DOCSLIB.ORG

Applied Anatomy of the Shoulder

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Applied Anatomy of the Shoulder Applied anatomy of the shoulder CHAPTER CONTENTS Rotator .cuff . e49 Introduction . e39 Nerves .and .blood .vessels . e49 Bones . e40 Suprascapular nerve . e49 Scapula . e40 Axillary nerve . e49 Humerus . e41 Subclavian artery and vein . e50 Clavicle . e41 Joints .and .intracapsular .ligaments . e41 Introduction Glenohumeral joint . e41 Subacromial space . e42 The main function of the joints of the shoulder girdle (Fig. 1) Acromioclavicular joint . e42 is to move the arm and hand into almost any position in rela- Sternoclavicular joint . e42 tion to the body. As a consequence the shoulder joint is highly Scapulothoracic gliding mechanism . e43 mobile, where stability takes second place to mobility, as is evident from the shape of the osseous structures: a large Extracapsular .ligaments . e43 humeral head lying on an almost flat scapular surface. Stability Coracoacromial ligament . e43 is provided mainly by ligaments, tendons and muscles; the Coracoclavicular ligaments . e43 bones and capsule are of secondary importance. Costocoracoid fascia . e43 The function of the shoulder girdle requires an optimal and Bursae . e44 integrated motion of several joints. In fact five ‘joints’ of impor- tance to ‘shoulder’ function can be distinguished:1 Subacromial–subdeltoid bursa . e44 • The glenohumeral joint (1) Subcoracoid bursa. e44 • The acromioclavicular joint (2) Shoulder .movements . e44 • The sternoclavicular joint (3) Muscles .and .tendons . e45 • The subacromial joint or subacromial gliding mechanism Adduction . e45 (4): the space between the coracoacromial roof and the Abduction . e46 humeral head, including both tubercles. This is the location of the deep portion of the subdeltoid bursa Medial rotation . e47 • The scapulothoracic gliding mechanism (5): this functional Lateral rotation . e47 joint is formed by the anterior aspect of the scapula Flexion of the elbow . e48 gliding on the posterior thoracic wall. Extension of the elbow . e48 Optimal mobility also requires an intact neurological and mus- Flexion . e48 cular system. © Copyright 2013 Elsevier, Ltd. All rights reserved. The Shoulder 2 6 1 4 3 1 2 5 3 5 4 Fig 1 • A global view of all five joints of the shoulder girdle: 1, glenohumeral joint; 2, acromioclavicular joint; 3, sternoclavicular joint; 4, subacromial joint or subacromial gliding mechanism; 5, scapulothoracic gliding mechanism. Fig 2 • Posterior view of the scapula: 1, coracoid process; 2, It is not our intention to give a complete anatomical review, acromion; 3, glenoid; 4, infraspinal fossa; 5, scapular spine; 6, which can be obtained from anatomy texts. Only those supraspinal fossa. structures which are of specific clinical importance will be focused on. 1 2 Bones Osseous structures of interest are the scapula, humerus and clavicle. Neither the vertebral column nor the thoracic cage is discussed here (see chapters on the anatomy of the cervical and thoracic spine). Scapula 3 The scapula is a thin sheet of bone that functions mainly as a site of muscle attachment (Figs 2–3, see Putz, Figs. 286, 287, 288). Its medial border is parallel to the spine, the lateral and superior borders are oblique. It has a superior, a lateral and an inferior angle. The inferior angle corresponds to the interspinal 4 level between the spinous processes of T7 and T8. The scapula contains four processes: the acromion, the cora- coid, the spine and the articular process (the glenoid). The dorsum of the scapula is convex. It is divided by its spine into two fossae: the supraspinal and infraspinal fossa, containing the corresponding muscles. The scapular spine runs Fig 3 • Anterior view of the scapula: 1, acromion; 2, coracoid from the junction of the upper and middle third of the medial process; 3, glenoid fossa; 4, anterior surface. border, where it is rather flat, and corresponds to the level of the third thoracic spinous process. Laterally it becomes more anterior aspect of the scapula, is a large concavity which con- prominent and meets the acromion at a right angle posteriorly. tains the subscapularis muscle. This angle is easily palpable and is one of the main bony land- At the lateral angle, just beyond the neck of the scapula, marks at the shoulder. The acromion turns further anteriorly is the glenoid fossa. This has a rather shallow surface, which and covers part of the humeral head. is directed anterolaterally and slightly cranially tilted. It is The coracoid process is found at the anterior aspect of the approximately one-quarter the size of the humeral head and scapula. The tip points outwards and is easily palpated in this, plus its shallow concavity, makes the joint both very the lateral part of the subclavian fossa. Further down, on the mobile and vulnerable to (sub)luxations. © Copyright 2013 Elsevier, Ltd. All rights reserved. e40 Applied anatomy of the shoulder 2 1 1 4 3 2 3 Fig 5 • Shoulder (glenohumeral) joint: 1, labrum; 2, glenoid cartilage; 3, shoulder capsule. Fig 4 • Superior view of humerus: 1, humeral head; 2, minor tuberosity; 3, major tuberosity; 4, bicipital sulcus. geometrical relationship between glenoid and head which is responsible for the considerable mobility of the joint but is also an important predisposing factor to glenohumeral instability. The ventral surface of the scapula is flat and covered with First, the large spherical head of the humerus articulates against the attachment of the subscapularis muscle, except for the the small shallow glenoid fossa of the scapula (only 25–30% medial border and inferior angle where the serratus anterior of the humeral head is covered by the glenoid surface). Second, muscle is inserted. the bony surfaces of the joint are largely incongruent (flat glenoid and round humerus). However, the congruence is Humerus greatly restored by the difference in cartilage thickness: glenoid cartilage is found to be the thickest at the periphery and thin- The articular surface of the humeral head points in a medial, nest centrally, whereas humeral articular cartilage is thickest posterior and slightly caudal direction and is separated from centrally and thinnest peripherally. This leads to a uniform the major and minor tuberosities by its anatomical neck. contact between humeral head and glenoid surface throughout When the arm is hanging down the side with its anterior shoulder motion. aspect facing the body, the greater tuberosity lies laterally and The labrum is a fibrous structure that forms a ring around the lesser tuberosity anteriorly. They are separated from each the periphery of the glenoid (see Putz, Fig. 298). It acts as an other by the bicipital sulcus (Fig. 4). anchor point for the capsuloligamentous structures and for the long head of the biceps. It further contributes to stability of the joint by increasing the depth of the glenoid socket, enlarg- Clavicle ing the surface area and acting as a load-bearing structure for the humeral head. The clavicle joins the sternum to the acromion. At its medial The synovial membrane of the joint capsule is mainly end it has a forward convexity whereas its lateral end is rather attached to the labrum, covering its inner surface, and at the more concave (see Putz, Fig. 284). anatomical neck of the humerus. It forms a sleeve around the The joint capsules of both the sternoclavicular and the intra-articular and inter-tubercular part of the long tendon of acromioclavicular joints are reinforced by several ligaments. the biceps. The clavicle has many muscular and ligamentous attach- The fibrous portion of the capsule is very lax and has several ments. The insertion of the coracoclavicular ligament is of recesses, depending on the position of the arm. At its caudal practical importance. It is found laterally on the inferior aspect end it forms the axillary recess, which allows normal elevation of the clavicle, and just medial to it is the origin of the sub- of the arm. Very often adhesions form here. clavius muscle. The joint capsule is large, loose and redundant: the capacity The clavicle gives support to the shoulder girdle by acting of the glenohumeral joint capsule is larger than that of the as a strut between scapula and sternum. Due to its S-shape, humeral head to allow full and free range of motion of the the outer end describes a much larger rotation during arm shoulder. elevation than its inner end. Therefore, lesions of the acromio- At the anterior portion of the capsule three local reinforce- clavicular joint ligaments are more frequent than are lesions of ments are present: the superior, medial and inferior gleno- the sternoclavicular joint ligaments. humeral ligaments (Fig. 6). These contribute, together with the subscapularis, supraspinatus, infraspinatus and teres minor Joints and intracapsular ligaments muscles, to the stability of the joint. The supraspinatus, infraspinatus, teres minor and subscapu- laris tendons reinforce the superior, posterior and anterior Glenohumeral joint capsule. By virtue of the blending of their tendons with the glenohumeral capsule and ligaments, selective contraction of The glenohumeral joint (Fig. 5) is a ball-and-socket between the cuff muscles can adjust the tension in these structures, humeral head and glenoid fossa. There is a remarkable producing ‘dynamic’ ligaments. © Copyright 2013 Elsevier, Ltd. All rights reserved. e41 The Shoulder Subacromial space thicker on its superior, anterior and posterior surfaces than on the inferior surface. The anteroposterior stability of the The suprahumeral gliding mechanism consists of the coracoac- acromioclavicular joint is controlled by the acromioclavicular romial arch (see below) on one side and the proximal part of ligaments and the vertical stability is controlled by coracocla- the humerus, covered by the rotator cuff and the biceps tendon vicular ligaments (conoid and trapezoid). on the other. Both parts are separated by the subacromial bursa that acts as a joint space (Fig. 7). Investigators point to the Sternoclavicular joint importance of contact and load transfer between the rotator cuff and the coracoacromial arch in the function of the normal The only osseous connection between the skeleton of the trunk shoulder.
Load more

Recommended publications
  • Considered a Bone of Both Shoulder Girdle and Shoulder Joint. the Shoulder Girdle Is Comprised of the Clavicle and the Scapula
    Considered a bone of both shoulder girdle and shoulder joint. The shoulder girdle is comprised of the clavicle and the scapula. The shoulder joint consists of the scapula and the humerus. The primary function of the shoulder girdle is to position itself to accommodate movements of the shoulder joint. 1 Superior angle—top point Inferior angle—bottom point Vertebral border—side closest to vertebral column Axillary border—side closest to arm Subscapular fossa—anterior fossa Glenoid fossa, glenoid labrum, glenoid cavity --The glenoid fossa is the shallow cavity where the humeral head goes. The glenoid labrum is the cartilage that goes around the glenoid fossa. So the glenoid fossa and glenoid labrum together comprise the glenoid cavity. Supraspinous fossa—posterior, fossa above the spine Spine of the scapula—the back projection Infraspinous fossa—posterior depression/fossa below spine Coracoid process—anterior projection head Acromion process—posterior projection head above spine 2 Scapulothoracic “joint” = NOT a true joint; there are no ligaments or articular capsule. The scapula just rests on the muscle over top the rib cage, which allows for passive movements. Sternoclavicular joint=where the clavicle (collarbone) and the sternum (breastbone) articulate; movement is slight in all directions and of a gliding, rotational type Acromioclavicular joint = where the clavicle and scapula (acromion process) articulate; AKA: AC Joint; movement is a slight gliding when elevation and depression take place. Glenohumeral joint = the shoulder joint 3 4 All 3 true joints: Sternoclavicular, AC and glenohumeral (GH) all work together to move arm in all directions. The GH allows the arm to go out to the side and be abducted, then the AC and Sternoclavicular joints kick in to allow the arm to go above shoulder level by allowing the shoulderblade to move up to increase the range of motion (ROM).
    [Show full text]
  • Thoracic Outlet and Pectoralis Minor Syndromes
    S EMINARS IN V ASCULAR S URGERY 27 (2014) 86– 117 Available online at www.sciencedirect.com www.elsevier.com/locate/semvascsurg Thoracic outlet and pectoralis minor syndromes n Richard J. Sanders, MD , and Stephen J. Annest, MD Presbyterian/St. Luke's Medical Center, 1719 Gilpin, Denver, CO 80218 article info abstract Compression of the neurovascular bundle to the upper extremity can occur above or below the clavicle; thoracic outlet syndrome (TOS) is above the clavicle and pectoralis minor syndrome is below. More than 90% of cases involve the brachial plexus, 5% involve venous obstruction, and 1% are associate with arterial obstruction. The clinical presentation, including symptoms, physical examination, pathology, etiology, and treatment differences among neurogenic, venous, and arterial TOS syndromes. This review details the diagnostic testing required to differentiate among the associated conditions and recommends appropriate medical or surgical treatment for each compression syndrome. The long- term outcomes of patients with TOS and pectoralis minor syndrome also vary and depend on duration of symptoms before initiation of physical therapy and surgical intervention. Overall, it can be expected that 480% of patients with these compression syndromes can experience functional improvement of their upper extremity; higher for arterial and venous TOS than for neurogenic compression. & 2015 Published by Elsevier Inc. 1. Introduction compression giving rise to neurogenic TOS (NTOS) and/or neurogenic PMS (NPMS). Much less common is subclavian Compression of the neurovascular bundle of the upper and axillary vein obstruction giving rise to venous TOS (VTOS) extremity can occur above or below the clavicle. Above the or venous PMS (VPMS).
    [Show full text]
  • Elbow Checklist
    Workbook Musculoskeletal Ultrasound September 26, 2013 Shoulder Checklist Long biceps tendon Patient position: Facing the examiner Shoulder in slight medial rotation; elbow in flexion and supination Plane/ region: Transverse (axial): from a) intraarticular portion to b) myotendinous junction (at level of the pectoralis major tendon). What you will see: Long head of the biceps tendon Supraspinatus tendon Transverse humeral ligament Subscapularis tendon Lesser tuberosity Greater tuberosity Short head of the biceps Long head of the biceps (musculotendinous junction) Humeral shaft Pectoralis major tendon Plane/ region: Logitudinal (sagittal): What you will see: Long head of biceps; fibrillar structure Lesser tuberosity Long head of the biceps tendon Notes: Subscapularis muscle and tendon Patient position: Facing the examiner Shoulder in lateral rotation; elbow in flexion/ supination Plane/ region: longitudinal (axial): full vertical width of tendon. What you will see: Subscapularis muscle, tendon, and insertion Supraspinatus tendon Coracoid process Deltoid Greater tuberosity Lesser tuberosity Notes: Do passive medial/ lateral rotation while examining Plane/ region: Transverse (sagittal): What you will see: Lesser tuberosity Fascicles of subscapularis tendon Supraspinatus tendon Patient position: Lateral to examiner Shoulder in extension and medial rotation Hand on ipsilateral buttock Plane/ region: Longitudinal (oblique sagittal) Identify the intra-articular portion of biceps LH in the transverse plane; then
    [Show full text]
  • THE STUDY of CORACOACROMIAL LIGAMENT MORPHOLOGY and ITS CLINICAL ASPECTS Sowmya S *1, Sharmada Kl 2, Meenakshi Parthasarathy 3
    International Journal of Anatomy and Research, Int J Anat Res 2020, Vol 8(1.2):7342-45. ISSN 2321-4287 Original Research Article DOI: https://dx.doi.org/10.16965/ijar.2019.377 THE STUDY OF CORACOACROMIAL LIGAMENT MORPHOLOGY AND ITS CLINICAL ASPECTS Sowmya S *1, Sharmada Kl 2, Meenakshi Parthasarathy 3. *1 Associate professor, Dept of Anatomy, Bowring & Lady Curzon Medical College & Research Institute, Karnataka, India, [email protected] 2 Tutor, Dept of Anatomy, Bowring & Lady Curzon Medical College & Research Institute, Karnataka, India, [email protected] 3 Professor, Dept of Anatomy, Bowring & Lady Curzon Medical College & Research Institute, Karnataka, India, [email protected] ABSTRACT Background: The coracoacromial ligament (CAL) as an integral component of the coracoacromial arch, plays an important role in shoulder biomechanics, joint stability, and proprioception thus maintains static restraint due to its dynamic interactions with ligaments, muscles and bony elements around the shoulder joint. Age-dependent changes due to chronic stress and cellular degradation cause thickening and stiffening of the CAL that may contribute to a spectrum of shoulder pathology from capsular tightness to rotator cuff tear arthropathy and impingement syndrome. Objectives: This study conducted to observe the different types of CAL and its relationship with coracoacromial veil. Materials and Methods: The study conducted on 50 upper limbs at Bowring & Lady Curzon medical college & research institute and Bangalore medical college & research institute. The upper limbs were dissected at the shoulder joint complex and acromion process and coracoid process were appreciated and coracoacromial ligaments were appreciated for their types and morphometry. Results and Conclusion: Four types of CAL were observed in this study.
    [Show full text]
  • Structure of the Human Body
    STRUCTURE OF THE HUMAN BODY Vertebral Levels 2011 - 2012 Landmarks and internal structures found at various vertebral levels. Vertebral Landmark Internal Significance Level • Bifurcation of common carotid artery. C3 Hyoid bone Superior border of thyroid C4 cartilage • Larynx ends; trachea begins • Pharynx ends; esophagus begins • Inferior thyroid A crosses posterior to carotid sheath. • Middle cervical sympathetic ganglion C6 Cricoid cartilage behind inf. thyroid a. • Inferior laryngeal nerve enters the larynx. • Vertebral a. enters the transverse. Foramen of C 6. • Thoracic duct reaches its greatest height C7 Vertebra prominens • Isthmus of thyroid gland Sternoclavicular joint (it is a • Highest point of apex of lung. T1 finger's breadth below the bismuth of the thyroid gland T1-2 Superior angle of the scapula T2 Jugular notch T3 Base of spine of scapula • Division between superior and inferior mediastinum • Ascending aorta ends T4 Sternal angle (of Louis) • Arch of aorta begins & ends. • Trachea ends; primary bronchi begin • Heart T5-9 Body of sternum T7 Inferior angle of scapula • Inferior vena cava passes through T8 diaphragm T9 Xiphisternal junction • Costal slips of diaphragm T9-L3 Costal margin • Esophagus through diaphragm T10 • Aorta through diaphragm • Thoracic duct through diaphragm T12 • Azygos V. through diaphragm • Pyloris of stomach immediately above and to the right of the midline. • Duodenojejunal flexure to the left of midline and immediately below it Tran pyloric plane: Found at the • Pancreas on a line with it L1 midpoint between the jugular • Origin of Superior Mesenteric artery notch and the pubic symphysis • Hilum of kidneys: left is above and right is below. • Celiac a.
    [Show full text]
  • Subacromial Decompression in the Shoulder
    Subacromial Decompression Geoffrey S. Van Thiel, Matthew T. Provencher, Shane J. Nho, and Anthony A. Romeo PROCEDURE 2 22 Indications P ITFALLS ■ Impingement symptoms refractory to at least • There are numerous possible 3 months of nonoperative management causes of shoulder pain that can ■ In conjunction with arthroscopic treatment of a mimic impingement symptoms. All potential causes should be rotator cuff tear thoroughly evaluated prior to ■ Relative indication: type II or III acromion with undertaking operative treatment clinical fi ndings of impingement of isolated impingement syndrome. Examination/Imaging Subacromial Decompression PHYSICAL EXAMINATION ■ Assess the patient for Controversies • Complete shoulder examination with range of • Subacromial decompression in motion and strength the treatment of rotator cuff • Tenderness with palpation over anterolateral pathology has been continually acromion and supraspinatus debated. Prospective studies • Classic Neer sign with anterolateral shoulder have suggested that there is no difference in outcomes with and pain on forward elevation above 90° when without subacromial the greater tuberosity impacts the anterior decompression. acromion (and made worse with internal rotation) • Subacromial decompression • Positive Hawkins sign: pain with internal rotation, performed in association with a forward elevation to 90°, and adduction, which superior labrum anterior- causes impingement against the coracoacromial posterior (SLAP) repair can potentially increase ligament postoperative stiffness. ■ The impingement test is positive if the patient experiences pain relief with a subacromial injection of lidocaine. ■ Be certain to evaluate for acromioclavicular (AC) joint pathology, and keep in mind that there are several causes of shoulder pain that can mimic impingement syndrome. P ITFALLS IMAGING • Ensure that an axillary lateral ■ Standard radiographs should be ordered, view is obtained to rule out an os acromiale.
    [Show full text]
  • Phty 101 – Week 1
    PHTY 101 – WEEK 1 1.7 Classify the shoulder (glenohumeral) joint and identify and/or describe its: • The glenohumeral joint is a multiaxial, synovial, ball and socket joint • Movements: o Flexion and extension- transverse axis o Abduction and adduction- anteroposterior axis o Internal and external rotation- longitudinal axis • Greatest amount of motion and most unstable joint in body • Function: positions and directs humerus, elbow and hand in relation to trunk (radioulnar joint deal with palm and fingers) • Combines with scapulothoracic, acromioclavicular and sternoclavicular joints • Articular surfaces: o Humeral head- ½ sphere, faces medially o Glenoid fossa- very shallow, faces laterally o Only 25-30% contact between articular surfaces o Shallower and smaller surface compared to hip • Glenoid labrum o Glenoid labrum- fibrous structure around glenoid fossa (adheres to edges), central part avascular and edges not greatly vascularised à doesn’t heal well, labrum functions to; - Facilitate mobility - Increase glenoid concavity- increasing mobility - Provide attachment for joint capsule, ligaments and muscles • Joint capsule o Very thin and lax- doesn’t compromise ROM o Attaches to glenoid labrum o Reflected (folded) inferiorly onto medial shaft of humerus o Reinforced by; - Rotator cuff tendons- supraspinatus, infraspinatus, teres minor, subscapularis - Rotator cuff tendons- action: internal or external rotation, function: pull humerus head in against fossa - Glenohumeral and coracohumeral ligaments (capsular) • Synovial membrane o Lines
    [Show full text]
  • Using Neutrality to Increase Shoulder Strength
    Using Neutrality To Increase Shoulder Strength SUSAN M. T. McKAY, OTR/L [email protected] GOAL Look at shoulder rehab in a different way. Strength can come from increasing flexibility and placing a joint in proper alignment. Conversely, strengthening a shoulder in improper alignment can cause injury. WHY PICK ON THE SHOULDER? . Impairs function/limits ADL’s . Pain in shoulder . Compensatory patterns can lead to back pain . Elderly rely on upper body to move/ambulate . The sooner issues are treated, the less physiological damage there is SHOULDER ANATOMY . Muscles and how they move . A basic review and more . Important to know… SHOULDER ANATOMY . Supraspinatus . Initiates and assists deltoid in abduction of arm and acts with other rotator cuff muscles. SHOULDER ANATOMY . Infraspinatus . Laterally rotate arm; helps to hold humeral head in glenoid cavity of scapula SHOULDER ANATOMY . Subscapularis . Medially rotates arm and adducts it; helps to hold humeral head in glenoid cavity of scapula SHOULDER ANATOMY . Teres Minor . Laterally rotate arm; helps to hold humeral head in glenoid cavity of scapula SHOULDER ANATOMY . Deltoid . Anterior part: flexes and medially rotates arm; Middle part: abducts arm; Posterior part: extends and laterally rotates arm SHOULDER ANATOMY . Latissimus dorsi . Extends, adducts, and medially rotates humerus; raises body toward arms during climbing SHOULDER ANATOMY . Teres Major . Adducts and medially rotates arm SHOULDER ANATOMY . Pectoralis major . Adducts and medially rotates humerus; draws scapula anteriorly and inferiorly; Acting alone: clavicular head flexes humerus and sternocostal head extends it SHOULDER ANATOMY . Pectoralis Minor . Stabilizes scapula by drawing it inferiorly and anteriorly against thoracic wall SHOULDER ANATOMY .
    [Show full text]
  • M1 – Muscled Arm
    M1 – Muscled Arm See diagram on next page 1. tendinous junction 38. brachial artery 2. dorsal interosseous muscles of hand 39. humerus 3. radial nerve 40. lateral epicondyle of humerus 4. radial artery 41. tendon of flexor carpi radialis muscle 5. extensor retinaculum 42. median nerve 6. abductor pollicis brevis muscle 43. flexor retinaculum 7. extensor carpi radialis brevis muscle 44. tendon of palmaris longus muscle 8. extensor carpi radialis longus muscle 45. common palmar digital nerves of 9. brachioradialis muscle median nerve 10. brachialis muscle 46. flexor pollicis brevis muscle 11. deltoid muscle 47. adductor pollicis muscle 12. supraspinatus muscle 48. lumbrical muscles of hand 13. scapular spine 49. tendon of flexor digitorium 14. trapezius muscle superficialis muscle 15. infraspinatus muscle 50. superficial transverse metacarpal 16. latissimus dorsi muscle ligament 17. teres major muscle 51. common palmar digital arteries 18. teres minor muscle 52. digital synovial sheath 19. triangular space 53. tendon of flexor digitorum profundus 20. long head of triceps brachii muscle muscle 21. lateral head of triceps brachii muscle 54. annular part of fibrous tendon 22. tendon of triceps brachii muscle sheaths 23. ulnar nerve 55. proper palmar digital nerves of ulnar 24. anconeus muscle nerve 25. medial epicondyle of humerus 56. cruciform part of fibrous tendon 26. olecranon process of ulna sheaths 27. flexor carpi ulnaris muscle 57. superficial palmar arch 28. extensor digitorum muscle of hand 58. abductor digiti minimi muscle of hand 29. extensor carpi ulnaris muscle 59. opponens digiti minimi muscle of 30. tendon of extensor digitorium muscle hand of hand 60. superficial branch of ulnar nerve 31.
    [Show full text]
  • MRI Patterns of Shoulder Denervation: a Way to Make It Easy
    MRI Patterns Of Shoulder Denervation: A Way To Make It Easy Poster No.: C-2059 Congress: ECR 2018 Type: Educational Exhibit Authors: E. Rossetto1, P. Schvartzman2, V. N. Alarcon2, M. E. Scherer2, D. M. Cecchi3, F. M. Olivera Plata4; 1Buenos Aires, Capital Federal/ AR, 2Buenos Aires/AR, 3Capital Federal, Buenos Aires/AR, 4Ciudad Autonoma de Buenos Aires/AR Keywords: Musculoskeletal joint, Musculoskeletal soft tissue, Neuroradiology peripheral nerve, MR, Education, eLearning, Edema, Inflammation, Education and training DOI: 10.1594/ecr2018/C-2059 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to third- party sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations.
    [Show full text]
  • Alliance Glenoid Surgical Technique
    Alliance™ Glenoid Surgical Technique Table of Contents Indications/Contraindications ................................................................................. 2 Introduction .............................................................................................................. 3 Compatibility with Other Zimmer Biomet Humeral Heads ..................................... 3 Pre-Operative Planning ............................................................................................ 3 Technique Summary ................................................................................................. 4 4-Peg Modular Glenoid ............................................................................................ 9 4-Peg Modular Augmented Glenoid ...................................................................... 13 3-Peg Modular Glenoid .......................................................................................... 20 3-Peg Monoblock Glenoid ...................................................................................... 24 2-Peg Monoblock Glenoid ...................................................................................... 28 Revision ................................................................................................................... 32 2 | Alliance Glenoid Surgical Technique The Alliance Glenoid has the following indications/intended uses: INDICATIONS CONTRAINDICATIONS • Non-inflammatory degenerative joint disease Absolute contraindications include infection, sepsis, including
    [Show full text]
  • 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
    [Show full text]