An understanding of the structure and function of the human body is vital for anyone studying the medical and health sciences. In this book, Leslie Klenerman provides a clear and accessible overview of the main systems of the human anatomy, illustrated with a number of clear explanatory diagrams.
The problems of the patellofemoral joint remain a challenge to the orthopaedic surgeon. In spite of many articles in scientific journals, an outstanding monograph, and several excellent textbook chapters, the patella is still an enigma in many respects. The etiology of patellar pain is controversial, and there is no completely satisfying explanation for its cause or its relationship to chondromalacia. Curiously, neither the widespread use of arthroscopy nor the advent of newer diagnostic tests such as CT scanning and magnetic resonance imaging have cast much light. Without a better understanding of why patellar disorders occur it is not surprising that there is no consensus on how to fix them. Arthros copy has contributed little except to the patient's psyche. The currently most popular surgical treatment for recurrent dislocation of the patella was first described 50 years ago. One concrete advance, albeit a small one, is a better understanding of the role of anatomical abnormalities and patellofemoral dysplasia in patellar instabilities. It gives me great pleasure that many of the contributors are, like Dr.
The aim of this treatise is to summarize the current understanding of the mechanisms for blood flow control to skeletal muscle under resting conditions, how perfusion is elevated (exercise hyperemia) to meet the increased demand for oxygen and other substrates during exercise, mechanisms underlying the beneficial effects of regular physical activity on cardiovascular health, the regulation of transcapillary fluid filtration and protein flux across the microvascular exchange vessels, and the role of changes in the skeletal muscle circulation in pathologic states. Skeletal muscle is unique among organs in that its blood flow can change over a remarkably large range. Compared to blood flow at rest, muscle blood flow can increase by more than 20-fold on average during intense exercise, while perfusion of certain individual white muscles or portions of those muscles can increase by as much as 80-fold. This is compared to maximal increases of 4- to 6-fold in the coronary circulation during exercise. These increases in muscle perfusion are required to meet the enormous demands for oxygen and nutrients by the active muscles. Because of its large mass and the fact that skeletal muscles receive 25% of the cardiac output at rest, sympathetically mediated vasoconstriction in vessels supplying this tissue allows central hemodynamic variables (e.g., blood pressure) to be spared during stresses such as hypovolemic shock. Sympathetic vasoconstriction in skeletal muscle in such pathologic conditions also effectively shunts blood flow away from muscles to tissues that are more sensitive to reductions in their blood supply that might otherwise occur. Again, because of its large mass and percentage of cardiac output directed to skeletal muscle, alterations in blood vessel structure and function with chronic disease (e.g., hypertension) contribute significantly to the pathology of such disorders. Alterations in skeletal muscle vascular resistance and/or in the exchange properties of this vascular bed also modify transcapillary fluid filtration and solute movement across the microvascular barrier to influence muscle function and contribute to disease pathology. Finally, it is clear that exercise training induces an adaptive transformation to a protected phenotype in the vasculature supplying skeletal muscle and other tissues to promote overall cardiovascular health. Table of Contents: Introduction / Anatomy of Skeletal Muscle and Its Vascular Supply / Regulation of Vascular Tone in Skeletal Muscle / Exercise Hyperemia and Regulation of Tissue Oxygenation During Muscular Activity / Microvascular Fluid and Solute Exchange in Skeletal Muscle / Skeletal Muscle Circulation in Aging and Disease States: Protective Effects of Exercise / References
This book was written in an attempt to fill a serious gap in medieal literature. A coneise anatomieal text, incorporating an atlas of the vaseular anatomy of the vertebral column and spinal cord, it has been designed to suit the needs of ort ho pedie surgeons, neurosurgeons, and neurologists. We also fee! that this work will he!p give direetion to further studies on the morphology and physiology of spinal eirculation. The book begins with a diseussion of the origins of the arteries whieh supply the vertebral eolumn. It eontinues with adescription of the various regions of the spine, the eervieal, thoraeie, and lumbar, and of the arteries which supply the meninges and spinal cord, the veins of the verte bral column, and venous and arterial distribution within the spinal cord. Anatomie studies of the eireulation both in bones and in the spinal cord require the use of teehniques whieh are erude and time consuming. Essential to sueeess is aecess to fresh postmortem human bodies, so that injeetions into the vaseular systems may be attempted before any disseetion has been made in the course of the routine pathologie examination. Permission to pursue these partieular anatomie studies eannot be obtained as a matter of routine. Beeause of the restrieted availability of speeimens therefore, only random sam pIes can be obtained.
Metabolic Bone Disease, Third Edition is the new, expanded edition of the classic text, featuring the latest advancements and research information in this fast-moving field. The Third Edition includes the most up-to-date information on molecular mechanisms, basic biology, pathophysiology, and diagnosis and management strategies of metabolic bone disease. - Edited by "fathers of the field" - An expanded version of a classic AP text - Complete coverage of a fast-growing field