Bones of Upper Limb
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Suprascapular Nerve Lesions at the Spinoglenoid Notch: Report of Three Cases and Review of the Literature 243
Journal ofNeurology, Neurosurgery, and Psychiatry 1991;54:241-243 241 Suprascapular nerve lesions at the spinoglenoid J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.54.3.241 on 1 March 1991. Downloaded from notch: report of three cases and review of the literature Jay A Liveson, Michael J Bronson, Michael A Pollack Abstract of root involvement (cervical pain, and change Lesions of the suprascapular nerve can from Valsalva's manoeuvre). His past medical occur at the supraspinatus notch (SSN) history was negative. On physical examination or at the spinoglenoid notch (SGN). Elec- cranial nerves were normal. No weakness was tromyographic (EMG), evaluation of the detected on careful manual muscle examin- infraspinatus, and especially the supra- ation. Sensation was intact. Deep tendon spinatus muscles distinguishes SGN reflexes were active and symmetrical with no from SSN lesions. Three cases of SGN pathological reflexes. There was no Homer's lesions, which are more common than sign. SSN lesions, are presented. The patient gave up weight lifting and started a programme of physiotherapy. His shoulder ache resolved rapidly, but his muscle Entrapment of the suprascapular nerve at the bulk did not return to normal for another 12 suprascapular notch (SSN) was first described months. He reported completely normal func- in 1963 by Kopell and Thompson.' No alter- tion. native entrapment site was recognised until 1981 when the first case of spinoglenoid notch Case 2 (SGN) entrapmnt was described by Ganzhorn A 22 year old right handed male was skeet et al.2 Since then nine additional cases of SGN shooting, a month before his examination. -
Arthroscopic Decompression of the Suprascapular Nerve at the Spinoglenoid Notch and Suprascapular Notch Through the Subacromial Space
Technical Note Arthroscopic Decompression of the Suprascapular Nerve at the Spinoglenoid Notch and Suprascapular Notch Through the Subacromial Space Neil Ghodadra, M.D., Shane J. Nho, M.D., M.S., Nikhil N. Verma, M.D., Stefanie Reiff, B.A., Dana P. Piasecki, M.D., Matthew T. Provencher, M.D., and Anthony A. Romeo, M.D. Abstract: Suprascapular nerve entrapment can cause disabling shoulder pain. Suprascapular nerve release is often performed for compression neuropathy and to release pressure on the nerve associated with arthroscopic labral repair. This report describes a novel all-arthroscopic technique for decom- pression of the suprascapular nerve at the suprascapular notch or spinoglenoid notch through a subacromial approach. Through the subacromial space, spinoglenoid notch cysts can be visualized between the supraspinatus and infraspinatus at the base of the scapular spine. While viewing the subacromial space through the lateral portal, the surgeon can use a shaver through the posterior portal to decompress a spinoglenoid notch cyst at the base of the scapular spine. To decompress the suprascapular nerve at the suprascapular notch, a shaver through the posterior portal removes the soft tissue on the acromion and distal clavicle to expose the coracoclavicular ligaments. The medial border of the conoid ligament is identified and followed to its coracoid attachment. The supraspinatus muscle is retracted with a blunt trocar placed through an accessory Neviaser portal. The transverse scapular ligament, which courses inferior to the suprascapular artery, is sectioned with arthroscopic scissors, and the suprascapular nerve is decompressed. Key Words: Arthroscopy—Suprascapular nerve—Transverse scapular ligament—Suprascapular notch—Rotator cuff—Shoulder. -
Table 9-10 Ligaments of the Wrist and Their Function
Function and Movement of the Hand 283 Table 9-10 Ligaments of the Wrist and Their Function Extrinsic Ligaments Function Palmar radiocarpal Volarly stabilizes radius to carpal bones; limits excessive wrist extension Dorsal radiocarpal Dorsally stabilizes radius to carpal bones; limits excessive wrist flexion Ulnar collateral Provides lateral stability of ulnar side of wrist between ulna and carpals Radial collateral Provides lateral stability of radial side of wrist between radius and carpals Ulnocarpal complex and articular Stabilizes and helps glide the ulnar side of wrist; stabilizes distal disk (or triangular fibrocartilage radioulnar joint complex) Intrinsic Ligaments Palmar midcarpal Forms and stabilizes the proximal and distal rows of carpal bones Dorsal midcarpal Forms and stabilizes the proximal and distal rows of carpal bones Interosseous Intervenes between each carpal bone contained within its proximal or distal row Accessory Ligament Transverse carpal Stabilizes carpal arch and contents of the carpal tunnel Adapted from Hertling, D., & Kessler, R. (2006). Management of common musculoskeletal disorders: Physical therapy principles and methods. Philadelphia, PA: Lippincott, Williams & Wilkins.; Oatis, C. A. (2004). Kinesiology: The mechanics and pathomechanics of human movement. Philadelphia, PA: Lippincott, Williams & Wilkins.; Weiss, S., & Falkenstein, N. (2005). Hand rehabilitation: A quick reference guide and review. St. Louis, MO: Mosby Elsevier. The radial and ulnar collateral ligaments provide lateral and medial support, respectively, to the wrist joint. The ulnocarpal complex is more likely to be referred to as the triangular fibro- cartilage complex (TFCC) and includes the articular disk of the wrist. The TFCC is the major stabilizer of the distal radioulnar joint (DRUJ) and can tear after direct compressive force such as a fall on an outstretched hand. -
Altered Alignment of the Shoulder Girdle and Cervical Spine in Patients with Insidious Onset Neck Pain and Whiplash- Associated Disorder
Journal of Applied Biomechanics, 2011, 27, 181-191 © 2011 Human Kinetics, Inc. Altered Alignment of the Shoulder Girdle and Cervical Spine in Patients With Insidious Onset Neck Pain and Whiplash- Associated Disorder Harpa Helgadottir, Eythor Kristjansson, Sarah Mottram, Andrew Karduna, and Halldor Jonsson, Jr. Clinical theory suggests that altered alignment of the shoulder girdle has the potential to create or sustain symptomatic mechanical dysfunction in the cervical and thoracic spine. The alignment of the shoulder girdle is described by two clavicle rotations, i.e, elevation and retraction, and by three scapular rotations, i.e., upward rotation, internal rotation, and anterior tilt. Elevation and retraction have until now been assessed only in patients with neck pain. The aim of the study was to determine whether there is a pattern of altered alignment of the shoulder girdle and the cervical and thoracic spine in patients with neck pain. A three-dimensional device measured clavicle and scapular orientation, and cervical and thoracic alignment in patients with insidious onset neck pain (IONP) and whiplash-associated disorder (WAD). An asymptomatic control group was selected for baseline measurements. The symptomatic groups revealed a significantly reduced clavicle retraction and scapular upward rotation as well as decreased cranial angle. A difference was found between the symptomatic groups on the left side, whereas the WAD group revealed an increased scapular anterior tilt and the IONP group a decreased clavicle elevation. These changes may be an important mechanism for maintenance and recurrence or exacerbation of symptoms in patients with neck pain. Keywords: neck pain, whiplash, scapula, posture Clinical theory suggests that altered alignment of of Biomechanics. -
Carpals and Tarsals of Mule Deer, Black Bear and Human: an Osteology Guide for the Archaeologist
Western Washington University Western CEDAR WWU Graduate School Collection WWU Graduate and Undergraduate Scholarship 2009 Carpals and tarsals of mule deer, black bear and human: an osteology guide for the archaeologist Tamela S. Smart Western Washington University Follow this and additional works at: https://cedar.wwu.edu/wwuet Part of the Anthropology Commons Recommended Citation Smart, Tamela S., "Carpals and tarsals of mule deer, black bear and human: an osteology guide for the archaeologist" (2009). WWU Graduate School Collection. 19. https://cedar.wwu.edu/wwuet/19 This Masters Thesis is brought to you for free and open access by the WWU Graduate and Undergraduate Scholarship at Western CEDAR. It has been accepted for inclusion in WWU Graduate School Collection by an authorized administrator of Western CEDAR. For more information, please contact [email protected]. MASTER'S THESIS In presenting this thesis in partial fulfillment of the requirements for a master's degree at Western Washington University, I grant to Western Washington University the non-exclusive royalty-free right to archive, reproduce, distribute, and display the thesis in any and all forms, including electronic format, via any digital library mechanisms maintained by WWu. I represent and warrant this is my original work, and does not infringe or violate any rights of others. I warrant that I have obtained written permissions from the owner of any third party copyrighted material included in these files. I acknowledge that I retain ownership rights to the copyright of this work, including but not limited to the right to use all or part of this work in future works, such as articles or books. -
Radiohamate Impingement After Proximal Row Carpectomy ‘Radiohamate Impingement PRC’
Acta Orthop. Belg., 2020, 86 e-supplement 1, 19-21 CASE REPORT Radiohamate impingement after proximal row carpectomy ‘Radiohamate impingement PRC’ Pieter Caekebeke, Luc De Smet From the Department of Orthopaedics UZ Leuven, Pellenberg, Belgium Radiocarpal impingement after PRC is a well-known from 0% to 18% (5). Radiocarpal and pisiform complication due to impingement of the radial styloid impingement have been described after PRC. The against the radial carpal bones. A less common first is probably due to the proximalization of the impingement syndrome is that of the pisiforme. distal row with impingement of the trapezium/ We describe a radiohamate impingement and its trapezoid against the radial styloid process. The diagnosis and treatment. Based on a case we saw treatment is a radial styloid process resection for at our practice. Diagnosis is bases on standard radiographs and SPECT-CT. The treatment is the first and a pisiformectomy for the latter (3,5). No initially conservative. Surgery is necessary when other impingement syndromes have been described. conservative treatment fails and consists of resectie We present a case of radiohamate impingement of the proximal pole of the hamate. syndrome after proximal row carpectomy. Keywords: Radiohamate ; impingement ; proximal row CASE REPORT carpectomy. A 53-year-old mechanic contacted us 1 year after a work-accident with localized radiocarpal INTRODUCTION pain and swelling. Radiographs showed a stage Proximal row carpectomy (PRC) is a well- two SLAC wrist. (Fig. 1) A PRC with synovectomy established motion-preserving salvage procedure was performed. The following 3 years were for degenerative disorders of the proximal carpal uneventful with no to minimal pain complaints. -
Suprascapular Nerve Entrapment: Technique for Arthroscopic Release
Techniques in Shoulder and Elbow Surgery 7(2):000–000, 2006 Ó 2006 Lippincott Williams & Wilkins, Philadephia | REVIEW | Suprascapular Nerve Entrapment: Technique for Arthroscopic Release Peter J. Millett, MD, MSc Steadman Hawkins Clinic, Vail, CO Harvard Medical School Boston, MA R. Shane Barton, MD, Iva´n H. Pacheco, MD, and Reuben Gobezie, MD Harvard Shoulder Service Harvard Medical School Brigham and Women’s Hospital Massachusetts General Hospital Boston, MA | ABSTRACT with suprascapular nerve palsy may present with an often vague range of symptoms or even be asympto- Suprascapular neuropathy can be caused by a variety of matic.3 Pain over the posterolateral shoulder or easy anatomic and pathologic entities as the nerve courses fatigability with overhead activities may be reported, or from the brachial plexus through the suprascapular and painless weakness of external rotation with or without spinoglenoid notches to innervate the supraspinatus and spinatus muscle atrophy may be noted. Compression of infraspinatus muscles. We describe techniques for arthro- the nerve at both the suprascapular and spinoglenoid scopically accessing the nerve at both the suprascapular notches are commonly reported mechanisms of injury and spinoglenoid notches and decompressing structural and will be discussed in detail. lesions that may be contributing to the neuropathy. The physical examination plays a critical role in Keywords: suprascapular neuropathy, suprascapular discerning the site of suprascapular nerve injury. notches, spinoglenoid notches, cyst decompression, arthro- Clinical observation of the patient’s shoulder girdle is scopic release important. More proximal injury, as seen with supra- | HISTORICAL PERSPECTIVE scapular notch compression, may result in atrophy of both the supraspinatus and infraspinatus, whereas more Isolated injury to the suprascapular nerve has long been distal compression at the spinoglenoid notch will result recognized as an etiologic entity producing shoulder pain in isolated infraspinatus weakness and atrophy (Fig. -
The Appendicular Skeleton Appendicular Skeleton
THE SKELETAL SYSTEM: THE APPENDICULAR SKELETON APPENDICULAR SKELETON The primary function is movement It includes bones of the upper and lower limbs Girdles attach the limbs to the axial skeleton SKELETON OF THE UPPER LIMB Each upper limb has 32 bones Two separate regions 1. The pectoral (shoulder) girdle (2 bones) 2. The free part (30 bones) THE PECTORAL (OR SHOULDER) GIRDLE UPPER LIMB The pectoral girdle consists of two bones, the scapula and the clavicle The free part has 30 bones 1 humerus (arm) 1 ulna (forearm) 1 radius (forearm) 8 carpals (wrist) 19 metacarpal and phalanges (hand) PECTORAL GIRDLE - CLAVICLE The clavicle is “S” shaped The medial end articulates with the manubrium of the sternum forming the sternoclavicular joint The lateral end articulates with the acromion forming the acromioclavicular joint THE CLAVICLE PECTORAL GIRDLE - CLAVICLE The clavicle is convex in shape anteriorly near the sternal junction The clavicle is concave anteriorly on its lateral edge near the acromion CLINICAL CONNECTION - FRACTURED CLAVICLE A fall on an outstretched arm (F.O.O.S.H.) injury can lead to a fractured clavicle The clavicle is weakest at the junction of the two curves Forces are generated through the upper limb to the trunk during a fall Therefore, most breaks occur approximately in the middle of the clavicle PECTORAL GIRDLE - SCAPULA Also called the shoulder blade Triangular in shape Most notable features include the spine, acromion, coracoid process and the glenoid cavity FEATURES ON THE SCAPULA Spine - -
Bone Limb Upper
Shoulder Pectoral girdle (shoulder girdle) Scapula Acromioclavicular joint proximal end of Humerus Clavicle Sternoclavicular joint Bone: Upper limb - 1 Scapula Coracoid proc. 3 angles Superior Inferior Lateral 3 borders Lateral angle Medial Lateral Superior 2 surfaces 3 processes Posterior view: Acromion Right Scapula Spine Coracoid Bone: Upper limb - 2 Scapula 2 surfaces: Costal (Anterior), Posterior Posterior view: Costal (Anterior) view: Right Scapula Right Scapula Bone: Upper limb - 3 Scapula Glenoid cavity: Glenohumeral joint Lateral view: Infraglenoid tubercle Right Scapula Supraglenoid tubercle posterior anterior Bone: Upper limb - 4 Scapula Supraglenoid tubercle: long head of biceps Anterior view: brachii Right Scapula Bone: Upper limb - 5 Scapula Infraglenoid tubercle: long head of triceps brachii Anterior view: Right Scapula (with biceps brachii removed) Bone: Upper limb - 6 Posterior surface of Scapula, Right Acromion; Spine; Spinoglenoid notch Suprspinatous fossa, Infraspinatous fossa Bone: Upper limb - 7 Costal (Anterior) surface of Scapula, Right Subscapular fossa: Shallow concave surface for subscapularis Bone: Upper limb - 8 Superior border Coracoid process Suprascapular notch Suprascapular nerve Posterior view: Right Scapula Bone: Upper limb - 9 Acromial Clavicle end Sternal end S-shaped Acromial end: smaller, oval facet Sternal end: larger,quadrangular facet, with manubrium, 1st rib Conoid tubercle Trapezoid line Right Clavicle Bone: Upper limb - 10 Clavicle Conoid tubercle: inferior -
Trapezius Origin: Occipital Bone, Ligamentum Nuchae & Spinous Processes of Thoracic Vertebrae Insertion: Clavicle and Scapul
Origin: occipital bone, ligamentum nuchae & spinous processes of thoracic vertebrae Insertion: clavicle and scapula (acromion Trapezius and scapular spine) Action: elevate, retract, depress, or rotate scapula upward and/or elevate clavicle; extend neck Origin: spinous process of vertebrae C7-T1 Rhomboideus Insertion: vertebral border of scapula Minor Action: adducts & performs downward rotation of scapula Origin: spinous process of superior thoracic vertebrae Rhomboideus Insertion: vertebral border of scapula from Major spine to inferior angle Action: adducts and downward rotation of scapula Origin: transverse precesses of C1-C4 vertebrae Levator Scapulae Insertion: vertebral border of scapula near superior angle Action: elevates scapula Origin: anterior and superior margins of ribs 1-8 or 1-9 Insertion: anterior surface of vertebral Serratus Anterior border of scapula Action: protracts shoulder: rotates scapula so glenoid cavity moves upward rotation Origin: anterior surfaces and superior margins of ribs 3-5 Insertion: coracoid process of scapula Pectoralis Minor Action: depresses & protracts shoulder, rotates scapula (glenoid cavity rotates downward), elevates ribs Origin: supraspinous fossa of scapula Supraspinatus Insertion: greater tuberacle of humerus Action: abduction at the shoulder Origin: infraspinous fossa of scapula Infraspinatus Insertion: greater tubercle of humerus Action: lateral rotation at shoulder Origin: clavicle and scapula (acromion and adjacent scapular spine) Insertion: deltoid tuberosity of humerus Deltoid Action: -
Parts of the Body 1) Head – Caput, Capitus 2) Skull- Cranium Cephalic- Toward the Skull Caudal- Toward the Tail Rostral- Toward the Nose 3) Collum (Pl
BIO 3330 Advanced Human Cadaver Anatomy Instructor: Dr. Jeff Simpson Department of Biology Metropolitan State College of Denver 1 PARTS OF THE BODY 1) HEAD – CAPUT, CAPITUS 2) SKULL- CRANIUM CEPHALIC- TOWARD THE SKULL CAUDAL- TOWARD THE TAIL ROSTRAL- TOWARD THE NOSE 3) COLLUM (PL. COLLI), CERVIX 4) TRUNK- THORAX, CHEST 5) ABDOMEN- AREA BETWEEN THE DIAPHRAGM AND THE HIP BONES 6) PELVIS- AREA BETWEEN OS COXAS EXTREMITIES -UPPER 1) SHOULDER GIRDLE - SCAPULA, CLAVICLE 2) BRACHIUM - ARM 3) ANTEBRACHIUM -FOREARM 4) CUBITAL FOSSA 6) METACARPALS 7) PHALANGES 2 Lower Extremities Pelvis Os Coxae (2) Inominant Bones Sacrum Coccyx Terms of Position and Direction Anatomical Position Body Erect, head, eyes and toes facing forward. Limbs at side, palms facing forward Anterior-ventral Posterior-dorsal Superficial Deep Internal/external Vertical & horizontal- refer to the body in the standing position Lateral/ medial Superior/inferior Ipsilateral Contralateral Planes of the Body Median-cuts the body into left and right halves Sagittal- parallel to median Frontal (Coronal)- divides the body into front and back halves 3 Horizontal(transverse)- cuts the body into upper and lower portions Positions of the Body Proximal Distal Limbs Radial Ulnar Tibial Fibular Foot Dorsum Plantar Hallicus HAND Dorsum- back of hand Palmar (volar)- palm side Pollicus Index finger Middle finger Ring finger Pinky finger TERMS OF MOVEMENT 1) FLEXION: DECREASE ANGLE BETWEEN TWO BONES OF A JOINT 2) EXTENSION: INCREASE ANGLE BETWEEN TWO BONES OF A JOINT 3) ADDUCTION: TOWARDS MIDLINE -
Four Unusual Cases of Congenital Forelimb Malformations in Dogs
animals Article Four Unusual Cases of Congenital Forelimb Malformations in Dogs Simona Di Pietro 1 , Giuseppe Santi Rapisarda 2, Luca Cicero 3,* , Vito Angileri 4, Simona Morabito 5, Giovanni Cassata 3 and Francesco Macrì 1 1 Department of Veterinary Sciences, University of Messina, Viale Palatucci, 98168 Messina, Italy; [email protected] (S.D.P.); [email protected] (F.M.) 2 Department of Veterinary Prevention, Provincial Health Authority of Catania, 95030 Gravina di Catania, Italy; [email protected] 3 Institute Zooprofilattico Sperimentale of Sicily, Via G. Marinuzzi, 3, 90129 Palermo, Italy; [email protected] 4 Veterinary Practitioner, 91025 Marsala, Italy; [email protected] 5 Ospedale Veterinario I Portoni Rossi, Via Roma, 57/a, 40069 Zola Predosa (BO), Italy; [email protected] * Correspondence: [email protected] Simple Summary: Congenital limb defects are sporadically encountered in dogs during normal clinical practice. Literature concerning their diagnosis and management in canine species is poor. Sometimes, the diagnosis and description of congenital limb abnormalities are complicated by the concurrent presence of different malformations in the same limb and the lack of widely accepted classification schemes. In order to improve the knowledge about congenital limb anomalies in dogs, this report describes the clinical and radiographic findings in four dogs affected by unusual congenital forelimb defects, underlying also the importance of reviewing current terminology. Citation: Di Pietro, S.; Rapisarda, G.S.; Cicero, L.; Angileri, V.; Morabito, Abstract: Four dogs were presented with thoracic limb deformity. After clinical and radiographic S.; Cassata, G.; Macrì, F. Four Unusual examinations, a diagnosis of congenital malformations was performed for each of them.