[Technical notes on mastectomy operations and axillary lymph-node excision with preservation of the pectoralis muscles].
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The trapezius is one of the critical targets of physical therapy for shoulder functional disorder because this muscle plays a great role in fixation and elevation of the shoulder. Trapezius (n = 63), latissimus dorsi (n = 5), pectoralis major (n = 7) and gluteus maximus (n = 7) muscles were obtained from 43 donated cadavers, and vascular morphologies were compared. An artery without a concomitant vein was found in 35 of 63 trapezius muscles. Moreover, twice as many venous merging sites as arterial branching sites were present in the trapezius. Notably, peripheral or distal venous tributaries were larger in caliber than the proximally located vein in 6.2% of all 404 venous merging sites in the trapezius. Moreover, similar paradoxical venous merging, in which tributaries were relatively thicker than drainage capacity of the venous trunk after merging according to Poisueille's law (peripheral or distal thickness >0.85 x proximal thickness), was observed in 39.1% (158 of 404 merging sites) in the trapezius, compared to 8-9% in the other 3 muscles. Given this vascular morphology, trapezius muscle seems likely to frequently display venous blood retention. Interestingly, venous valves were not observed in the trapezius, compared to 1-7 valves per one of the other 3 muscles. Abundant venous mergings without valves might form a venous network acting as a reservoir. Therefore, for the trapezius, collateral venous routes such as the external vertebral plexus are essential to provide additional peripheral drainage. However, sufficient muscle-pump function does not seem to be expected for trapezius muscle, given the venous courses parallel to muscle fibers.
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Computed tomography (CT) can demonstrate disorders of the chest wall muscles clearly. CT scans of the thorax were carried out in seven patients with Poland's Syndrome. All patients with Poland's Syndrome had the clavicular portion of the pectoralis major, but were lacking the sternocostal portion of the pectoralis major. The pectoralis minor was absent in four of seven patients.
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We have previously shown that subjects with traumatic tetraplegia use the clavicular portion of the pectoralis major to expire actively. To determine if we could improve the expiratory function of these subjects, we studied six patients in whom the pectoralis major was trained by repetitive, strenuous, isometric contractions for 6 wk. Six patients receiving conventional respiratory rehabilitation served as control subjects. Training of the pectoralis major produced marked increases in the maximal isometric muscle strength (mean +/- SE: 54.6 +/- 5.8%; p less than 0.005) and in expiratory reserve volume (46.6 +/- 9.9%; p less than 0.005). Functional residual capacity did not change, such that residual volume decreased by 14.1 +/- 2.9% (p less than 0.005). In contrast, the control patients did not develop any significant alterations. We conclude that unlike conventional rehabilitation, training the pectoralis major for strength improves expiratory function in tetraplegic subjects. Therefore, training of this muscle should increase the effectiveness of coughing and might reduce the prevalence of bronchopulmonary infections in such subjects.
A study was conducted to determine the influence of electrical stimulation (50,200, or 350 V ac) on biochemical and textural changes in broiler breast muscle. Sixty-four broilers were stunned (50 V ac) prior to kill, and all but a control group were pulse stimulated during bleeding. After processing, carcasses were held in 10-C water for 1 h, then in 2-C ice/water slush for 1 h prior to muscle removal at 2 h post-mortem (PM). Bagged samples were held at 2 C for 24 h, then cooked. The pH, R value (ratio of adenine nucleotides to inosine nucleotides), cook yield, fluids and solids lost (F&S), and objective texture were measured. In addition, 16 broilers processed in the same manner were used in producing a profile of sarcoplasmic protein/enzyme changes in the breast muscle by cation exchange fast protein-liquid chromatography at 10 min, 2, and 24 h PM. The R values and soluble protein were also determined. Stimulation at 200 and 350 V accelerated the onset of rigor noted by lower pH values at 10 min and 1 h PM, and higher R values at 2 h PM. Muscle stimulated at 350 V exhibited the lowest cook yield and highest percentage of F&S lost, suggesting both the loss of functional properties and muscle integrity due to this treatment. All control and stimulated samples exhibited shear values in excess of what would be considered tender. Hardness and chewiness values increased as stimulation voltage levels increased. Only one of the seven principal chromatographic peaks decreased in response to increased electrical stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)