t\t\t\t\t\t\tThe upper and middle lobes have been removed. The lobar bronchi (2, 17) have been preserved with their segmental divisions. The lower lobe has been partially dissected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchus of upper right lobe  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery (upper pointer, branch to upper lobe lower pointer, interlobar part)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior branch lower lobe right pulmonary artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior segmental bronchus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower lobe (pointer on interlobar surface)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Basal branch anterior right pulmonary artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior basal segmental bronchus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial basal segmental bronchus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior intersegmental vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial basal segmental bronchus (left pointer, anterior branch; right pointer, medial branch)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragmatic surface lower lobe  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior tracheobronchial lymph nodes  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Right superior pulmonary vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchus of middle right lobe  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior pulmonary vein  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrium  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower lobe left lung  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_64", "text": "Dissection of lungs in situ\n\t\t\t\t\t\t\t\t\t\t Right lung.\n\t\t\t\t\t\t\t\t\t\tThe right upper lobe (10) and middle lobe (19) have been pulled across the midline of the body to demonstrate the hilar region of the lower lobe and to display the interlobar parts of the pulmonary vessels. Small areas of fusion between the upper and lower lobes (1), and between the middle and lower lobes (3), have been divided in order to separate the lobes. The bronchopulmonary lymphatic vessels and nodes of the lower lobe have been preserved.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of fusion between upper and middle lobes  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right main bronchus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of fusion between middle and lower lobes  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Interlobar surface lower lobe  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior branch of lower lobe, right pulmonary artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior segmental bronchus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchopulmonary lymph nodes  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilar part right pulmonary artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower lobe  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe (reflected across midline)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Interlobar surface upper lobe  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Right superior pulmonary vein (posterior branch to upper lobe)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery (ascending branch of interlobar part)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery (interlobar part)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Right superior pulmonary vein (branch to middle lobe and anterior segment of upper lobe, cut off)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery (branch to middle lobe)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchus of middle right lobe  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Right inferior pulmonary vein (branch to middle lobe)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle lobe (pointer on interlobar surface)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_65", "text": "Dissection of lungs in situ\n\t\t\t\t\t\t\t\t\t\t Right lung.\n\t\t\t\t\t\t\t\t\t\tThe apical (4) and anterior (14) segmental bronchi have been freed and pulled forward to permit exposure of the posterior segmental bronchus (6) and its two rami (5). Branches of the pulmonary artery and vein have been cut off in various ways. The continuity of these vessels may be ascertained by reference to the several preceding views of this series.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal pleura  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of lung (dissected)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of apical segmental bronchi (left pointer, apical branch; right pointer, anterior branch)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Apical segmental bronchus (retracted)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of posterior segmental bronchi (upper pointer, apical branch; lower pointer, posterior branch)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior segmental bronchus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of anterior segmental bronchi (left pointer, posterior branch; right pointer, anterior branch)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Right superior pulmonary vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchus of middle right lobe  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior mediastinal lymph node  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Right main bronchus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior segmental bronchus (retracted)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch right pulmonary artery (upper pointer, branch to upper lobe lower pointer, interlobar part of branch to middle and lower lobes)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrium (interior)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_66", "text": "Dissection of lungs in situ\n\t\t\t\t\t\t\t\t\t\t Right lung.\n\t\t\t\t\t\t\t\t\t\tThe dissection has been carried more deeply into the lung. Various branches of the pulmonary vessels have been divided or partially removed to permit better visualization of the bronchial distribution.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of apical branch right pulmonary artery (cut off refer to no. in previous view)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Apical segmental bronchus (note division above pointer into apical and anterior branches)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior segmental bronchus (note division near pointer into anterior and posterior branches)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch right pulmonary artery (cut off refer to no. 5 in previous view)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Intersegmental vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral segmental bronchus middle lobe (anterior branch)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial segmental bronchus of middle lobe (note division into superior and inferior branches)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Vein of middle lobe (note division into medial and lateral branches)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior intersegmental vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Apical branches of apical branch right pulmonary artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch right pulmonary artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Right brachiocephalic vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Left common carotid artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Right phrenic nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Left brachiocephalic vein (cut off)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vagus nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Filament of pulmonary plexus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery (entering upper lobe)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Cardiac plexus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchopulmonary lymph node  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Right superior pulmonary vein  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of right pulmonary artery (to middle lobe)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_67", "text": "Dissection of lungs in situ\n\t\t\t\t\t\t\t\t\t\t Right lung.\n\t\t\t\t\t\t\t\t\t\tThe dissection has been extended from that shown in the previous view to include the anterior and apical segments of the upper lobe.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe right lung  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Apical segmental bronchus (pointer on apical branch)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Apical branch right pulmonary artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior intersegmental vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior branch right pulmonary artery Lower pointer Intersegmental vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior segmental bronchus (pointer on anterior branch)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch to middle lobe right pulmonary artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial segmental bronchus of middle lobe  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Division between upper and middle lobes (no horizontal fissure on medial aspect of specimen)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle lobe right lung  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior lobe right lung  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic trunk and right brachiocephalic vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior mediastinal lymph node and lymph vessel  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Left brachiocephalic vein (cut off)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery and vein and lymph vessel  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Right auricle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium (reflected)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium (covered by pleura and pericardium)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Transversus thoracis muscle (cut off)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_68", "text": "Dissection of lungs in situ\n\t\t\t\t\t\t\t\t\t\t Right lung.\n\t\t\t\t\t\t\t\t\t\tThe close relation of branches of the pulmonary artery (4, blue) to the bronchial branches is evident, as well as the distinct intersegmental position of branches of the pulmonary vein (9, red).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery (branches to superior lobe)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior intersegmental vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchopulmonary lymph node  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch to middle lobe pulmonary artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Filament of pulmonary plexus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial segmental bronchus of middle lobe  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior branch of no. 6  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior branch of no. 6  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Intersegmental veins of middle lobe  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle lobe right lung (mediastinal surface)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior lobe right lung  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Right vagus nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava (covered by pleura)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery and vein  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Right superior pulmonary vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium (covered by pleura and pericardium)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal cartilage V"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_69", "text": "Dissection of lungs in situ\n\t\t\t\t\t\t\t\t\t\t Right lung.\n\t\t\t\t\t\t\t\t\t\tThe right pleural cavity has been opened and the lung has been retracted laterally. The hilar parts of the upper and middle lobes have been dissected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Axilla  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary. artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchopulmonary lymph node (note lymphatic vessels entering node from region of middle lobe bronchus)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch to middle lobe right pulmonary artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial segmental bronchus of middle lobe  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib VI (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle lobe right lung (no visible horizontal fissure separates upper and middle lobes in this preparation)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Oblique fissure Lower pointer: Inferior lobe right lung  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe right lung  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein (covered by pleura)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Right brachiocephalic vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic trunk  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Left brachiocephalic vein  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior mediastinal lymph node  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava (covered by pleura)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Thymus (partially resected)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary veins  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternum  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium (distended covered by pericardium and pleura)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal cartilage V (cut off)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_70", "text": "Dissection of lungs in situ\n\t\t\t\t\t\t\t\t\t\t General view of vascular and bronchial distribution within lungs.\n\t\t\t\t\t\t\t\t\t\tThe specimen is shown in a considerably more advanced stage of dissection than that in the previous view. The upper lobes of both lungs and the right middle lobe have been removed. However, the major vessels and bronchi to these parts have been preserved. Most of the heart has been removed. The ascending aorta has been cut off to expose the right pulmonary artery (8). The pericardium has been cut away except for its posterior and diaphragmatic parts.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Right common carotid artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right subclavian artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve right  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anterior mediastinal lymph node Lower pointer: Lymphatic Vessels  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchus of upper right lobe  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Right. superior pulmonary vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchus of middle right lobe  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Right inferior pulmonary vein (at entrance into left atrium)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral basal segmental bronchus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior lobe right lung  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava (cut off at entrance into right atrium)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Pleura  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Left common carotid artery (cut off)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Cardiac plexus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchus of upper left lobe  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Left inferior pulmonary vein  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial basal segmental bronchus  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrium  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower lobe left lung"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_71", "text": "Dissection of lungs in situ\n\t\t\t\t\t\t\t\t\t\t General view of vascular and bronchial distribution within lungs.\n\t\t\t\t\t\t\t\t\t\tThe lungs have been dissected from their medial surfaces and are reflected laterally for this photograph. Fragmentary portions of all of the chambers of the heart have been preserved. The great vessels have been kept intact, although the aorta (8) and pulmonary trunk (27) have been elevated to expose more posterior parts of the heart.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic trunk  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe right lung  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Right superior pulmonary vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ramus anterior right pulmonary artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta (pointer on aortic valve)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Bronchus of right middle lobe  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Right inferior pulmonary vein (at entrance into left atrium)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Margins of window cut through interatrial septum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle lobe right lung  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior lobe right lung  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava (cut off at entrance into right atrium)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Valve of inferior vena cava  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal (medial) cusp of tricuspid valve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Anterior cusp of mitral valve Right pointer: Left ventricle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Left phrenic nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Left common carotid artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Parietal pleura  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vagus nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior mediastinal lymph node  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior pulmonary vein  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior segmental bronchus of upper lobe  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lateral branch left pulmonary artery  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Left auricle  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrium (pointer on posterior wall atrium in this specimen abnormally dilated)  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingula of left lung  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower lobe left lung"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_72", "text": "Dissection of lungs in situ\n\t\t\t\t\t\t\t\t\t\t Bronchogram, anteroposterior view\n\t\t\t\t\t\t\t\t\t\tThis film of a living subject was made after the bronchial tree had been partially filled with iodized oil. The air passages are distinguished in some places by their content of air (e.g. 1, 2) and elsewhere by their content of radio-opaque material either alone or in combination with air. The manner of branching of the bronchi within both lower lobes is partially obscured by overlapping shadows. Details of the bronchial distribution in these lobes are shown in the lobar dissections which follow.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Conus elasticus (air-filled)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea (air-filled)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Apical segmental bronchus of upper lobe  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior segmental bronchus of upper lobe  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior segmental bronchus of upper lobe  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior segmental bronchus of lower lobe  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lateral segmental bronchus of middle lobe Lower pointer: Medial segmental bronchus of middle lobe  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Anterior basal segmental bronchus Right pointer: Medial basal segmental bronchus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral basal segmental bronchus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior basal segmental bronchus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Left border of aortic arch  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior apical segmental bronchus Lower pointer: Anterior segmental bronchus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Main bronchi  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior lingular bronchus Lower pointer: Inferior lingular bronchus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial basal segmental bronchus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral basal segmental bronchus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior basal segmental bronchus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior basal segmental bronchus Lower pointer: Heart"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_73", "text": "Dissection of lungs in situ\n\t\t\t\t\t\t\t\t\t\t Larynx, trachea, main bronchi and lungs\n\t\t\t\t\t\t\t\t\t\tThe anterior part of the thoracic wall has been removed. The neck and mediastinum have been dissected to display the major cervical and thoracic parts of the respiratory system. Reference should be made to views 116-ff. for earlier phases of the dissection of this specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Mandible  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Digastric muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Hyoid bone (covered by fibrous tissue)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Submandibular gland  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Larynx  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sympathetic trunk  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve right  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Right vagus nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve (subclavian artery cut off to reveal loop formed by this nerve below artery)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of lung (lying within cupula pleurae)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe right lung  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein (cut off at point of entrance into superior vena cava)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Right main bronchus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Esophagus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary veins  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle lobe right lung  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava (cut off at entrance into right atrium)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial plexus (cut off)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve left  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve left  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch (cut off)  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe left lung  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Left main bronchus  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk (cut off)  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior pulmonary vein  36\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic aorta  37\n\t\t\t\t\t\t.\n\t\t\t\t\t Left inferior pulmonary vein (at entrance into left atrium)  38\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  39\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower lobe left lung  40\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternum"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_74", "text": "Surface views of lungs\n\t\t\t\t\t\t\t\t\t\t Left lung, lateral aspect\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of lung  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior margin  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingula  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique fissure (pointer on interlobar surface of lower lobe)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower lobe  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior margin"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_75", "text": "Surface views of lungs\n\t\t\t\t\t\t\t\t\t\t Left lung, medial aspect\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique fissure  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Hilus of lung (pointer on cut edge of pleura at hilar margin)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower lobe  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Left main bronchus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal surface  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Impression of descending aorta  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of lung  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Impression of left subclavian artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Impression of aortic arch  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary veins  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior margin  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cardiac impression (pointer on central part of large depression)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lingula of left lung  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior margin  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragmatic surface"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_76", "text": "Surface views of lungs\n\t\t\t\t\t\t\t\t\t\t Right lung, lateral aspect\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique fissure  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower lobe  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle lobe  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior margin  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of lung  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior margin  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Horizontal fissure (incomplete anteriorly)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of lung"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_77", "text": "Surface views of lungs\n\t\t\t\t\t\t\t\t\t\t Right lung, medial aspect\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Impression of azygos vein  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Impression of superior vena cava  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Hilus of lung  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Impression of medial surface of heart  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior margin  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle lobe (horizontal fissure which separates upper and middle lobes, not visible at anterior margin of this specimen)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique fissure  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior margin  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragmatic surface  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of lung  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of lung  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Right main bronchus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of right pulmonary artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary veins  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower lobe  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal surface  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral part medial surface  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary ligament (cut edge)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_78", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Interior of left atrium and left ventricle viewed from left\n\t\t\t\t\t\t\t\t\t\tThis fresh specimen has been opened by a vertical incision which extends from a point near the apex upward along the left border of the heart to separate the anterior and posterior cusps of the mitral valve. The cut continues upward to open the left atrium along its left border. Fascicles of the left branch of the A-V bundle are clearly visible as delicate white strands in the endocardium of the septal wall (5) of the left ventricle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left auricle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of anulus fibrosus (indicated by dotted line in drawing)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cusp mitral valve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior papillary muscle (divided by incision)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular part interventricular septum (pointer indicates location of left crus atrioventricular bundle)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle (cavity)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Valve of foramen ovale  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Interatrial septum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of entrance of right superior pulmonary vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Fat in coronary sulcus (sectioned)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cusp of mitral valve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Chordae tendineae  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior papillary muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of myocardium  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of heart"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_79", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Interior of left ventricle.\n\t\t\t\t\t\t\t\t\t\tThe anterior cusp of the mitral valve has been freed of its chordal attachments and retracted upward. By this means the posterior cusp of the valve (7), the valvular ostium (6) and the interior of the left atrium have been brought to view.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrioventricular opening  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal (medial) cusp of tricuspid valve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular part interventricular septum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cusp of mitral valve (retracted)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of wall of left ventricle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrioventricular opening (left atrium visible in background)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cusp of mitral valve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior papillary muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Chordae tendineae  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior papillary muscle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_80", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Interior of left ventricle.\n\t\t\t\t\t\t\t\t\t\tMost of the interventricular septum has been resected from the specimen shown in the preceding view. The part of the septum which remains runs vertically through the center of the photograph.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior wall of right ventricle (retracted)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cusp tricuspid valve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Valve of inferior vena cava (viewed through right atrioventricular opening)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior papillary muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Chorda tendinea  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal (medial) cusp of tricuspid valve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cusp tricuspid valve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Membranous part interventricular septum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Atrioventricular septum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior semilunar cusp (aortic valve)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Anulus fibrosus (sectioned) Lower pointer: Cut wall of conus arteriosus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cusp of mitral valve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular part interventricular septum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Chordae tendineae  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior papillary muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Chordae tendineae (of posterior cusp of mitral valve)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior papillary muscles"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_81", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Interior of right and left ventricles, anterior view\n\t\t\t\t\t\t\t\t\t\tTwo incisions have been made in this specimen. The initial cut through the anterior wall of the heart has opened the right ventricle and conus arteriosus and has produced a large flap (3) which is retracted. The second cut (10) has been made through the interventricular septum and has been extended upwards to include the anterior wall of the aorta. The septum has been retracted to expose the interior of the left ventricle (17).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Fat in coronary sulcus (sectioned)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Flap of anterior wall of right ventricle (retracted)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cusp tricuspid valve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrioventricular opening  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal (medial) cusp of tricuspid valve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior papillary muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cusp tricuspid valve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Interventricular septum (cut through)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta (opened)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic valve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Valve of pulmonary trunk  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Conus arteriosus (interior)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cusp of mitral valve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle left  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Papillary muscles  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of anterior interventricular sulcus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle (external surface)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_82", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Interior of left auricle viewed through left atrium\n\t\t\t\t\t\t\t\t\t\tThe specimen has been rotated so that the interior of the left auricle is visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left auricle (interior)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary veins (opening into left atrium)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrioventricular opening  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Fat in coronary sulcus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Reflected flap of atrial wall  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Right inferior pulmonary vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Line of reflection of serous pericardium  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Interatrial septum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cusp of mitral valve"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_83", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Mitral valve viewed through left atrium\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the previous view has been turned so that the view is directed downward through the ostium of the mitral valve (1).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrioventricular opening  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary veins (upper vein obscured)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fat in posterior part of coronary sulcus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Reflected flap of posterior atrial wall  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary veins  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava (at point of entrance into right atrium)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Line of reflection of serous pericardium  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cusp of mitral valve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Fat in coronary sulcus overlying coronary sinus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cusp of mitral valve"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_84", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Interior of left atrium, posterior view\n\t\t\t\t\t\t\t\t\t\tThe left atrium has been opened by means of a U-shaped incision through its posterior wall. The left surface of the interatrial septum (13) appears opposite this incision.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk (cut across at bifurcation into right and left branches)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary veins (cut at entry into left atrium)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Left auricle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Fat in posterior part of coronary sulcus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrioventricular opening  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Reflected flap of posterior atrial wall  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Line of reflection of serous pericardium  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary veins  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Valve of foramen ovale (falx septi)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Interatrial septum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_85", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Interior of right ventricle viewed through ostium of tricuspid valve\n\t\t\t\t\t\t\t\t\t\tThe walls of the open right atrium have been stretched apart. The fibrous ring of the tricuspid valve (indicated by dotted line in the drawing) is held in an open position to expose the cavity of the right ventricle. The conus arteriosus leads out of the upper left part of the ventricular cavity and is not visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Trabeculae carnae  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Septomarginal trabecula (moderator band, along the surface of which the right branch of the atrioventricular bundle is visible as a narrow white streak)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal (medial) cusp of tricuspid valve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of atrioventricular node (subendocardial)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronary sinus (opening into right atrium)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Valve of coronary sinus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Valve of inferior vena cava  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Endocardium of anterior wall of right atrium  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anulus fibrosus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cusp tricuspid valve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior papillary muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Chordae tendineae  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior papillary muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cusp tricuspid valve"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_86", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Tricuspid valve viewed from below\n\t\t\t\t\t\t\t\t\t\tThe ventricular aspect of the tricuspid valve is displayed by viewing the heart from a position near its apex. The interior of the right atrium is visible through the ostium of the valve.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Myocardium of anterior wall of right ventricle (cut and elevated)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cusp tricuspid valve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal (medial) cusp of tricuspid valve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Chordae tendineae  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Epicardium of right ventricle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior papillary muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Trabeculae carnae  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior papillary muscle (attached to reflected flap of ventricular wall)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Fossa ovalis Right pointer: Border of fossa ovalis  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Right auricle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrioventricular opening (arrow on drawing indicates interior of right atrium beyond opening)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cusp tricuspid valve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraventricular crest  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Area in which right branch of A-V bundle descends into right ventricle (covered by endocardium)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Septomarginal trabecula (moderator band)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal papillary muscles"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_87", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Tricuspid valve, anterior view\n\t\t\t\t\t\t\t\t\t\tAn elongated opening has been made in the anterior wall of the right ventricle and conus arteriosus. The flap formed by the incision has been retracted downward. The right atrium is visible in the upper left portion of the specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fat in coronary sulcus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Trabeculae carnae (cut across in dissection)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cusp tricuspid valve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Chordae tendineae  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cusp tricuspid valve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior papillary muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Right auricle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Conus arteriosus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraventricular crest  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal papillary muscles  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Endocardial surface of reflected ventricular wall  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal (medial) cusp of tricuspid valve"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_88", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Interior of right ventricle, anterior view\n\t\t\t\t\t\t\t\t\t\tThe right ventricle, conus arteriosus and pulmonary trunk have been opened. The part of the ventricular wall which gives attachment to the anterior papillary muscle (7) has been reflected. The right atrium remains open from a previous dissection.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right auricle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium (opened)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cusp tricuspid valve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrioventricular opening  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior papillary muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Trabeculae carnae  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cusp tricuspid valve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal (medial) cusp of tricuspid valve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of myocardium of right ventricle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Right semilunar cusp  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar valves  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Valve of left pulmonary trunk Anterior semilunar cusp  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Conus arteriosus (cut margins retracted)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraventricular crest  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal papillary muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Chordae tendineae  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Septomarginal trabecula (moderator band)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of anterior interventricular sulcus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_89", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Tricuspid valve viewed through right atrium\n\t\t\t\t\t\t\t\t\t\tThe view is directed into the cavity of the right ventricle through the opened right atrium and the ostium (2) of the tricuspid valve.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Right auricle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Margins of right atrioventricular opening  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary veins (cut across)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectinate muscles  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cusp tricuspid valve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Septomarginal trabecula (moderator band)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista terminalis (in reflected part of atrial wall)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Papillary muscles  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cusp tricuspid valve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Chordae tendineae  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal (medial) cusp of tricuspid valve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t External surface of right atrium  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava (cut off)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_90", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Coronary sinus, external and internal aspects\n\t\t\t\t\t\t\t\t\t\tThe right atrial wall has been cut and reflected in such a way that the cut section of the wall is seen in relation to the coronary sinus (5). The view into the atrium is from the right side. The heart is in a position with its apex directly downward.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectinate muscles in reflected part of atrial wall  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sinus of vena cava  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Valve of inferior vena cava  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronary sinus (covered by muscle fibers continuous with atrial myocardium)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Valve of coronary sinus Lower pointer: Latex cast in opening of coronary sinus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle (myocardium exposed)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior interventricular sulcus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cardiac vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Interatrial septum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Fossa ovalis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Border of fossa ovalis  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of atrioventricular node (covered by endocardium)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal (medial) cusp of tricuspid valve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrioventricular opening  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cusp tricuspid valve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Myocardium right atrium  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronary sulcus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Right coronary artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle (myocardium exposed)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_91", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Interior of right atrium, posterior wall\n\t\t\t\t\t\t\t\t\t\tAn opening has been made in the anterosuperior part of the wall of the right atrium. Parts of the wall have been reflected to reveal the interior of this chamber. The heart has been positioned with its apex directed downward.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary veins  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervenous tubercle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Valve of inferior vena cava  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Valve of coronary sinus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectinate muscles (in reflected part of atrial wall)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of atrioventricular node (covered by endocardium)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrioventricular opening  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista terminalis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium (cut along line of reflection onto heart)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista terminalis (cut across, also see 10)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Border of fossa ovalis  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Fossa ovalis  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Right auricle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Fat overlying coronary sulcus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_92", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Ventricular myocardium, posterior view of deep layer\n\t\t\t\t\t\t\t\t\t\tThe superficial layer of myocardium (3) has been removed from the diaphragmatic surface of the left ventricle. The deep layer of myocardium (4), thus exposed, has been traced toward the right side of the heart. Along the posterior interventricular sulcus some of the fibers of this layer have been cut across to split open the interventricular septum into which much of the deep layer appears to turn.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left fibrous trigone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrioventricular opening  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial layer of myocardium (lower pointer indicates cut edge of this layer)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep layer of myocardium  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Right fibrous trigone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrioventricular opening  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Membranous part interventricular septum (in depths of dissection)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular part interventricular septum (split open)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle (superficial layer of myocardium intact)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut ends of fibers of deep layer of myocardium  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Notch at apex of heart  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of heart"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_93", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Ventricular myocardium; cardiac valves and ostia, basal view\n\t\t\t\t\t\t\t\t\t\tThe atria have been cut off close to their attachments to the atrioventricular valve rings.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right semilunar cusp  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior semilunar cusp  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Left semilunar cusp (together 2-4 make up the pulmonary valve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Nodule of valve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left coronary artery (at origin from aortic sinus)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Left fibrous trigone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrioventricular opening  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cusp of mitral valve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cusp of mitral valve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Myocardium left atrium (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Right fibrous trigone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Atrioventricular bundle (bundle of His)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior interventricular sulcus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrioventricular opening  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Conus arteriosus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Left semilunar cusp (aortic)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Right semilunar cusp Lower pointer: posterior semilunar cusp (of aortic valve)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Right coronary artery (at origin from aortic sinus)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Atrioventricular septum  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior semilunar cusp (pulmonary)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal (medial) cusp of tricuspid valve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cusp tricuspid valve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Myocardium right atrium (cut across)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_94", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Ventricular myocardium, apical view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Conus arteriosus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interventricular sulcus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Vortex of myocardium of right ventricle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vortex ofmyocardium of left ventricle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Openings in myocardium for septal branches of coronary vessels  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_95", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Ventricular myocardium, posterior view of superficial layer\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Grooves for ventricular branches of right coronary artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of heart  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Notch at apex of heart  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrioventricular opening  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior interventricular sulcus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Openings in myocardium for septal branches of coronary vessels"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_96", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Ventricular myocardium, anterior view of superficial layer\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Conus arteriosus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus which accommodated marginal branch of right coronary artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Openings in myocardium for septal branches of coronary vessels  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Notch at apex of heart  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interventricular sulcus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of heart"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_97", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Atrial myocardium, basal view\n\t\t\t\t\t\t\t\t\t\tThe epicardium has been removed from all parts of the atria with the exception of the left auricle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum arteriosum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Left auricle (epicardium intact)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior pulmonary vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left inferior pulmonary vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrium  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Right superior pulmonary vein (note tributary joining vein close to atrial wall) Lower pointer: Right inferior pulmonary vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle (epicardium intact)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior interventricular sulcus (pointer on middle cardiac vein)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Right auricle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Sino-atrial node  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Interatrial groove"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_98", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Basal surface of heart, epicardium intact\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch right pulmonary artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Line of reflection of pericardium  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum arteriosum (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardial reflections at margins of oblique sinus (an intermediate line of reflection, indicated at lower pointer, subdivides the oblique sinus in this specimen)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary veins  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrium  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Fat in coronary sulcus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Right auricle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary veins  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior interventricular sulcus"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_99", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Coronary angiogram\n\t\t\t\t\t\t\t\t\t\tThe heart is viewed from in front. Thorotrast has been injected into the right (5) and left (13) coronary arteries by means of a cannula inserted through the aorta. The vessels have been ligated close to their origins. In the drawing, vessels in the foreground of the view have been indicated by solid lines, while those in the background have been shown by broken lines.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right auricle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Right coronary artery (pointer near origin of artery from aorta)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Artery to sinoatrial node  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Marginal branch of right coronary artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior interventricular branch of left coronary artery (anomalous see text above)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Left auricle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Left coronary artery (pointer near origin of artery from aorta)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Circumflex branch of left coronary artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Interventricular septal branch of left coronary artery (note other smaller septal branches below this one)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interventricular branch of left coronary artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventricular branch of 16  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventricular branch of circumflex branch  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of heart"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_100", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Coronary vessels, posterior view\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the previous view has been dissected to demonstrate the distribution of the coronary arteries and cardiac veins on the posteroinferior aspect of the heart.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Fragment of aorta at point of attachment of ligamentum arteriosum  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Left auricle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary veins (superior vein partially hidden)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Left oblique atrial vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventricular branches of circumflex branch of left coronary artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Great cardiac vein  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronary sinus (covered by thin layer of muscle continuous with atrial myocardium)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardial reflection at margin of oblique sinus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrium  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary veins  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Atrial branch of left coronary artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Right coronary artery (in coronary sulcus)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of dissected. area  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cardiac vein (in posterior interventricular sulcus)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior interventricular branch of right coronary artery"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_101", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Posterior surface of heart, epicardium intact\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary vein  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrium (pointers terminate on pericardial reflections which form boundaries of oblique sinus of pericardial cavity)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Fragment of aorta preserved at attachment of ligamentum arteriosum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligamentum arteriosum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary vein  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium (parietal side)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronary sinus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Right auricle (interior, visible through right atrium)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista terminalis  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronary sulcus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cardiac vein (overlying posterior interventricular sulcus)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_102", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Coronary vessels viewed from left side\n\t\t\t\t\t\t\t\t\t\tThe epicardium has been dissected to expose portions of the left coronary artery and the great cardiac vein. The pulmonary trunk has been opened and the left auricle has been retracted.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk (opened)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right semilunar cusp pulmonary trunk  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Filament of cardiac plexus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interventricular branch of left coronary artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of heart  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrium  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left auricle (retracted)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Circumflex branch of left coronary artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Great cardiac vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventricular branch of left coronary artery"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_103", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Left surface of heart, epicardium intact\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Aorta  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary artery (cut off at origin from pulmonary trunk)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Left auricle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Left coronary artery (ventricular branch)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrium  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary veins (cut off at entrance to left atrium)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Fat in coronary sulcus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Tributary to great cardiac vein  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of heart"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_104", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Coronary arteries, anterior view\n\t\t\t\t\t\t\t\t\t\tThe heart is positioned to display its anterosuperior surface. The epicardium has been removed to expose the right coronary artery (6) and the anterior interventricular branch (13) of the left coronary artery. The previous view illustrates the specimen before dissection.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right superior pulmonary vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right auricle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Right coronary artery (in coronary sulcus)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ventricular branch of right coronary artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Epicardium at margin of dissected area  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Epicardial fat at margin of dissected area  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interventricular branch of left coronary artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interventricular sulcus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tributary to great cardiac vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of heart"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_105", "text": "Detailed dissection of heart\n\t\t\t\t\t\t\t\t\t\t Anterior surface of heart, epicardium intact\n\t\t\t\t\t\t\t\t\t\tThis specimen, from a young woman, displays an abundance of fat in the epicardium.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Right auricle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fat covering coronary sulcus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Right margin  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Notch at apex of heart  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Aorta  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left auricle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Conus arteriosus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interventricular branch of left coronary artery (covered by fat)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of heart"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_106", "text": "Dissection of pericardium and heart in situ\n\t\t\t\t\t\t\t\t\t\t Lines of reflection of serous pericardium onto heart and great vessels\n\t\t\t\t\t\t\t\t\t\tThe heart has been removed except for small margins of the left atrium at the points of entrance of the pulmonary veins (3, 10). The lines along which the serous layer of pericardium reflects onto the heart and its great vessels are visible and are indicated in the drawing at various points (2). A dotted, double-pointed arrow indicates the location of the transverse sinus of the pericardium. A series of small arrows indicates the boundaries of the oblique sinus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of serous pericardium along line of reflection onto heart and great vessels  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary veins (entering left atrium)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right phrenic nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vena cava  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta (covered by serous pericardium)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse pericardial sinus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Left fold of vena cava  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pulmonary veins (entering left atrium)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique pericardial sinus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Serous pericardium"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_107", "text": "Dissection of pericardium and heart in situ\n\t\t\t\t\t\t\t\t\t\t Interatrial wall sectioned; sinuses of pericardium\n\t\t\t\t\t\t\t\t\t\tThe interatrial wall has been cut vertically to show the relation of the fossa ovalis to the left atrium. The remains of both ventricles and part of the posterior wall of the left atrium have been removed so that the oblique sinus of the pericardial cavity may be visualized.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Right phrenic nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Red latex cast in right superior pulmonary vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Valve of foramen ovale (falx septi, in left atrium)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Border of fossa ovalis (sectioned vertically)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Fossa ovalis (sectioned vertically) Lower pointer: Interatrial septum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast in inferior vena cava  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vagus nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left phrenic nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse pericardial sinus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Left superior pulmonary vein (covered by serous layer of pericardium)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrium (remnant of posterior wall)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast in left inferior pulmonary vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique pericardial sinus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragmatic part of pericardium"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_108", "text": "Dissection of pericardium and heart in situ\n\t\t\t\t\t\t\t\t\t\t Interior of left atrium and left ventricle.\n\t\t\t\t\t\t\t\t\t\tThe latex cast has been cut away to display the cavity of the left atrium and the posterior cusp of the mitral valve with its associated chordae tendineae.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse pericardial sinus (indicated on drawing by double pointed arrow)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Wall of left atrium (cut)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fossa ovalis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast in coronary sinus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Valve of inferior vena cava  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Red latex cast in left auricle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast protruding from left pulmonary veins  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Left atrium  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cusp of mitral valve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Chordae tendineae  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior papillary muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior papillary muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_109", "text": "Dissection of pericardium and heart in situ\n\t\t\t\t\t\t\t\t\t\t Latex cast of cavities of left atrium and left ventricle; transverse sinus of pericardium\n\t\t\t\t\t\t\t\t\t\tThe aorta and pulmonary trunk have been cut off to expose the transverse sinus of the pericardial cavity (3) and the left atrium. The anterior wall of the left atrium and the anterior cusp of the mitral valve have been resected to uncover the red latex cast which fills the left atrium and is continuous through the atrioventricular ostium with the cast of the left ventricle.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Transverse pericardial sinus Lower pointer: Wall of left atrium (cut across)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sinus of vena cava  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Membranous part interventricular septum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular part interventricular septum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Blue latex within coronary sinus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Left auricle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Red latex cast in left atrium (position of anterior segment of fibrous mitral valve ring indicated on drawing by dotted line below pointer)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast within left atrioventricular opening  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast within left ventricle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior papillary muscle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_110", "text": "Dissection of pericardium and heart in situ\n\t\t\t\t\t\t\t\t\t\t Interior of left ventricle.\n\t\t\t\t\t\t\t\t\t\tThe latex cast within the left ventricle has been partially removed to expose the anterior cusp of the mitral valve together with its chordae tendineae and related papillary muscles.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic valve (pointer on left semilunar cusp)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Membranous part interventricular septum  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium (pointer indicates area of sinus venarum cavarum)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast within inferior vena cava  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular part of interventricular septum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left auricle (opened to expose latex cast)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cusp of mitral valve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Chordae tendineae  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior papillary muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast within cavity of left ventricle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_111", "text": "Dissection of pericardium and heart in situ\n\t\t\t\t\t\t\t\t\t\t Conduction system of heart.\n\t\t\t\t\t\t\t\t\t\tThe camera angle has been adjusted to provide a cross-sectional view of the interventricular septum (19). This septum has been retracted slightly away from the left ventricle and has been cut in such a way that the course of the atrioventricular bundle (6) can be traced from its origin in the A-V node (5) to its division into right and left branches (17, 18) at the junction of the membranous and muscular parts of the interventricular septum. The parts of the conduction system have been colored white to provide better photographic contrast.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of wall of right atrium (note sinusoidal spaces filled with latex and continuous with cavity of atrium)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fossa ovalis  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Border of fossa ovalis  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Atrioventricular node (colored white)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Trunk of atrioventricular bundle (colored white)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronary sinus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal (medial) cusp of tricuspid valve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cusp tricuspid valve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Myocardium of right ventricle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Left auricle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Left coronary artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic valve (left semilunar cusp)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Membranous part interventricular septum (partially resected to display A-V bundle)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Left crus atrioventricular bundle (colored white)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Right crus atrioventricular bundle (colored white)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular part interventricular septum  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast in cavity of left ventricle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_112", "text": "Dissection of pericardium and heart in situ\n\t\t\t\t\t\t\t\t\t\t Interatrial cleavage plane\n\t\t\t\t\t\t\t\t\t\tAn incision has been made in the epicardium (6) bordering the right atrium. The superior vena cava and upper part of the right atrium have been reflected anteriorly and to the left to display the plane of cleavage between the myocardial layers of the right and left atria. In the upper part of the area of contact of the atria there is no interconnection of the two myocardial layers. In the lower part (9), which overlies the point of entrance of the lower right pulmonary vein into the left atrium, there is considerable interweaving of muscle fibers of the two atria. The proximity of this cleavage plane to the fossa ovalis can be readily visualized, although the fossa ovalis is partially obscured in this view.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein (divided)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right main bronchus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Tracheobronchial lymph node  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Cardiac plexus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pulmonary artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Incision in epicardium to display interatrial cleavage plane  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Myocardium of left atrium (overlying upper right pulmonary vein)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve filament of cardiac plexus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of intermingling atrial muscle fasciculi  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sino-atrial node  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Fossa ovalis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Wall of right atrium  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Right phrenic nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava (retracted)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Left coronary artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast within left ventricle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Interventricular septum  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Border of fossa ovalis  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast within inferior vena cava"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_113", "text": "Dissection of pericardium and heart in situ\n\t\t\t\t\t\t\t\t\t\t Latex cast of cavity of left ventricle and origin of aorta\n\t\t\t\t\t\t\t\t\t\tThe opening into the left ventricle, which was shown in the previous view, has been extended to include the root of the ascending aorta and to expose the aortic semilunar valves.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Reflection of pericardium onto aorta  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Filaments of cardiac plexus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Right coronary artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Aortic valve (right semilunar cusp) Lower pointer: Aortic sinus (filled with latex cast)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Right crus atrioventricular bundle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista terminalis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Valve of inferior vena cava  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Left phrenic nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Left coronary artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic valve (left semilunar cusp)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Interventricular septum (cut away)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Myocardium of left ventricle (cut across)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast of cavity of left ventricle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_114", "text": "Dissection of pericardium and heart in situ\n\t\t\t\t\t\t\t\t\t\t Latex cast of cavity of left ventricle; septal branch of left coronary artery\n\t\t\t\t\t\t\t\t\t\tThe wall of the left ventricle has been resected to expose the red latex cast which fills the ventricle. The myocardium at one point near the apex measures only 1 mm. in thickness. The conus arteriosus has been removed to demonstrate the origin of the ascending aorta and a large septal branch (11) of the left coronary artery.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right coronary artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right atrium  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Right crus atrioventricular bundle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista terminalis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternum (cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left coronary artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal branch of left coronary artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium (cut edge)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Interventricular septum (dissected)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast within left ventricle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Myocardium of left ventricle (cut across)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Notch at apex of heart"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_115", "text": "Dissection of pericardium and heart in situ\n\t\t\t\t\t\t\t\t\t\t Conduction system of heart.\n\t\t\t\t\t\t\t\t\t\tThe sinoatrial node (4) has been exposed by removal of the epicardium near the junction of the superior vena cava and the right atrium. The atrioventricular node (16) has been exposed by the removal of endocardium and some atrial myocardium just above the entrance of the coronary sinus into the right atrium. The atrioventricular bundle has been dissected in its course into the membranous atrioventricular septum, and its right branch (15) has been uncovered by the removal of endocardium and a portion of the myocardium of the muscular interventricular septum. A segment of the septal cusp of the tricuspid valve has also been cut away.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Reflection of pericardium onto superior vena cava  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right coronary artery (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sinoatrial node  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Interventricular septum (membranous part) Lower pointer: Right fibrous trigone (exposed by removal of atrial myocardium)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Border of fossa ovalis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Fossa ovalis  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Myocardium of right atrium (left pointer indicates position of a delicate tendon which extends from the right fibrous trigone toward the border of fossa ovalis)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Latex cast in coronary sinus Lower pointer: Valve of coronary sinus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Valve of inferior vena cava  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast in inferior vena cava  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal (medial) cusp of tricuspid valve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Valve of pulmonary trunk (pointer on left semilunar cusp)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Right crus atrioventricular bundle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Atrioventricular node (no distinct boundary found between node and myocardium inferior to it)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Septomarginal trabecula (moderator band)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior papillary muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_116", "text": "Dissection of pericardium and heart in situ\n\t\t\t\t\t\t\t\t\t\t Interior of right atrium and right ventricle\n\t\t\t\t\t\t\t\t\t\tThe latex cast has been removed from the specimen shown in the previous view.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic trunk  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sino-atrial node  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Border of fossa ovalis  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fossa ovalis  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Crista terminalis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Valve of inferior vena cava  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast cut across at junction of vena cava inferior with vena caval sinus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior cardiac branch of vagus nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior semilunar cusp, (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Left semilunar cusp  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Right semilunar cusp (cut across) (11-13 make up the pulmonary valve)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraventricular crest  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Septal (medial) cusp of tricuspid valve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast in coronary sinus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior papillary muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior papillary muscle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_117", "text": "Dissection of pericardium and heart in situ\n\t\t\t\t\t\t\t\t\t\t Latex cast of cavities of right atrium and right ventricle\n\t\t\t\t\t\t\t\t\t\tThe anterior walls of the right atrium, right ventricle, conus arteriosus and pulmonary trunk have been cut away to reveal a blue latex cast which fills the interior of these chambers. Impressions in the cast produced by muscle trabeculae are clearly visible. Casts of several anterior cardiac veins (9) have been dissected free in removing the wall of the heart and are visible attached at their points of entry into the right atrium.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior extent of pericardial cavity  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Right auricle (epicardium and myocardium intact) Lower pointer: Latex cast of right auricle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Right coronary artery (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of right atrioventricular opening  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cast of right atrium  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Cast of right atrioventricular opening  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cardiac veins  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Myocardium of right ventricle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left vagus nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast of sinus of anterior cusp of pulmonary valve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast of conus arteriosus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interventricular sulcus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Latex cast of right ventricle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_118", "text": "Dissection of pericardium and heart in situ\n\t\t\t\t\t\t\t\t\t\t Ascending aorta; aortic arch and branches\n\t\t\t\t\t\t\t\t\t\tThe branches of the aortic arch have been exposed by removing the overlying brachiocephalic vein. The superior extent of the pericardial sac in this specimen is indicated at 8. The entire ascending aorta is thus seen to lie within the pericardial cavity. The pleural coverings of the superior mediastinum have been reflected laterally on both sides to provide better exposure of the structures within the area.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cardiac branch vagus nerve (upper branch)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrocervical trunk  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cardiac branch vagus nerve (lower branch)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic trunk  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardial branch of thyrocervical trunk  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior extent of pericardial cavity  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta (covered by serous layer of pericardium)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Left phrenic nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior laryngeal nerve Lower pointer: Esophagus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic duct  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Superior cardiac branch vagus nerve Lower pointer: Vagus nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Mediastinal pleura (reflected)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lung  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Conus arteriosus"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_119", "text": "Dissection of pericardium and heart in situ\n\t\t\t\t\t\t\t\t\t\t Heart and great vessels\n\t\t\t\t\t\t\t\t\t\tThe thymus has been removed and structures deeper in the superior mediastinal region have been freed of their connective tissue coverings. The pericardial sac has been opened more widely.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyrocervical trunk  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve right  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cardiac branch vagus nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic trunk  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Left brachiocephalic vein Lower pointer: Right internal thoracic vein (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium (reflected)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Right auricle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of sternum (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior thyroid vein (cut off)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal thoracic vein Lower pointer: Internal thoracic artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Thymic vein  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta (covered by serous layer of pericardium)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardiacophrenic vein  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Conus arteriosus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of heart"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_120", "text": "Dissection of pericardium and heart in situ\n\t\t\t\t\t\t\t\t\t\t Heart exposed within pericardial activity\n\t\t\t\t\t\t\t\t\t\tThe anterior wall of the pericardial sac has been incised and the cut edges have been reflected. The epicardium remains intact.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Thymus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium (reflected flaps)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right auricle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Right ventricle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Right margin of heart  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fatty lobule  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe left lung  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Conus arteriosus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Mediastinal pleura  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interventricular sulcus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Arcuate margin of heart  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardial cavity"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_121", "text": "Dissection of pericardium and heart in situ\n\t\t\t\t\t\t\t\t\t\t Thymus and related structures, close-up view\n\t\t\t\t\t\t\t\t\t\tThe upper portion of the specimen from the preceding view is shown here to illustrate in more detail the relations of the thymus to nearby mediastinal structures.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior trunk brachial plexus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Vagus nerve Lower pointer: Recurrent laryngeal nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous remnant of cervical portion of thymus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Right subclavian artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Mediastinal pleura (cut and reflected)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Cardiac plexus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Right brachiocephalic vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery (displaced posteriorly)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia enclosing thymus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardiacophrenic artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Left internal jugular vein  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Left common carotid artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic duct  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Subclavian artery Lower pointer: Subclavian vein  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Left brachiocephalic vein Lower pointer: Internal thoracic vein  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Thymus (right lobe)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Thymic branch internal thoracic artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Thymus (left lobe)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior sternopericardial ligament  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_122", "text": "Dissection of pericardium and heart in situ\n\t\t\t\t\t\t\t\t\t\t Thymus and pericardium; superior sternopericardial ligament\n\t\t\t\t\t\t\t\t\t\tThe internal thoracic arteries have been cut off (6, 21). The pleura has been cut away from the pericardium and the fascia which covered the thymus has been partially removed. A portion of this fascia (9) fuses firmly with the pericardium to form one of the sternopericardial ligaments. The sternal attachment of this ligament was in the area of origin of the sternothyroid muscles and was detached in the preparation of the dissection.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right recurrent laryngeal nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pleura (cut to display apex of lung)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Right brachiocephalic vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Phrenic nerve Lower pointer: Internal thoracic artery (displaced posteriorly)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardiacophrenic artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior sternopericardial ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Right lung  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Mediastinal pleura (cut and reflected from pericardium)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of sternum (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid gland  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid arteries  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve left  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracic duct  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Right subclavian artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Left brachiocephalic vein  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Thymus (right lobe)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Thymus (left lobe)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Left lung  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Mediastinal pleura (cut and reflected)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous bands attaching pericardium to costal cartilages"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_123", "text": "Thoracic viscera in situ\n\t\t\t\t\t\t\t\t\t\t Radiograph of thorax, anteroposterior view\n\t\t\t\t\t\t\t\t\t\tThe subject is a young female. The film was made during full inspiration.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra Th. I (outlines of lower vertebrae not included in drawing but are clearly visible in stereoscopic view)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I (anterior part)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea (radiolucent)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Mammary body  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Right margin of heart  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm (right dome)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pulmonary trunk  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Left main bronchus (faintly visible as translucent band)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Heart  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Left ventricle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Apex of heart  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm (left dome)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_124", "text": "Thoracic viscera in situ\n\t\t\t\t\t\t\t\t\t\t Anterior view of thoracic contents, rib cage removed\n\t\t\t\t\t\t\t\t\t\tBoth upper limbs have been detached. The upper nine ribs have been removed bilaterally with the exception of the first rib on the left. The manubrium and most of the body of the sternum have also been removed. The pleural cavities have been opened. On the right the apex of the lung is visible within the cupula of the pleura.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right brachiocephalic vein (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia surrounding thymus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe right lung  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pleura (cut along costomediastinal reflections)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle lobe right lung  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior lobe right lung  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pleural fold  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Xiphoid process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of rectus abdominis muscle (lamina posterior)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Linea alba  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus abdominis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of rectus abdominis muscle (lamina anterior)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid cartilage  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Left internal jugular vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid gland  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Thymus  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe left lung  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium (covered by mediastinal pleura)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior mediastinal cavity  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal cartilage VI  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm (covered by diaphragmatic pleura)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Pleura (cut along costodiaphragmatic reflection)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_125", "text": "Thoracic viscera in situ\n\t\t\t\t\t\t\t\t\t\t Anterior view of thoracic contents, rib cage intact\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Phrenic nerve Lower pointer: Anterior scalene muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe right lung (in cupula pleurae, which has been opened)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe right lung  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Horizontal fissure right lung  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle lobe right lung  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique fissure  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior lobe right lung  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragmatic pleura  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Xiphoid process  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath rectus abdominis muscle (posterior surface)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Rectus abdominis muscle (cut off) Lower pointer: Sheath of rectus abdominis muscle (anterior surface)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Left internal jugular vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Thymus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternoclavicular joint  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Manubrium of sternum  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper lobe left lung  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior mediastinum  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Oblique fissure  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower lobe left lung  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of costal pleura at line of reflection onto mediastinum (upper pointer) and diaphragm (lower pointer)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_126", "text": "Dissection of breast and anterolateral thoracic wall\n\t\t\t\t\t\t\t\t\t\t Anterior thoracic wall, internal aspect\n\t\t\t\t\t\t\t\t\t\tAll of the thoracic viscera have been removed except those structures which pass through the superior thoracic aperture (thoracic inlet). The pleura and the endothoracic fascia have been excised anteriorly.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebra Th. III (pointer on posterior longitudinal ligament)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Esophagus (cut off) Lower pointer: Trachea (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent laryngeal nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Aortic arch  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal cartilage II  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of sternum (covered by sternal membrane)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointers: Internal thoracic veins Lower pointer: Internal thoracic artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior intercostal branch internal thoracic artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternal branches internal thoracic artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternal part of diaphragm  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Pericardium  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Right subclavian vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternothyroid muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve right  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vena cava (cut off)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Azygos vein (cut off)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertical fascial bands related to transversus thoracis muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Right internal thoracic artery  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Left internal thoracic vein  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Innermost intercostal muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Transversus thoracis muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_127", "text": "Dissection of breast and anterolateral thoracic wall\n\t\t\t\t\t\t\t\t\t\t Seventh intercostal space.\n\t\t\t\t\t\t\t\t\t\tThe ribs above the eighth on the left side have been cut off along the mid-axillary line. The intercostal muscles of the seventh space have been retained and have been separated into their three layers (17, 18, 19). The middle layer, the internal intercostal muscle, becomes membranous in its posterior portion. The transition from muscle to membrane occurs just anterior to the cut end of the seventh rib (16). The membrane has been incompletely preserved in the seventh interspace. In the sixth interspace the membrane is clearly visible (14). The intercostal vessels and nerve have been separated slightly.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib VIII  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal groove VII  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal artery (a piece of this vessel several cms. in length has been removed laterally)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve VII  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Endothoracic fascia  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Diaphragm  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal vein VI (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior intercostal artery VI (cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve VI (cut off)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Innermost intercostal muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal intercostal membrane  15\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib VII (cut off)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle (reflected laterally)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Innermost intercostal muscle (reflected inward)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal intercostal muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of intercostal nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous branch intercostal nerve VII"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_128", "text": "Dissection of breast and anterolateral thoracic wall\n\t\t\t\t\t\t\t\t\t\t Vessels and nerves of first and second left intercostal spaces; Internal thoracic vessels; sternal lymph nodes; sternocostal joint\n\t\t\t\t\t\t\t\t\t\tThe costal part of the parietal pleura has been exposed in the anterior portions of the first and second intercostal spaces.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Manubrium of sternum  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cutaneous branch intercostal nerve I  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocostal ligament (pointer crosses sternal angle)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating branch internal thoracic artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocostal joint III  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocostal ligament (a delicate band in this specimen)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid gland (right lobe)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Thymus Right pointer: Common carotid artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Carotid sheath  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Left subclavian artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle (cut off)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Internal thoracic artery (pointer near origin) Lower pointer: Costoclavicular ligament (cut off)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of sternocostal joint I  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal pleura  18\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternal lymph nodes  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal intercostal muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostal nerve II  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal thoracic artery and vein  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib III  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior intercostal branch internal thoracic artery  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Costochondral junction Lower pointer: Costal cartilage III (note that a portion of the cartilage has been removed to allow the sternocostal joint to be opened)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_129", "text": "Dissection of breast and anterolateral thoracic wall\n\t\t\t\t\t\t\t\t\t\t Intercostal muscles, anterior view\n\t\t\t\t\t\t\t\t\t\tThe external intercostal muscles have been removed from the first and second interspaces anteriorly to expose the internal intercostal muscles. A third, innermost layer of muscle has not been shown in this dissection. For a view of this layer reference should be made to 115-7.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Mammary body  4\n\t\t\t\t\t\t.\n\t\t\t\t\t External abdominal oblique muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus abdominis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vagus nerve left  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein (at junction with subclavian vein)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternum  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal intercostal muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal membrane  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Costochondral junction  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of rectus abdominis muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Linea alba"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_130", "text": "Dissection of breast and anterolateral thoracic wall\n\t\t\t\t\t\t\t\t\t\t First and second left intercostal spaces, close-up view of nerves to external intercostal muscle\n\t\t\t\t\t\t\t\t\t\tThe external intercostal muscle has been reflected in the first intercostal space to expose the internal intercostal muscle. The intrinsic muscle fascia has been removed. In the second interspace the external intercostal has been dissected to illustrate a portion of its nerve supply.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle (reflected upward)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal intercostal muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  4\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous branch intercostal nerve II  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to external intercostal muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal intercostal muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of posterior intercostal artery"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_131", "text": "Dissection of breast and anterolateral thoracic wall\n\t\t\t\t\t\t\t\t\t\t External intercostal muscles viewed from left\n\t\t\t\t\t\t\t\t\t\tThe left upper limb has been detached from the specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis minor muscle (cut across near origin)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle (abdominal part, cut off near origin)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t External abdominal oblique muscle (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib VIII (pointer on costochondral junction)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior scalene muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle (upper part, cut across)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle right  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle middle part, cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib VI  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle (lower part, cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus posterior inferior muscle (cut across at insertions)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Erector spinae muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib XII"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_132", "text": "Dissection of breast and anterolateral thoracic wall\n\t\t\t\t\t\t\t\t\t\t Pectoral muscles\n\t\t\t\t\t\t\t\t\t\tThe left pectoralis major (9) has been reflected. Its clavicular (2), sternocostal (3) and abdominal (4) origins have been preserved. The pectoralis minor (10) is covered by a layer of the clavipectoral fascia.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicular part pectoralis major muscle (cut across)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocostal part of pectoralis major muscle (cut across)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Abdominal part pectoralis major muscle (cut across) Lower pointer: Sheath of rectus abdominis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraclavicular nerves  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior thoracic nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of pectoral fascia  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle (reflected laterally)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis minor muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of sternum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoral fascia (at former position of lateral border of pectoralis major)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous branch intercostal nerve VII"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_133", "text": "Dissection of breast and anterolateral thoracic wall\n\t\t\t\t\t\t\t\t\t\t External layer of muscles in inframammary region\n\t\t\t\t\t\t\t\t\t\tThe fascia has been removed from the latissimus dorsi (3), serratus anterior (4) and external oblique (9) muscles on the right side. Cutaneous nerves and vessels have been preserved.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracoepigastric vein  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia of breast  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle (lowest digitations)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous branch intercostal nerve VIII (posterior branch)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous branch intercostal nerve VIII (anterior branch)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Nipple (mammary papilla) Lower pointer: Areola  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Mammary body  9\n\t\t\t\t\t\t.\n\t\t\t\t\t External abdominal oblique muscle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_134", "text": "Dissection of breast and anterolateral thoracic wall\n\t\t\t\t\t\t\t\t\t\t Sagittal section of right breast\n\t\t\t\t\t\t\t\t\t\tThe breast of a 20 year old woman has been sectioned in a sagittal plane which passes through the nipple. The specimen is unfixed and, as a result of this, the lactiferous ducts are not clearly visible in the photograph. (Later examination of the specimen after it had been fixed following photography revealed the presence of six lactiferous ducts close to the plane of section. There were no obvious lactiferous sinuses along these ducts.)\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoral fascia  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Mammary gland lobules  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle (cut across)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis minor muscle (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Mammary body (gland lobules not distinguishable)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Suspensory ligaments of breast  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Skin (cut section)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lobule of fat  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Nipple (mammary papilla)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Area occupied by lactiferous duct (see note above)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_135", "text": "Dissection of breast and anterolateral thoracic wall\n\t\t\t\t\t\t\t\t\t\t Right breast dissected in situ\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary fascia  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral thoracic artery and vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracoepigastric vein  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Nipple (mammary papilla)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Areola  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous branch intercostal nerve VI  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Mammary branch internal thoracic artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior cutaneous branch intercostal nerve II  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of sternum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Mammary body  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous ligaments (this and other suspensory bands of the breast were divided in removing the skin)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of rectus abdominis muscle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_136", "text": "Dissection of breast and anterolateral thoracic wall\n\t\t\t\t\t\t\t\t\t\t Superficial vessels and nerves; breast; pectoral fascia and muscles\n\t\t\t\t\t\t\t\t\t\tThe fascia remains intact on the left side of the specimen. On the right side the fascia has been cut away except in the area occupied by the mammary gland.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltopectoral triangle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Axilla  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Nipple (mammary papilla)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcutaneous fat of breast  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Mammary body  11\n\t\t\t\t\t\t.\n\t\t\t\t\t External abdominal oblique muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Rectus abdominis muscle (covered by sheath of rectus abdominis muscle)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial cervical fascia  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle supraclavicular nerves  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior supraclavicular nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Sternal angle Lower pointer: Anterior cutaneous branch intercostal nerve II  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoral fascia  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous branch intercostal nerve IV  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_137", "text": "Mammary gland\n\t\t\t\t\t\t\t\t\t\t Left breast of a young woman\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Areola  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior axillary fold  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachium  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Mammary body  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Areolar glands  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Nipple (mammary papilla)"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_138", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Head and neck of right sixth rib, medial view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of rib  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface of head of rib  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Crest of head of rib  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal crest  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of rib  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface costal tubercle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of rib  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal groove  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of rib"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_139", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t First, third and eighth ribs of right side viewed from below\n\t\t\t\t\t\t\t\t\t\tThe epiphysis of the first rib is missing.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of rib  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphyseal line  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of rib  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysis  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal crest  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface costal tubercle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal tubercle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of rib  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal groove  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of rib"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_140", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t First, third, and eighth ribs of right side viewed from above\n\t\t\t\t\t\t\t\t\t\tThe tubercle for the scalenus anterior muscle and the groove for the subclavian artery are not clearly demarcated on the first rib. The relations of this muscle and artery to the rib are shown in 127-3.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal tubercle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of rib  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of rib  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphyseal line  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal crest  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of rib  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of rib"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_141", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Sternum, right anterolateral view\n\t\t\t\t\t\t\t\t\t\tartery Manubrium of sternum B. Body of sternum  C. Xiphoid process\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular notch  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicular notch  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal notch I  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal notch II  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal notch III  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal notch IV  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal notch V  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal notch VI  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal notch VII  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternal angle"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_142", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Representative thoracic and lumbar vertebrae viewed from above\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina of vertebral arch  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle of vertebral arch  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral foramen  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse costal facet  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior costal facet  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory process  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_143", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Representative thoracic and lumbar vertebrae viewed from above\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina of vertebral arch  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle of vertebral arch  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral foramen  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse costal facet  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior costal facet  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory process  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_144", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Representative thoracic and lumbar vertebrae, left posterolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process (pointer on articular surface)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral foramen  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina of vertebral arch  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Area for attachment of ligamentum flavum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior costal facet  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse costal facet  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vertebral notch  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vertebral notch  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory process  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_145", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Representative thoracic and lumbar vertebrae, left anterolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process (pointer on articular surface)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior costal facet  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle of vertebral arch  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse costal facet  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior vertebral notch  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior vertebral notch"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_146", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated thoracic vertebrae, left posterolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process (pointer on articular surface)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral canal  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lamina of vertebral arch  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse costal facet  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior costal facet  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior costal facet  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pedicle of vertebral arch  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramen  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory process  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process"}
{"_id": "stanford_medicine_thorax_clean$$$corpus_147", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated thoracic vertebrae, left anterolateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse costal facet  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Intervertebral foramen  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of vertebra  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior articular process  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior costal facet  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Mamillary process  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior articular process"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_1", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Interosseous membrane\n\t\t\t\t\t\t\t\t\t\tThe specimen has been rotated somewhat medially.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Osteofibrous compartment for abductor pollicis longus and extensor pollicis brevis muscles  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Antebrachial interosseous membrane  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (insertion)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle (deep part)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (tendon of insertion)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Bursa bicipitoradialis  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Cubital joint capsule  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle (insertion)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal recurrent ulnar artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator quadratus muscle (remnant of distal part of muscle)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Distal radioulnar joint capsule"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_2", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Nerve supply to pronator quadratus muscle\n\t\t\t\t\t\t\t\t\t\tThe muscle has been reflected medially from its insertion.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of pronator quadratus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal ligament (pointer on compartment for abductor pollicis longus and extensor pollicis brevis muscles)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior carpal branch radial artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial anterior branch radial artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle (tendon)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Carpal sulcus (pointer on anterior radiocarpal ligament)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator quadratus muscle (reflected medially)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Antebrachial interosseous membrane  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (area of origin)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_3", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Pronator quadratus muscle; close-up view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis longus muscle (area of origin)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Extensor carpi radialis brevis muscle (tendon) Left pointer: Extensor carpi radialis longus muscle (tendon)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle (tendon)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch radial artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator quadratus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior carpal branch radial artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial anterior branch radial artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle (tendon of insertion)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial carpal eminence  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Carpal sulcus (pointer on sheath of common tendon of flexor muscles)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar carpal eminence  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle (insertion)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Antebrachial interosseous membrane  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous artery and vein  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (area of origin)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_4", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Pronator quadratus muscle; origins of deep layer of flexor muscles\n\t\t\t\t\t\t\t\t\t\tThe flexor pollicis longus and flexor digitorum profundus muscles have been removed. Short ends of muscle fibres remain in the areas of origin of these muscles (6,15).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of common tendon of flexor muscles (opened)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator quadratus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle (tendon of insertion)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis longus muscle (area of origin)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Flexor digitorum superficialis (radial head) Right pointer: Pronator teres muscle (insertion)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Nutritive artery of radius  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal recurrent ulnar artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (area of origin)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Antebrachial interosseous membrane"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_5", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Nerve supply to flexor digitorum profundus muscle (continued)\n\t\t\t\t\t\t\t\t\t\tBranches of the ulnar (17) and median (volar interosseous branch, 20) nerves to the flexor digitorum profundus muscle have been dissected. In this specimen the interosseous arteries arise separately from the ulnar artery. Consequently the common interosseous artery is absent.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous nerve (elevated)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Median artery (large)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (insertion)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis longus muscle (retracted laterally)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch anterior interosseous nerve (to flexor pollicis longus muscle)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (to middle finger)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (to index finger)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior recurrent ulnar artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (ulnar head)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (humeral head)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of ulnar nerve (to flexor digitorum profundus muscle)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal recurrent ulnar artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches anterior interosseous nerve (to flexor digitorum profundus muscle)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (to fifth finger)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle fourth finger)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_6", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Nerve supply to flexor digitorum profundus muscle (continued)\n\t\t\t\t\t\t\t\t\t\tThe portion of the flexor digitorum profundus to the index finger (5) has been retracted laterally and the remainder of the muscle (13) has been retracted medially. The distal ramification of branches of the volar interosseous nerve and artery in the muscle is visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator quadratus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch anterior interosseous nerve (to flexor digitorum profundus muscle)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch anterior interosseous artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (to digit II)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis longus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (insertion)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch anterior interosseous nerve (to flexor digitorum profundus muscle)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch anterior interosseous nerve (to flexor digitorum profundus muscle)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomotic branch between median and ulnar nerves  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (to digits III-V)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulriar artery"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_7", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Nerve supply to flexor digitorum profundus muscle; volar interosseous artery and nerve\n\t\t\t\t\t\t\t\t\t\tThe flexor pollicis longus muscle has been retracted laterally to reveal the muscular branches of the interosseous nerve which supply the medial part of the muscle. Nerves to the flexor digitorum profundus have been exposed, particularly to that part of the muscle which inserts on the index finger.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomotic loop between two muscular branches of anterior interosseous nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis longus muscle (retracted laterally)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (insertion)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch anterior interosseous nerve (to flexor pollicis longus muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Median artery (large)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch ulnar artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery (proximal part)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (to digit II)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (to digits III-V)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch anterior interosseous nerve (to parts of flexor digitorum profundus muscle)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch anterior interosseous nerve (to parts of flexor digitorum profundus muscle)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of ulnar nerve (to medial part of flexor digitorum profundus muscle)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_8", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Nerve supply to flexor pollicis longus muscle\n\t\t\t\t\t\t\t\t\t\tThe muscle has been elevated and its fascicles separated or cut away in part to expose the intramuscular course of its nerve.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle (tendon of insertion)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle (tendon of insertion)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor can radialis brevis muscle (tendon of insertion)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (radial head, cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (insertion)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch anterior interosseous nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis longus muscle (elevated)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomotic branch between median and ulnar nerves  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous nerve"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_9", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Flexor pollicis longus and flexor digitorum profundus muscles\n\t\t\t\t\t\t\t\t\t\tThe ulnar artery (11,26)has been resected and the deep flexors separated from each other.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscles  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial carpal eminence  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle (tendon of insertion)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle (tendon)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle (tendon)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle (tendon)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis longus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (insertion)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Brachial artery Lower pointer: Median nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of ulnar nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (ulnar head)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior recurrent ulnar artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal recurrent ulnar artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomotic branch between median and ulnar nerves  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (to digits III-V)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (to digit II)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator quadratus muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle (tendon of insertion)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar carpal eminence (ligamentum carpi transversum transected)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_10", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Course of ulnar nerve and artery in right forearm\n\t\t\t\t\t\t\t\t\t\tThe flexor digitorum sublimis and flexor carpi ulnaris muscles have been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle (tendon)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Brachioradialis muscle (tendon) Right pointer: Extensor carpi radialis longus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis longus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (radial head)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (insertion)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle of humerus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (humeral head)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (ulnar head)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal recurrent ulnar artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of ulnar nerve (to flexor digitorum profundus muscle)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomotic branch between median and ulnar nerves  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle (tendon)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia within carpal tunnel"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_11", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Nerve and blood supply to flexor carpi ulnaris muscle; recurrent ulnar arteries\n\t\t\t\t\t\t\t\t\t\tThe flexor digitorum sublimis muscle has been removed and the humeral head of the flexor carpi ulnaris has been reflected medially. The median nerve has been elevated.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent radial artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch muscularis ulnar artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (area of insertion)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Median artery (large)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of ulnar nerve (to flexor digitorum profundus muscle)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal recurrent ulnar artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (ulnar head)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior recurrent ulnar artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle (reflected medially)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior ulnar collateral artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (tendon of insertion)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (humeral head)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle (origin)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle of humerus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle (origin of humeral head)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis muscle (origin of humeral head)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of ulnar nerve"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_12", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Nerve and blood supply to flexor digitorum sublimis muscle\n\t\t\t\t\t\t\t\t\t\tThe flexor digitorum sublimis (14) has been detached from its radial origin (5) and reflected medially. An unusually large median artery (15) occurs in this specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius (covered by periosteum)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis longus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (radial head)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (area of insertion)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of median nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (left pointer, radial head, reflected; right pointer, humeral head)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Median artery (unusually large)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Palmar cutaneous branch of median nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_13", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Ulnar artery in cubital fossa\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Communicating branch from musculocutaneus nerve to median nerve (similar branches are commonly found higher in the arm as accessory parts of the lateral head of the median nerve)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle (retracted laterally)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Lateral antebrachial cutaneous nerve Lower pointer: Radial artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of pronator teres muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis muscle (radial head)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial artery and vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Nerve to flexor carpi radialis muscle (see previous view)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior recurrent ulnar artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (ulnar head)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal recurrent ulnar artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis muscle (humeral head)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_14", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Flexor digitorum sublimis muscle\n\t\t\t\t\t\t\t\t\t\tThe pronator teres (5,14) and flexor carpi radialis (7) muscles have been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (area of insertion)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (radial head)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle (tendon of insertion)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior carpal ligament (reflected laterally)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis brevis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligament of digital sheath IV  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pronator teres muscle (humeral head) Lower pointer: Medial epicondyle of humerus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (humeral head)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery and nerve"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_15", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Nerve supply to right pronator teres and flexor carpi radialis muscles\n\t\t\t\t\t\t\t\t\t\tThe humeral head (4) of the pronator teres has been divided and its fascicles separated to display branches of the median nerve and ulnar artery within the muscle. The flexor carpi radialis muscle has been retracted medially and dissected in a similar manner.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Vena comitans of radial artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (humeral head)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (pointer near insertion on radius)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of median nerve (to both heads of pronator teres muscle)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of median nerve (to flexor carpi radialis muscle)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior recurrent ulnar artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (ulnar head)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_16", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Relation of median nerve to pronator teres muscle\n\t\t\t\t\t\t\t\t\t\tThe humeral head of the pronator teres has been cut away (9,16). The flexor carpi radialis has been transected at its origin (18) and reflected medially. No lymph nodes were found in the cubital fossa in this specimen.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial veins  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of median nerve (to flexor carpi radialis muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (ulnar head)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (humeral head; note associated muscular branches of median nerve)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of middle antebrachial cutaneous nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilic vein  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial intermuscular septum  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior ulnar collateral artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (humeral head)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle of humerus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle (reflected medially)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior recurrent ulnar artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (humeral head)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_17", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Superficial layer of flexor muscles separated, close-up view of distal part of right forearm\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis brevis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial anterior branch radial artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of radial nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle (tendon)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendinous slip in position of palmaris longus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle (tendon)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch to the hand of ulnar nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior carpal ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Palmar cutaneous branch of ulnar nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle (retracted)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermuscular septum  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal branch of ulnar nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_18", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Superficial layer of flexor muscles separated, right forearm\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral antebrachial cutaneous  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of radial nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial fascia  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior ulnar collateral artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (humeral head)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle of humerus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermuscular septum  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior carpal ligament"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_19", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Left palmaris longus muscle\n\t\t\t\t\t\t\t\t\t\tThe palmaris longus muscle is essentially absent in the right forearm shown in 97-1. Only a slender tendon extends into the antebrachial fascia. In the opposite forearm, shown here, the palmaris longus is well-developed. In addition, an accessory tendinous slip (10) extends proximally from the tendon of the palmaris longus to blend into the antebrachial fascia. The radial artery originates from the brachial artery at a high level.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (covered by lacertus fibrosus)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Palmaris longus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory tendinous slip of palmaris longus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of radial nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle (tendon)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Palmaris longus muscle (tendon)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis brevis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle of humerus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle (left pointer, ulnar head; right pointer, humeral head)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Palmar aponeurosis  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Palmaris brevis muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_20", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Relation of flexor muscles to radial border of right foramen\n\t\t\t\t\t\t\t\t\t\tThe antibrachial fascia has been removed. Superficial nerves and veins have been retained.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral antebrachial cutaneous nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal antebrachial cutaneous nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Thumb  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of radial nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Bicipital aponeurosis  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch middle antebrachial cutaneous nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilic vein"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_21", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Superficial layer of flexor muscles, right foramen\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Skin  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial fascia  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch middle antebrachial cutaneous nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral antebrachial cutaneous nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch middle antebrachial cutaneous nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of radial nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of middle brachial cutaneous nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (medial head)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilic vein  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar branch of middle antebrachial cutaneous nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle of humerus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (covered by aponeurosis)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Palmaris longus muscle (tendon present but muscle deficient)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_22", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Superficial veins and nerves in right cubital fossa, close-up view\n\t\t\t\t\t\t\t\t\t\tThe cubital fossa (11) is covered by a layer of fascia which blends with the lacertus fibrosus (13) and which is continuous with the antibrachial fascia (9).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcutaneous plexus of veins  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep lamina of superficial fascia  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Communication between superficial and deep veins  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Median cubital vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral antebrachial cutaneous nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of lateral antebrachial cutaneous nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch middle antebrachial cutaneous nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Antibrachial fascia  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Median antebrachial vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of cubital fossa (covered by fascia)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch middle antebrachial cutaneous nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Bicipital aponeurosis  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilic vein"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_23", "text": "Volar aspect of forearm\n\t\t\t\t\t\t\t\t\t\t Superficial nerves and vessels of right forearm\n\t\t\t\t\t\t\t\t\t\tThe skin and subcutaneous tissue have been removed. The antibrachial fascia remains in place.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of radial nerve (terminal branch)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle (tendon covered by fascia)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Antibrachial fascia  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of lateral antebrachial cutaneous nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch middle antebrachial cutaneous nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Median antebrachial vein  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior branch middle antebrachial cutaneous nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar branch of middle antebrachial cutaneous nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Palmaris brevis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Palmar cutaneous branch of median nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Palmar cutaneous branch of ulnar nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilic vein"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_24", "text": "Arm\n\t\t\t\t\t\t\t\t\t\t Relation of left radial nerve to triceps muscle, posterior view\n\t\t\t\t\t\t\t\t\t\tThe long and lateral heads of the triceps muscle have been transected (19) and reflected laterally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres minor muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Circumflex scapular artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of radial nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (long head, reflected laterally)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches brachial artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (lateral head, reflected laterally; pointer on intramuscular aponeurosis which unites long and lateral heads of muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle (area of origin)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial nerve (retracted medially)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracobrachialis muscle (in background)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of radial nerve (to lateral head of triceps)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Deep brachial artery (continues distally as radial collateral artery) Lower pointer: Body of humerus (covered by periosteum pointer on sulcus of radial nerve)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal antebrachial cutaneous nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (medial head)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior ulnar collateral artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of radial nerve (to lower part of medial head of triceps and to anconeus muscle)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of radial nerve (to medial head of triceps)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (transected; upper pointer, lateral head; lower pointer, long head)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_25", "text": "Arm\n\t\t\t\t\t\t\t\t\t\t Nerve supply to left triceps muscle, medial view\n\t\t\t\t\t\t\t\t\t\tThe long head of the triceps has been retracted posteriorly.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior angle of scapula  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapularis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Axillary nerve Lower pointer: Posterior circumflex artery of humerus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle (tendon of insertion)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (long head)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of radial nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior brachial cutaneous nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of radial nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (medial head)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Musculocutaneous nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of humerus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracobrachialis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep brachial artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior ulnar collateral artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery (anomalous high or from brachial artery)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch musculocutaneous nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial intermuscular septum  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch brachial artery"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_26", "text": "Arm\n\t\t\t\t\t\t\t\t\t\t Relation of right radial nerve to humerus, posterior view\n\t\t\t\t\t\t\t\t\t\tThe lateral head (14) of the triceps muscle has been divided and separated to expose the underlying radial nerve and deep brachial artery.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus fossa  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of humerus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (long head)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep brachial artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of radial nerve (to medial head of triceps)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal antebrachial cutaneous nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior transverse ligament of scapula  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion of scapula  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (medial head)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (lateral head)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_27", "text": "Arm\n\t\t\t\t\t\t\t\t\t\t Right triceps muscle, posterior view\n\t\t\t\t\t\t\t\t\t\tThe long and lateral heads of the muscle have been separated to expose the radial nerve.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Inferior transverse ligament of scapula Lower pointer: Transverse scapular artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of scapula  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of humerus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (long head)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Spine of scapula  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromioclavicular ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres minor muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Surgical neck of humerus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (lateral head)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anconeus muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_28", "text": "Arm\n\t\t\t\t\t\t\t\t\t\t Left triceps muscle, posteromedial view\n\t\t\t\t\t\t\t\t\t\tThe brachial fascia has been removed. The superficial nerves which were shown in the previous view have been retained.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch intercostobrachial nerve (displaced upward)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral brachial cutaneous axillary nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior brachial cutaneous nerve of radial nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t IntercostobrachIal nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of middle brachial cutaneous nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (long head)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (medial head)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Medial intermuscular septum Lower pointer: Brachialis muscle (covered by fascia)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle of humerus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus fascia  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle antibrachial cutaneous nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilic vein"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_29", "text": "Arm\n\t\t\t\t\t\t\t\t\t\t Superficial nerves and vessels of left arm, posteromedial view\n\t\t\t\t\t\t\t\t\t\tThe skin and subcutaneous tissue have been removed. The brachial fascia (5) is intact. The arm has been rotated medially.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral brachial cutaneous axillary nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch intercostobrachial nerve (displaced slightly upward)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostobrachial nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior brachial cutaneous nerve of radial nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial fascia  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of middle brachial cutaneous nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of middle antebrachial cutaneous nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle of humerus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilic vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Ulnar branch of middle antebrachial cutaneous nerve Lower pointer: Anterior branch middle antebrachial cutaneous nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral antebrachial cutaneous nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of circumflex artery of scapula  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous branch of posterior branch thoracic nerve III  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus fascia  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia covering latissimus dorsi muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch of lateral cutaneous branch of intercostal nerve V"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_30", "text": "Arm\n\t\t\t\t\t\t\t\t\t\t Left brachialis muscle, anteromedial view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of humerus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of humerus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior Ulnar collateral artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial intermuscular septum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle of humerus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (ulnar head)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (humeral head)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (long head)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Musculocutaneous nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral antebrachial cutaneous nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch musculocutaneous nerve (to brachialis muscle)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior ulnar collateral artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (tendon of insertion)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous membrane"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_31", "text": "Arm\n\t\t\t\t\t\t\t\t\t\t Nerve supply to left coracobrachialis, biceps and brachialis muscles, medial view\n\t\t\t\t\t\t\t\t\t\tThe muscles have been retracted to show the course of the musculocutaneous nerve.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral margin of scapula  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracodorsal artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle (tendon of insertion)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior ulnar collateral artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial intermuscular septum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint of humerus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cord of brachial plexus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Musculocutaneous nerve Lower pointer: Branches of musculocutaneous nerve (to coracobrachialis muscle)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral head of median nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior circumflex artery of humerus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracobrachialis muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial head of median nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph node along course of deep brachial artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (short head)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (long head)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of musculocutaneous nerve (to biceps brachii muscle)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch radial artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery (note anomalous, but not infrequent, high origin from brachial artery)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral antebrachial cutaneous nerve  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of musculocutaneous nerve (to brachialis muscle)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_32", "text": "Arm\n\t\t\t\t\t\t\t\t\t\t Vessels, nerves and muscles of left arm, medial view\n\t\t\t\t\t\t\t\t\t\tThe brachial fascia has been removed. The brachial plexus and axillary artery have been displayed from their normal positions to bring various branches into view. The axillary vein has been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid major muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapularis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Circumflex artery of scapula Left pointer: Thoracodorsal artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial artery (deep to median nerve)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial intermuscular septum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilic vein  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle of humerus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle (cut off)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cord of brachial plexus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cord of brachial plexus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle cord of brachial plexus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Musculocutaneous nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracobrachialis muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapular artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral and medial heads of median nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial veins  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery (anomalous high origin)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial lymph nodes  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Median cubital vein"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_33", "text": "Arm\n\t\t\t\t\t\t\t\t\t\t Right biceps muscle. anterior view\n\t\t\t\t\t\t\t\t\t\tThe deep fascia has been removed. The shoulder joint has been opened to display the tendon of the long head of the biceps.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoacromial ligament (acromioclavicular joint)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion of scapula  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Long head of biceps brachii muscle (intracapsular part of tendon) Lower pointer: Greater tubercle of humerus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse humeral ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser tubercle of humerus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracobrachialis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of humerus (covered by periosteum)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Long head biceps brachii muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Short head  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial nerve (superficial branch)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of insertion of biceps  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Median nerve Lower pointer: Radial artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Transverse scapular artery Right pointer: Suprascapular nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process of scapula  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral margin of scapula  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapularis muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Circumflex artery of scapula  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle of humerus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Bicipital aponeurosis"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_34", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Course of right axillary nerve\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the previous view has been dissected to illustrate the relations of the axillary nerve. The capsule of the shoulder joint (8) has been detached from the surgical neck of the humerus. The upper part of the humerus has been cut away. Veins have been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromioclavicular ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion of scapula  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus muscle (tendon of insertion)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Infraspinatus muscle Lower pointer: Joint capsule of humerus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Subcoracoid bursa Lower pointer: Glenoid labrum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Glenoid cavity  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres minor muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of humerus (pointer on area of attachment to humerus)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch axillary nerve (to teres minor muscle)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (long head)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of humerus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle (clavicular origin)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process of scapula  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (long head)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapularis muscle (area of insertion on lesser tubercle)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (short head)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapularis muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis minor muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Musculocutaneous nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior circumflex artery of humerus  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Circumflex scapular artery  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle (partially resected)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_35", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Cavity of right shoulder joint, lateral view\n\t\t\t\t\t\t\t\t\t\tThe muscles of the shoulder have been resected and the lateral part of the joint capsule cut away. The upper part of the humerus has been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromioclavicular ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Subdeltoid bursa  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion of scapula  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of supraspinatus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcoracoid bursa  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Glenoid labrum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Glenoid cavity  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres minor muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of humerus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of axillary nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior circumflex artery of humerus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process of scapula  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior glenohumeral ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (short head)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of subscapularis muscle (detached from lesser tubercle)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Bursa subscapularis Lower pointer: Middle glenohumeral ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (long head)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_36", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Cavity of left shoulder joint, posterior view\n\t\t\t\t\t\t\t\t\t\tThe articular capsule has been incised vertically and the humerus retracted laterally. The head of the humerus has been rotated posteriorly.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion of scapula (cut)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of humerus (cut edge turned inward)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Glenoid labrum  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (long head)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of superior glenohumeral ligament (covered internally by articular capsule)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus muscle (tendon fused with joint capsule)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of humerus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of subscapularis muscle (opening of bursa subscapularis visible)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle glenohumeral ligament (covered internally by articular capsule)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anatomic neck of humerus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior glenohumeral ligament (covered internally by articular capsule)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of humerus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres minor muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of humerus (reinforced by inferior glenohumeral ligament)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of humerus  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinoglenoid notch  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of scapula  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Glenoid cavity  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (long head)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior circumflex artery of humerus"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_37", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Capsule and ligaments of left shoulder joint, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Subacromial bursa  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle (origin)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of humerus (articular cartilage of humerus visible through thin portion of capsule)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres minor muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior circumflex artery of humerus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of humerus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (lateral head)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion of scapula  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse scapular artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Spine of scapula  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus fossa  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (long head)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Circumflex artery of scapula  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapularis muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_38", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Capsule and ligaments of left shoulder joint, inferior view\n\t\t\t\t\t\t\t\t\t\tThe humerus has been abducted.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapularis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Bursa of subscapularis muscle (opened)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process of scapula  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapularis muscle (cut close to insertion)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior circumflex artery of humerus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Circumflex artery of scapula  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (long head)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior glenohumeral ligament (blended with joint capsule of humerus)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of acromion  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres minor muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (lateral head)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_39", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Capsule and ligaments of left shoulder joint, superior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Spine of scapula  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinoglenoid notch  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus fossa  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of humerus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse scapular artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior transverse ligament of scapula  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapularis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoclavicular ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process of scapula  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromial articular surface  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion of scapula  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of supraspinatus muscle covering capsule of shoulder joint  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of greater tubercle of humerus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoacromial ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of lesser tubercle of humerus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of humerus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior circumflex artery of humerus"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_40", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Capsule and ligaments of left shoulder joint, anterior view\n\t\t\t\t\t\t\t\t\t\tThe subscapular muscle has been partially cut away from the specimen shown previously (91-7). The capsule of the shoulder joint is reinforced anteriorly by the middle and inferior glenohumeral ligaments (5,6). The contours of these extracapsular ligaments are not clearly visible externally. They are more evident in the interior of the joint (94-7).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior transverse ligament of scapula  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Scapular notch  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapularis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapular fossa  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of humerus (pointer indicates position of middle glenohumeral ligament, visible internally in view 94-7)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of humerus (pointer indicates position of inferior glenohumeral ligament, visible internally in view 94-7)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (long head)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Circumflex scapular artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprascapular nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse scapular artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoclavicular ligament (cut off)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process of scapula  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis minor muscle (tendon of insertion)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromial articular surface  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Bursa of subscapularis muscle (translucent area of wall indicates position of a deeper bursal sac both bursae communicate with cavity of shoulder joint)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracobrachialis muscle and short head bicipitis brachii muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoacromial ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracohumeral ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of subscapularis muscle (lower portion muscular)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (long head, elevated)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of humerus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior circumflex artery of humerus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior circumflex artery of humerus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_41", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Nerve and blood supply to supraspinatus and infraspinatus muscles\n\t\t\t\t\t\t\t\t\t\tThe muscles have been detached from their origins and reflected laterally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus muscle (reflected)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion of scapula  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus muscle (reflected)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial nerve (in background)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial artery (in background)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse scapular artery (cut off and displaced superiorly from normal position)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Coracoid process of scapula Lower pointer: Superior transverse ligament of scapula  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial angle of scapula  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprascapular nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus fossa  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Spine of scapula  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus fossa  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Circumflex scapular artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of teres major muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_42", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Relations of supraspinatus, infraspinatus and tres minor muscles to shoulder joint, superior view\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in 93-6 is viewed here from above and somewhat laterally. The approximate positions of the insertions of the supraspinatus, infraspinatus and teres minor muscles into the greater tubercle and shaft of the humerus are indicated in the drawing at 3, 5, and 7.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process of scapula  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of facet on greater tubercle of humerus for tendon of supraspinatus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (long head)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of facet on greater tubercle of humerus for tendon of infraspinatus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of humerus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of teres minor muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (lateral head)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior circumflex artery of humerus (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres minor muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch axillary nerve (cut off)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (long head)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of acromion  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary vein  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: External jugular vein (cut off) Lower pointer: Supraclavicular part of brachial plexus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoacromial ligament  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprascapular nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Omohyoid muscle (cut off)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of acromioclavicular joint  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion of scapula  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Spine of scapula"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_43", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Quadrangular and triangular spaces, close-up view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres minor muscle (fused with infraspinatus muscle)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Branch axillary nerve (to deltoid muscle, previously removed) Lower pointer: Quadrangular space  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch axillary nerve (to teres minor muscle)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior circumflex artery of humerus (cut off)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral brachial cutaneous (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii (lateral head)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (long head)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Circumflex artery of scapula  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Triangular space  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_44", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Supraspinatus, infraspinatus, teres minor and teres major muscles\n\t\t\t\t\t\t\t\t\t\tThe fascia has been removed. The teres minor in this specimen is fused with the infraspinatus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromioclavicular ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion of scapula  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres minor muscle (fused with infraspinatus muscle)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior circumflex artery of humerus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch axillary nerve (to teres minor muscle)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (lateral head)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Circumflex artery and vein of scapula  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (long head)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Long thoracic nerve Lower pointer: Serratus anterior muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator muscle of scapula  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch superficial cervical artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Spine of scapula  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of tendon of insertion of trapezius muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral margin of scapula  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid major muscle (cut off)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_45", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Dorsal scapular nerve\n\t\t\t\t\t\t\t\t\t\tThe rhomboid muscles have been cut away. The scapula hs been retracted laterally from the thorax so that the deep surfaces of the levator scapulae(2) and serratus anterior (4,11) muscles are exposed. The dorsal scapular nerve (3) can be traced through the levator scapular muscle toward its termination in the rhomboid muscles (see previous view).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial cervical artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator muscle of scapula  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal nerve of scapula  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle (upper part)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid minor muscle (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral margin of scapula  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of superficial transverse artery to trapezius (refer to 931)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid major muscle (cut off)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory slip of serratus anterior muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial layer interposed between serratus anterior muscle and thoracic wall  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle (middle part)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Splenius capitis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle scalene muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending branch superficial transverse artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial transverse artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Descending branch superficial transverse artery Lower pointer: Lymph node  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior superior serratus muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process thoracic vertebra II  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of rhomboid major muscle (cut off)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib III  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbodorsal fascia  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (cut off)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_46", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Nerve supply to left rhomboideus major muscle\n\t\t\t\t\t\t\t\t\t\tThe fascia has been removed from the rhomboid muscles and the fascicles of the rhomboideus major have been separated to expose branches of the dorsal scapular nerve.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (reflected laterally)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial transverse vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator muscle of scapula  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial transverse artery (divided)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of trapezius on spine of scapula  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral margin of scapula  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus fascia  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid minor muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal nerve of scapula  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid major muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbodorsal fascia"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_47", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Nerve and blood supply to left lattisimus dorsi muscle\n\t\t\t\t\t\t\t\t\t\tThe muscle has been divided close to its origin (13) and reflected laterally. The thick layer of fascia deep to the muscle remains intact.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior brachial cutaneous nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle (reflected laterally)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle of humerus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus fascia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracodorsal nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracodorsal artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior angle of scapula  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial layer deep to latissimus dorsi muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinalis muscle (covered by lumbodorsal fascia)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle (cut across near origin)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior inferior serratus muscle (beneath fascia)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_48", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Nerve supply to trapezius muscle, close-up view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion of scapula  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of superficial transverse artery (12)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (reflected laterally)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus fascia  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial cervical artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid minor muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of medial angle of scapula  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus fascia  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial transverse artery (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of trapezius muscle into spine of scapula  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (origin)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid major muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral margin of scapula"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_49", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Nerve and blood supply to left trapezius muscle\n\t\t\t\t\t\t\t\t\t\tThe muscle has been reflected laterally from its origin. The underlying fascia remains intact.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Origins of muscle trapezius (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia (deep lamina of external layer)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory nerve (XI)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle (reflected laterally)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion of scapula  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of superficial transverse artery to trapezius (divided)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral brachial cutaneous nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostobrachial nerve (displaced upwards)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process vertebrae C. VII  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid major muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sacrospinalis muscle (beneath lumbodorsal fascia)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Triangle of auscultation  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_50", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Muscles of right scapular region, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous branch of posterior branch thoracic nerve II  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus fascia  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral margin of scapula  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Triangle of auscultation  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior supraclavicular nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion of scapula  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Rete acromiale  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Spine of scapula  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostobrachial nerve (displaced slightly upward)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_51", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Right lattisimus dorsi and trapezius muscles, posterior view\n\t\t\t\t\t\t\t\t\t\tSuperficial nerves and vessels have been preserved to the left of the midline. The deep fascia has been removed on the right side.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia (external layer)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinous process thoracic vertebra II  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral brachial cutaneous  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior brachial cutaneous nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial fascia  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Cutaneous branch of branch posterior thoracic nerve V  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch of lateral cutaneous branch of intercostal nerve V  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of latissimus dorsi muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior cluneal nerves  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion of scapula  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus fascia  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbodorsal fascia  17\n\t\t\t\t\t\t.\n\t\t\t\t\t External abdominal oblique muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Hiac crest"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_52", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Nerve and blood supply to left deltoid muscle, lateral view\n\t\t\t\t\t\t\t\t\t\tThe deltoid muscle has been detached from its origin and reflected laterally. Fascia has been removed from the deep surface of the muscle to expose nerves and blood vessels. The infraspinatus fascia (10) remains intact.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Subdeltoid bursa overlying head of humerus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle (in background)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia over shoulder joint  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Surgical neck of humerus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular branch of posterior circumflex artery of humerus  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle (reflected laterally)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch to deltoid of thoracoacromial artery (reflected with deltoid muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromial origin of deltoid muscle (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus fascia  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres minor muscle (visible through infraspinatus fascia)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior circumflex artery of humerus"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_53", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Fascial planes anterior to left shoulder joint\n\t\t\t\t\t\t\t\t\t\tA layer of fascia (6)extends laterally from the short head of the biceps across the shoulder joint. This layer blends with a fascia, aponeurotic in character, which continues upward from the insertion of the pectoralis major (18). The tendon of insertion of the subscapular muscle (4) is covered by a combination of the subscapular fascia. This layer has been reflected superiorly (3).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Subdeltoid bursa  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoacromial ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral portion of subscapular fascia (reflected superiorly)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of insertion of subscapularis muscle (pointer on lesser tubercle of humerus)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process of scapula  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial layer continuous with fascia of biceps muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of intertubercular sulcus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior circumflex artery of humerus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracobrachialis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (short head)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major bursa (pointer on tendon of long head of biceps muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial veins  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapularis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse humeral ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of humerus (covered by periosteum)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle (tendon of insertion)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_54", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Conoid and trapezoid ligaments, anterior view of left shoulder\n\t\t\t\t\t\t\t\t\t\tThe pectoralis minor muscle has been removed. The tendon of insertion of the pectoralis major (30) has been elevated to reveal an underlying bursa.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezoid ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Accessory band  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Conoid ligament (92-4 make up the coracoclavicular ligament)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse scapular artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavius muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprascapular nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cord of brachial plexus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapularis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracoacromial artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Musculocutaneous nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve (lateral head)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph vessel  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromioclavicular joint capsule  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion (cut fibers of deltoid muscle visible)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoacromial ligament  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Subdeltoid bursa  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracohumeral ligament  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Pectoralis minor muscle (cut off) Right pointer: Coracoid process of scapula  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracobrachialis muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (long head covered by fascia)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary nerve  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (short head)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of humerus  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Bursa pectoralis major muscle (tendon of long head of biceps visible in depths of bursa)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle (tendon of insertion, cut off)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_55", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Left subdeltoid bursa\n\t\t\t\t\t\t\t\t\t\tThe left deltoid muscle has been cut from its acromial and clavicular origins and reflected laterally. The subdeltoid bursa (15) has been opened. Continuity of the pectoral fascia with the fascia over the coracobrachialis muscle is visible at 12. A thin layer of fascia has been removed from the deep surface of the deltoid muscle to expose the axillary nerve (17) and vessels.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of acromioclavicular joint  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle (divided at clavicular origin)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromial branch thoracoacromial artery (note articular branch of lateral anterior thoracic nerve accompanying this vessel)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Coracoacromial ligament Lower pointer: Coracohumeral ligament  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process of scapula  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis minor muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracobrachialis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Musculocutaneous nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Biceps brachii muscle (short head covered by fascia) Right pointer: Biceps brachii muscle (tendon of long head visible beneath fascia)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of confluence of pectoral fascia with fascia of coracobrachialis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary lymph nodes (central group)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle (reflected laterally)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Subdeltoid bursa (this bursa extends beneath acromial process superiorly and thus forms a common subdeltoid-subacromial bursa)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia covering joint capsule of humerus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Posterior circumflex artery of humerus Right pointer: Axillary nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Surgical neck of humerus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of insertion of pectoralis major muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle (reflected laterally and inferiorly)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_56", "text": "Shoulder\n\t\t\t\t\t\t\t\t\t\t Right deltoid muscle, lateral view\n\t\t\t\t\t\t\t\t\t\tThe skin and tela subcutanea have been cut away from the shoulder and pectoral regions. The deep fascia has been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromioclavicular ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps muscle (lateral head)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternalis muscle (variant)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_57", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Left subscapular muscle (continued)\n\t\t\t\t\t\t\t\t\t\tThe shoulder has been detached from the thorax and turned so that the subscapular muscle is visible. The axillary artery and brachial plexus have been retracted from the field except for the median and musculocutaneous nerves.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator muscle of scapula (cut across)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid minor muscle (cut across)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch superficial transverse artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Rhomboid major muscle (cut across)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle (middle part, cut across)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapularis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle (lower part, cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle (cut across)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle (upper part, cut across)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior margin of scapula  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Omohyoid muscle (cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprascapular nerve (cut across)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse scapular artery (cut across)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior transverse ligament of scapula  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process of scapula  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of subscapular nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Musculocutaneus nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of subscapular nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracodorsal nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Quadrangular space  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior circumflex artery of humerus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapular artery (cut off)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Circumflex artery of scapula (entering triangular space)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracodorsal artery  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_58", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Left subscapular muscle\n\t\t\t\t\t\t\t\t\t\tThe shoulder has been pulled away from the thoracic wall and the axillary artery and brachial plexus retracted laterally. The subscapular fascia (7) has been partially removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Clavicle (cut off) Lower pointer: Subclavius muscle (cut off)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse scapular artery (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprascapular nerve (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Omohyoid muscle (cut off)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial angle of scapula  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapularis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapular fascia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Long thoracic nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process of scapula  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoclavicular ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser tubercle of humerus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapular nerves (upper subscapular nerves)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cord of brachial plexus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracodorsal nerve (middle subscapular nerve) (also see 21)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapular nerve (lower subscapular nerve)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracobrachialis muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapular artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracodorsal nerve (also see 16)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_59", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Left serratus anterior muscle, anterolateral view\n\t\t\t\t\t\t\t\t\t\tThe roots (1) of the brachial plexus have been divided and the subclavian vessels (2,3) cut off. The shoulder and arm have been pulled away from the thorax in order to expose the entire extent of the serratus anterior muscle. The axillary artery and infraclavicular part of the brachial plexus have been retracted from their normal positions.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Middle scalene muscle Lower pointer: Brachial plexus (cut across through roots)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Subclavian artery Lower pointer: Anterior scalene muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostobrachial nerve (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis minor muscle (area of origin)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibers of origin of pectoralis major muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous branch of intercostal nerve V  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib V  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Slip of origin of external abdominal oblique muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of cervical nerve V to serratus anterior muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse artery and vein of scapula  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Levator muscle of scapula  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle (cut off)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process of scapula  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of humerus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle (upper part)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Long thoracic nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery (displaced laterally with brachial plexus)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle (middle part)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of humerus  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Subscapularis muscle Lower pointer: Subscapular artery  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of deltoid muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle (detached from origin and retracted upward)  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle (lower part)  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_60", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Left axilla (continued); brachial plexus and axillary artery\n\t\t\t\t\t\t\t\t\t\tThe axillary vein and its branches have been cut away. Component parts of the brachial plexus have been separated slightly.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular trunk  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian vein (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapularis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Long thoracic nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Cervical nerve V Lower pointer: Cervical nerve VI  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve VII  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Cervical nerve VIII  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprascapular nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse scapular artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cord of brachial plexus  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch axillary artery (to subscapularis muscle)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process of scapula  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Musculocutaneous nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Coracobrachialis muscle Lower pointer: Anterior circumflex artery of humerus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior circumflex artery of humerus  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery (note anomalous bifurcation a short distance distal to pointer. The lateral branch continues as the radial artery, the medial branch as the brachial artery)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracodorsal nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle antibrachial cutaneous nerve  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracodorsal artery  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Teres major muscle  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_61", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Left axilla (continued); relations of arteries, veins and nerves, close-up view\n\t\t\t\t\t\t\t\t\t\tThe trunks (5,6,7), cords (24) and various branches of the brachial plexus are shown in relation to the subclavian (9,10) and axillary (14) vessels.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: levator muscle of scapula Lower pointer: Dorsal nerve of scapula  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of long thoracic nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial transverse artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper trunk  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle trunk  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lower trunk (91-4 pertain to the supraclavicular part of brachial plexus)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve (lying upon anterior scalene muscle)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian trunk  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of origin of subclavius muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery and vein  15\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromioclavicular ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoclavicular ligament  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoacromial ligament  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Suprascapular nerve Lower pointer: Transverse scapular artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapular nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process of scapula  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Posterior cord Middle pointer: Lateral cord Lower pointer: Middle cord (together these are infraclavicular parts of the brachial plexus)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Musculocutaneous nerve  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial nerve  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracobrachialis muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_62", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Left axilla (continued); general view of contents, clavicle removed\n\t\t\t\t\t\t\t\t\t\tThe subclavius muscle and the medial two-thirds of the clavicle have been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial cervical artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Phrenic nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Subclavian artery Lower pointer: Subclavian vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternohyoid muscle (visible through cut-out portion of capsule of sternoclavicular joint)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Subclavian trunk Right pointer: Rib I  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Axillary artery Lower pointer: Axillary vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostobrachial nerve (cut off)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper trunk  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle trunk (11 and 12 pertain to the supraclavicular part of the brachial plexus)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse scapular artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior belly of omohyoid muscle (cut off)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprascapular nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle (cut off)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process of scapula  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of humerus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapularis muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Musculocutaneous nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of humerus  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial veins  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracodorsal nerve  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_63", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Left sternoclavicular joint opened\n\t\t\t\t\t\t\t\t\t\tThe capsule has been resected to expose the articular disc (4) which separates the medial and lateral cavities of the joint. The sternal end of the clavicle is covered with fibrocartilage. The unevenness of this surface is of common occurrence.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternohyoid muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior jugular vein (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternoclavicular joint capsule (pointer on interclavicular ligament which has been divided)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Medial joint cavity Right pointer: Articular disc  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Manubrium of sternum  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Costoclavicular ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of origin of subclavius muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternal articular surface clavicle (covered with fibrocartilage)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_64", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Left sternoclavicular joint capsule and ligaments\n\t\t\t\t\t\t\t\t\t\tThe left sternocleidomastoid muscle has been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left sternohyoid muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior jugular veins (cut off)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Jugular venous arch (situated in suprasternal space)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternal origin of sternocleidomastoid muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Interclavicular ligament Lower pointer: Manubrium of sternum (covered by periosteum)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior deep cervical lymph node  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia (middle layer)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicular branch of thoracoacromial artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternoclavicular joint capsule (pointer on sternoclavicular ligament)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of origin of subclavius muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I (covered by membrane)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_65", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Left axilla (continued); general view of neck, shoulder and axilla, clavicle intact\n\t\t\t\t\t\t\t\t\t\tThe left sternocleidomastoid and trapezius muscles have been removed and the deep structures of the neck dissected. The deltoid, pectoralis major, pectoralis minor and subclavius muscles have also been cut away and the axilla freed of connective tissue and lymphatic structures. The arm has been rotated slightly medially.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Thyroid gland  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Costoclavicular ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternoclavicular joint (opened)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Manubrium of sternum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal intercostal muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal jugular vein  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial cervical artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraclavicular part of brachial plexus  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoclavicular ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromioclavicular joint capsule  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of humerus  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoacromial ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process of scapula  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Humerus  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraclavicular part of brachial plexus  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (long head)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (short head)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracobrachialis muscle  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Supreme thoracic artery  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Origin of pectoralis minor muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_66", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Left axilla (continued); relations of structures in posterior part of axillary fossa\n\t\t\t\t\t\t\t\t\t\tThe structures in the posterior part of the axilla have been exposed and are shown in relation to vessels and nerves already encountered. A distinct fascial lamina (21) is present in the cleft between the serratus anterior and subscapular muscles. Each of these muscles is also covered by its own fascia.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Suprascapular nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapular nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior cord of brachial plexus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cord of brachial plexus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lateral thoracic nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Thoracoacromial artery (cut off) Lower pointer: Anterior medial thoracic nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Communicating loop between medial and lateral anterior thoracic nerves Lower pointer: Supreme thoracic artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery and vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostobrachial nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (short head)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Musculocutaneous nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial and lateral heads of median nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral thoracic artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph vessel  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Subscapular artery (accompanied by subscapular vein) Lower pointer: Teres major muscle (covered by fascia)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracodorsal nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary lymph nodes (lateral group)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Long thoracic nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial layer (see text above)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_67", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Left axilla (continued); general view of contents; subclavius muscle\n\t\t\t\t\t\t\t\t\t\tThe pectoralis major and minor muscles have cervical been resected. The deltoid muscle has been divided close to its origin (10) and reflected laterally. The subclavius muscle (5) has been exposed by removal of the coracoclavicular fascia. The sternocleidomastoid and trapezius muscles have been resected and the external layer of cervical fascia removed. Several lymphatic trunks (20) enter the lateral group of axillary lymph nodes (22) from the arm. Some of the axillary nodes have been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Omohyoid muscle (superior belly)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior deep cervical lymph nodes  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavius muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lateral thoracic nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I (pointer on origin of subclavius muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior medial thoracic nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary lymph node  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle (divided at origin)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process of scapula  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis minor muscle (cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapular fascia  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracobrachialis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Musculocutaneous nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary vein  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph vessel  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial vein  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary lymph node (lateral)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_68", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Left axilla (continued); relations of vessels, nerves and lymphatic structures, close-up view\n\t\t\t\t\t\t\t\t\t\tThe arm has been abducted. The axillary sheath (5) remains on the proximal parts of the axillary artery and vein but has been removed distally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavius muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoclavicular fascia (partially removed)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lateral thoracic nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary sheath (partially removed)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary lymph nodes (subclavian group)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian trunk  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary lymph nodes (central group)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostobrachial nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis minor muscle (reflected)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracobrachialis muscle (covered by fascia)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of confluence of axillary, pectoral and brachial fascia  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Musculocutaneous nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior medial thoracic nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery and vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracodorsal nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary lymph nodes (subscapular group)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary lymph node (lateral)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Long thoracic nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of serratus anterior muscle  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary lymph node (anterior pectoral)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_69", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Left axilla; coracoclavicular fascia removed\n\t\t\t\t\t\t\t\t\t\tThe coracoclavicular fascia (12) has been partially removed and the connective tissue taken out of the axillary fossa.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular branch of lateral anterior thoracic nerve to acromioclavicular and shoulder joints  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavius muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lateral thoracic nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cord of brachial plexus  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery and vein  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian trunk  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary lymph nodes (subclavian group)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary lymph nodes (central group)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoclavicular fascia  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostobrachial nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary lymph nodes (anterior pectoral group)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracoacromial artery (cut off)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis minor muscle (reflected laterally)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior medial thoracic nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Supreme thoracic artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle (reflected laterally)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary lymph nodes (lateral group)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Axillary fascia Lower pointer: Lateral thoracic artery"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_70", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Right axillary fascia, inferior aspect\n\t\t\t\t\t\t\t\t\t\tThe skin and subcutaneous connective tissue have been removed from the right axilla. The axillary fascia (7) is continuous with the pectoral (1) and brachial fascia (3) and with the fascia which covers the serratus anterior and latissimus dorsi muscles.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoral fascia (pointer on anterior axillary fold, formed by underlying pectoralis major muscle)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of brachial artery (covered by brachial fascia)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial fascia  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch lateral thoracic artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Breast  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercostobrachial nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary fascia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior axillary fold (formed by latissimus dorsi muscle)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior branch of lateral cutaneous branch of intercostal nerve III"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_71", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Deep lamina of coracoclavicular fascia\n\t\t\t\t\t\t\t\t\t\tThe left pectoralis minor muscle (18,27) has been cut near its origin and reflected laterally. The layer of coracoclavicular fascia (19) deep to this muscle is continuous laterally with the pectoral (22) and axillary fascia (21). The axillary vein is visible through a natural opening in the coracoclavicular fascia.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Clavicular branch of thoracoacromial artery Lower pointer: Axillary vein  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior jugular vein  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicular part pectoralis major muscle (cut across)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle (sternal origin)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior supraclavicular nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary lymph node (of subclavian group)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocostal part pectoralis major muscle (cut across)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle (in first intercostal space)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal intercostal muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternal angle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal cartilage II  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Clavicle Lower pointer: Subclavius muscle (covered by coracoclavicular fascia)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lateral thoracic nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoral branch of thoracoacromial artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle (reflected)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of axillary fossa  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis minor muscle (reflected)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoclavicular fascia  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Aberrant muscular slip  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary fascia  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoral fascia (cut along lateral border of pectoralis major and left in situ when muscle was reflected)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracoepigastric vein  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral thoracic artery  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary lymph node (one of anterior pectoral group)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia over latissimus dorsi muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Origins of pectoralis minor muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_72", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Branches of left thoracoacromial artery, close-up view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle (covered by periosteum)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Subclavius muscle Lower pointer: Coracoclavicular fascia  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicular part pectoralis major muscle (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of origin of subclavius muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Subclavian trunk (one of several subclavian lymphatic trunks) Right pointer: Axillary lymph node (of subclavian group)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Clavicular branch of thoracoacromial artery Lower pointer: Thoracoacromial vein (cut off)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of lateral anterior thoracic nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis minor muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t External intercostal muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lymph node in deltopectoral triangle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular branch of anterior thoracic nerve to acromioclavicular and shoulder joints  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromial branch thoracoacromial artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lateral thoracic nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch to deltoid of thoracoacromial artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary connective tissue  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoral branch of thoracoacromial artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle (reflected laterally)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_73", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Left thoracoacromial vessels\n\t\t\t\t\t\t\t\t\t\tThe pectoralis major muscle has been reflected inferiorly from its origin. The fascia which covered the deep surface of the muscle has been removed except for a narrow band (18). The fascia has also been removed from the pectoralis minor muscle (7) and this muscle divided but not reflected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t External jugular vein  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle supraclavicular nerves  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Clavicular branch of thoracoacromial artery Lower pointer: Axillary lymph node (of subclavian group)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracoacromial vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of anterior lateral thoracic nerve  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis minor muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of sternum  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocostal origins of pectoralis major muscle (cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Clavicle Lower pointer: Subclavius muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromial branch thoracoacromial artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lateral thoracic nerve (cut off)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch to deltoid of thoracoacromial artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior lateral thoracic nerve (distal continuation of 14)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoral branch of thoracoacromial artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoral fascia  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_74", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Right pectoralis minor muscle\n\t\t\t\t\t\t\t\t\t\tThe relations of the pectoralis minor muscle to the axillary artery and brachial plexus can be seen. The subclavian and axillary veins have been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraclavicular part of brachial plexus (pointer on upper trunk)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezius muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Omohyoid muscle (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle (cut off)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process of scapula  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracobrachialis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Musculocutaneous nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle (cut off)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial veins  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Axilla  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis minor muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Latissimus dorsi muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial cervical artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Common carotid artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial transverse artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse scapular artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior scalene muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Trachea  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Lateral cord of brachial plexus Right pointer: Axillary artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic artery  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachiocephalic veins  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending aorta  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Internal mammary artery  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_75", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Nerve and blood supply of left pectoralis major muscle\n\t\t\t\t\t\t\t\t\t\tThe pectoralis major (9) has been reflected laterally from its clavicular (2) and sternocostal (3) origins. A narrow band of the pectoral fascia (8) which invested the deep surface of the muscle has been retained.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicular part pectoralis major muscle (cut across)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocostal part pectoralis major muscle (cut across)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Abdominal part pectoralis major muscle (cut across) Lower pointer: Sheath of rectus abdominis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraclavicular nerves  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary vein  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior thoracic nerve (branches of thoracoacromial vessels lie close to nerve)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of pectoral fascia  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis major muscle (reflected laterally)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoralis minor muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib II  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of sternum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoral fascia (at former position of lateral border of pectoralis major)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous branch of intercostal nerve VI"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_76", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Right pectoralis major and deltoid muscles, anterior view\n\t\t\t\t\t\t\t\t\t\tThe deep fascia has been removed. A well-developed sternalis muscle (9) is present. Later dissection revealed that this variant was not bilateral.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (upper pointer, short head; lower pointer, long head)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicular part pectoralis major muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocostal part pectoralis major muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternalis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternum"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_77", "text": "Pectoral region and axilla\n\t\t\t\t\t\t\t\t\t\t Superficial structures of left arm and thorax, anterior view\n\t\t\t\t\t\t\t\t\t\tThe skin, subcutaneous tissue and platysma muscle have been removed. The deep fascia remains in place. Superficial nerves and vessels have been preserved.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocleidomastoid muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle (covered by fascia)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicular part pectoralis major muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior supraclavicular nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of sternal angle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Mammary branch internal mammary artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior pectoral cutaneous branches intercostal nerves  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternocostal part pectoralis major muscle (covered by pectoral fascia)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of rectus abdominis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior supraclavicular nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid muscle (covered by fascia)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltopectoral triangle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle supraclavicular nerves  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of lateral brachial cutaneous nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Axilla  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral thoracic artery and thoracoepigastric vein  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (covered by brachial fascia)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of dorsal antebrachial cutaneous nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle (covered by brachial fascia)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Serratus anterior muscle (covered by fascia)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral cutaneous branches of intercostal nerves"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_78", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Angiogram, left hand of adult male, A-P view\n\t\t\t\t\t\t\t\t\t\tThe arteries have been filled with thorotrast. Two variations from the commonly described arrangement of the vessels are to be noted. (A) The a. volaris indicis radialis is absent. A branch of the first dorsal metacarpal artery (3, upper pointer) supplies the area normally reached by this vessel. (B)The superficial volar branch (7) of the radial artery does not enter into the formation of the superficial volar arch (16). This latter situation occurs frequently.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Terminal arch of proper volar digital arteries  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of princeps pollicis artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metacarpal arteries I-II  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep palmar arch  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating branches  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal branch radial artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial anterior branch radial artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Rete carpi dorsale  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior carpal branch radial artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior proper digital arteries  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior common digital artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior metacarpal arteries II-III  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior metacarpal artery IV  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial palmar arch  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep anterior branch ulnar artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal branch ulnar artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of anterior interosseous artery"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_79", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Right hand of adult female, A-P view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Phalanx III  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Phalanx II  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Phalanx I  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sesamoid bones  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal V  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Hook of hamate bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Hamate bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Pisiform bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Triquetral bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna (styloid process poorly developed)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal I  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezium bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezoid bone (in background)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitate bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Scaphoid bone  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of epiphyseal line  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_80", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Right elbow of 9 1/2-year-old boy, lateromedial view\n\t\t\t\t\t\t\t\t\t\tThe ossification center for the medial epicondyle of the humerus is not visible in this view. This film was obtained through the courtesy of Dr. Sydney F. Thomas.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of humerus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon fossa  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysis of head of humerus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysis of olecranon  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of radius  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ulna  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid fossa of humerus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid process of ulna  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysis of head of radius  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of radius"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_81", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Right elbow of 9 1/2-year-old boy, A-P view\n\t\t\t\t\t\t\t\t\t\tThis film was obtained through the courtesy of Dr. Sydney F. Thomas.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of humerus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of olecranon fossa  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysis of head of humerus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysis of head of radius  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of radius  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of radius  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphysis of medial epicondyle of humerus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon (in background)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid process of ulna  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ulna"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_82", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Angiogram, right shoulder of newborn, A-P view\n\t\t\t\t\t\t\t\t\t\tThorotrast was injected into the innominate artery. The vertebral border of the scapula is only faintly visible parallel and close to the descending branch (16) of the transverse cervical artery.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse scapular artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Spine of scapula  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromial branch thoracoacromial artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch to deltoid of thoracoacromial artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pectoral branch of thoracoacromial artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior circumflex artery of humerus  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep brachial artery (incompletely filled)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Muscular branch brachial artery Lower pointer: Body of humerus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Nutritive artery of humerus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial cervical artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ascending branch superficial transverse artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial transverse artery (arises from a common stem with transverse scapular artery)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Subclavian artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Clavicular branch of thoracoacromial artery Lower pointer: Thoracoacromial artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Descending branch superficial transverse artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Axillary artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral thoracic artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapular artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Circumflex scapular artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Thoracodorsal artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial artery"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_83", "text": "Radiography\n\t\t\t\t\t\t\t\t\t\t Right shoulder of 16-year-old girl, A-P view\n\t\t\t\t\t\t\t\t\t\tThis film was obtained through the courtesy of Dr. Sydney F. Thomas.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Rib I  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Clavicle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Spine of scapula  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Scapular notch  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process of scapula  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Epiphyseal line Right pointer: Acromioclavicular joint  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion of scapula  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of humerus  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater tubercle of humerus  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser tubercle of humerus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Epiphyseal line  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Glenoid cavity of scapula  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of humerus  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral margin of scapula"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_84", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated right carpal bones, distal surfaces\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle of trapezium bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for first metacarpal bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezium bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surfaces for second metacarpal bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezoid bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitate bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for third metacarpal bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for fourth metacarpal bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus for tendon of flexor carpi radialis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Carpal sulcus  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Hook of hamate bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Pisiform bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate bone (in background)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Triquetral bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Hamate bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for fifth metacarpal bone"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_85", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated right carpal bones, proximal and distal rows separated\n\t\t\t\t\t\t\t\t\t\tThe bones have been divided at the mid-carpel joint and the proximal row turned dorsally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Hook of hamate bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Hamate bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Triquetral bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pisiform bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitate bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezoid bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle of trapezium bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezium bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Scaphoid bone"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_86", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated right carpal bones, proximal surfaces\n\t\t\t\t\t\t\t\t\t\tThe eminentia carpi ulnaris is formed by 2 and 3. The eminentia carpi radialis is formed by 6 and 8.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Carpal sulcus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Hook of hamate bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pisiform bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Triquetral bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle of trapezium bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezium bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle of scaphoid bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezoid bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Scaphoid bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitate bone"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_87", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated right carpal bones, dorsal view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezium bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for first metacarpal bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Nutritive foramina  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Scaphoid bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surfaces for radius  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezoid bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitate bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Hamate bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Triquetral bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pisiform bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate bone"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_88", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated right carpal bones, volar view\n\t\t\t\t\t\t\t\t\t\tNutrient foramina are visible on several of the rough non-articular surfaces of the bones.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitate bone  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Hamulus of hamate bone  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for fifth metacarpal bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Hamate bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Triquetral bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pisiform bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezoid bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular surface for first metacarpal bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberculum of trapezium bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for tendon of flexor carpi radialis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezium bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle of scaphoid bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Scaphoid bone"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_89", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated bones of right hand, dorsal view\n\t\t\t\t\t\t\t\t\t\tI-V. Digits of the hand I. Thumb H. Index III. Long IV. Ring V. Little.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t I-V\n\t\t\t\t\t\t.\n\t\t\t\t\t Digits of the hand  I\n\t\t\t\t\t\t.\n\t\t\t\t\t Thumb  II\n\t\t\t\t\t\t.\n\t\t\t\t\t Index  III\n\t\t\t\t\t\t.\n\t\t\t\t\t Long  IV\n\t\t\t\t\t\t.\n\t\t\t\t\t Ring  V\n\t\t\t\t\t\t.\n\t\t\t\t\t Little  1\n\t\t\t\t\t\t.\n\t\t\t\t\t Distal phalanx  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle phalanx  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Proximal phalanx  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle phalanx  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Proximal phalanx  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal II  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Nutritive foramen  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous metacarpal space  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal I  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process of third metacarpal  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezium bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezoid bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Scaphoid bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitate bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of distal phalanx  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of phalanx  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of phalanx  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint of phalanx  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of phalanx  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of phalanx  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of metacarpal  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of metacarpal  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of metacarpal  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Hamate bone  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Triquetral bone  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Pisiform bone"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_90", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Articulated bones of right hand, volar view\n\t\t\t\t\t\t\t\t\t\tI-V. Digits of the hand I. Thumb II. Index III. Long IV. Ring V. Little\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t I-V\n\t\t\t\t\t\t.\n\t\t\t\t\t Digits of the hand  I\n\t\t\t\t\t\t.\n\t\t\t\t\t Thumb  II\n\t\t\t\t\t\t.\n\t\t\t\t\t Index  III\n\t\t\t\t\t\t.\n\t\t\t\t\t Long  IV\n\t\t\t\t\t\t.\n\t\t\t\t\t Ring  V\n\t\t\t\t\t\t.\n\t\t\t\t\t Little  1\n\t\t\t\t\t\t.\n\t\t\t\t\t Third phalanx  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Nutritive foramen (arrows indicate direction of nutritive canals)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Second phalanx  4\n\t\t\t\t\t\t.\n\t\t\t\t\t First phalanx  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal V  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Hamate bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pisiform bone  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Triquetral bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity of distal phalanx  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of third (distal) phalanx  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of third (distal) phalanx  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Phalangeal joint  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of second phalanx  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of second phalanx  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Second phalanx  17\n\t\t\t\t\t\t.\n\t\t\t\t\t First phalanx  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal I  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezoid bone  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezium bone  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitate bone  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Scaphoid bone"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_91", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right radius and ulna, posterior view of distal parts\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t -\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal surface  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Head (pointer on groove for tendon of extensor carpi ulnaris muscle)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular circumference  -\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar notch (of radius)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Carpal articular surface  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal surface  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for tendons of common extensor digitorum muscle and extensor indicis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Groove for tendon of extensor pollicis longus muscle Lower pointer: Dorsal tubercle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Groove for tendon of extensor carpi radialis brevis muscle Lower pointer: Groove for tendon of extensor carpi radialis longus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_92", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right radius and ulna, anterior view of proximal parts\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior margin  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior surface  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Carpal articular surface  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior margin  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior surface  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular circumference  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Head"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_93", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right radius and ulna, posterior view of proximal parts\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal surface  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar notch  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid process (in background)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial notch (of ulna)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular circumference  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Fovea of head  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Head  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_94", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right radius and ulna, anterior view of proximal parts\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial notch (of ulna)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Fovea of head  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Head  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular circumference  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar notch  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid process  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_95", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right humerus, posterior view of distal part\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial margin  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon fossa  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus of ulnar nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior surface  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral margin  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum (in background)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlea"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_96", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right humerus, anterior view of distal part\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Body  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterolateral surface  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral margin  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial fossa  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior border  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior medial surface  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial margin  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid fossa  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlea"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_97", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right humerus, posterior view of proximal part\n\t\t\t\t\t\t\t\t\t\tSeceral nutrient foramina are visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Head  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anatomic neck  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Body  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater tubercle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of epiphyseal line  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Surgical neck"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_98", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right humerus, anterior view of proximal part\n\t\t\t\t\t\t\t\t\t\tNumerous nutrient foramina are visible in the region of the neck of the humerus.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anatomic neck  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater tubercle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertubercular sulcus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater tubercular crest  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Body  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Head  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser tubercle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of epiphyseal line  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Surgical neck  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Crest of lesser tubercle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_99", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right humerus, radius and ulna, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t -\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  1\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Crest of supinator muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Body (pointer on medial surface)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal margin  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal surface  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous crest  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular circumference  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar notch  -\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular circumference  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous crest  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Body (pointer on dorsal surface)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal margin  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Dorsal tubercle Lower pointer: Styloid process  -\n\t\t\t\t\t\t.\n\t\t\t\t\t Humerus  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Head  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial margin  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior surface  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon fossa  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus of ulnar nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Anatomic neck  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater tubercle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Remnant of epiphyseal line  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Surgical neck  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Body  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid tuberosity  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus of radial nerve  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral margin  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlea"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_100", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right humerus, radius and ulna, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t -\n\t\t\t\t\t\t.\n\t\t\t\t\t Humerus  1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anatomic neck  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Greater tubercle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Intertubercular sulcus  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Surgical neck  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Crest of greater tubercle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Deltoid tuberosity  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterolateral surface  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral margin  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Radial fossa Lower pointer: Capitulum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Trochlea  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Head  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Lesser tubercle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Crest of lesser tubercle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of humerus (pointer on nutritive foramen)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior medial surface  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial margin  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid fossa  -\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular circumference  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Head  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Nutritive foramen  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous crest  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior surface  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Body (pointer on anterior margin)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Carpal articular surface  -\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon  31\n\t\t\t\t\t\t.\n\t\t\t\t\t Semilunar notch  32\n\t\t\t\t\t\t.\n\t\t\t\t\t Coronoid process  33\n\t\t\t\t\t\t.\n\t\t\t\t\t Tuberosity  34\n\t\t\t\t\t\t.\n\t\t\t\t\t Nutritive foramen  35\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous crest  36\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior surface  37\n\t\t\t\t\t\t.\n\t\t\t\t\t Body (pointer on anterior margin)  38\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitulum  39\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_101", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right scapula, lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus fossa  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromial angle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Spine of scapula  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinoglenoid notch  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus fossa  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal surface  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior angle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Medial angle (superior angle) Lower pointer: Superior margin  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraglenoid tubercle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Glenoid cavity  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraglenoid tubercle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of axilla"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_102", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right scapula, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial angle (superior angle)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus fossa  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Spine of scapula  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Trigone of spine  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Nutritive foramen  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraspinatus fossa  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral margin  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior angle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Angle of acromion  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Spinoglenoid notch  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Glenoid cavity (located at lateral angle)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of scapula  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraglenoid tubercle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for circumflex scapular artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of axilla"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_103", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right Scapula, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromion  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Coracoid process  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Scapular notch  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Glenoid cavity (located at lateral angle)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Neck of scapula  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Infraglenoid tubercle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Margin of axilla  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular line  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromial articular surface  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Spine of scapula (in background)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Supraspinatus fossa  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Superior margin  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial angle (superior angle)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Subscapular fossa  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Vertebral margin  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Inferior angle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_104", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right Clavicle, inferior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromial articular surface  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Area for attachment of trapezoid ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove on inferior surface for insertion of subclavius muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior border of shaft  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Costal tubercle (unnamed depression medial to pointer lies in area of attachment of costoclavicular ligament)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternal extremity  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromial extremity  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Conoid tubercle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Nutritive foramen  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior border of shaft  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior surface"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_105", "text": "Osteology\n\t\t\t\t\t\t\t\t\t\t Right Clavicle, superior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Acromial extremity  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Conoid tubercle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Shaft  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternal extremity  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Sternal articular surface"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_106", "text": "Sections of forearm and hand\n\t\t\t\t\t\t\t\t\t\t Transverse section of hand near bases of fingers\n\t\t\t\t\t\t\t\t\t\tThe capsules of the metacarpophalangeal joints are cut in this section, which passes across the heads of the second to fifth metacarpal bones.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous muscle I  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle II  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle II  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle III  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous muscle II  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligament of digital sheath IV  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper palmar digital nerve of ulnar nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle IV  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep transverse metacarpal ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle IV  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Digital sesamoid bones  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous muscle III (near insertion into extensor expansion)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor expansions  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (tendons blending with capsules of metacarpophalangeal joints)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Subcutaneous dorsal metacarpophalangeal bursae  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (tendon to index finger)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (tendon to index finger)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle I  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Digital sesamoid bone  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I (insertion)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal I (head)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament of metacarpophalangeal joint III"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_107", "text": "Sections of forearm and hand\n\t\t\t\t\t\t\t\t\t\t Transverse section of distal third of hand\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Palmar aponeurosis Left pointer: Transverse fascicle of palmar aponeurosis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Flexor digitorum superficialis (tendon to fourth finger) Lower pointer: Flexor digitorum profundus muscle (tendon to fourth finger)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle IV  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Flexor digitorum superficialis (tendon to fifth finger) Left pointer: Flexor digitorum profundus muscle (tendon to fifth finger)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypothenar fascia  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal V (head)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous fascia (continuous in this area with deep transverse metacarpal ligament)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous muscle III  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle IV  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous fascia  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (tendon to fourth finger)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal subcutaneous cleft  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous muscle II  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle III  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal subaponeurotic cleft  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor pollicis muscle (aberrant bundle)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle II  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous muscle I  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metacarpophalangeal subcutaneous bursa  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Anterior common digital artery Right pointer: Common palmar digital nerve of median nerve  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Flexor digitorum superficialis (tendon to middle finger) Right pointer: Flexor digitorum profundus muscle (tendon to middle finger)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle II  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Common palmar digital nerve of median nerve  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Flexor digitorum superficialis (tendon to index finger) Right pointer: Flexor digitorum profundus muscle (tendon to index finger)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle I  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_108", "text": "Sections of forearm and hand\n\t\t\t\t\t\t\t\t\t\t Transverse section of middle third of hand, partially dissected\n\t\t\t\t\t\t\t\t\t\tThe flexor tendons and the interosseous, hypothenar and lumbrical muscles have been removed to a depth of 5 mm. from the surface of the section to illustrate synovial sheaths and fascial planes.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Palmar aponeurosis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia (lobules of fat removed to illustrate vertical septa)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle III  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Flexor digitorum superficialis (tendon to fourth finger) Lower pointer: Flexor digitorum profundus muscle (tendon to fourth finger)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Common palmar digital nerve of ulnar nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle IV  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Flexor digitorum profundus muscle (tendon to fifth finger) Right pointer: Flexor digitorum superficialis muscle (tendon to fifth finger)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper palmar digital nerve of ulnar nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia of opponens digiti minimi muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor and flexor digiti minimi muscles  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypothenar fascia  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal V  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous muscle III  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle IV  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Common extensor digitorum muscle (tendon to fifth finger) Right pointer: Dorsal fascial of the hand  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous fascia  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous muscle II  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle III  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle II  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous fascia  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous muscle I  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor indicis muscle (tendon)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Flexor digitorum superficialis and profundus muscles (tendons within synovial sheaths) Right pointer: Lumbrical muscle II  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Common palmar digital nerve of median nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Flexor digitorum superficialis (tendon to index finger) Right pointer: Flexor digitorum profundus muscle (tendon to index finger)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper palmar digital nerve of median nerve  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle I  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor pollicis muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_109", "text": "Sections of forearm and hand\n\t\t\t\t\t\t\t\t\t\t Transverse section of proximal third of hand, partially dissected\n\t\t\t\t\t\t\t\t\t\tInterosseous and hypothenar muscles have been removed to a depth of 5 mm. on the proximal section to illustrate the interosseous and hypothenar fasciae and the various septa which extend to the metacarpal bones. The flexor tendons to the middle finger (15) have also been removed from the proximal section to display the synovial sheath which encloses them. The \"mid-palmar space\", a cleft-like region of delicate connective tissue deep to the flexor tendons and lumbrical muscles, has been spread open at 14. A single, dense, fibrous septum (2) extends from the palmar aponeurosis to the volar interosseous fascia lateral to the second lumbrical. This separates the flexor tendons and lumbrical of the index finger from the remaining tendons and lumbricals. The \"mid-palmar space\" is thus interrupted by this septum. A similar space, or cleft, lateral to this septum has been designated as the \"thenar space\". This cleft can be traced around the distal margin of the adductor pollicis to the area between the adductor and the first dorsal interosseous muscle. Other septa similar to the one described (2) appear more distally in the palm. These separate the remaining tendons and lumbricals from each other as they approach the fingers.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Flexor digitorum superficialis (tendon) Right pointer: Lumbrical muscle I  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Fibrous septum between palmar aponeurosis and anterior interosseous fascia (see text above)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Palmar aponeurosis  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (tendons)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Opponens digiti minimi muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal V  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (tendons covered by dorsal fascial of the hand)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal subaponeurotic cleft  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Hypothenar fascia  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous fascia  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous fascia (note septa extending from this layer to metacarpals)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior common digital artery and nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Mid-palmar space (cleft), exposed by anterior retraction of lumbrical muscle and synovial sheath  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of common tendon of flexor muscles (tendons removed)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia (traversed by vertical fibrous septa between dermis and palmar aponeurosis)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor fascia  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor pollicis muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis longus muscle (within synovial sheath)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Phalanx I  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle (tendon)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (tendons)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscles  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous muscles  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Sesamoid bone  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis brevis muscle (insertion)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_110", "text": "Sections of forearm and hand\n\t\t\t\t\t\t\t\t\t\t Transverse section of right wrist\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Palmaris longus muscle (insertion into partial aponeurosis)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse carpal ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep anterior branch ulnar artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Palmaris brevis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Hamulus of hamate bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Pisometacarpal ligament  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal V  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi ulnaris muscle (tendon of insertion)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (tendons in carpal canal invested by synovial sheath)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitate bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (tendons)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (tendons in carpal canal invested by synovial sheath)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Median nerve Right pointer: Flexor pollicis longus muscle (tendon in carpal canal invested by synovial sheath)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Opponens pollicis muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis brevis muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal I  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle (tendon)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezium bone  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle (tendon)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle (tendon of insertion)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle (tendon of insertion)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezoid bone  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal II  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle (tendon of insertion)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal III"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_111", "text": "Sections of forearm and hand\n\t\t\t\t\t\t\t\t\t\t Transverse section of right wrist\n\t\t\t\t\t\t\t\t\t\tThe synovial sheaths within the carpal canal are so closely applied to the tendons that the serous spaces are not visible. The sheath common to the flexor digitorum sublimis and flexor digitorum profundus has a broad mesotendon in the midpart of the carpal canal. The location of this mesotendon is marked by an asterisk on the drawing. Synovial spaces are present on both sides of the mesotendon but are more extensive medially.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse carpal ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (tendons in carpal canal, invested by synovial sheath which forms the \"ulnar bursa\")  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery and nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pisiform bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (tendons in carpal canal, invested by synovial sheath which forms the \"ulnar bursa\")  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of common tendon of flexor muscles (blended with intercarpal ligaments)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Triquetral bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi ulnaris muscle (tendon)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digiti minimi muscle (tendon)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Hamate bone  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal fascia of the hand  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (tendons)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Palmaris longus muscle (tendon)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Median nerve Right pointer: Flexor pollicis longus muscle (invested by synovial sheath which forms \"radial bursa\")  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis brevis muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezium bone  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle (tendon)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle (tendon)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Scaphoid bone Lower pointer: Trapezoid bone  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle (tendon)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle (tendon)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitate bone  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle (tendon)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_112", "text": "Sections of forearm and hand\n\t\t\t\t\t\t\t\t\t\t Transverse section of distal part of right forearm\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery and nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator quadratus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi ulnaris muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digiti minimi muscle (tendon)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor indicis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Antebrachial interosseous membrane  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Antibrachial fascia  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Palmaris longus muscle (tendon)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle (tendon)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis longus muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle (tendon)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of radial nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle (tendon)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle (tendon)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous artery"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_113", "text": "Sections of forearm and hand\n\t\t\t\t\t\t\t\t\t\t Transverse section of distal part of right fourth finger and fingernail\n\t\t\t\t\t\t\t\t\t\tThe eponychium (cuticle) has been partially scraped away to reveal the depth of the sulcus matricis unguis (1).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sulcus matricis of nail  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of nail  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Stratum corneum of nail (cut edge)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Stratum germinativum of nail (cut edge)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Matrix of nail  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Vallum of nail (lower pointer on cut edge)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral margin of nail  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Eponychium  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Phalanx III  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Periosteum  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Corium (dermis)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Epidermis (stratum germinativum)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Epidermis (stratum corneum) (sulci and cristae skin are visible on cut edge of epidermis)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_114", "text": "Sections of forearm and hand\n\t\t\t\t\t\t\t\t\t\t Sagittal section of right middle finger, medial view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (tendon cut off in synovial sheath)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Phalanx I  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (insertion of tendon into base of second phalanx)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (insertion of tendon into shaft of second phalanx)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Phalanx II  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (insertion of tendon into base of terminal phalanx)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Digital joint (distal interphalangeal joint)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Hidden margin of nail  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Vallum of nail  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of nail (stratum corneum)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of nail (stratum germinativum)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Free margin of nail  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Matrix of nail  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Phalanx I  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (insertion of tendon into third phalanx)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior accessory ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (tendon cut off in synovial sheath)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior accessory ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Vinculum longum (cut off)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Corium (dermis)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Epidermis (stratum germinativum)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Epidermis (stratum corneum)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of digital sheath (internal surface)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_115", "text": "Joints of right index finger\n\t\t\t\t\t\t\t\t\t\t Proximal interphalangeal joint opened, medial view\n\t\t\t\t\t\t\t\t\t\tThe ligaments and capsule of the joint have been cut. The extensor tendon and extensor expansion have also been transected to allow the proximal phalanx to be pulled away from the middle phalanx. The bones are in a position of flexion.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of middle phalanx (covered by articular cartilage)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor expansion (divided)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Phalangeal joint (covered by articular cartilage)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (tendon of insertion divided)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule (cut)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament (divided)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Phalanx  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Synovial fold  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior accessory ligament (divided)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligament of digital sheath"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_116", "text": "Joints of right index finger\n\t\t\t\t\t\t\t\t\t\t Capsule and ligaments of proximal interphalangeal joint, medial view\n\t\t\t\t\t\t\t\t\t\tThe extensor expansion (2) has been reflected dorsally to display the insertion of the central part of the extensor tendon (4) on the base of the middle phalanx.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Phalanx I  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor expansion (reflected dorsally)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (insertion of central part of tendon into base of second phalanx)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Phalanx II (covered by periosteum)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligament of digital sheath  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial band continuous between cruciate part of sheath ligament and extensor expansion opposite interphalangeal joint (divided and reflected dorsally)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior accessory ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligament of digital sheath (cruciate ligament)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular branch of proper palmar digital artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of digital sheath  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligament of digital sheath (annular ligament)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_117", "text": "Joints of right index finger\n\t\t\t\t\t\t\t\t\t\t Metacarpophalangeal joint opened, medial view\n\t\t\t\t\t\t\t\t\t\tThe ligaments and capsule of the joint have been cut. The head of the metacarpal bone has been rotated medially and proximally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpophalangeal joint capsule  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Extensor indicis muscle (tendon of insertion) Right pointer: Common extensor digitorum muscle (tendon of insertion)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of metacarpal II (covered with articular cartilage)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament (cut)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of metacarpal II  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Synovial fold  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle I  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of extensor tendons on base of proximal phalanx  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor expansion (reflected dorsally)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Phalanx I  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligament of digital sheath  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of phalanx (covered with articular cartilage)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament (inner aspect of lateral ligament)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior accessory ligament (left pointer on cut edge, right pointer on articular surface of ligament)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of digital sheath  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (tendon)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (tendon)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_118", "text": "Joints of right index finger\n\t\t\t\t\t\t\t\t\t\t Capsule and ligaments of metacarpophalangeal joint, medial view\n\t\t\t\t\t\t\t\t\t\tThe finger has been removed from the hand by transecting the shaft of the metacarpal bone (2). The first volar interosseous muscle (3) has been reflected dorsally with the extensor expansion of the medial side of the finger. Transverse fibers of the extensor expansion have been divided (4).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor indicis muscle (right pointer indicates insertion on base of proximal phalanx. Tendon of extensor digitorum contributes to this insertion)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal II  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous muscle I (reflected dorsally)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse fibers of extensor expansion (divided)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor expansion (reflected)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor indicis muscle and common extensor digitorum muscle (tendons of insertion fused)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Phalanx I  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligament of digital sheath II (pointer on cruciate ligament)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligament of digital sheath II (pointer on annular ligament)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpophalangeal joint capsule  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior accessory ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of digital sheath  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis and profundus muscles (tendons cut off)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle I  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_119", "text": "Dorsal aspect of left hand and fingers\n\t\t\t\t\t\t\t\t\t\t Extensor tendons\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Insertion of extensor expansion into base of terminal phalanx Lower pointer: Collateral parts of extensor expansion (the lumbrical and interosseous muscles insert into these proximally (3) and the collateral parts of the tendon of the common extensor digitorum insert into these dorsally opposite the proximal interphalangeal joint)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Central part of tendon of common extensor digitorum muscle (upper pointer indicates insertion on base of middle phalanx)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor expansion (insertion of lumbrical and interosseous muscles)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of metacarpophalangeal joint (covered by transverse fibers of extensor expansion)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Junctural tendon  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscles II-V  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digiti minimi proper muscle (tendon of insertion)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of nail  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Root of nail  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunula of nail  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Vallum of nail  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of distal interphalangeal joint  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of proximal interphalangeal joint  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligament of digital sheath  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor expansion of thumb  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor pollicis muscle (insertion)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle (tendon of insertion)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor indicis muscle (tendon of insertion)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (tendons of insertion)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_120", "text": "Joints of right wrist and hand\n\t\t\t\t\t\t\t\t\t\t Frontal section, posterior view\n\t\t\t\t\t\t\t\t\t\tThe joint spaces have been opened by flexion of the wrist and hand. The interosseous intercarpal ligaments have not been cut. The capitate and hamate bones are held together firmly by a strong interosseous ligament.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of metacarpal II  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermetacarpal joint  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezoid bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle (tendon cut obliquely)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitate bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Synovial fold  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral carpi radial ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Scaphoid bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous intercarpal ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Radiocarpal joint  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle (partially tendinous)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Palmar metacarpal ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Base of metacarpal V  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Carpometacarpal joint  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Synovial fold Lower pointer: Extensor carpi ulnaris muscle (tendon)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercarpal joint  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Triquetral bone  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate bone  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral carpi ulnar ligament  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Distal radioulnar articular disc  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process of ulna  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of ulna  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Distal radioulnar joint (lower pointer, sacciform recess)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator quadratus muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_121", "text": "Joints of right wrist and hand\n\t\t\t\t\t\t\t\t\t\t Articular cavities, anterior view\n\t\t\t\t\t\t\t\t\t\tThe volar ligaments have been removed and the articular capsules have been incised to allow the carpal and metacarpal bones to be pulled apart. The interosseous ligament between the hamate and capitate has been cut. The interosseous ligaments of the bases of the metacarpals have also been incised.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Palmar metacarpal ligaments  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermetacarpal joint  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Hamulus of hamate bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous intercarpal ligament  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Hamate bone  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi ulnaris muscle (tendon of insertion)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Synovial fold  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint capsule of pisiform bone  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Joint of pisiform bone (cavity extends proximally nearly to articular disc, 13)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pisiform bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercarpal joint  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Triquetral bone  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Distal radioulnar articular disc (partially removed)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of ulna  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal II  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpophalangeal joints  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle (insertion)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezoid bone  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpotrapezial joint  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle of trapezium bone  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezium bone  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitate bone  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Scaphoid bone (pointer on tubercle)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Lunate bone  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Radiocarpal joint  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_122", "text": "Joints of right wrist and hand\n\t\t\t\t\t\t\t\t\t\t Capsules and ligaments, anterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal I  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Flexor carpi radialis muscle (tendon of insertion) Lower pointer: Anterior intercarpal ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitate bone  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior metacarpal ligament  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal V  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Hamulus of hamate bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Pisometacarpal ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi ulnaris muscle (tendon of insertion)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pisohamate ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Pisiform bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle (tendon of insertion)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral carpal ulnar ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle (tendon of insertion)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpotrapezial joint capsule (pointer on anterior oblique ligament)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezium bone (left pointer on tubercle)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse carpal ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral carpal radial ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Carpal radial ligament  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior radial carpal ligament  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior ulnar carpal ligament  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Distal radial ulnar joint capsule  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_123", "text": "Joints of right wrist and hand\n\t\t\t\t\t\t\t\t\t\t Capsules and ligaments, posterior view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal intercarpal ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpometacarpal ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezoid bone  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Carpometacarpal pollicis joint capsule (pointer of posterior oblique ligament)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle (tendon of insertion)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezium bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral carpal radial ligament  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal arcuate ligament  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process of radius  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal V  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metacarpal ligament  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi ulnaris muscle (tendon of insertion)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Hamate bone  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Capitate bone  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Triquetral bone (covered by ligaments)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral carpal ulnar ligament (covered by synovial sheath of extensor carpi ulnaris)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process of ulna  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Distal radial-ulnar joint capsule  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal radial-carpal ligament  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal ligament (osteofibrous canals opened)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal tubercle of radius"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_124", "text": "Joints of right wrist and hand\n\t\t\t\t\t\t\t\t\t\t Capsules and ligaments, medial view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process of ulna  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral carpal ulnar ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Triquetral bone (covered by ligaments)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal intercarpal ligament (hamate bone underlies tip of pointer)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Intercarpal articular capsule  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Carpal extensor muscle of ulna (tendon of insertion)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal V  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Pisometacarpal ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal I (in background)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular capsule of carpometacarpal pollicis  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse carpal ligament (in background, cut across)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Pisiform bone Lower pointer: Carpal flexor muscle of ulna (tendon of insertion)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  *\n\t\t\t\t\t\t.\n\t\t\t\t\t [Legend above restored translation from Latin]"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_125", "text": "Joints of right wrist and hand\n\t\t\t\t\t\t\t\t\t\t Capsules and ligaments, lateral view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal III  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal II  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpophalangeal joint capsule  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle (insertion)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle (insertion)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Trapezoid bone  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal joint ligament  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal radiocarpal ligament  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Scaphoid bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal tubercle of radius  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process of radius  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle (tendon of insertion in background of view)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Pisiform bone (in background)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Collateral carpi radial ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of tubercle of trapezium bone  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Carpometacarpal joint capsule of thumb (pointer on radial ligament) Lower pointer: Tubercle of trapezium bone  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Posterior oblique ligament of carpometacarpal joint of thumb  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle (tendon of insertion)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal I"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_126", "text": "Dorsal aspect of hand\n\t\t\t\t\t\t\t\t\t\t Relations of radial artery at wrist, lateral view of left hand\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of radial nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle (tendon of insertion)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal ligament  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle (tendon of insertion)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle (tendon of insertion)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle (tendon of insertion)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal II  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpophalangeal joint I  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal I  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Carpometacarpal joint capsule of thumb  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial anterior branch radial artery"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_127", "text": "Dorsal aspect of hand\n\t\t\t\t\t\t\t\t\t\t Compartments for extensor tendons deep to dorsal carpal ligament, lateral view of right hand\n\t\t\t\t\t\t\t\t\t\tThe ligament has been cut to open the various compartments for the tendons. The synovial sheaths of the tendons have also been opened. The proximal and distal limits of these sheaths are not visible on all of the tendons. The smooth portions of the tendons are covered by synovial membrane reflected from the sheaths.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (tendons of insertion)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor indicis muscle (tendon of insertion)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Distal margin of synovial sheath of common extensor digitorum muscle (cut at line of reflection from tendons)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal ligament  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digiti minimi muscle (tendon of insertion)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process of ulna  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of radial nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle (tendon)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle (tendon)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle (tendon)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Insertion of extensor carpi radialis brevis muscle into base of third metacarpal bone  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metacarpal artery II  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of dorsal metacarpal artery I  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal I (covered by periosteum)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_128", "text": "Dorsal aspect of hand\n\t\t\t\t\t\t\t\t\t\t Superficial branch of radial nerve at wrist, lateral view\n\t\t\t\t\t\t\t\t\t\tThe specimen has been turned so that the lateral (radial) border of the wrist is in the foreground. The cephalic vein (3, 7) has been cut to display the course of the superficial branch of the radial nerve.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal digital nerves of radial nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein (distal portion)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular branch of superficial branch of radial nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein (proximal portion)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of radial nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle (tendon)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle (tendon)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral antebrachial cutaneous nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery and veins  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis longus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle (tendon)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial anterior branch radial artery  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of compartment deep to dorsal carpal ligament for abductor pollicis longus muscle and extensor pollicis brevis muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle (tendons of insertion, one of which joins abductor pollicis brevis muscle)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis brevis muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_129", "text": "Dorsal aspect of hand\n\t\t\t\t\t\t\t\t\t\t Dorsal interosseous muscles\n\t\t\t\t\t\t\t\t\t\tThe extensor tendons have been cut away and the dorsal interosseous fascia has been removed. A small part of the third dorsal interosseous muscle passes obliquely across the intermetacarpal space to insert on the shaft of the third metacarpal. The first dorsal interosseous muscle has a similar arrangement.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal branch radial artery  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle (tendon of insertion)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle (tendon of insertion)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle (tendon of insertion)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of dorsal metacarpal artery I  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metacarpal artery II  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal II  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle II  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (tendon to index finger)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor indicis muscle (tendon of insertion)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse fibers of extensor expansion  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (tendons of insertion)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metacarpal artery III  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle III (left pointer on muscle described in text above)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle IV  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal V  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of carpometacarpal articulation  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Dorsal carpal ligament Right pointer: Compartment for common extensor digitorum muscle and extensor indicis muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi ulnaris muscle (tendon cut off within compartment)  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Compartment for extensor digiti minimi muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_130", "text": "Dorsal aspect of hand\n\t\t\t\t\t\t\t\t\t\t Compartments for extensor tendons deep to dorsal carpal ligament\n\t\t\t\t\t\t\t\t\t\tThe ligament has been cut to expose the tendons lying within the various compartments. The synovial sheaths of these tendons have been opened. The proximal and distal limits of these sheaths are not sharply defined on all of the tendons.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle (tendon)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle (tendon)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle (tendon)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of dorsal metacarpal artery I  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal II  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor indicis muscle (tendon)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Junctural tendon  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle IV  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (tendons)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi ulnaris muscle (tendon)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal ligament (cut to open compartments containing extensor tendons)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Styloid process of ulna Right pointer: Extensor digiti minimi muscle (tendon)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_131", "text": "Dorsal aspect of hand\n\t\t\t\t\t\t\t\t\t\t Extensor tendons, close-up view of right hand\n\t\t\t\t\t\t\t\t\t\tThe investing layer of deep fascia has been removed from the back of the hand with the exception of two bands (4) which are distinctly heavier than the other areas of the fascia. The proximal one of these bands is continuous with the dorsal carpal ligament.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of radial nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal ligament (compartments for extensor tendons visible deep to ligament)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular branch of superficial branch of radial nerve (cut)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal fascia of the hand  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle (tendon of insertion)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch dorsal metacarpal artery I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metacarpal artery II  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I (fascia removed)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal II (covered by periosteum)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor indicis muscle (tendon of insertion)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Junctural tendon  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal digital artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Small junctural tendon from common extensor digitorum muscle to fifth finger (frequently a distinct tendon of the extensor digitorum passes to the fifth finger)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (tendons of insertion)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digiti minimi muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of common extensor digitorum muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal hand branch of ulnar nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of styloid process of ulna"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_132", "text": "Dorsal aspect of hand\n\t\t\t\t\t\t\t\t\t\t Superficial nerves and vessels of right hand, close-up view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal digital nerves of radial nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I (covered by dorsal interosseous fascia)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal venous rete of hand  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal fascial of the hand  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch dorsal metacarpal artery I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (tendons covered by dorsal fascial of the hand)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor indicis muscle (tendon of insertion)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Digital venous arch  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal digital arteries  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal digital nerves of ulnar nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digiti minimi muscle (tendon of insertion)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metacarpal artery IV  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial fascia  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of dorsal hand branch of ulnar nerve"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_133", "text": "Dorsal aspect of hand\n\t\t\t\t\t\t\t\t\t\t Dorsal branch of ulnar nerve, medial view of right hand\n\t\t\t\t\t\t\t\t\t\tThe specimen has been turned so that the medial border of the forearm and hand is in the foreground.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Anconeus muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi ulnaris muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digiti minimi muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process of ulna  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal ligament  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal fascial of the hand  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal rete venosum of the hand  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal digital nerves of ulnar nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Abductor digiti minimi muscle Right pointer: Abductor pollicis brevis muscle (in background)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of pisiform bone  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal hand branch of ulnar nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ulna  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilic vein  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle antibrachal cutaneous nerve"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_134", "text": "Dorsal aspect of hand\n\t\t\t\t\t\t\t\t\t\t Superficial nerves and vessels of right hand, general view\n\t\t\t\t\t\t\t\t\t\tThe antibrachial fascia and the dorsal fascia of the hand have been removed. The dorsal carpal ligament remains in place.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal antebrachial cutaneous nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of radial nerve  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anastomosis between superficial branch of radial nerve and dorsal antebrachial cutaneous nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of compartment deep to dorsal carpal ligament for extensor pollicis longus muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal digital nerves of radial nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal digital artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal digital nerves of ulnar nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous fascia  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of dorsal hand branch of ulnar nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal ligament  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digiti minimi muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_135", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Origins of deep layer of extensor muscles\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of radial nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle (insertion)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle (area of origin)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Antebrachial interosseous membrane  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle (tendon)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous nerve (terminal part)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Compartment for common extensor digitorum muscle and extensor indicis muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Compartment for extensor digiti minimi muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Compartment for extensor carpi ulnaris muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of extensor indicis muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of extensor pollicis longus muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_136", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Dorsal interosseous nerve\n\t\t\t\t\t\t\t\t\t\tThe deep extensor muscles have been cut and reflected. The compartment for the common extensor tendons deep to the dorsal carpal ligament has been dissected to display the terminal articular branches of the dorsal interosseous nerve.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle (cut)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle (cut)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle (tendon)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle (tendon)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Compartment for extensor pollicis longus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal ligament (compartments for extensor tendons opened)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Compartment for common extensor digitorum muscle and extensor indicis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular branches of dorsal interosseous (antebrachial) nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal branch of radial artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi ulnaris. muscle (tendon of insertion)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Compartment for extensor digiti minimi muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Compartment for extensor carpi ulnaris muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor indicis muscle (cut)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle (cut and reflected)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Antebrachial interosseous membrane"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_137", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Nerve supply to extensor pollicis brevis muscle\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of radial nerve (to extensor pollicis brevis muscle)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch anterior interosseous artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor indicis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermuscular septum  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous artery"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_138", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Nerve supply to abductor pollicis longus, extensor pollicis longus and extensor indicis proprius muscles\n\t\t\t\t\t\t\t\t\t\tThe muscles have been dissected to demonstrate the intramuscular course of branches of the deep branch of the radial nerve.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (insertion)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of radial nerve (to abductor pollicis longus muscle)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle (dissected)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle (dissected)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Muscular branch of radial nerve (to extensor indicis muscle) Right pointer: Extensor indicis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous (antibrachial) nerve (see 108-4)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of radial nerve (to extensor pollicis brevis muscle)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of radial nerve (to extensor pollicis longus muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent interosseous artery"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_139", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Relation of deep branch of radial nerve to deep extensor muscles\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of radial nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle (superficial layer reflected)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of radial nerve (to abductor pollicis longus muscle)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle (tendon in compartment deep to dorsal carpal ligament)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle (tendon in compartment deep to dorsal carpal ligament)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process of ulna  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor indicis muscle cut off)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous artery  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anconeus muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_140", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Deep layer of extensor muscles, general view\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (insertion)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus and brevis muscles (tendons)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Extensor carpi radialis longus muscle (tendon) Right pointer: Extensor carpi radialis brevis muscle (tendon)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metacarpal artery II  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscles  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (tendons, cut off)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal ligament (compartments for extensor tendons opened)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Compartment for extensor digiti minimi muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process of ulna  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor indicis muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Intermuscular septum  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of radial nerve"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_141", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Nerve supply to deep lamina of supinator muscle\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle of humerus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Cubital joint capsule (position of head of radius)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anconeus muscle (cut off)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of radial nerve (to deep lamina of supinator muscle)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Recurrent interosseous artery Right pointer: Dorsal interosseous artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral antebrachial cutaneous nerve  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent radial artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of radial nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle (deep layer)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle '(superficial layer, resected)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_142", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Nerve supply to supinator muscle\n\t\t\t\t\t\t\t\t\t\tThe superficial lamina of the supinator has been detached from its origin and reflected upward.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of radial nerve (to supinator muscle)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent radial artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of radial nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of recurrent radial artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle (superficial belly , reflected from origin)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent interosseous artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle (origin of superficial lamina)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle (deep lamina)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anconeus muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_143", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Recurrent radial artery\n\t\t\t\t\t\t\t\t\t\tSeveral branches of the artery have been cut off. These supplied the extensor muscles shown in previous views.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle (cut close to origin)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of radial nerve  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Terminal superficial branch of recurrent radial artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Origin of extensor carpi radialis brevis muscle Lower painter: Origin of common extensor digitorum muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Cubital joint capsule (position of head of radius)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch radial  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent radial artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar vein  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle (superficial belly)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle (deep lamina)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_144", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Nerve supply to anconeus muscle\n\t\t\t\t\t\t\t\t\t\tThe anconeus (5) has been cut from its origin and reflected downward.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle of humerus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (tendon of insertion)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of radial nerve (to anconeus muscle)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of head of radius  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anconeus muscle (reflected)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent interosseous artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of radial nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent radial artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle (superficial layer)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle (deep layer)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_145", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Anconeus muscle\n\t\t\t\t\t\t\t\t\t\tA lateral expansion of the tendon of insertion of the triceps muscle which covered the anconeus has been partially cut away.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle of humerus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle (tendon of insertion)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anconeus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent interosseous artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi ulnaris muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna (covered by periosteum)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch of recurrent radial artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_146", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Nerve supply to extensor carpi radialis brevis muscle\n\t\t\t\t\t\t\t\t\t\tThe muscle has been detached and retracted dorsally. The specimen has been turned so that the radial border of the forearm lies in the foreground of the view.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Median nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (divided but not reflected)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle (area of insertion)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Brachioradialis muscle (tendon of insertion) Left pointer: Extensor carpi radialis longus muscle (tendon of insertion)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle (dissected)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch radial artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of radial nerve (to extensor carpi radialis brevis muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of radial nerve"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_147", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Nerve supply to extensor digitorum communis muscle\n\t\t\t\t\t\t\t\t\t\tThe muscle has been retracted downward.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of head of radius (covered by articular capsule)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Supinator muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (retracted)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of radial nerve (muscular branches)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of dorsal interosseous artery  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Muscular branch of radial nerve (to extensor carpi radialis brevis muscle) Right pointer: Deep branch of radial nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_148", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Nerve supply to extensor digiti quinti proprius muscle\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle of humerus  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi ulnaris muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digiti minimi muscle (reflected downward)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral antebrachial cutaneous nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of radial nerve  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of radial nerve (to extensor digiti minimi muscle)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_149", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Nerve supply to extensor carpi ulnaris muscle\n\t\t\t\t\t\t\t\t\t\tThe muscle has been cut from its origin and pulled downward. The brachioradialis and extensor carpi radialis longus muscles have been removed.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle of humerus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent radial artery  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anconeus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent interosseous artery  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi ulnaris muscle (retracted)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulna  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digiti minimi muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous artery  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of radial nerve (cut)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral antebrachial cutaneous nerve (cut)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of radial nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of radial nerve (to extensor carpi ulnaris muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_150", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Nerve supply to extensor carpi radialis longus muscle\n\t\t\t\t\t\t\t\t\t\tThe brachioradialis muscle has been retracted upward and the extensor carpi radialis longus has been detached from its origin and reflected laterally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle (area of origin)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle (area of origin)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle of humerus  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of radial nerve (to extensor carpi radialis longus muscle)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle (reflected laterally)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent radial artery  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle (retracted upward)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of radial nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of radial nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_151", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Nerve supply to brachioradialis muscle\n\t\t\t\t\t\t\t\t\t\tThe muscle has been detached from its origin and retracted laterally.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal antebrachial cutaneous nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle (retracted laterally from origin)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of radial nerve (to brachioradialis muscle)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral antebrachial cutaneous nerve  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Biceps brachii muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of radial nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of radial nerve  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Pronator teres muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_152", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Extensor muscles separated\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis.m.  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Extensor carpi radialis longus muscle (tendon of insertion) Right pointer: Extensor carpi radialis brevis muscle (tendon of insertion)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle (tendon of insertion)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle (tendon of insertion)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal II  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle of humerus  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anconeus muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi ulnaris muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digiti minimi muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal ligament"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_153", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Relations of extensor muscles to ulnar border of forearm\n\t\t\t\t\t\t\t\t\t\tThe specimen shown in the previous view has been turned medially so that the relation of the ulna (15) to the extensor muscles (above) and the flexor muscles (below) is visible.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal antebrachial cutaneous nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lateral epicondyle of humerus  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anconeus muscle  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digiti minimi muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi ulnaris muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process of ulna  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar nerve (in sulcus of ulnar nerve)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Medial epicondyle of humerus  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Middle antibrachial cutaneous nerve  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle (ulnar head)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Basilic vein  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Body of ulna  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal hand branch of ulnar nerve"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_154", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Superficial layer of extensor muscles, general view\n\t\t\t\t\t\t\t\t\t\tThe antibrachial fascia has been removed and the brachial fascia cut away from the lower part of the arm.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachial fascia  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal antebrachial cutaneous nerve  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Triceps brachii muscle  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Olecranon  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anconeus muscle  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi ulnaris muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor digiti minimi muscle  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tributary of basiic vein (communicates with dorsal interosseous veins)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Styloid process of ulna  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal hand branch of ulnar nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachialis muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Brachioradialis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of radial nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal carpal ligament"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_155", "text": "Dorsal aspect of right forearm\n\t\t\t\t\t\t\t\t\t\t Superficial vessels and nerves; antibrachial fascia\n\t\t\t\t\t\t\t\t\t\tThe skin has been removed except at the borders of the forearm and hand. The proximal third of the forearm is not shown.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal antebrachial cutaneous nerve  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Antibrachial fascia  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Cephalic vein (and tributary veins)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial branch of radial nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal venous rete of the hand  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metacarpal veins  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Digital venous arch  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal hand branch of ulnar nerve  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Location of styloid process of ulna  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Skin and superficial fascia at margin of dissection"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_156", "text": "Lateral aspect of right hand\n\t\t\t\t\t\t\t\t\t\t Insertion and of second lumbrical and second dorsal interosseous muscles on lateral side of middle finger\n\t\t\t\t\t\t\t\t\t\tThe index finger has been removed by transecting the second metacarpal bone and the muscles, vessels and nerves of the finger. The second lumbrical and second dorsal interosseous muscles can be traced to their insertions on the middle finger. The latter muscle inserts partly into the extensor expansion (2) and partly into the base of the first phalanx. Fascia (18) of the lumbrical muscle has been incised and reflected to demonstrate the \"lumbrical canal.\"\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligament of digital sheath  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Extensor expansion Right pointer: Location of metacarpophalangeal joint  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle II (left pointer, insertion into extensor expansion; right pointer, insertion into base of proximal phalanx)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle II  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep transverse metacarpal ligament  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metacarpal artery II  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous muscle I  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal II (transected)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (tendon to index finger, transected)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch dorsal metacarpal artery I (dorsal digital artery)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor pollicis muscle (transverse head)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial palmar arch  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Flexor digitorum superficialis (cut) Middle pointer: Flexor digitorum profundus muscle (cut) Right pointer: Lumbrical muscle I  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Anterior common digital artery Right pointer: Common palmar digital nerve of median nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial septa which extended from palmar aponeurosis (removed) to anterior interosseous fascia and, indirectly, to metacarpal bones  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous fascia  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial extension around lumbrical muscle II (incised and reflected to expose \"lumbrical canal\")"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_157", "text": "Lateral aspect of right hand\n\t\t\t\t\t\t\t\t\t\t Nerve and blood supply to first dorsal interosseous muscle\n\t\t\t\t\t\t\t\t\t\tThe muscle has been detached from its origin on the first metacarpal bone and dissected. The course of the deep branch of the ulnar nerve toward its point of entry into this muscle is shown in 105-1.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Common extensor digitorum muscle (tendon to index finger)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor indicis muscle (tendon of insertion)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metacarpal artery II  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal II  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle II (dorsal interosseous fascia removed)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metacarpal artery III  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal metacarpal artery I (displaced)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis brevis muscle (tendon of insertion)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor carpi radialis longus muscle (tendon of insertion)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpotrapezial joint capsule  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery continuing into deep palmar arch  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal digital arteries  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch radial artery (to dorsal interosseous muscle I)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of ulnar nerve (to dorsal interosseous muscle I)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I (dissected)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle (tendon of insertion)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle (tendon of insertion)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor expansion of thumb  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Distal continuation of tendon of of extensor pollicis longus muscle"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_158", "text": "Lateral aspect of right hand\n\t\t\t\t\t\t\t\t\t\t Relations of first dorsal interosseous, first lumbrical and adductor pollicis muscles\n\t\t\t\t\t\t\t\t\t\tThe fascia has been removed from the muscles.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of metacarpophalangeal joint of index finger  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle I  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch dorsal metacarpal artery I (dorsal digital artery)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal digital nerves of radial nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor pollicis muscle (transverse head)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch dorsal metacarpal artery I (dorsal digital artery)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Tributary to cephalic vein  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis brevis muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal I  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis brevis muscle (tendon of insertion)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor pollicis longus muscle (tendon of insertion)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Position of metacarpophalangeal joint of thumb  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Extensor expansion  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper palmar digital nerve of median nerve  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper palmar digital artery"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_159", "text": "Volar aspect of right hand\n\t\t\t\t\t\t\t\t\t\t Branches of deep volar arch\n\t\t\t\t\t\t\t\t\t\tNutrient, perforating and muscular branches of the deep volar arch have been exposed by removing parts of the dorsal interosseous muscles. Other branches of the arch have been shown in previous views.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep palmar arch  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior metacarpal artery (cutoff)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of deep palmar arch (to dorsal interosseous muscle II)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Princeps pollicis artery Right pointer: Digital branch of radial artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of deep palmar arch (to dorsal interosseus muscle I)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating branch  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular branch of deep palmar arch  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpotrapezial joint capsule  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle of trapezium bone  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle (tendon of insertion)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior carpal branch radial artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Radius  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Distal radioulnar joint capsule Right pointer: Ulna  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior radiocarpal ligament  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle (insertion)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Pisohamate ligament Left pointer: Pisometacarpal ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular branches of ulnar artery  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Recurrent carpal branch of deep palmar arch  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Perforating branches  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep anterior branch ulnar artery (cut off)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Nutrient branches of deep palmar arch to metacarpals  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal V  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscles II-IV (partially resected)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_160", "text": "Volar aspect of right hand\n\t\t\t\t\t\t\t\t\t\t Dorsal interosseous muscles\n\t\t\t\t\t\t\t\t\t\tThe volar interossei have been removed but the areas of origin (4) and tendons of insertion (7) of these muscles are indicated.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep palmar arch  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of ulnar nerve (to dorsal interossei)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscles I-IV  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Areas of origin of anterior interosseous muscles  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of origin of adductor pollicis muscle (transverse head)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous muscles (tendons of insertion)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscles II-IV  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscle with morphological similarity to anterior interossei (see 105-3)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal I  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Princeps pollicis artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle (tendon of insertion)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial anterior branch radial artery  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Tubercle of trapezium bone  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Hamulus of hamate bone  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Deep branch of ulnar nerve Right pointer: Articular branch of deep branch of ulnar nerve  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep anterior branch ulnar artery (cut off)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior metacarpal artery"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_161", "text": "Volar aspect of right hand\n\t\t\t\t\t\t\t\t\t\t Volar and dorsal interosseous muscles\n\t\t\t\t\t\t\t\t\t\tThe adductor pollicis muscle has been removed. The volar interosseous fascia and transverse capsular ligaments have been cut away to display the interosseous muscles. The first dorsal interosseous muscle has been detached from its origin on the first metacarpal bone. An independent, small muscle (8) remains attached to the first metacarpal. This corresponds in origin and insertion with the regular volar interosseous muscles.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle I  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Head of metacarpal II  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpophalangeal joint capsule  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Articular branches of deep branch of ulnar nerve  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseus muscle II  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous muscle I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscle with origin and insertion corresponding to that of other anterior interossei  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal I  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Princeps pollicis artery  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of flexor carpi radialis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpotrapezial joint capsule  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse carpal ligament (cut)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Area of origin of flexor pollicis brevis muscle (deep head) Lower pointer: Origin of adductor pollicis muscle (oblique head)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Hamulus of hamate bone  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of ulnar nerve (branches to interosseous muscles visible but not labeled)  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep palmar arch  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep anterior branch ulnar artery (cut off)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior metacarpal artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle III  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous muscle II  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle IV  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Anterior interosseous muscle III Right pointer: Articular branch of deep branch of ulnar nerve  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior accessory ligament"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_162", "text": "Volar aspect of right hand\n\t\t\t\t\t\t\t\t\t\t Nerve supply to oblique head of adductor pollicis and deep head of flexor pollicis brevis muscles\n\t\t\t\t\t\t\t\t\t\tThe transverse head (22) of the adductor pollicis has been cut close to its origin from the shaft of the third metacarpal bone. The oblique head (6) has been divided and dissected to show the course of branches from the deep ramus of the ulnar nerve.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep transverse metacarpal ligament  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle I  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous muscle I  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous fascia  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor pollicis muscle (oblique head, divided)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscle fascicle with origin from shaft of first metacarpal and insertion on base of first phalanx (independent of deep head of flexor pollicis brevis and comparable to anterior interosseous muscles; frequently referred to as first anterior interosseous muscle)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Princeps pollicis artery  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis brevis muscle (deep head, dissected)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of ulnar nerve (to dorsal interosseous muscle I)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of ulnar nerve (to oblique head of adductor pollicis muscle and deep part of flexor pollicis brevis muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpotrapezial joint capsule  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse carpal ligament  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior carpal rete  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle (tendon of insertion)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Pisiform bone (covered by ligament)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch ulnar artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Pisometacarpal ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Branch perforans (from recurrent carpal branch of deep anterior arch)  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of ulnar nerve  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep palmar arch  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor pollicis muscle (transverse head, near origin)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Dorsal interosseous muscle III Lower pointer: Anterior interosseous muscle II  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal V  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior accessory ligament  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Digital fibrous sheath (transected, flexor tendons removed)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_163", "text": "Volar aspect of right hand\n\t\t\t\t\t\t\t\t\t\t Nerve supply to transverse head of adductor pollicis muscle\n\t\t\t\t\t\t\t\t\t\tThe muscle has been cut and dissected to show the intramuscular course of branches of the deep branch of the ulnar nerve.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of ulnar nerve (upper pointer, to dorsal interosseous muscle I; lower pointer, to flexor pollicis brevis muscle)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of ulnar nerve (to adductor pollicis muscle)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep transverse metacarpal ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor pollicis muscle (transverse head)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle I  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis brevis muscle (area of insertion)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal I  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis brevis muscle (deep head)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor pollicis muscle (oblique head)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Radiocarpal ligament (pointer on capitate bone covered by ligament)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle (tendon of insertion)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Pisiform bone  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of ulnar nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep palmar arch  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Opponens digiti minimi muscle (dissected and retracted medially)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior metacarpal arteries  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle III  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous muscle II  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Dorsal interosseous muscle IV Right pointer: Anterior interosseous muscle III"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_164", "text": "Volar aspect of right hand\n\t\t\t\t\t\t\t\t\t\t Thenar muscles; deep volar arch; deep branch of ulnar nerve\n\t\t\t\t\t\t\t\t\t\tThe volar interosseous fascia has been partially cut away.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of digital sheath II  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep transverse metacarpal ligament  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of ulnar nerve (to lumbrical muscle II)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle II  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous fascia (partially resected)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle III  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle IV  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle I  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis longus muscle (tendon of insertion)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle I  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis brevis muscle (insertion)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis brevis muscle (area of insertion of superficial head)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor pollicis muscle (transverse head)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Opponens pollicis muscle  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis brevis muscle (deep head)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor pollicis muscle (oblique head)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpotrapezial joint capsule  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse carpal ligament  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Volar carpal rete  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Superficial anterior branch radial artery  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch ulnar artery (in position usually occupied by deep anterior branch ulnar artery)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of ulnar nerve  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of ulnar nerve (to opponens digiti minimi muscle)  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Opponens digiti minimi muscle (retracted medially)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep anterior branch ulnar artery (anomalous origin more distal than usual see 22 above)  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia separating hypothenar from interosseous muscles  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Deep palmar arch Right pointer: Deep anterior venous arch  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior metacarpal artery IV  30\n\t\t\t\t\t\t.\n\t\t\t\t\t Interosseous muscles"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_165", "text": "Volar aspect of right hand\n\t\t\t\t\t\t\t\t\t\t Thenar muscles\n\t\t\t\t\t\t\t\t\t\tThe second metacarpal bone has been transected and the index finger removed. The tendon of the flexor pollicis longus muscle (9) has been cut off. The abductor pollicis brevis (10) has been partially resected. The remaining thenar muscles have been separated. The palmar aponeurosis has been cut away and the flexor tendons have been removed from the carpal canal (16).\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor pollicis muscle (oblique head)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior common digital artery  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpal II (cut)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior radial index artery  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor pollicis muscle (transverse head)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Dorsal interosseous muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle II  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligament of digital sheath  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis longus muscle (tendon of insertion)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis brevis muscle (divided and partially removed)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis brevis muscle (left pointer superficial head; right pointer deep head)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Opponens pollicis muscle  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for tendon of flexor pollicis longus muscle  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor pollicis longus muscle (tendon of insertion)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle (tendon of insertion)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Carpal tunnel  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior carpal ligament  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery and nerve  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse carpal ligament  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi muscle  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Left pointer: Deep branch of ulnar nerve Right pointer: Deep anterior branch ulnar artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous fascia  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior common digital artery  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascial septum between palmar aponeurosis and anterior interosseous fascia  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse fascicle of palmar aponeurosis"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_166", "text": "Volar aspect of right hand\n\t\t\t\t\t\t\t\t\t\t Nerve supply to third and fourth lumbrical muscles and opponens digiti quinti muscle\n\t\t\t\t\t\t\t\t\t\tThe flexor tendons and lumbrical muscles have been retracted distally. The opponens digiti quinti muscle has been dissected.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of common tendon of flexor muscles (opened, tendons and lumbrical muscles reflected distally)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle III  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle IV  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (tendon to fifth finger)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle I (cut off)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor pollicis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis brevis muscle (deep head)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Metacarpotrapezial joint capsule  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse carpal ligament  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Carpal tunnel  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of of ulnar nerve  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch ulnar artery (in position usually occupied by deep anterior branch ulnar artery)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep branch of ulnar nerve  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor and abductor digiti minimi muscles (area of origin)  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of ulnar nerve (to opponens digiti minimi muscle)  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Opponens digiti minimi muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep anterior branch ulnar artery (aberrant origin more distal than usual)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous fascia  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of ulnar nerve (to Iumbrical muscle III)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper palmar digital artery  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of ulnar nerve (to lumbrical muscle IV)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor and abductor digiti minimi muscles (area of insertion)  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon of digital sheath V (opened)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_167", "text": "Volar aspect of right hand\n\t\t\t\t\t\t\t\t\t\t Nerve supply to second lumbrical muscle, close-up view\n\t\t\t\t\t\t\t\t\t\tThe flexor tendons and lumbrical muscles of the third, fourth and fifth fingers have been retracted medially. The second lumbrical muscle (5) has been dissected. Its nerve (4) in this instance is a branch of the deep volar branch of the ulnar nerve which reaches the muscle after passing through the adductor pollicis muscle. Usually the second lumbrical receives its nerve supply from the median nerve.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle I  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (tendon to index finger)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep transverse metacarpal ligament  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of ulnar nerve (to lumbrical muscle II)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle II  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (tendon to third finger)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle III (retracted medially)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (tendon to fourth finger)  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle IV (upper pointer on accessory muscular slip to ulnar side of fourth finger)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor pollicis muscle (transverse head)  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Groove for tendon of flexor pollicis longus muscle  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branches of median nerve (to lumbrical muscle I)  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of ulnar nerve (to flexor pollicis brevis muscle)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia over adductor pollicis muscle (partially resected)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Branches of anterior metacarpal artery III  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseous fascia  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Deep anterior branch ulnar artery  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior metacarpal artery IV  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of ulnar nerve (to lumbrical muscle III)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Opponens digiti minimi muscle  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Proper palmar digital artery"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_168", "text": "Volar aspect of right hand\n\t\t\t\t\t\t\t\t\t\t Flexor tendons reflected from carpal canal; volar interosseous fascia\n\t\t\t\t\t\t\t\t\t\tThe posterior walls of the common synovial sheath (18) and the sheath of the flexor pollicis longus (14) have been preserved within the carpal canal. These sheaths appear to be continuous in this dissection. However, at a time when both sheaths were intact, air injected into one did not pass into the other. A prominent ridge (16) marks the line of attachment of the mesotendon within the common sheath.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (tendon to index finger)  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (tendon to index finger)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis longus muscle (tendon of insertion)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Area of insertion of abductor pollicis brevis muscle and flexor pollicis brevis muscle (superficial head)  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscle I (branches of median nerve visible as they enter muscle)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor pollicis muscle  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis brevis muscle (deep head)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscle slip originating with flexor pollicis brevis muscle and inserting with opponens pollicis muscle  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Opponens pollicis muscle (area of insertion)  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Carpometacarpal joint capsule  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Opponens pollicis muscle (remnant of proximal part of muscle)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Transverse carpal ligament  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi radialis muscle (tendon of insertion)  14\n\t\t\t\t\t\t.\n\t\t\t\t\t Tendon sheath of flexor pollicis longus muscle (posterior wall exposed by removing tendon)  15\n\t\t\t\t\t\t.\n\t\t\t\t\t Radial artery  16\n\t\t\t\t\t\t.\n\t\t\t\t\t Cut edge of mesotendon of flexor digitorum muscles  17\n\t\t\t\t\t\t.\n\t\t\t\t\t Fascia covering pronator quadratus muscle  18\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of common tendon of flexor muscles (posterior wall exposed by reflecting tendons)  19\n\t\t\t\t\t\t.\n\t\t\t\t\t Ulnar artery and nerve  20\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor carpi ulnaris muscle (insertion into pisiform bone)  21\n\t\t\t\t\t\t.\n\t\t\t\t\t Right pointer: Muscular branch ulnar artery (in usual position of deep anterior branch ulnar artery) Left pointer: Deep branch of ulnar nerve  22\n\t\t\t\t\t\t.\n\t\t\t\t\t Upper pointer: Fascia of adductor pollicis muscle Lower pointer: Deep anterior branch ulnar artery (aberrant position, see 21 above)  23\n\t\t\t\t\t\t.\n\t\t\t\t\t Opponens digiti minimi muscle  24\n\t\t\t\t\t\t.\n\t\t\t\t\t Anterior interosseus fascia  25\n\t\t\t\t\t\t.\n\t\t\t\t\t Muscular branch of ulnar nerve (to lumbrical muscle III)  26\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi muscle  27\n\t\t\t\t\t\t.\n\t\t\t\t\t Sheath of common tendon of flexor muscles (distal limit on deep aspect of reflected tendons)  28\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  29\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (deep surfaces of tendons reflected distally)"}
{"_id": "stanford_medicine_upper_extremity_clean$$$corpus_169", "text": "Volar aspect of right hand\n\t\t\t\t\t\t\t\t\t\t Insertions of flexor tendons\n\t\t\t\t\t\t\t\t\t\tThe digital tendon sheaths have been opened and the flexor tendons elevated. The hand is viewed somewhat from its medial aspect.\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t 1\n\t\t\t\t\t\t.\n\t\t\t\t\t Heavy fascial bands extending along sides of fingers  2\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum profundus muscle (tendon of insertion)  3\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis longus muscle (insertion)  4\n\t\t\t\t\t\t.\n\t\t\t\t\t Proximal limit of synovial sheath of third finger  5\n\t\t\t\t\t\t.\n\t\t\t\t\t Adductor pollicis muscle (transverse head)  6\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digitorum superficialis (tendons of insertion)  7\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor pollicis brevis muscle (deep head)  8\n\t\t\t\t\t\t.\n\t\t\t\t\t Lumbrical muscles  9\n\t\t\t\t\t\t.\n\t\t\t\t\t Flexor digiti minimi muscle  10\n\t\t\t\t\t\t.\n\t\t\t\t\t Abductor digiti minimi muscle  11\n\t\t\t\t\t\t.\n\t\t\t\t\t Ligament of digital sheath (cut edge)  12\n\t\t\t\t\t\t.\n\t\t\t\t\t Vincula longa  13\n\t\t\t\t\t\t.\n\t\t\t\t\t Vincula brevia"}