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Musculoskeletal system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Figure 3.21a shows the subscapularis tendon in the longitudinal plane. It appears as a hyperechoic band that follows the contour of the lesser tuberosity. Anteriorly, the deltoid muscle can be observed. The supraspinatus should be evaluated from the superior facet of the greater tuberosity to the acromion, along its long (Fig. 3.21b) and short axes. Figure 3.21c shows the infraspinatus tendon. The ACJ is shown in Fig. 3.21d. The articular surfaces are smooth and rounded, with the joint space identified as the hypoechoic gap between them. Adjacent bony structures show posterior acoustic shadowing.
Anatomy and biomechanics of the shoulder
Published in Andreas B. Imhoff, Jonathan B. Ticker, Augustus D. Mazzocca, Andreas Voss, Atlas of Advanced Shoulder Arthroscopy, 2017
Lucca Lacheta, Bastian Scheiderer
The deltoid muscle consists of three portions and seven segments: (1) the anterior part originates from the lateral end of the clavicle and anterior-third of the acromion, (2) the middle part attaches to the mid-third of the lateral aspect of the acromion, and (3) the posterior part to the posterior third of the lateral acromion as well as the scapular spine.39,40
Deltoid and Scapular Regions
Published in Gene L. Colborn, David B. Lause, Musculoskeletal Anatomy, 2009
Gene L. Colborn, David B. Lause
Deltoid Muscle. Identify the deltoid muscle. Define its borders and the orientation of its fibers by freeing the muscle of its fascial investment. The deltoid arises from the lateral third of the clavicle and the acromion process and spine of the scapula. Note the convergence of its fibers toward the deltoid tuberosity of the humerus. The deltoid is the principal abductor of the arm. Its anterior and posterior fibers, respectively, assist in flexion and extension of the arm. The deltoid is innervated by the axillary nerve from C5 and C6 (primarily C5).
Development of a New Model of Humeral Hemiarthroplasty in Rats
Published in Journal of Investigative Surgery, 2023
Efi Kazum, Eran Maman, Zachary T. Sharfman, Reut Wengier, Osnat Sher, Amal Khoury, Ofir Chechik, Oleg Dolkart
Anasthesia carried out with isoflurane under high flow oxygen. The trans-deltoid lateral approach was used. Skin incision was performed proximal and distal to the lateral border of the acromion, in a parallel axis to the humerus. The middle third (acromial) part of the deltoid muscle was exposed and split between its longitudinal fibers (Figure 1A + B). The muscle was then retracted to allow exposure of the cranial third of the humerus. The anatomical landmarks (subscapularis tendon, lesser tuberosity, bicipital groove with the bicipital tendon and the greater tuberosity) were identified. Gentle sharp dissection of the anterior fibers of the supraspinatus and the superior fibers of the subscapularis tendons at the rotator interval was performed. Biceps tendon tenotomy followed by dislocation of the humeral head was performed. The center of the humeral head was identified and burred with a dremel tool and conical burr (Skill Tools, Mt. Prospect, Illinois, USA). The burr hole was expanded to create a round cavity with thin cortices in the proximal humeral head at the level of the rotator cuff insertion to the tuberosities (Figure 1C). After measurements of the native humeral head, a 2.7–2.9 mm stainless steel metal bearing ball was inserted into the cavity (Figure 1D, F). Joint reduction was then performed. Stability and joint mobility were tested. Closure of the supraspinatus and subscapularis were performed with 4/0 vicryl. The deltoid was then closed with 4/0 vicryl and the skin with 4/0 nylon sutures.
No decrease of muscle strength, function and exercise found after reverse shoulder arthroplasty follow-up
Published in European Journal of Physiotherapy, 2021
Thea Morin Melås, Bård Bogen, Justin A. M. J. Van Leeuwen
Total shoulder arthroplasty (TSA) is widely used as a treatment option in patients with symptomatic glenohumeral arthritis. However, this procedure has been associated with poorer outcome in the rotator cuff-deficient shoulder due to the so-called ‘rocking horse’ effect. This effect entails superior migration of the humeral head with eccentric loading of the glenoid component, which is associated with instability, and can cause early loosening of the arthroplasty components [1]. Reverse shoulder arthroplasty (RSA) is considered to be a better treatment option for patients with substantial loss of function due to weakness or rupture of the rotator cuff muscles [2]. With RSA, the ball and socket are reversed, shifting the centre of rotation laterally. This should lead to biomechanical advantages for the deltoid muscle, which plays a greater part postoperatively and has proven to be important for a good functional outcome after RSA [3].
Restoration of shoulder external rotation by means of the infraspinatus muscle reinnervation with a radial nerve branch transfer
Published in British Journal of Neurosurgery, 2020
Paulo L. Tavares, Mario G. Siqueira, Roberto S. Martins, Monise Zaccariotto, Luciano Foroni, Carlos O. Heise, Davi Solla
Muscles relating to the approach are demonstrated in Figure 2. Dissecting in the posterior suprascapular area the supraspinatus and infraspinatus branches of the suprascapular nerve were separated, after opening the superior transverse scapular ligament (Figure 3), and the infraspinatus branch was dissected in the supraspinatus fossa until the spinoglenoid notch. After lateral and superior displacement of the deltoid muscle, the infraspinatus muscle was partially detached from the scapular spine and a layer between the scapula and the infraspinatus fascia was developed, from the most lateral portion of the inferior border of the spine of the scapula and from the surface of the scapula itself. The infraspinatus muscle originates from the medial two-thirds of the posterior surface of the scapula, below the spine of the scapula, which makes it simpler to displace the muscle posteriorly and inferiorly, given its loose adhesion to the most lateral part of the scapula. The infraspinatus branch of the suprascapular nerve was identified in the region of the spinoglenoid notch, next to the suprascapular artery. Once identified, the nerve was dissected in a proximal direction, as far as the point at which it goes round the side of the spine of the scapula and enters the infraspinous fossa (Figure 4).