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The Heart (HT)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Circumflex scapular artery: Arises from the subscapular artery and reaches the muscles on the dorsum of the scapula after curving around the axillary border of the scapula. The circumflex scapular artery takes part in the scapular anastomoses, along with several other vessels. The anastomoses occur on both the anterior and posterior surfaces. Participating vessels include the dorsal scapular, subscapular (via the circumflex scapular), and suprascapular arteries. These anastomoses create a potential collateral circulation pathway for the arm in the event of axillary artery obstruction or ligation.
Deltoid and Scapular Regions
Published in Gene L. Colborn, David B. Lause, Musculoskeletal Anatomy, 2009
Gene L. Colborn, David B. Lause
In the triangular space between the teres minor, teres major and the long head of the triceps, identify the circumflex scapular artery. The circumflex scapular artery is one of the two principal branches of the subscapular artery. The subscapular artery most commonly arises from the third part of the axillary artery.
Reconstructive Microsurgery in Head and Neck Surgery
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
John C. Watkinson, Ralph W. Gilbert
In order to take full advantage of this group of flaps a detailed understanding of the vascular anatomy of this area is critical (Figure 93.7). The axillary artery gives rise to the subscapular artery, which descends in the posterior axilla to give rise to the circumflex scapular artery and the thoracodorsal artery. The circumflex scapular artery provides nutrient and periosteal supply to the lateral border of the scapula, then divides into two perforating branches that supply the skin overlying the scapula. The circumflex scapular artery lies in the space bordered inferiorly by the teres major muscle, superiorly by the teres minor muscle and laterally by the long head of the triceps. Once through this space the artery divides into the two aforementioned branches, giving rise to a parascapular perforator and a transverse scapular perforator. The thoracodorsal artery descends inferiorly, providing branches to the serratus anterior and the latissimus dorsi, as well as providing the angular artery, a branch that supplies the distal one-third of the scapula and its overlying musculature. The venous drainage is via paired venae comitantes, which usually join the axillary vein close to the origin of the subscapular artery. It can easily be appreciated from this vast array of vessels that any combination of flaps may be harvested depending on the requirements for the reconstructive defect. The cutaneous flaps available include a transverse scapular flap, a parascapular flap and a thoracodorsal artery perforator flap. The myocutaneous flaps available include the latissimus dorsi flap; the myogenous flaps available include serratus anterior, the latissimus dorsi and the teres major muscles. The osseous flaps include the scapular bone flap based on the nutrient vessels from the circumflex scapular artery or the scapular tip via the angular artery.
Anatomical feasibility study of the infraspinatus muscle neurotization by lower subscapular nerve
Published in Neurological Research, 2023
Aneta Krajcová, Michal Makel, Gautham Ullas, Veronika Němcová, Radek Kaiser
Complex scapular fractures are operated via the Judet posterior approach in which the skin incision is made along the scapular spine and curved caudally along the medial edge of the scapular body. Then, the infraspinatus muscle is detached from the floor of the infraspinous fossa [11,23]. Therefore, we used the same approach in our study. The circumflex scapular artery, a branch of the subscapular artery, is the only structure (with accompanying veins) passing through the triangular space [12]. It then runs on the ventral surface of the infraspinatus muscle. After the mobilization of the IB-SSN, this vessel can be therefore used as a guiding structure for dissecting the ‘tunnel’ from the infraspinous fossa into the triangular space [12] (formed by teres minor and major muscles and long head of the triceps). For approaching this space, it is recommended to cut the skin between the teres muscles. Therefore, we propose to make a U-shaped skin incision for LSN – IB-SSN nerve transfer (Figure 7). In revision cases after previous orthopaedic procedure for scapular fracture performed via the Judet approach, the incision should follow the primary cut and then be prolonged caudo-laterally parallel to the scapular spine.
Early tangential excision debulking after free latissimus dorsi flap reconstruction for soft tissue defects: presentation of three cases
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Hiroko Murakami, Kazuo Sato, Yuta Izawa, Tatsuhiko Muraoka, Yoshihiko Tsuchida
A 66-year-old man was caught in a cultivator machine. It took more than 3 h to rescue him from the machine. Upon hospitalization, the patient was in a shock state due to blood loss. He was transferred to our hospital 7 h after his injury (Figure 2(A,B)). Although we performed emergency debridement thoroughly, the wound was contaminated, and an infection developed. Several debridement procedures were needed because of wound infection before bone fixation. After the infection subsided, soft tissue reconstruction was performed using free LD flap at 4 weeks after injury (Figure 2(C)). The subscapular artery (SSA) with the circumflex scapular artery (CSA) were interposed to anastomose between the transected TP. The TDV was end-to-end anastomosed with the accompanying vein of TP. On day 6 after flap reconstruction, the first tangential excision was performed, and several tangential excisions were repeated using a razor blade, arthroscopic shaver, and hydrosurgery system (Figure 2(D)). Full-thickness skin graft (FTSG) was performed at 4 weeks after free flap reconstruction. The wound healed without complications. The patient could walk with regular shoes without assistance (Figure 2(E)).
Beneficial Effect of U-74389 G and Sildenafil in An Experimental Model of Flap Ischemia/Reperfusion Injury in Swine. Histological and Biochemical Evaluation of the Model
Published in Journal of Investigative Surgery, 2020
Stavros-Loukas Karamatsoukis, Eleni-Andriana Trigka, Marianna Stasinopoulou, Antigoni Stavridou, Argyro Zacharioudaki, Kalliopi Tsarea, Maria Karamperi, Theodoros Pittaras, Othon Papadopoulos, Efstratios Patsouris, Nikolaos Nikiteas, Georgios C. Zografos, Apostolos E. Papalois
Initially, an incision was made in the posterior axillary fold extended down posteroinferiorly to identify the LD muscle. Subsequently, the LD muscle flaps as well as the thoracodorsal vessels, identified 2–3 cm medial to the lateral edge of the muscle, were carefully prepared for occlusion (Figure 1a, b) [26]. The pedicle was dissected and skeletonized up to the level of the circumflex scapular artery, while the anterior border of the muscle was elevated, exposing the underlying serratus muscle. The posterior edge of LD was identified under the trapezius muscle and was released. The perforating branches of the intercostal vessels were coagulated. The elevation of the flap was conducted from the distal to the proximal edge until the entire muscle was solely based on the thoracodorsal vessels (Figure 1c). The procedure continued according to the aforementioned protocol, with occlusion taking place after 2.5–3 hours. After the 2-hour reperfusion period animals were euthanized.