Approaches Flashcards
Posterior approach to shoulder
- internervous plane
- positioning
- initial dissection
- dangers
infraspinatus (suprascapular) and teres minior (axillary)
lateral
detach posterior deltoid at origin and retract inferiorly
suprascapular nerve, axillary nerve, posterior circumflex humeral artery
anterior approach to humerus
- internervous plane
- dangers
superiorly deltoid (axillary) and pec major (med and lat pectoral nerves)
distally medial brachialis (MC) and lateral brachialis (radial)
radial nerve, axillary nerve, anterior circumflex humeral artery
lateral approach to distal humerus
- internervous plane
- dangers
not a true internervous plane - triceps and brachioradialis (both radial)
radial
Anterolateral approach to distal humerus
- internervous plane
- dangers
not a true internervous plane - between brachialis and brachioradialis (both radial)
LCNF and radial
Medial approach to distal humerus
- internervous plane
- dangers
common flexor origin (median/ulna) and triceps (radial)
posterior branch medial cutaneous nerve of forearm, and ulna nerve
Anterolateral approach to elbow / cubital fossa
- internervous plane
- dangers
proximally - brachialis (MC) and brachioradialis (radial)
distally - brachioradialis (radial) and pronator teres (median)
radial nerve, PIN, LCNF
Anteromedial approach to the elbow
- internervous plane
- dangers
proximally - brachalis (MC) and triceps (radial)
distally - brachialis (MC) and pronator teres (median)
ulna nerve, median nerve
Posteromedial approach to coronoid process
- internervous plane
- dangers
Superficially between humeral and ulna heads of FCU (ulna)
Deeper between ulna head of FCU (ulna) and pronator teres (median)
ulna nerve
Kocher’s
- IN plane
ECU (PIN) and anconeus (radial)
Kaplan
- IN plane
ERCB (radial)) and EDC (PIN)
Henry’s
- IN plane
BR (radial) and FCR (median)
Subcutaneous approach to ulna
- IN plane
FCU (ulna) and ECU (PIN)
Posterior approach to radius
- IN plane
Proxiamlly same as Kaplan
distally between ECRB (radial) and EPL (PIN)
anterior approach to hip
- other name
- IN plane
superficial sartorious (femoral) and TFL (superior gluteal)
deep rectus femoris (femoral) and glut medius (superior gluteal)
anterolateral approach to hip
- other names
- between which muscles
Watson-Jones or Charnley
TFL (superior gluteal) and glut medius (superior gluteal)
lateral approach to the hip
- other name
- between which muscles
modified Hardinge
glut medius split
medial approach to the hip
- IN plane
superficially adductor longus and gracilis (both obturator)
deep adductor brevis (anterior division) and adductor Magnus (posterior division / tibial nerve)
anterior approach to ankle
- between which muscles
EHL and EDL
posterolateral approach to ankle
- IN plane
peroneals (SPN) and FHL (TN)
important nerves in posterior approach to C1/2 - and where they’re from
greater occipital nerve - posterior ramus C2
third occipital nerve - posterior ramus C3
anatomy of recurrent laryngeal nerves
which more at risk for anterior cervical spine
left - branches at level of arch of aorta - ascends between trachea and oesophagus
right - hooks around subclavian artery, runs next to trachea and later crosses to midline - more at risk
plane for anterior approach cervical spine
SCM and strap muscles of the larynx
Windows of ilioinguinal approach
lateral - lateral to iliopsoas
middle - iliopsoas and femoral vascular bundle
medial - medial to femoral vascular bundle
posterior approach to SIJ
detach and reflect glut maximus and glut medius - cannot go too inferior due to inferior gluteal artery and nerve
structure seen in anterior approach pubic symphysis
superficial epigastric arteries
dangers in anterior approach to SIJ
LFCN and L4/5 nerve roots
