DOCSLIB.ORG

Placement of Bone Screws in a Standing Horse for Treatment of a Fracture of the Greater Tubercle of the Humerus M

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Placement of Bone Screws in a Standing Horse for Treatment of a Fracture of the Greater Tubercle of the Humerus M EQUINE VETERINARY EDUCATION / AE / AUGUST 2013 381 Case Report Placement of bone screws in a standing horse for treatment of a fracture of the greater tubercle of the humerus M. Madron,S.Caston* and K. Kersh Department of Veterinary Clinical Sciences College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA. *Corresponding author email: [email protected] Keywords: horse; greater tubercle; fracture; internal fixation; standing Summary report of 16 fractures of the shoulder region identified only one A mature Thoroughbred gelding that was used as a high level fractured tubercle which was the intermediate (Dyson 1985). jumper presented for evaluation of a nonweightbearing One case series specifically describing greater tubercle forelimb lameness following a fall. Radiographs revealed a fractures is available and includes 15 horses with information complete, noncomminuted, minimally displaced sagittal on clinical signs, radiographic technique, treatment and fracture of the greater tubercle. Supporting limb laminitis was a outcome (Mez et al. 2007). Prior to this study, published major concern in the short term based on the severe lameness information on greater tubercle fractures included a limited at presentation. Open reduction with internal fixation was number of individual case reports (Allen and White 1984; chosen over stall rest in an attempt to more rapidly return the Yovich and Aanes 1985; Dyson and Greet 1986; Adams and weightbearing function to the limb. The procedure was Turner 1987; Thomas and Livesey 1997; Tudor et al. 2001). performed standing and 3 bone screws were placed standing Fractures of the greater tubercle can often be diagnosed in an attempt to avoid implant or catastrophic bone failure that based on patient history, physical examination findings and can accompany recovery from general anaesthesia. The day radiography (Mez et al. 2007). Common examination findings following surgery the lameness was significantly improved as include lameness, pain on flexion and extension of the the horse was able to bear some weight on the heel. The shoulder, resentment to palpation, reduction in the cranial gelding was discharged 5 days following surgery and was fully phase of the stride and swelling over the shoulder region (Allen weightbearing at the walk. Six months following surgery the and White 1984; Yovich and Aanes 1985; Dyson and Greet horse was free of lameness and resumed training. This report 1986; Adams and Turner 1987; Mez et al. 2007). Less common describes our experience and rationale in placing bone findings include palpable crepitus, atrophy of the supra- and screws in a standing horse for treatment of a greater tubercle infraspinatus muscles and instability of the shoulder with lateral fracture. excursion when weightbearing (Adams and Turner 1987; Thomas and Livesey 1997; Tudor et al. 2001). Radiography is commonly used to identify greater Introduction tubercle fractures. Mediolateral, craniocaudal and the The greater tubercle of the humerus is a palpable bony craniomedial-caudolateral oblique projections are standard prominence commonly referred to as the point of the shoulder. radiographic views for locating fractures of the greater tubercle It is located on the craniolateral aspect of the proximal (Butler et al. 2000). In addition, the cranioproximal-craniodistal humerus and is divided into cranial and caudal parts. The oblique view has proven useful for identifying fractures not cranial part serves as the insertion for the tendon of the lateral readily seen on the standard views as well as improving branch of the supraspinatus muscle, while the caudal part evaluation of fracture configuration (Mez et al. 2007). Surgical serves as the insertion for the tendons of the infraspinatus and nonsurgical treatments have been successful in returning muscle (Dyce et al. 2002). These tendons span the shoulder horses in a number of different disciplines to work. Surgical joint providing lateral stability and serving as collateral treatment has included removal of the fracture fragment or ligaments. open reduction with internal fixation (Allen and White 1984; Two additional tubercles, the lesser and the intermediate, Dyson and Greet 1986; Adams and Turner 1987; Thomas and are present on the proximal humerus. The lesser tubercle is Livesey 1997; Mez et al. 2007). located on the medial aspect of the humerus and serves as the insertion site for the medial branch of the supraspinatus muscle as well as the tendon of the subscapularis muscle History and case details providing medial stability to the shoulder joint (Dyce et al. An 8-year-old Thoroughbred gelding (502 kg) used as a high 2002). The intermediate tubercle separates the greater and level jumper was referred for evaluation of a left forelimb lesser tubercles and forms a sulcus on either side known as the lameness. A caretaker had witnessed the horse falling onto his intertubercular groove. This groove provides a pathway for left side earlier in the day while running in a paddock. At the tendon of the biceps brachii muscle and also contains the presentation the horse was nonweightbearing on the limb. The intertubercular (bicipital) bursa (Dyce et al. 2002). point of the shoulder was mildly swollen, painful to palpation Fractures of the greater tubercle are uncommon and and painful to flexion and extension. No crepitus was generally do not extend into the weightbearing articular appreciated during palpation and no abrasions or lacerations portion of the humerus (Dyson 1985, 1986; Mez et al. 2007). A were present in the shoulder region. Pulse and respiratory rates retrospective study of 54 cases of equine humeral fractures did were mildly elevated with the remainder of the physical not include any tubercle fractures (Carter et al. 1993). Another examination being within normal limits. © 2012 EVJ Ltd 382 EQUINE VETERINARY EDUCATION / AE / AUGUST 2013 Fig 1: Mediolateral radiograph of the fractured greater tubercle. Radiographs of the shoulder region revealed a complete, noncomminuted, minimally displaced sagittal fracture of the greater tubercle of the humerus that extended just proximal to the deltoid tuberosity. The fracture was readily identified on the mediolateral, craniomedial-caudolateral oblique and the cranioproximal-craniodistal oblique projections (Figs 1 and 2). There was no radiographic evidence that the fracture extended into the humeral head and no other abnormalities were noted. Open reduction with internal fixation was the treatment Fig 2: Cranioproximal-craniodistal oblique radiograph of the selected in an attempt to return the weightbearing function to fracture gap (arrows), fractured greater tubercle (A) and the the limb and reduce the risk of supporting limb laminitis. The intermediate tubercle (B). temperament of the gelding was such that a standing repair was considered possible to avoid implant complications as continued to 5 cm proximal to the deltoid tuberosity. The well as catastrophic bone failure that can occur with a incision was made parallel to the cranial edge of the deltoid general anaesthetic recovery (Adams and Turner 1987; muscle and a tissue plane between the brachiocephalic Thomas and Livesey 1997; Mez et al. 2007). muscle and the deltoid muscle was identified and incised to expose the greater tubercle (Nixon and Watkins 1996). A Gelpi Preoperative care retractor was used to separate the muscle bellies to increase exposure. At this time a 1.2 mm ¥ 25.4 mm needle was used to Prior to surgery a 14 gauge 5.5 inch (14 cm) i.v. catheter was infiltrate multiple areas of the periosteum around the fracture placed in the left jugular vein and the area over the point of line as well as areas of proposed screw placement with the shoulder was clipped and cleaned with 4% chlorohexidine. mepivacaine. The fracture line was identified, debrided with a Procaine penicillin (22,000 u/kg bwt i.m. twice daily), small bone curette and flushed with 1 litre of saline. The gentamicin sulphate (6.6 mg/kg bwt i.v. once daily) and fragment was minimally displaced proximally and reduction flunixin meglumine (1.1 mg/kg bwt i.v. twice daily) were was achieved by placing traction distally on the 4.0 mm insert initiated 1 h before surgery. Sedation and analgesia were placed into the first glide hole. Additional local anaesthesia provided by an i.v. infusion of detomidine (loading dose was provided by infiltrating the initial glide hole with 30–40 ml 6 mg/kg bwt; continuous rate infusion of 0.8 mg/kg bwt/min) as mepivacaine to bathe the fracture gap as mepivacaine well as preoperative butorphanol (0.02 mg/kg bwt i.v.). could be visualised exiting multiple sites of the fracture line. Reduction was evaluated by digital palpation and minimal Surgical technique traction was necessary to reduce the fragment. The gelding was placed in treatment stocks and the surgical One cancellous (6.5 mm ¥ 95 mm) and 2 cortical (5.5 mm site aseptically prepared, quadrant drapes placed and an ¥ 90 mm) bone screws were placed in lag fashion across the incise drape (Ioban)a applied. Local anaesthesia was fracture gap. The order of screw placement included the most provided by infiltrating the skin, subcutaneous tissues and proximal followed by the most distal with the middle screw muscles in the surgical site with 60 ml of 2% mepivacaine in an being placed last. A washer was used with each screw and all inverted-V pattern. A 1.2 mm ¥ 88.9 mm spinal needle was screws were placed according to AO/ASIF technique. Digital used to infiltrate the deeper tissues with mepivacaine. A 15 cm radiography was used to assess accuracy of screw skin incision beginning just proximal to the greater tubercle was placement. Prior to closure the surgical site was lavaged with © 2012 EVJ Ltd EQUINE VETERINARY EDUCATION / AE / AUGUST 2013 383 2 l of sterile saline. The incision was closed in 3 layers. The fascia of the brachiocephalic muscle and the deltoid muscle was opposed with 0-poliglecaprone in a simple continuous pattern.
Load more

Recommended publications
  • Isolated Avulsion Fracture of the Lesser Tuberosity of The
    (aspects of trauma) Isolated Avulsion Fracture of the Lesser Tuberosity of the Humerus in an Adult: Case Report and Literature Review Aman Dhawan, MD, Kevin Kirk, DO, Thomas Dowd, MD, and William Doukas, MD solated avulsion fractures of also describe our operative technique, comminuted 3-cm lesser tuberosity the lesser tuberosity of the including use of heavy, nonabsorb- fracture fragment retracted approxi- proximal humerus are rare. able suture. mately 2 cm from the donor site We report the case of a right- (Figures 1B–1D). No biceps tendon Ihand–dominant woman in her early ASE EPORT subluxation or injury and no intra- C R 30s who sustained such an injury, A right-hand–dominant woman in articular pathology were noted. with an intact subscapularis tendon her early 30s presented with right The lesser tuberosity fracture was attached to the lesser tuberosity frag- shoulder pain 1 day after a fall down surgically repaired less than 2 weeks ment. Treatment included surgery to a flight of stairs. During the acci- after injury. Through a deltopectoral restore tension to the subscapularis dent, as her feet slipped out from approach, the rotator interval and muscle and maintain the force couple underneath her and her torso fell the 3×2-cm fracture fragment were about the shoulder joint. One year after injury, the patient reported no pain, excellent range of motion, and “[To be diagnosed] this injury...requires... return to activities. This case demonstrates the diag- careful review of orthogonal radiographs nostic challenge of this injury, which requires a high index of suspicion and and advanced imaging.” careful review of orthogonal radio- graphs and advanced imaging.
    [Show full text]
  • Body Mechanics As the Rotator Cuff Gether in a Cuff-Shape Across the Greater and Lesser Tubercles the on Head of the Humerus
    EXPerT CONTENT Body Mechanics by Joseph E. Muscolino | Artwork Giovanni Rimasti | Photography Yanik Chauvin Rotator Cuff Injury www.amtamassage.org/mtj WORKING WITH CLieNTS AFFecTED BY THIS COmmON CONDITION ROTATOR CUFF GROUP as the rotator cuff group because their distal tendons blend and attach to- The four rotator cuff muscles are gether in a cuff-shape across the greater and lesser tubercles on the head of the supraspinatus, infraspinatus, the humerus. Although all four rotator cuff muscles have specific concen- teres minor, and subscapularis (Fig- tric mover actions at the glenohumeral (GH) joint, their primary functional ure 1). These muscles are described importance is to contract isometrically for GH joint stabilization. Because 17 Before practicing any new modality or technique, check with your state’s or province’s massage therapy regulatory authority to ensure that it is within the defined scope of practice for massage therapy. the rotator cuff group has both mover and stabilization roles, it is extremely functionally active and therefore often physically stressed and injured. In fact, after neck and low back conditions, the shoulder is the most com- Supraspinatus monly injured joint of the human body. ROTATOR CUFF PATHOLOGY The three most common types of rotator cuff pathology are tendinitis, tendinosus, and tearing. Excessive physi- cal stress placed on the rotator cuff tendon can cause ir- ritation and inflammation of the tendon, in other words, tendinitis. If the physical stress is chronic, the inflam- matory process often subsides and degeneration of the fascial tendinous tissue occurs; this is referred to as tendinosus. The degeneration of tendinosus results in weakness of the tendon’s structure, and with continued Teres minor physical stress, whether it is overuse microtrauma or a macrotrauma, a rotator cuff tendon tear might occur.
    [Show full text]
  • 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
    [Show full text]
  • 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:
    [Show full text]
  • Humerus Weight: Norm Light Lesser Tubercle Ant Surface Bumps: Abs
    Collection:______________ ID#:______________ Secondary ID#:______________ 1: _________ 2: _________ : ___ /____/ _____ :_________ Est. Age: Point1: _________ Point2: _________ Est. Sex: M / M? / ? / F? / F Range1: _________ Range2: _________ Cranium L & M & All R parietal depression: abs pres abs pres spheno-occipital synchondrosis: open closed occipital condyle lipping: abs ≥50% ≥75% abs ≥50% ≥75% Vertebral Column Midline Midline C1 lipping: abs ≥50% # scorable lipping: candlewax: C1 eburnation: abs pres C: (10) abs ≥3mm abs pres L1 spinous process: rnd flat ossified L1 sup body surface: NF PF RL FF GF flat porous T: (24) abs ≥5mm abs pres L1 inf body surface: NF PF RL FF GF flat porous L: (10) abs ≥5mm abs pres L5 superior margin: rnd shp lip(any) L5 inferior margin: rnd shp lip(any) DISH: abs ≥4 verts C T L L5 sup body surface: NF PF RL FF GF flat porous L5 inf body surface: NF PF RL FF GF flat porous S1 margin: rnd shp lipped S1-2 fusion: >1cm <1cm closed Sacral elbow: abs pres Sternum & Ribs L & All R & All R1 fusion: abs fused abs fused sternum central dorsal ridge: abs pres R2 rim profile: (2) reg irreg abs cone claw both R3-10 rim profile: (16) reg irreg abs cone claw both R2 shingle rib: (2) norm shingle R3-10 shingle ribs: (16) norm shingle Clavicle & Scapula L R clav med epiphysis fusion: NF PF RL FF NF PF RL FF clav med epiphysis gravel: abs pres abs pres clav med macroporosity: abs ≥3 many abs ≥3 many clav lateral macroporosity: abs ≥3 abs ≥3 scap glen fossa elevated shp & lip: abs <½ ≥½ abs <½ ≥½ Humerus L & All R humerus
    [Show full text]
  • Chapter 5 the Shoulder Joint
    The Shoulder Joint • Shoulder joint is attached to axial skeleton via the clavicle at SC joint • Scapula movement usually occurs with movement of humerus Chapter 5 – Humeral flexion & abduction require scapula The Shoulder Joint elevation, rotation upward, & abduction – Humeral adduction & extension results in scapula depression, rotation downward, & adduction Manual of Structural Kinesiology – Scapula abduction occurs with humeral internal R.T. Floyd, EdD, ATC, CSCS rotation & horizontal adduction – Scapula adduction occurs with humeral external rotation & horizontal abduction © McGraw-Hill Higher Education. All rights reserved. 5-1 © McGraw-Hill Higher Education. All rights reserved. 5-2 The Shoulder Joint Bones • Wide range of motion of the shoulder joint in • Scapula, clavicle, & humerus serve as many different planes requires a significant attachments for shoulder joint muscles amount of laxity – Scapular landmarks • Common to have instability problems • supraspinatus fossa – Rotator cuff impingement • infraspinatus fossa – Subluxations & dislocations • subscapular fossa • spine of the scapula • The price of mobility is reduced stability • glenoid cavity • The more mobile a joint is, the less stable it • coracoid process is & the more stable it is, the less mobile • acromion process • inferior angle © McGraw-Hill Higher Education. All rights reserved. 5-3 © McGraw-Hill Higher Education. All rights reserved. From Seeley RR, Stephens TD, Tate P: Anatomy and physiology , ed 7, 5-4 New York, 2006, McGraw-Hill Bones Bones • Scapula, clavicle, & humerus serve as • Key bony landmarks attachments for shoulder joint muscles – Acromion process – Humeral landmarks – Glenoid fossa • Head – Lateral border • Greater tubercle – Inferior angle • Lesser tubercle – Medial border • Intertubercular groove • Deltoid tuberosity – Superior angle – Spine of the scapula © McGraw-Hill Higher Education.
    [Show full text]
  • Ultrasound-Guided Pain Interventions in Shoulder Region
    T ECHNIQUES IN R EGIONAL A NESTHESIA AND P AIN M ANAGEMENT 17 (2013) 81– 95 Available online at www.sciencedirect.com www.elsevier.com/locate/trap Ultrasound-guided pain interventions in shoulder region n Concepcion del-Olmo, MDa, , Pilar de-Diego, MDa, Paloma Morillas, MDb, Miguel Garcia-Navlet, MDc aDepartment of Anesthesia and Pain Medicine, Hospital ASEPEYO, Calle Joaquin de Cardenas 2, 28820 Coslada, Madrid, Spain bDepartment of Anesthesia and Intensive Care, Hospital General Universitario Gregorio Marañón, Madrid, Spain cDepartment of Traumatology, Hospital ASEPEYO, Coslada, Madrid, Spain article info abstract Keywords: Shoulder pain is one of the common complaints to physicians in general practice. Among Shoulder injection therapeutic measures used to treat this pain, invasive techniques, such as joints and Rotator cuff periarticular injection, as well as suprascapular and axillary nerve block, play a crucial role. Glenohumeral joint Ultrasound guidance is a safe alternative to blind techniques, increasing the safety and Axillary nerve accuracy of the procedure and reducing complications. A good understanding of the anatomy Suprascapular nerve and sonoanatomy is of paramount importance in performing the ultrasound-guided injections. & 2014 Elsevier Inc. All rights reserved. Introduction glenohumeral, acromioclavicular, and sternoclavicular), and 2 gliding mechanisms (the scapulothoracic and subacromial) Pain in shoulder region can originate from various structures, all acting as a single biomechanical unit. including the subacromial-subdeltoid bursa, the glenohumeral The glenohumeral joint (GHJ) is the joint with the greatest and acromioclavicular joint, the long head of biceps, and the range of mobility. Its articular surfaces are the humeral head rotator cuff. Interventional pain procedures are an important and the glenoid fossa.
    [Show full text]
  • Muscles of the Upper Limb.Pdf
    11/8/2012 Muscles Stabilizing Pectoral Girdle Muscles of the Upper Limb Pectoralis minor ORIGIN: INNERVATION: anterior surface of pectoral nerves ribs 3 – 5 ACTION: INSERTION: protracts / depresses scapula coracoid process (scapula) (Anterior view) Muscles Stabilizing Pectoral Girdle Muscles Stabilizing Pectoral Girdle Serratus anterior Subclavius ORIGIN: INNERVATION: ORIGIN: INNERVATION: ribs 1 - 8 long thoracic nerve rib 1 ---------------- INSERTION: ACTION: INSERTION: ACTION: medial border of scapula rotates scapula laterally inferior surface of scapula stabilizes / depresses pectoral girdle (Lateral view) (anterior view) Muscles Stabilizing Pectoral Girdle Muscles Stabilizing Pectoral Girdle Trapezius Levator scapulae ORIGIN: INNERVATION: ORIGIN: INNERVATION: occipital bone / spinous accessory nerve transverse processes of C1 – C4 dorsal scapular nerve processes of C7 – T12 ACTION: INSERTION: ACTION: INSERTION: stabilizes / elevates / retracts / upper medial border of scapula elevates / adducts scapula acromion / spine of scapula; rotates scapula lateral third of clavicle (Posterior view) (Posterior view) 1 11/8/2012 Muscles Stabilizing Pectoral Girdle Muscles Moving Arm Rhomboids Pectoralis major (major / minor) ORIGIN: INNERVATION: ORIGIN: INNERVATION: spinous processes of C7 – T5 dorsal scapular nerve sternum / clavicle / ribs 1 – 6 dorsal scapular nerve INSERTION: ACTION: INSERTION: ACTION: medial border of scapula adducts / rotates scapula intertubucular sulcus / greater tubercle flexes / medially rotates / (humerus) adducts
    [Show full text]
  • Bone Handout”)
    The Skeletal System (“Bone Handout”) Bone Markings - as in Table 6.1, know categories, names, descriptions and categories of bone markings Common Fractures - as in Table 6.2, identify type from pictures The Axial Skeleton Skull Cranial bones frontal (supraorbital foramen) parietal temporal (mastoid process, external auditory(acoustic) meatus, styloid process, zygomatic process, stylomastoid foramen) occipital (foramen magnum, hypoglossal canal, occipital condyles) sphenoid (optic canal, superior orbital fissure, sella turcica, foramen rotundum, foramen ovale, foramen spinosum , greater wings, lesser wings) ethmoid (olfactory foramina) Relevant Figures: 7.4, 7.6, 7.7a, 7.9 Facial bones nasal maxilla (infraorbital foramen, inferior orbital fissure) zygomatic mandible (mental foramen, body, ramus, mandibular condyle) lacrimal (lacrimal fossa) palatine inferior nasal conchae vomer Relevant Figures: 7.4, 7.6, 7.7a Sutures coronal sagittal lambdoid squamous Relevant Figures: 7.4, 7.5 Paranasal Sinuses frontal sphenoidal maxillary ethmoidal Relevant Figures: 7.15 Fontanels anterior posterior sphenoidal mastoid Relevant Figures: 7.28 Hyoid bone Relevant Figures: 7.17 1 Vertebrae Parts of a “typical vertebra” using thoracic as example body vertebral arch (pedicle, lamina, vertebral foramen) intervertebral foramen transverse process spinous process superior articular process inferior articular process Divisions of vertebral column cervical (transverse foramina) thoracic (transverse costal facet - for tubercle of rib, superior and inferior costal
    [Show full text]
  • Upper Extremity Scapula
    Lab 6 FUNCTIONAL HUMAN ANATOMY LAB #6 UPPER/LOWER EXTREMITY OSTEOLOGY OSTEOLOGY: UPPER EXTREMITY SCAPULA: Borders: Medial (Vertebral) - most superior aspect called the Superior angle Lateral - most inferior aspect called the inferior angle Fossa: Supraspinous fossa Infraspinous fossa Subscapular fossa Glenoid fossa Other Features: acromion process coracoid process scapular spine scapular notch infraglenoid tubercle - located at the bottom of the glenoid fossa supraglenoid tubercle - located at the top of the glenoid fossa Note: the shape of the Glenoid fossa suggests that shoulder stability is heavily reliant on connective tissues surrounding the joint to prevent dislocation CLAVICLE: sternal end - blunt, articulates with the Manubrium acromial end - flat/bladelike, articulates with the Acromium process HUMERUS: head greater tubercle lesser tubercle interturbicular (bicipital) groove - located between the tubercles deltoid tuberosity shaft medial/lateral epicondyles capitulum - the part of the distal condyle that articulates with the Radius trochlea - the part of the distal condyle that articulates with the Ulna olecranon fossa coronoid fossa ULNA: 1 Lab 6 coronoid process olecranon process trochlear notch ulnar tuberosity body head (distal end) radial notch - where the proximal end of the radius articulates interosseous border (lateral side) styloid process RADIUS: body neck head (proximal end) radial tuberosity anterior oblique line interosseous border styloid process CARPAL BONES # of rows? # of bones? Which carpal primarily articulates
    [Show full text]
  • Shoulder Anatomy
    ShoulderShoulder AnatomyAnatomy www.fisiokinesiterapia.biz ShoulderShoulder ComplexComplex BoneBone AnatomyAnatomy ClavicleClavicle – Sternal end – Acromion end ScapulaScapula Acromion – Surfaces end Sternal Costal end Dorsal – Borders – Angles ShoulderShoulder ComplexComplex BoneBone AnatomyAnatomy Scapula 1. spine 2. acromion 3. superior border 4. supraspinous fossa 5. infraspinous fossa 6. medial (vertebral) border 7. lateral (axillary) border 8. inferior angle 9. superior angle 10. glenoid fossa (lateral angle) 11. coracoid process 12. superior scapular notch 13 subscapular fossa 14. supraglenoid tubercle 15. infraglenoid tubercle ShoulderShoulder ComplexComplex BoneBone AnatomyAnatomy HumerousHumerous – head – anatomical neck – greater tubercle – lesser tubercle – greater tubercle – lesser tubercle – intertubercular sulcus (AKA bicipital groove) – deltoid tuberosity ShoulderShoulder ComplexComplex BoneBone AnatomyAnatomy HumerousHumerous – Surgical Neck – Angle of Inclination 130-150 degrees – Angle of Torsion 30 degrees posteriorly ShoulderShoulder ComplexComplex ArticulationsArticulations SternoclavicularSternoclavicular JointJoint – Sternal end of clavicle with manubrium/ 1st costal cartilage – 3 degree of freedom – Articular Disk – Ligaments Capsule Anterior/Posterior Sternoclavicular Ligament Interclavicular Ligament Costoclavicular Ligament ShoulderShoulder ComplexComplex ArticulationsArticulations AcromioclavicularAcromioclavicular JointJoint – 3 degrees of freedom – Articular Disk – Ligaments Superior/Inferior
    [Show full text]
  • Chapter 6 the Shoulder, Humerus, Elbow and Radius
    Chapter 6 The shoulder, humerus, elbow and radius Scapulohumeral (shoulder) joint and humerus RADIOGRAPHIC TECHNIQUE Equipment The scapulohumeral joint may be radiographed with the horse standing if a high-output x-ray machine is available. Better-quality radiographs are generally obtained with the horse under general anaesthesia in lateral recumbency. With the horse anaesthetized, positioning is easier and longer exposure times can be used without risk of movement, so a lower output x- ray machine may be used. The radiation hazard to personnel is also reduced. Digital systems, or rare earth screens and appropriate fi lm, are essential due to the high exposures required to penetrate the large muscle mass in this area. A grid is recommended to reduce the effects of scattered radiation, and lead should be placed behind the cassette to limit back scatter. There is less soft tissue to penetrate cranially; therefore it may be necessary to repeat a view with different exposure factors in order to assess both the cranioproximal aspect of the humerus and the more caudally situated scapu- lohumeral joint properly. Alternatively an aluminium wedge fi lter can be used to modify the exposure. For mediolateral radiographs obtained with the horse standing, the cassette should be mounted in a holder and not hand held. Both mediolateral and oblique views are required for a complete assessment of the scapulohumeral joint, and in selected cases arthrography yields valuable additional information. Positioning Mediolateral view standing The forelimb to be examined is positioned next to the cassette and the limb is protracted as much as the horse will comfortably allow, to avoid super- imposition of the left and right shoulder joints (Figure 6.1).
    [Show full text]