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The chordae tendinae take as restricting cables to limit this noteworthy stir of the mitral leaflets buy unisom 25mg with visa sleep aid app for iphone, facilitating their coaptation buy genuine unisom on line sleep aid hypnosis. Papillary muscle contraction tensions the chordae order unisom cheap online sleep aid light bulb, providing another arrangement by which the chordae frustrate disproportionate leaflet activity buy unisom 25 mg amex insomnia music. In summing-up to chordal part in days mentioned generic confido 60 caps with amex, papillary muscle ischemia or infarction may undertaking the mitral apparatus to prove inadequate purchase cyklokapron canada, resulting in acute mitral regurgitation discount phenergan online mastercard. This latter basically time becomes ostensible during mitral valve replacement because numberless chordal attachments to the papillary muscles are intentionally severed. The tricuspid valve is normally composed of anterior, succeeding, and septal leaflets. Conspicuously, the proximal open coronary artery lies within this furrow, and the vessel be required to be carefully avoided during tricuspid valve repair or replacement. A after view (properly) shows left-hand circumflex and buttocks descending coronary arteries. Distal connections or collateral vessels between the principal coronary arteries may also provide an substitute route of blood abundance to regions of myocardium that story distal to a turbulent stenosis or occlusion. Unusually, the improvement of coronary collaterals in rejoinder to persistent myocardial ischemia is highly variable and quite unpredictable in patients with coronary artery disease. Be that as it may, this is not unexceptionally the event, as both vessels perfuse the posterior-medial papillary muscle in the remaining patients. Note that most hand coronary purl occurs during diastole while right coronary go (and coronary sinus flow) occurs mostly during late systole and at diastole. The piercing branches dole out into stupid capillary networks located parallel to the myocardial bundles. Arterial branches with diameters between 50 and 500 Ојm appearance interconnecting anastomoses (Fig. Coronary collaterals between another branches of the unvaried coronary artery or between branches of two unusual coronary arteries are also variably today. Coronary collateral blood drift is usually minimal in the dearth of a hemodynamically expressive stenosis because the driving load across the collateral vessel is evenly matched. It stands to ratiocinate that the measure of coronary collateral formation commonly determines whether patients with 749 coronary artery sickness intention increase anginal symptoms in feedback to increases in myocardial oxygen consumption. Outline 12-5 A: Diagram of the arterial-to-arterial and venous-to-venous anastomoses of the coronary arterial arrangement, which appropriate distraction of swirl if one distribution becomes blocked. B: Diagram of the epicardial coronary vessels lying on the cardiac muscle surface, the percipient immersed vessels, and the subendocardial arterial plexus connecting the deep vessels. Most commonly, there are two coronary veins located along either side of each larger coronary arterial branch. The pure coronary veins converge into the coronary sinus that empties into the bottom aspect of the advantageous atrium straightaway upstairs the tricuspid valve. As in other capillary beds, coronary capillaries are the sites for the purpose oxygen and carbon dioxide barter and looking for the swing of larger molecules . Impulse Conduction the apparatus via which the heartlessness is electrically activated is vital an eye to its playing. Decreases in firing fee, delays or blockade of universal conduction, or the aspect of supportive pacemakers . Histologic grilling of atrial myocytes hardly ever allows differentiation of cells that are specifically elaborate in the internodal pathway, but the one of a kind conducting characteristics of these specialized myocytes may be indubitably identified in the electrophysiology laboratory. This is the putative organization nearby which the gather together of Kent produces Wolff“Parkinson“Unblemished syndrome. Two other determinants of coronary surge are utensil size and blood viscosity, but these factors are comparatively persistent. Resting coronary blood glide in the grown up is take 250 mL/min (1 mL/min/g; 5% of normal matured cardiac result). As a fruit, the subendocardial layer is much more susceptible to ischemia when a flow-limiting coronary stenosis, pressure-overload hypertrophy, or distinct tachycardia is today. Coronary blood course is also reduced when aortic diastolic influence is crestfallen, such as occurs in acute aortic valvular insufficiency. Another noted determinant of coronary blood swirl is coronary vascular refusal stimated using the proportion of coronary blood run to perfusion influence), which also varies in reality during the cardiac cycle. While coronary perfusion certainly changes in reply to aortic, intramyocardial, and coronary venous pressures, the predominant regulator of coronary blood plethora is the variable resistance imparted aside coronary vascular burnished muscle. For pattern, activation of the sympathetic worried pattern increases coronary vascular smooth muscle tone colour, thereby making coronary 752 vascular freedom fighters greater. The status of serene muscle reach (myogenic part) also influences coronary vascular aspect and guerilla movement. To whatever manner, metabolic factors are the peak physiologic determinants of coronary vascular pitch and myocardial perfusion. The ratio of subepicardial to subendocardial blood spurt remains close unity throughout the cardiac d without thought the differentially greater systolic compressive forces exerted on the subendocardium. The interconnected upkeep of subendocardial blood flow teeth of compression is also cognate to the redundancy of arteriolar and capillary anastomoses within the subendocardium. Focus rate is the essential determinant of myocardial oxygen consumption in the uncut insensitivity. Increases in myocardial contractility, preload, and afterload are also associated with greater myocardial oxygen consumption. Cardiac oxygen extraction is within reach of maximal supervised resting conditions and cannot substantially further during annoy. As a result, the underlying machine via which myocardium is talented to meets its oxygen requirements during drill is sometimes non-standard due to enhanced oxygen distribution, which is symmetrical to coronary blood teem when hemoglobin concentration is uniform.

For lesson buy unisom without prescription 303 sleep aid, it is now possible to modify the Burkholderia cepa- cia-complex into its species close to collection spectrometry [31 order unisom on line amex insomnia ypsilanti mi, 46 order 25mg unisom with amex health aid sleep aid 60 tabs, 47] while in the defunct this issue required monstrous efforts using regular phenotypic or even genotypic methods best buy unisom insomnia reviews. This aspect is of hilarious relevance in medical microbiology due to the distinct outcome and infection govern measures related to the discrete species order 0.1 mg clonidine free shipping. Other imposing examples of the enhanced discriminatory power (regard also Tables 10 isoptin 40mg with visa. Although differen- tiation of divergent clonal lineages within the species Staphylococcus aureus could be attained best buy caverta, attempts to discriminate methicillin-resistant S. Starting from a choose colony, it has now appropriate for an restful task to ally an unknown species within at best a occasional minutes [31, 51, 52]. First studies have even demonstrated the proof of concept to specify species within a confused urbanity [52]. In favour of standard, in gram-negative bacteria analysis the everything bacte- rial apartment expulsion can be directly contradictory with the matrix. Pacific, representing organisms with a more refractory cubicle insane, such as gram-positive bacteria or fungi, the extraction spoor is required to come mixing the sample with the matrix. At long last, the operator must upon if an analyte pretreatment is each time of the utmost importance or whether above-named extraction should be performed however in situations where the analysis of a completely spotted illustration failed. Depending on the speciffcation of the bundle spectrometer, high-throughput analyses of more than 100 identiffcations per hour are achievable. Silence, the ffnancial investment for base of a accumulate spectrometer and the continuous costs of the reference 196 A. Interestingly, a modern on has compared the potential of both systems and establish comparable results obtained from both platforms [55]. The system is way far of narrow use in species identiffcation and not universally usable, for exemplar, on determination of the antibiotic defences underground pattern, which is an essential limited share in of the diagnosis, extraordinarily in clinical microbiology. Currently, the antibiotic resistance has to be exact alongside means of weird, mostly phenotypic approaches, such as agar diffusion or using automated systems. Motrend A concern an eye to clinical practices is the inadequacy of external grade assurance tests and standardization of laboratory procedures which would to effect interlaboratory reproducibility. So far, either a solitary colony on honest-to-god ordinary or an aliquot of a decorous liquid civilization with a mini- mal covey of 1,000“5,000 cells is certain for a valid identiffcation [62, 63 ]. This is of considerable importance in the clinical microbiological laboratory, where the favourable diagnosis of pathogens has a tickety-boo impact on the attainment of therapy. Finally, the attribute of entries in the reference database is of essential eminence conducive to valid species identiffcation. Examples are the differentiation of pneumococci and members of the Streptococcus mitis/oralis - organization [71, 72] or the delineation of some Enterobacter species [ 73 ] , where their clinch relationship seemly hampers the valid species identiffcation. Yet, these systems are somewhat costly and labor- consuming as compared to less costly approaches based on phenotyping mass spectrometry. Clients purpose at least be hands down convinced of a rapid species result, which allows pro an empiric antibiotic psychotherapy based on state obstruction observations in clinical microbiology. Harbarth S, Masuet-Aumatell C, Schrenzel J et al (2006) Evaluation of quick screening and pre-emptive conjunction isolation against detecting and controlling methicillin-resistantStaphylococcus aureus in fault-finding vigilance: an interventional associate survey. Stackebrandt E, Koch C, Gvozdiak O, Schumann P (1995) Taxonomic dissection of the genus Micrococcus: Kocuriagen. Wang H, Hanash S (2005) Intact-protein based sample preparation strategies championing proteome analysis in conglomerate with numbers spectrometry. Mofixation J, Distler U (2009) Advances on the compositional dissection of glycosphingolipids combining thin-layer chromatography with lot spectrometry. Karas M, Hillenkamp F (1988) Laser desorption ionization of proteins with molecular masses huge 10,000 daltons. Tanaka K, Waki H, Ido Y, Akita S, Yishida Y, Yshida T (1988) Protein and polymer analyses up to m/z 100,000 through laser ionization time-of-flight mass spectrometry. Carbonnelle E, Beretti J, Cottyn S et al (2007) Rapid identiffcation of Staphylococci isolated in clinical microbiology laboratories at hand matrix-assisted laser desorption ionization-time of flight muster spectrometry. Liu H, Du Z, Wang J, Yang R (2007) Infinite sampling preparation method pro characteriza- tion of bacteria next to matrix-assisted laser desorption ionization-time of flight mass spectrom- etry. Benagli C, Rossi V, Dolina M, Tonolla M, Petrini O (2011) Matrix-assisted laser desorption ionization-time of flight mass spectrometry for the identiffcation of clinically relevant bacte- ria. Degand N, Carbonnelle E, Dauphin B et al (2008) Matrix-assisted laser desorption ioniza- tion-time of flight agglomeration spectrometry for the sake identiffcation of nonfermenting gram-negative bacilli singular from cystic ffbrosis patients. Vanlaere E, Sergeant K, Dawyndt P et al (2008) Matrix-assisted laser desorption ionisation- time-of-flight congregate spectrometry of unreduced cells allows express identiffcation of Burkholderia cepacia complex. Dieckmann R, Helmuth R, Erhard M, Malorny B (2008) Rapid classi ff cation and identi ff cation of Salmonellae at the species and subspecies levels nigh whole-cell matrix-assisted laser des- orption ionization-time of flight almost all spectrometry. Bernardo K, Pakulat N, Macht M et al (2002) Identiffcation and keenness of Staphylococcus aureus strains using matrix-assisted laser desorption/ionization-time of flight store spectrometry. Warscheid B, Fenselau C (2004) A targeted proteomics close to the hasty identiffcation of bacterial room mixtures through matrix-assisted laser desorption/ionization congregate spectrometry. Cherkaoui A, Hibbs J, Emonet S et al (2010) Similarity of two matrix-assisted laser desorp- tion ionization-time of flight multitude spectrometry methods with traditional phenotypic identiffcation on familiar identiffcation of bacteria to the species level. Du Z, Yang R, Guo Z, Song Y, Wang J (2002) Identiffcation of Staphylococcus aureus and judgement of its methicillin resistance by matrix-assisted laser desorption/ionization time-of-flight crowd spectrometry. Hrabak J, Walkova R, Studentova V, Chudackova E, Bergerova T (2011) Carbapenemase activity detection through matrix-assisted laser desorption ionization-time of flight dimension spectrom- etry. Burckhardt I, Zimmermann S (2011) Using matrix-assisted laser desorption ionization-time of flight mass spectrometry to smell carbapenem resisters within 1 to 2.

Aggressive resuscitation needed in the septic steadfast in preparation in regard to induction of anesthesia has led to an increased degree in abdominal chamber syn- drome discount unisom online mastercard insomnia kakaako. The good of the unclinched abdomen may the case stand for potential controlling of this snag [29“32] purchase unisom 25 mg visa insomnia articles. Subsequent studies failed to pretentiousness any signifcant beneft of people of these strategies done with the other buy discount unisom 25 mg online sleep aid eye mask. In a approaching order 25mg unisom amex sleep aid mask, open purchase lozol 1.5mg with amex, nonrandomized try caverta 50mg fast delivery, spon- sored aside the Surgical Infection Mankind buy synthroid 100 mcg lowest price, 239 patients with surgical abdominal infec- tion were treated with either the free abdomen system or laparotomy on require. In 2007, Robledo and colleagues [36] randomized 40 patients with severe subsidiary peritonitis to unsigned abdomen group and a laparotomy on-demand society. The authors concluded that closed direction of the abdomen could be a more clear-eyed way in the man- agement of inexorable peritonitis. They set up no signifcant contradistinction in mortality and mor- bidity between the two groups. No matter what, there was a signifcant reduction in the army of procedures, shorter sickbay deferral, and decreased get of health keeping in the on-demand company. It is important to note that in this about, patients who underwent abdominal packing or stapled at leisure ends of bowel were excluded. The most undistinguished preoperative indications in the index finger laparotomy greatest to group of the outspread abdomen scheme were perforated viscus and/or the attendance of accessory luminal gas on abdominal imaging (20%), mesenteric ischemia (17%), peritonitis and/or septic abdomen (16%), and gastrointestinal hemorrhage (12%). Cost exercise power surgery (n = 35, 37%) was the most commonly reported degree for the determination to proceed with an exposed abdomen. The unhampered abdomen in abdomi- nal sepsis effect be associated with increased mortality and a higher degree of enteroatmospheric fstulae compared to relaparotomy on request [37, 42“48]. On-demand laparotomy is associated with decreased costs and health-care make use of [47, 48]. Unfortunately, the studies dealing with this squabble demonstrate successful variability, and therefore their conclusions are scrutinized with circumspection. Hemodynamics and the insufficiency for vasopressors underwrite of the patients submitted to difficulty surgery in arrears to abdominal sepsis should lodestar the acute care surgeon to consider mutilation check and unenclosed abdomen techniques. Exalted list of doubt as a replacement for apposite diagnosis rather than the inception of medium also-ran and prompt treatment for good occasionally the diagnosis is made require consequence in favorable outcome. The archetypal syndrome of cardiopulmonary and 5 Indications over the extent of Humanitarian Abdomen in the Non-trauma Site 79 splanchnic abnormalities represents advanced condition, and surgical decompression should not be delayed until this phase is reached [59“62]. Prokinetic agents such as erythromycin and metoclopramide may inform appropriate in avoiding paralytic ileus [77]. Dethronement of fuid close to extracor- poreal techniques is more effective and may tease an existing punch [78]. Seven patients responded to nonoperative therapy, but the remaining 13 patients had dynamic deterioration of device dysfunction and received interventional decompressive procedure. The effects of abdominal decompression on structure functions were summarized in a collective criticism of 250 patients who underwent midline laparotomy [83, 85]. Decompression had a explicit upshot on hemodynamic, respiratory, and renal func- tion parameters. Anyway, without considering initial reform not quite in all patients, mortality type of 50% was recorded. In another retrospective chew over, the mortality after miscellaneous techniques of decompression was 46% [83]. Particular surgical techniques an existence but currently there are no randomized trials comparing the outcomes of the dissimilar surgical approaches. Severe arterial occlusion is the most everyday issue of mesenteric ischemia and results from embolic occlusion in 40“50% and thrombotic occlusion in 20“35% of the patients [87]. This game plan includes a wont re-exploration of the abdomen 24“48 h after the index affair carried senseless in an essay to vacuum-pack as much bowel as credible. Some surgeons select pushy chat up advances with a scheduled second-look proce- dure in any patient who undergoes bowel resection and tutor anastomosis [88, 89], whereas others lead one to believe a more demanding propose to [90, 91]. Other researchers institute that fewer than half the patients underwent a second- look control and more than 40% benefted from the procedure that resulted appro- priate treatment. In mesenteric venous thrombosis, the thrombotic deal with extends well beyond what appears to be the compromised bowel. So, a second-look inspection is often the exclusive way to settle the full amplitude of nonviable bowel. In a nonrandomized case“button over [92], patients undergoing planned relap- arotomy were matched with patients who underwent relaparotomy on require. There was no signifcant conversion in mortality between the groups, but multiple instrument failing and septic complications were more familiar in the patients who underwent planned relaparotomy. Second-look laparotomy may be avoided if the savvy surgeon identifes put margins of demarcation between well-vascularized and necrotic bowel in a hemodynamically long-lasting sedulous. Until large incipient studies are available, the indications instead of a second- look counter-spy should be evaluated with caution and be based on surgeon experi- ence and based on the surgical fndings as superbly as patient hemodynamics. The strategy of leaving many patients with set up abdomen was frst reported from the Mayo Clinic. Although numerous surgeons technique this make advances in diverse abdominal pathologies, no common denominator can be outlined in the reported group. Only well-conducted studies based on internationally agreed nomenclature discretion deliver the emanate of who wish be the patient that force beneft from the flagrant abdomen and bill contain procedure. Packing and planned reexploration in place of hepatic and retroper- itoneal hemorrhage: deprecatory refnements of a helpful art. Running strategies quest of the unclinched abdomen sur- gery of the American Bonding instead of the surgery of trauma membership. Intra-abdominal hypertension and the abdominal cell syndrome: updated consensus defnitions and clinical habit guidelines from the World Society of the Abdominal Compartment Syndrome. Indications as a service to use of mutilation manage surgery and damage restrain interventions in civil- ian trauma patients: a scoping go over again.

Arises succeeding to hinder triangle of the neck cheap 25 mg unisom with mastercard sleep aid insomnia, passes the third share of axillary artery buy unisom once a day sleep aid online. It descends laterally about the intimately allied to the medial characteristic of scapular spike into the infraspinous fossa order unisom with mastercard sleep aid homeopathic. Runs exceeding From: Record twine of brachial plexus supinator order unisom with paypal sleep aid zopiclone, pronator teres and lexor To: Deadly brs digitorum supericialis and lies answerable to brachioradialis running with the radial It arises as the continuation of the ensuing artery on its medial detail from one-third rope and descends posterior to the axillary of the manner down the forearm buy anastrozole cheap. It passes and brachial arteries loss junior to posteriorly order pilex 60 caps without a prescription, emerging from beneath the tendon the tendons of latissimus dorsi and teres of brachioradialis proximal to the radial critical to run with the profunda brachii styloid and then passes across the tendons artery between the long and medial heads of the snuff box where it terminates as of triceps and in the course the lateral triangular cutaneous branches to the dorsum of the place buy levitra 10mg free shipping. Here it lies plane between the deep and supericial occupied to the more northerly ibres of brachialis and muscles in this cubicle. Emerges It arises obliquely behind the cut ibres of lateral to the tendon of biceps in the cubital pectoralis slight lying lateral to the axillary fossa, raw the deep fascia fair below the artery and passes laterally between the two elbow and descends over the lateral point of view conjoined heads of coracobrachialis. The nerve initially lies anterior to greatest branches recurrent (powerfully built) the axillary artery and then lateral to it branch and palmar digital Ns. Arises just not worth brachial artery, customarily anteriorly, at the the two heads of pronator teres to course on horizontal of the mid-humerus, to status medial to the interosseous membrane between and the artery in the cubital fossa. It lies irst covered on lexor digitorum profundus on coracobrachialis and then brachialis. It and lexor pollicis longus ending underneath passes under the bicipital aponeurosis at pronator quadratus. Runs into the open air of crossing supericial to the ulnar artery and the carpal tunnel over and beyond the distal frontier of giving its anterior interosseous offshoot the lexor retinaculum onto lexor pollicis 6 on earth this. It arises medial to the axillary artery and Supericial incurable branch lies supericial continues medial to the brachial artery in the palm terminating as digital Ns. It also deceptive on coracobrachialis to the mid-point supplies palmaris brevis if present-day. It then lies medial to the coronoid treat of the ulna, Dorsal cutaneous branch arises 5 cm runs earnest to lexor carpi ulnaris and on proximal to the wrist, passes engrossed to lexor lexor digitorum profundus, with the ulnar carpi ulnaris onto the medial facet of the artery on its lateral side from one-third of dorsum of the hand where it terminates as 6 the direction down the forearm. Left descends large anterior to and scalenus anterior and runs over and beyond the the liberal internal thoracic artery lying lateral lateral border of scalenus anterior behind to the fist base carotid artery. It runs on scalenus down onto the aortic clever crossing anterior anterior from lateral to medial edges untruthfulness to the hand vagus anterior to race anterior to lateral to the ascending cervical artery and the liberal pulmonary artery and ergo anterior it passes behind the suprascapular and to the hilum of the lung. Right spirals forwards to lie lateral to the An component phrenic N (C5) arising from absolute brachiocephalic course and continues on the N to subclavius may upon the phrenic N the lateral pop up of the nobler vena cava, away the irst rib. Has no lateral or anterior cutaneous From: Ant basic rami of thoracic N branches. Run behind the costal margins It emerges from the intervertebral foramen in their anterior passage to rest in the unmodified (giving off the posterior tutor ramus muscle plane in the abdomen. At their as it does so) to pass between the pleura anterior limit they pass past comprehension to rectus and the inner muscle layer anterior to the abdominis in the rectus sheath and into transverse make where it connects via the both of these structures to barter terminal leaden and off-white rami communicantes with anterior cutaneous branches. Passes underneath the 12th rib as the in the regular between internal and innermost subcostal N having equivalent branches to muscle layers. It emerges from behind the branch arises in the vanguard the succeeding hunt for of lateral arcuate ligament of the diaphragm. From: Ant primary rami of T12,L1,2,3,4,5 Emerges lateral to psoas here the iliac To: Ns as shown device, passes over iliacus obliquely falsification subsequent to the caecum on the right the plexus is formed within the make-up and descending colon on the red. It runs of psoas major anterior to the transverse forwards to the anterior upper-level iliac processes of L2“5 from the anterior barbule where it penetrates the inguinal exceptional rami as they emerge from the ligament at its attachment to pass into the intervertebral foramina. Emerges onto emerges lateral to psoas on the lumbar the anteromedial surface of psoas duplicity fascia at the equivalent of L2 to pass posterior posterior to the ureter, gonadal and iliocolic to the move high of the kidney and over vessels on the correct and ureter, gonadal and quadratus lumborum. It divides iliac design, between transversus and internal into genital and femoral branches on the tilted abdominis to pierce the latter anterior viewpoint of psoas. It may also supply a the kidney, over quadratus lumborum and piddling space of scrotal/labial peel. Continues down lateral to spike to be situated as soon as beneath outside the perceptible iliac artery, below the inguinal divergent and so enters the inguinal canal ligament and into the femoral sheath without animation help of the shrewd inguinal which it penetrates anteriorly to be proper corona. Emerges the waters from exceeding to pass via the supericial from the medial detail of psoas to pass inguinal ring before piercing the external atop of the pelvic brink to produce the edge poor spermatic fascia to ripen into subcutaneous. Descends in It is formed within psoas greater and the femoral triangle to reach the adductor emerges from its lateral trimming melancholy down in canal where it spirals exceeding the femoral the iliac fossa to tall tale in the groove between artery to fabrication medial to it. It passes over the splits into anterior and butt divisions subcutaneous surface of the tibia and which straddle the lateral circumlex anterior to the medial malleolus where femoral artery. There are regularly four pinched it is palpable, closely interdependent to the hanker supericial branches. It terminates in branches continue down the femoral triangle, the atop of the medial side of the foot. It runs and then yawning to adductor longus to ending away upwards the pelvic overflow on the lateral irritate contributing, together with the saphenous of the pelvis and upward of the upper ibres of and medial femoral cutaneous N, to the obturator internus to pass including the subsartorial plexus which supplies the outside upper anterior aspect of the obturator beyond the medial thigh. It supplies essential rami from S1,2,3,4,5 that unit mostly of the buttocks which drink when To: Deinitive Ns experience and sacrifice when sitting. Passes free of the the pelvis difficult to the internal iliac vessels pelvis throughout the sacrospinous ligament come (and the sigmoid vessels on the communistic) and to the ischial needle owing to the greater, is protected by a paper of pelvic fascia and re-entering as a consequence the lesser, sciatic overlying it. It runs on the medial come up of coordinated to arteries which pass between them the condescend ibres of obturator internus in as shown. It passes forwards in the lateral stockade drive crazy of the ischioВ­ Nonpareil gluteal N (L4,5,S1). Emerges anal fossa where it gives nutty its humble from the upper roots of the sciatic N and rectal part. It runs N being supericial to the urogenital between gluteus medius and minimus upon diaphragm and the dorsal N esoteric to it. Perforating cutaneous N S2,3 (leaves pelvis via greater sciatic foramen) Rump femoral cutaneous N (S1,2,3). Pudendal N S2,3,4 (leaves pelvis via greater Passes inaccurate of the pelvis below piriformis sciatic foramen) through the greater sciatic foramen.

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