The male pelvic floor is a complex structure formed by several muscles. The levator ani muscle and the perineal muscles are important components of the pelvic floor. The perineal muscles comprise the external anal sphincter, bulbospongiosus, superficial transverse perineal muscles, and ischiocavernosus. Although the connections of the muscles of the pelvic floor have been reported recently, the anatomical details of each muscle remain unclear. In this study, we examined the male pelvic floor to clarify the connection between the muscles related to function. Fifteen male pelvises were used for microscopic dissection, and three male pelvises were used for histological examination. On the lateral aspect, the perineal muscles were connected to each other. Bundles of the levator ani muscle extended to connect to the perineal muscles. In addition, the extended muscle bundle from the levator ani muscle and the perineal muscles surround the external urethral sphincter. On the medial aspect, the levator ani muscle and the external anal sphincter form the anterior and posterior muscular slings of the anal canal. The connection between the perineal muscles and levator ani muscle indicates a possible close relationship between the functions of the urethra and anus.
The region anterior to the anal canal in women is composed of intertwined smooth and skeletal muscles. The present study aimed to clarify skeletal muscle morphology in the anterior region of the anal canal. The pelvic floor muscles of 28 pelvic halves from 16 female cadavers (mean age 79.75 years) were dissected from the inferior aspect to examine the perineal muscles, followed by midline transection and dissection from the inner surface to examine the pelvic outlet muscles. The bulbospongiosus muscle was found to be attached to the lateral surface of the external anal sphincter. The superficial transverse perineal muscle crossed superiorly to the bulbospongiosus and coursed medially toward its contralateral muscle bundle deep to the anterior portion of the external anal sphincter. The superficial transverse perineal muscle formed the middle sling. From the medial aspect, the anterior part of the levator ani was divided into anterior and posterior bundles to form the anterior and posterior slings, respectively. This study proposes that three muscular slings could be important in supporting the pelvic floor in women. In addition, this study shows that the anterior skeletal muscular wall of the anal canal is composed of the anterior muscle bundle of the levator ani, superficial transverse perineal, and proper external anal sphincter muscles.
Background Posterior shoulder instability was reported to be more common than had been previously reported. However, the detailed morphology of the origin of the long head of the triceps brachii (LHT), which is located at the posteroinferior part of the glenohumeral joint and associated with the stability of the head of the humerus, has been unknown. The purpose of the current study was to clarify the detailed morphology of the origin of the LHT. Methods A total of 64 specimens from 36 cadavers (11 males and 25 females) were used. After dissecting the origin of the LHT in 54 specimens of 27 cadavers, the width of the origin of the LHT was measured with a caliper by 2 observers. The origin of the LHT was also investigated histologically in 18 specimens. Sections were analyzed with Masson’s trichrome staining and Safranin O staining. Results Some fibers of the LHT originated more from the cranial area than from the infraglenoid tubercle and descended along the posterior rim of the glenoid cavity. The width of the origin on the dorsal surface of the scapula was 31.2 mm. The origin from the bone had a developed uncalcified fibrocartilage histologically. In addition, the LHT was fused with the glenohumeral joint capsule and was attached to the glenoid labrum directly. Conclusions The LHT could affect the glenohumeral joint capsule or the glenoid labrum because of their connections to each other and be associated with the posterior shoulder instability indirectly.
As Thailand becomes an aged society it is important to promote advancements in geriatric medicine to provide the best care for older individuals. The right assistive facilities and household mobility equipment are essential for everyday activities. The use of home adaptations and assistive products can maximize the quality of life for older individuals and make life more convenient for those with disabilities. This study aimed to investigate the experience of occupational therapists, using home adaptations and assistive products. An individual interview was conducted with eight occupational therapists who worked at regional hospitals and centers of excellence throughout Thailand using a qualitative study. The results were interpreted through thematic analysis. Five main themes emerged: (1) empowering independent living at home, (2) accident prevention and safety, (3) family financial constraints and barriers, (4) availability and accessibility of products, and (5) matching products with clients’ capabilities and needs. Based on an occupational therapy approach, this study examines Thailand's needs for home adaptations and assistive products, as well as barriers to accessing those products and services. Through a contribution to knowledge and information based on occupational therapists' experience, the laws and regulations regarding home adaptations and assistive products for people with disabilities can be improved. Additionally, the interdisciplinary team and authorities involved in this issue should also collaborate to formulate guidelines for home adaptations and assistive products for older individuals and persons with disabilities in the future.
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