China
Africa
Explore chapters and articles related to this topic
Deltoid and Scapular Regions
Published in Gene L. Colborn, David B. Lause, Musculoskeletal Anatomy, 2009
Gene L. Colborn, David B. Lause
Suprascapular Artery and Nerve. Trace the suprascapular artery from its origin to its crossing of the transverse scapular ligament to enter the supraspinous fossa, deep to the supraspinatus muscle (Fig. 5:6). Identify and clean the supraspinatus muscle and then, beginning medially, reflect the muscle laterally from the supraspinous fossa far enough to expose the suprascapular nerve and artery. Identify the infraspinatus muscle and reflect it laterally from the infraspinous fossa toward its humeral insertion.
Arthroscopic resection of the superomedial scapula and scapulothoracic bursectomy
Published in Andreas B. Imhoff, Jonathan B. Ticker, Augustus D. Mazzocca, Andreas Voss, Atlas of Advanced Shoulder Arthroscopy, 2017
Several neurovascular structures are at risk if surgical intervention is considered in the treatment of snapping scapula syndrome. The accessory spinal nerve and transverse cervical artery are both localized near the superomedial angle of the scapula, and are therefore in close proximity during surgical removal of the superomedial angle. The accessory nerve enters the levator scapulae muscle near the superomedial angle and runs along the medial scapular border under the trapezius muscle.4 The transverse cervical artery is separated by the levator scapulae muscle. The artery branches into the dorsal scapular artery running along the medial border of the scapula with the dorsal scapula nerve, the suprascapular artery, and a superficial branch that runs with the accessory spinal nerve.4 The dorsal scapula artery and nerve course deep to the levator scapulae, the rhomboid major and minor, 1 cm medial to the medial border of the scapula (Figure 43.2). Portals should be placed below the scapular spine and at least 3 cm medial to the medial border of the scapula to avoid these structures. The long thoracic nerve runs on the superficial aspect of the serratus anterior muscle, and therefore it should not be at risk during scapulothoracic debridement if debridement is confined to the scapulothoracic space, since the deep aspect of the muscle borders this space. Finally, the suprascapular artery and nerve are at risk as they enter the suprascapular notch. The distal between the superior medial angle tip and the medial aspect of the suprascapular notch is 4.4 cm, with the shortest distance of 2.4 cm.21 Resection can therefore be considered safe if it is limited to only 2 cm in a medial to lateral direction from the superomedial corner.
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).