Hind foot drumming: morphological adaptations of the muscles and bones of the hind limb in three African mole-rat species.

Seismic signalling in the form of hind foot drumming plays an integral role in the communication of several species of African mole-rats (Bathyergidae). To produce these vibrational signals, alternating hind limbs strike the ground repetitively at high speeds by flexion and extension of the hip and knee. This descriptive study aimed to determine whether anatomical differences in hind limb osteology and/or musculature between drumming and non-drumming species of three Bathyergidae species could be detected. Formalin-fixed left and right hind limbs of 24 animals (N = 48) consisting of three species (n = 16 each) of two drumming species, Georychus capensis and Bathyergus suillus, and one non-drumming species, Cryptomys hottentotus natalensis, were dissected to determine the origins and insertions of individual muscles. After dissection, all soft tissue was removed by maceration. Hind limb bones, including the pelvis, were photographed, and the exact muscle origin and insertion points were electronically mapped onto the images using imaging software. On lateral view, the acetabular position was parallel to the sacrum in G. capensis, while being more ventral in position in the other two species. The shape of the femur head was spherical and the neck defined in all species. The distal shaft of the femur was gracile and the epicondyles were robust and prominent in the non-drumming C. h. natalensis compared with the drumming species. Shallow and relatively wide patellar grooves were observed in all three species. In the two drumming species, m. gracilis was single, whereas it was double in C. h. natalensis. In all three species, m. tensor fasciae latae was absent. The more dorsal positioning of the acetabulum in G. capensis may be needed to increase the stability of the spine and allow for more force to be exerted on the pelvis during drumming. It is unlikely that m. gracilis plays a role in drumming, as the singularity or doubling thereof is variable among rodents. It is additionally postulated that m. gluteus superficialis has taken the hip rotator role of m. tensor fasciae latae as it partially inserted onto the lateral fascia of the thigh. The more robust ilia, femoral shafts and tibiae observed in the two drumming species studied here are possible adaptations for hind foot drumming, as robust bones are able to withstand the additional biomechanical loading during drumming.

Pregnancy after a TRAM flap procedure: principles of nursing care.

Breast cancer is the most common malignancy in women in the United States and affects more than 200,000 women annually. The incidence increases exponentially with age from the 3rd to the 5th decade of life. Many women are now choosing to have a more natural breast reconstruction concomitantly with their mastectomy. A TRAM (transverse rectus abdominis myocutaneous) flap is a procedure to reconstruct the breast mound using autologous tissue. Women of childbearing age who have undergone a TRAM flap may safely consider pregnancy after such a procedure. The principles of nursing care for pregnant women who have undergone a TRAM flap surgery are presented in this article. A case report of pregnancy after a TRAM flap is included.

Fostering intuition: a role of the trauma nurse mentor.

Intuitive knowledge is a relative component of the critical thinking process. Intuition is discussed along with examples of how nurses have demonstrated intuitive thinking in the trauma setting. Recommendations are offered for how the mentor trauma nurse can foster an awareness and the development of intuition in the novice practitioner.

Pulmonary contusions: management and implications for trauma nurses.

TOPIC: Pathophysiology of pulmonary contusions, current methods for assessing blunt chest trauma patients, pulmonary parameters and diagnostic methodology, and innovative ventilatory treatment. PURPOSE: To heighten awareness of pulmonary contusion, the treatment and potential sequelae. SOURCES: Published information and clinical experience. CONCLUSION: A pulmonary contusion is a common potentially lethal chest injury seen in this country. Trauma clinicians should have heightened awareness about this injury because the injury is often overlooked and the clinicians frequently do not comprehend the mechanisms causing pulmonary contusions.

Pulmonary contusion: the hidden danger in blunt chest trauma.

Pulmonary contusion, known as the most common potentially lethal chest injury seen in this country, necessitates aggressive nursing assessment and diagnosis if treatment is to be effective and prognosis improved. Initial chest x-rays will usually not display the severity of the contusion. The nurse maintains a high index of suspicion for pulmonary contusion when assessing chest trauma patients. By monitoring ventilatory parameters to assess oxygenation, the nurse acknowledges that hypoxemia is the hallmark clinical sign. Through comprehension of the different mechanisms of injury, the role of chest compliance, and the pathologic alterations, the critical care nurse delivers skillful and knowledgeable care to the patient with a pulmonary contusion.