Scapula approximation

Approximately two-thirds of all pressure sores occur on the sacrum and heels. The remaining third occur predominately on the elbows, ankles, trochanters, ischia, knees, scapulas, shoulders, or occiput.35 Pressure sores are classified according to the extent of tissue destruction.40 The staging of pressure sores is presented in Table 70-7. 

Proper electrode placement is the single most important fector for determining whether transcutaneous pacing will be effective. The proper position of the cathode (negative) electrode is directly over the cardiac apex or over the position of ECG chest leads V3 (Fig. 7.1). The anode (positive) electrode is placed either posteriorly (recommended) on the back between the spine and the lower half of the left or right scapulae, or, alternatively, if the back is inaccessible, over the right upper chest centered approximately 6-10 cm above the... 

Place one finger at the inferior angle of each scapula, at approximately the level of the seventh thoracic vertebra. Are they level ... 

The second functional joint is the scapulothoracic joint. This is formed by the scapula and the posterior thorax (ribs). Because muscle and fascia lie between the articulating surfaces, it is not a true joint with approximated articular surfaces and is also lacking a capsule. 

Fig. 6.28a,b. Short head of the biceps tendon, coracobrachialis and pectoralis minor. a,b Transverse 12-5 MHz US images obtained a at the level of the coracoid process of the scapula and b approximately 2 cm caudal to it. In a, the relationship of the coracoid (Co) with the humeral head (HH), the subscapularis tendon (SubS) and the deltoid muscle are illustrated. The coracoid is easily identified with US owing to its medial position relative to the humeral head and the curvilinear hyperechoic appearance of its bony surface. In b, three individual structures are seen arising from the coracoid. From lateral to medial, they are the hyperechoic tendon of the short head of the biceps (curved arrow), the hypoechoic myotendinous junction of the coracobrachialis (straight arrow) and that of the pectoralis minor (arrowheads)... 

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