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Examination of Pediatric Shoulder
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Resisted shoulder forward flexion with fully extended elbow is done initially in supinated position (thumbs up position) and next with the forearm in pronation (thumbs down position). The test is said to be positive when the patient complains of pain in the bicipital groove, especially with the arm supinated. This test may give a false-positive result in SLAP lesions (Figure 5.12).
The shoulder
Published in David Silver, Silver's Joint and Soft Tissue Injection, 2018
Resisted flexion of the forearm will cause additional pain over the bicipital groove. The bicipital groove (the intertubercular sulcus) is palpable at the anterolateral tip of the head of the humerus. When the subject rotates the arm medially and laterally, the groove becomes more easily identifiable.
Pedicled Flaps in Head and Neck Reconstruction
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Ralph W. Gilbert, John C. Watkinson
This flap was first described by Ariyan in the late 1970s.12, 13 The muscle’s origins are the clavicle, the sternum and slips from the upper seven ribs. There is also a variable origin from the aponeurosis of the external oblique, which is variable in size. It is inserted into the bicipital groove of the humerus. The muscle has three major segmental sub units: clavicular; sternocostal; and an external segment (the most lateral part of the muscle), which originates from the ribs.
Shoulder magnetic resonance imaging findings in manual wheelchair users with spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2022
Omid Jahanian, Meegan G. Van Straaten, Brianna M. Goodwin, Ryan J. Lennon, Jonathan D. Barlow, Naveen S. Murthy, Melissa M.B. Morrow
The long head of the biceps tendon originates on the supraglenoid tubercle, curving over the humeral head and entering the bicipital groove between the supraspinatus and subscapularis tendons (the rotator cuff interval).23 In the region of the rotator cuff interval many structures are intimately associated with each other including the long head of the biceps, the superior subscapularis tendon, the anterior supraspinatus tendon, and ligaments of the shoulder.23 The medial border of the biceps pulley is formed by the attachment of the subscapularis tendon to the lesser tubercle of the humerus, therefore disruption of the subscapularis is commonly seen with medial subluxation of the biceps tendon.24 Surgeons often observe concomitant subscapularis and biceps tendon pathology at the time of treatment for supraspinatus and infraspinatus tears.24 Mehta and colleagues recently found that the prevalence of biceps disease was significantly related to the size of posterior/superior rotator cuff tears, thus highlighting the importance of reporting concomitant biceps disease with rotator cuff data.24
Everything pectoralis major: from repair to transfer
Published in The Physician and Sportsmedicine, 2020
Kamali Thompson, Young Kwon, Evan Flatow, Laith Jazrawi, Eric Strauss, Michael Alaia
The sternocostal head is the larger of the two muscles, making up 80% of the entire muscle volume and is composed of seven overlapping segments [3,27,32] (Figure 1). The sternocostal head originates from the second to sixth rib and the costal margin of the sternum with the fibers running upward and laterally. The inferior fibers of the pectoralis major are innervated by the medial pectoral nerve (C8-T1), which exits the medial cord of the brachial plexus, travels with the lateral thoracic artery to pierce the pectoralis minor at the midclavicular line and enters the pectoralis major at a mean of 11.0 cm medial to the humeral insertion (95% confidence interval 8.6–15.3 cm) and 2 cm proximal to the inferior edge [4,20,30]. Its’ primary role is the forward elevation of the humerus, as well as internal rotation, horizontal adduction, and extension. Tendons from both muscular heads converge laterally and insert on to the lateral lip of the bicipital groove of the humerus and the anterior lip of the deltoid tuberosity [30]. The crossing of the tendons occurs as the inferior sternocostal head rotates 180° transforming it into the posterior lamina, while the clavicular head becomes the anterior lamina [33].
Surgical management of type II superior labrum anterior posterior (SLAP) lesions: a review of outcomes and prognostic indicators
Published in The Physician and Sportsmedicine, 2019
Sean Sullivan, Ian D. Hutchinson, Emily J Curry, Lee Marinko, Xinning Li
Variability in this technique is primarily in the location of reattachment for the biceps tendon, the approach and the fixation device for the tendon itself. If the reattachment is above or at the level of the intertubercular groove, the biceps maintains an optimal or near-optimal length–tension relationship; however, it may remain vulnerable to pathology (tenosynovitis) within the groove which may result in residual pain and may lead to higher risk for tendinopathy and possible revision surgery [31]. Fixation distal to the groove removes the potential for pain generation in the bicipital groove; however, care must be taken to maintain the length–tension relationship of the biceps at this level using anatomic tensioning techniques. Mini-open subpectoral approaches allow easier access to the shoulder and have an advantage of either direct fixation of LHBT to short-head (biceps transfer) or to the humerus [32,33]. The biceps transfer technique is thought to be effective in preventing the Popeye deformity compared to tenotomy however can shift the trajectory of the biceps in the direction of the coracoid process and therefore may be more suitable for lower demand patients [33].