Final, normal anatomy 2013
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The document provides an overview of arthroscopic shoulder anatomy and highlights important structures to identify during a shoulder arthroscopy. It describes establishing portals and systematically inspecting the subscapularis, ligaments, labrum, articular surface, recesses, tendons, and bursa. Common anatomic variants are also noted that should not be treated as pathology. The goal is to follow a consistent routine to allow reproducible visualization of shoulder anatomy.
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2) The physical examination evaluates posture, spinal alignment, and flexibility from multiple angles. It also evaluates the shoulders, ribs, pelvis, and for any neurological deficits.
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Limb deformity
This document discusses the evaluation and treatment of limb deformities. It defines deformities as abnormalities in length, angulation, rotation or translation from the normal anatomical position. Deformities are evaluated clinically and radiographically, including x-rays to assess the mechanical and anatomical axes. Treatment depends on the type of deformity and involves osteotomies like wedge or dome osteotomies to realign the bones, followed by fixation for healing. Length deformities may use distraction or compression methods, while angulation, rotation and translation deformities require osteotomies and realignment followed by stabilization.
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To understand deformities of the extremities, it is important to first understand and establish the parameters and limits of normal alignment.
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both frontal and sagittal planes axis lines are applicable to any longitudinal projection of a bone.
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Hallux valgus
Hallux valgus contiene; definición, etiología, anatomía, características, diagnóstico, tratamento, cirugía, anatomía patológica y sus características. De igual forma, incluye los factores desencadenantes, clasificación roger mann y sus complicaciones.
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hallux valgus & hallux rigidus
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Presentation includes pain with shoe wear and prominence over the first MTP joint. Exam evaluates the first ray and associated deformities. Radiographs measure angles to guide treatment and assess for degenerative changes.
Management begins conservatively with shoe modifications. Surgical options range from soft tissue procedures for mild cases to osteotomies or fusions for more severe
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This document summarizes the Version 8 upgrade to the SRS software. Version 8 provides upgraded features required for meaningful use, including the ability to select dates of service and view multiple providers in chart lists. It also integrates pharmacy and appointment data into the clinical summary. A referring provider field was removed from the summary screen but remains accessible elsewhere. The upgrade goes live on April 23, 2012 across the Rothman Institute.
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Final, normal anatomy 2013
- 1. Arthroscopic Shoulder Anatomy Christopher M. Aland MD Rothman Institute, Newtown, PA
- 2. Disclaimer • I own stock in J &J, and Arthrocare • I am on the Membership committee of AANA • I have no conflicts which would interfere with this course
- 3. Introduction • The essence of viewing shoulder anatomy in a reproducible fashion is the consistent use of portal placement • Develop YOUR routine and follow it every time. Using a checklist or cheat sheat is OK
- 4. Intra-articular anatomy • Initial portal should be posterior • No need to pre inject joint—ok for bursa • Subscapularis is a more consistent anatomic finding—orient off this • Establish anterior portal outside-to-in.
- 5. Intra-articular anatomy • Initial portal should be posterior • No need to pre inject joint—ok for bursa • Subscapularis is a more consistent anatomic finding—orient off this • Establish anterior portal outside-to-in.
- 6. Intra-articular anatomy • Middle glenohumeral ligament—MGHL • Variable • Originates superoglenoid tubercle to inferior aspect of lesser tuberosity
- 7. Intra-articular anatomy • Inferior glenohumeral ligament—IGHL • Diagonal fold • More prominent in ER • Anterior band part of “hammock”
- 8. Intra-articular anatomy • Internally rotate arm, follow subscap laterally • Inspect footprint • Anterior recess
- 9. Intra-articular anatomy • Internally rotate arm, follow subscap laterally • Inspect footprint • Anterior recess
- 10. Intra-articular anatomy • Superior glenohumeral ligament-SGHL • Just anterior to biceps tendon • Forms pulley to support biceps in groove • Subscap path usually assoc with SGHL path
- 11. Intra-articular anatomy • Running across the top of visual field should be biceps tendon • Look into groove • Sublux into joint • Follow to superior glenoid
- 12. Intra-articular anatomy • Running across the top of visual field should be biceps tendon • Look into groove • Sublux into joint • Follow to superior glenoid
- 13. Intra-articular anatomy • Running across the top of visual field should be biceps tendon • Look into groove • Sublux into joint • Follow to superior glenoid
- 14. Intra-articular anatomy • Probe labrum, but remember where attachment really is – Meniscoid – Superior recess • Follow labrum anteriorly • Anatomic variants
- 15. Intra-articular anatomy • Inspect the articular surface • Normal thinning in center • Look for bony abnormalities • Drive through sign
- 16. Intra-articular anatomy • Inferior recess • Look for loose bodies • Lax capsule
- 17. Intra-articular anatomy • Abduct arm and roll up posteriorly • Normal bare area • Undersurface of cuff • Cord and cable
- 18. Intra-articular anatomy • Use switching sticks to rotate camera anteriorly • Inspect posterior labrum • Follow around to front to inspect subscap and recess
- 19. Intra-articular anatomy • Use switching sticks to rotate camera anteriorly • Inspect posterior labrum • Follow around to front to inspect subscap and recess
- 20. Intra-articular anatomy • Use switching sticks to rotate camera anteriorly • Inspect posterior labrum • Follow around to front to inspect subscap and recess
- 21. Intra-articular anatomy • Use switching sticks to rotate camera anteriorly • Inspect posterior labrum • Follow around to front to inspect subscap and recess
- 22. Bursal anatomy • Superior cuff • Coraco-acromial ligament • Bursa—veil of tears • Any previously placed markers
- 23. Common variants • Don’t fix these • Buford complex • Sublabral foramen • Superior recess
- 24. Common variants • Don’t fix these • Buford complex • Sublabral foramen • Superior recess
- 25. Common variants • Don’t fix these • Buford complex • Sublabral foramen • Superior recess
- 26. Common variants • Don’t fix these • Buford complex • Sublabral foramen • Superior recess
- 27. Thank-you