Shoulder Joint Part 1 Flashcards
What cavity covers the humeral head?
Glenoid
What is the glenoid cavity surrounded by?
labrum glenoidale
Where does the shoulder joint capsule:
A) Originate?
B) Insert?
A) Proximal part of labrum
B) Distal to articular coverage of humeral head
The origin of the biceps tendon is surrounded by joint capsule which is in close proximity to what medially?
subscapularis muscle
The origin of the biceps tendon is surrounded by joint capsule which is in close proximity to what laterally? (2)
supraspinatus and infraspinatus muscles
Passive stabilisers of the shoulder joint? (4)
Mediolateral glenohumeral ligaments
Joint capsule
Labrum glenoidale
Biceps brachii muscle
Active stabilisers of the shoulder joint? (4)
Supraspinatous muscle
Infraspinatus muscle
Subscapularis muscle
Teres minor muscle
What is the normal value for shoulder flexion in a dog?
57 degrees
What is the normal value for shoulder flexion in cats?
32 degrees
What is the normal shoulder joint extension in cats and dogs?
164 degrees
What is the position of a dog for the caudo-lateral approach to the shoulder?
Lateral recumbency
What anatomical landmarks are identified before proceeding with a caudo-lateral approach to shoulder? (3)
Spine f scapula
Shaft of humerus
Great tubercle of humerus
Where is the skin incision made for a caudo-lateral shoulder approach?
Middle of scapula of spine to shaft of humerus
What is exposed on the approach to caudo-lateral shoulder approach after retracted fat.
Acromium head and deltoid head of deltoid muscle?
Where is the incision made after palpating acromion on the caudo-lateral approach to the shoulder? Extends to?
Ventral border of spine of scapula, extend distally to acromial part of deltoid muscle
After careful muscle dissection on the caudo-lateral shoulder approach, what is then palpable?
Glenoid
Where is the teres minor identified on the caudo-lateral approach?
Proximally
Where is the caudal circumflex artery and vein and muscular branch of axillary nerve identified on the caudo-lateral approach?
Distally
What can be used on the caudo-lateral approach to protect the axillary nerve?
Penrose drain
When placing retractors for the caudo-lateral approach, how should the teres minor de displaced?
Dorsally
which direction is joint capsule incised for a caudo-lateral approach?
Longitudingal
What retractors for under joint capsule for caudo-lateral approach?
Mini gelpi
How can we further expose the joint capsule/humeral head in the caudo-lateral approach?
Retract joint capsule, internal rotation and flexion
Which material is the joint capsule closed in the caudo-lateral approach?
Absorbable suture (2-0/3-0)
Care must be taken to avoid injury to which nerve when performing the caudolateral approach to the shoulder joint?
The muscular branch of the axillary nerve
Is the following step true or false?
External rotation and adduction of the limb allow for maximal exposure of the humeral head.
This sentence is false, the internal rotation and adduction of the limb allow for maximal exposure of the humeral head.
How are muscles closed in the caudolateral approach to the shoulder joint?
Reattach the insertions of teres minor muscle +/- infraspinatus muscle.
Suture the intermuscular septum between scapular and acromial part of the deltoid muscle.
Reattach the cranial border of the acromial part of the deltoid muscle to the fascia on the proximal portion of the humeral shaft.
Suture the scapular part of deltoid muscle to the scapular spine.
What position is the patient in for Craniomedial region of the shoulder?
Dorsal recumbency
For the Craniomedial region of the shoulder how is the skin incision made?
Make a skin incision that starts medial and slightly cranial to the acromion and continues distally ending at the midshaft of the humerus.
What is retracted on the first approach to the the Craniomedial region of the shoulder?
Braciocephalicus m
What does tenodesis involve of the shoulder joint?
Securing a cut tendon to the proximal humerus
Which radiographic view is most useful for identifying irregularities in the intertubercular groove of the proximal humerus?
Flexed craniodistal cranioproximal view
For the cranio medial approach, how is the skin incision made?
Make a skin incision that starts medial and slightly cranial to the acromion and continues distally ending at the midshaft of the humerus.
What muscle is retracted medially after incising S/C tissue in the cranio medial approach?
Brachiocephalicus m.
What needs to be ligated on the cranio medial approach?
omobrachial vein.
On the cranio medial approach, order the following steps.
- Retract the pectoral muscles
- Transect the insertion of the deep pectoral muscles
- Transect the insertion of the subscapularis m on the lesser tubercle of the humerus
- Transect the insertion of the superficial pectoral m close to humerus
- Transect the tendon of the coracobrachialis m
- Transect the insertion of the superficial pectoral m close to humerus
- Transect the insertion of the deep pectoral muscles
- Retract the pectoral muscles
- Transect the tendon of the coracobrachialis m
- Transect the insertion of the subscapularis m on the lesser tubercle of the humerus
on the cranio medial approach, where is the joint capsule incised?
Parallel to the medial rim of the glenoid cavity.
How is the medial joint capsule exposed on the cranio medial approach?
Subscapularis m belly retracted
What approach to the shoulder can be used to gain more exposure of the neck and glenoid cavity of the scapula and the humeral head?
The craniomedial approach can be combined with the cranial and craniolateral approach
How is the joint capsule closed?
2-0/3-0 interruped absrobable monofilament