By K. Kasim. Washington & Lee University.

Furthermore buy 30 caps rumalaya fort fast delivery,because of the in- Knowledge Check credible complexity of these body regions buy discount rumalaya fort 30caps online,they are susceptible to numerous congenital conditions that occur during prenatal 21. List the clinically important structures that can be ob- penchant for contact sports and fast-moving vehicles, puts the served or palpated in the buttock and lower extremity. Surface and Regional © The McGraw−Hill Anatomy, Sixth Edition Anatomy Companies, 2001 Chapter 10 Surface and Regional Anatomy 331 Iliacus m. Surface and Regional © The McGraw−Hill Anatomy, Sixth Edition Anatomy Companies, 2001 332 Unit 4 Support and Movement Patella Patella Patellar ligament Patellar ligament Tibialis anterior m. Tendo calcaneus Inferior extensor retinaculum Superior extensor retinaculum Tendons of extensor digitorum longus m. Surface and Regional © The McGraw−Hill Anatomy, Sixth Edition Anatomy Companies, 2001 Chapter 10 Surface and Regional Anatomy 333 readily gain access to the internal structures of the head and neck Sciatic n. Also, the risk for contracting certain diseases is greatly increased by the social na- Biceps femoris m. Developmental Conditions Congenital malformations of the head and neck regions result from genetic or environmental causes and are generally very seri- Common fibular ous. The less severe malformations may result in functional dis- nerve ability, whereas the more severe malformations usually make life Tibial nerve impossible. The cause of anencephaly is unknown, but genetic and geographic Gastrocnemius m. South Wales, for example, reports incidences of anencephaly as high as 1 in every 105 births. It occurs more frequently in females than males, and the damage to the developing embryo occurs between day 16 and day 26 following conception. Mi- crocephaly is characterized by premature closure of the sutures of the skull. If the child is untreated, underdevelopment of the brain and mental retardation will result. A cleft palate and cleft lip is a common congenital condi- tion of varying degrees of severity. A bilateral, or double, cleft occurs when the maxillary and median nasal process on both sides fail to unite.

Mulligan SA buy rumalaya fort 30caps fast delivery, Schwartz ML buy rumalaya fort 30caps amex, Broussard MF, Andrews JR masses and dynamic forces. In the pronator syndrome, (2000) Heterotopic calcification and tears of the ulnar collat- compression occurs as the median nerve passes between eral ligament: radiographic and MR imaging findings. Am J the two heads of the pronator teres and under the fibrous Roentgenol 175(4):1099-1102 10. O’Driscoll SW (2000) Classification and evaluation of recur- arch of the flexor digitorum profundus. Clin Orthop 370:34-43 The radial nerve can become entrapped following di- 11. Potter HG, Weiland AJ, Schatz JA, Paletta GA, Hotchkiss RN rect trauma, mechanical compression by a cast or overly- (1997) Posterolateral rotatory instability of the elbow: useful- ing space-occupying mass, or a dynamic compression as ness of MR imaging in diagnosis. Radiology 204(1):185-189 a result of repeated pronation, forearm extension, and 12. Dunning CE, Zarzour ZD, Patterson SD, Johnson JA, King GJ (2001) Ligamentous stabilizers against posterolateral rotatory in- wrist flexion, as is seen in violinists and swimmers. J Bone Joint Surg Am 83-A(12):1823-1828 Motor neuropathy of the hand extensors is a dominant 13. Bredella MA, Tirman PF, Fritz RC, Feller JF, Wischer TK, feature when the posterior interosseous nerve is en- Genant HK (1999) MR imaging findings of lateral ulnar col- trapped. Rosenberg ZS, Beltran J, Cheung YY (1994) Pseudodefect of Sports Med 26(3):193-205 the capitellum: potential MR imaging pitfall. Rosenberg ZS, Beltran J, Cheung Y, Broker M (1995) MR 61(6A):832-839 imaging of the elbow: normal variant and potential diagnostic 17.

Familial Disapproval It is far more comfortable generic rumalaya fort 30caps on-line, although not essential buy rumalaya fort 30 caps on-line, if the immediate family approves of the surgery. If there is disapproval, then less-than- optimal results may produce a reaction of, “See, I told you so! Patients You Do Not Like (or Who Do Not Like You) Regardless of the surgeon’s personality, in life there are people you simply do not like or who do not like you. A clash of personalities for what- ever reason is bound to affect the outcome of the case, regardless of the actual quality of the postoperative result. No matter how interesting such a case may appear, it is far better to decline the patient. The “Surgiholic” A patient who has had various plastic surgery procedures performed and who is a “surgiholic” often is attempting to compensate for a poor self-image with repeated surgeries. In addition to the implications of such a personality pattern, the surgeon is also confronted with a more difficult anatomical situation because of the previous surgeries. Often, the percentage of achievable improvement is not worth the risk of the procedure. Generally speaking, there is a clear risk–benefit ratio to every surgi- cal procedure. If the risk–benefit ratio is favorable, the surgery should probably be encouraged and has a reasonable probability of success. If the risk–benefit ratio is unfavorable, then the reverse not only applies but the unintended consequences of the unfavorable outcome may turn out to be disproportionate to the surgical result. The only way to avoid 190 Gorney this debacle is to learn how to distinguish those patients whose body image and personality characteristics make them unsuitable for the surgery that they seek. THE WHEEL OF MISFORTUNE: EXPOSURES MOST LIKELY TO GENERATE CLAIMS It should come as no surprise that the overwhelming majority of all malpractice claims lodged against plastic and reconstructive surgeons are concentrated in a handful of aesthetic surgery operations. Unlike other surgical specialists, the plastic surgeon attending a patient who seeks aesthetic improvement is not trying to make a sick patient well, but rather a well patient better. This not only places a heavier burden of responsibility on the operating surgeon but also subjects him or her to a broader range of possible reasons for unhappiness. Sources of dis- satisfaction can range from a poor result to something as unpredictable as a patient’s hidden emotional agenda or a simple communications failure.