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Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
The sternoclavicular joint, between the sternum of the thoracic cage and the clavicle, has several ligaments associated with it. There are anterior and posterior sternoclavicular ligaments which pass directly across the joint. In addition, there is an interclavicular ligament which passes between the right and left clavicles, across the suprasternal notch. There is also a costoclavicular ligament lateral to the joint. This ligament passes from the first rib to the clavicle and assists in keeping the medial end of the clavicle in place.
Brachiocephalic artery reconstruction
Published in Sachinder Singh Hans, Alexander D Shepard, Mitchell R Weaver, Paul G Bove, Graham W Long, Endovascular and Open Vascular Reconstruction, 2017
Jamil Borgi, Mitchell R. Weaver
Median sternotomy is performed by incising the skin from the sternal notch to the xiphoid process with a No. 10 blade scalpel. Electrocautery is then used to divide the subcutaneous tissues until the sternum is reached. The interclavicular ligament is then split and the midline of the sternum is marked from the sternal notch to the xiphoid process. After having the anesthesiologist suspend ventilation, a standard pneumatic saw is used to divide the sternum in the midline. The saw can be used from cranial-to-caudal or caudal-to-cranial depending on surgeon preference. After controlling any periosteal bleeding points, a sternal retractor is placed on the mid-to-lower aspect of the sternal edges.
The Articulations of the Upper Member
Published in Gene L. Colborn, David B. Lause, Musculoskeletal Anatomy, 2009
Gene L. Colborn, David B. Lause
The articular disk is attached about its circumference to the clavicle and the manubrium of the sternum by anterior and posterior sternoclavicular ligaments and by interclavicular ligaments, which are thickenings of the capsule. The disk is attached below to the cartilage of the first rib.
Sports-related sternoclavicular joint injuries
Published in The Physician and Sportsmedicine, 2019
Justin E. Hellwinkel, Eric C. McCarty, Morteza Khodaee
The SCJ is the only articulation between the axial and appendicular skeleton of the upper limbs. The joint space contains a fibrocartilagenous disc between the sternal end of the clavicle and the manubrium, which is all surrounded by a thick fibrous capsule. Supporting ligamentous structures include the costoclavicular ligament (CCL) from the first rib, the interclavicular ligament, and sternoclavicular ligaments anteriorly and posteriorly (Figure 2). The stout soft tissue support allows for movement in all planes through the joint. The CCL is the primary supporting structure preventing superior displacement of the clavicle by opposing pull of the sternocleidomastoid muscle. Integrity of this ligament in medial clavicular injury yields superior outcomes compared to surgical reconstruction or absence of the ligament, underlining its importance for stability [4]. The CCL has the largest footprint of any supporting structure and can sustain an axial force of approximately 5000 N before failure [5]. The anterior and posterior sternoclavicular ligaments are thickened portions of the capsule that provide anterior and posterior stabilization of the medial clavicle [6,7]. The posterior sternoclavicular ligament provides greater strength and stability relative to the anterior ligament [6]. The clavicle is the first bone to ossify, although the medial clavicular physis does not completely fuse until 25 years of age [8]. Displaced Salter-Harris injuries can easily be misdiagnosed as SCJ dislocations in younger patients because of similar injury patterns and clavicular displacement. Given the physis is a weak connection near the SC junction, it is likely that physeal injury is more common than true dislocation in younger patients, though this distinction is difficult to evaluate [9].
Vestibular function in adults with intellectual disabilities: feasibility and outcome of a vestibular screening protocol in Special Olympics athletes
Published in International Journal of Audiology, 2021
Laura Leyssens, Ruth Van Hecke, Karlien Moons, Sofie Luypaert, Melina Willems, Maya Danneels, Sarie Martens, Cleo Dhondt, Leen Maes
cVEMP measurements were conducted using the Neuro-Audio equipment (version 2010, Neurosoft, Ivanovo, Russia) and accompanying software. Because of the high prevalence of middle ear pathologies in the ID population, acoustic stimuli were presented using bone conduction. More specifically, 500 Hz tone bursts (rise/fall time = 1 ms; plateau time = 2 ms; repetition rate = 5 Hz) at an intensity of 59 dB normalised Hearing Level (nHL) (129 dB Force Level (FL)) were delivered monaurally at the mastoid, using a B-71 bone conductor. A minimum of 60 sweeps were presented per trial, and at least two trials were administered to ensure reproducibility of the response. The responses were recorded unilaterally using self-adhesive Ag/AgCl surface electrodes (Blue Sensor, Ambu) applied on the upper 1/3rd part of the sternocleidomastoid muscle (SCM) (active), on the sternum just beneath the interclavicular ligament (reference), and on the nasion (ground). Electrode and inter-electrode impedances were checked regularly and kept below 5 kOhm and 2 kOhm, respectively. Contraction of the SCM was achieved by lifting and rotating the head to the non-stimulus side in supine position. Measurements were always initiated at the right side, but the SCM electromyographic (EMG) activity was closely monitored throughout the measurement and kept between 80 and 250 µV, and left-right differences in SCM activity were kept below 16 µV (Rosengren 2015). Additionally, a pre-stimulus EMG measurement of at least 20 ms was conducted for calculation of the background EMG activity. To maintain the stability of the SCM contraction, one examiner gave continuous visual or verbal biofeedback to the participant and provided external support of the head when necessary. For the participants with ID, distraction material (e.g. tablet with video or a toy) was occasionally used to ensure sustained head rotation and muscle tension. More details about the applied stimulus and response parameters can be consulted in Martens et al. (2019).