Shoulder anatomy

Kent B.E. 1971. Functional anatomy of the shoulder complex. A review. Phys. Ther. 51 867. 

Radiographic images of frontal views of shoulders before and after total shoulder arthroplasty. (A) The preoperative anatomy and (B) the placement of the humeral component can be clearly seen. The UHMWPE glenoid component in (B) is radiolucent and is evident only as a space between the humeral component and bone of the glenoid (images courtesy of Jon jP Warner, Massachusetts General Hospital). 

In general, the success rate of TSR exceeds 90% for a wide range of common shoulder problems. As in THA and TKA, the aim of TSA is to reduce pain, restore damaged anatomy, and restore function. As for hip and knee arthroplasty, there are continuing concerns about component fixation and persisting instability of the joint. 

Given the recent interest in the axillary vein, it is recommended once again that the implanting physician become thoroughly familiar with the anatomy of the anterior thoracic wall, shoulder, and axilla. It is imperative that the physician visit the anatomic laboratory to refresh and review the regional anatomy and surface landmarks. 

Fig. 4.54 Sagittal section of the shoulder girdle demonstrating superficial and deep anatomy with automatic implantable cardioverter defibrillator placement under the pectoralls major muscle. (From Belott PH, Reynolds DW. Permanent pacemaker and cardioverter defibrillation implantation. In Ellenbogen KA, Kay N, WUkoff BL, eds. Clinical cardiac pacing and defibriUation, 2nd ed. Philadelphia WB Saimders, 2000, with permission.)...

The professor of anatomy is showing a student two glass cabinets with skeletons and asked the student who are these skeletons I do not know, replied the student. The prof made efforts to help him Look the skeleton on the left has narrow hips and broad shoulders, and the skeleton on the right has broad hips and narrow shoulders who are these skeletons I do not know, replied the confused student. At that point, the professor got irritated and... 

Figure 17.1 Anatomy of the gas cylinder. This shows how the valve and collar are attached to the cylinder body, and the meaning of some of the markings on the cylinder shoulder. The markings on the bottom line indicate either the date of manufacture or the most recent test date. The month corresponds to the left-hand numbers, and the year to the right-hand numbers, with the inspector s insignia in between. The plus sign indicates that the cylinder can be filled to 10 percent over the marked service pressure (for certain gases only).

As for other sites in the body, a deep knowledge of anatomy, of the proper scanning technique and of the normal imaging findings is essential in order to perform an accurate shoulder examination with US. 

Because most indications for shoulder US are concerned with the rotator cuff, most of this section will focus on the examination of these tendons. Before discussing the normal US anatomy and examination technique of the cuff, some important points should be taken into account. 

In neuropathies around the shoulder, the small size of nerves, the complex regional anatomy and problems of access due to the acoustic shadowing from superficial bone structures, makes direct evaluation of nerves difficult with US. Axillary neuropathy may be caused by stretching injuries (anterior dislocation) or extrinsic compression in the quadrilateral space caused by fractures of the upper humerus, improper use of crutches, casts, fibrous bands and inferior (from the 9 to 7o clock positions) paragle-... 

Chiou HJ, Chou YH, Wu JJ et al (1999) Alternative and effective treatment of shoulder ganglion cyst ultrasonographically guided aspiration. J Ultrasound Med 18 531-535 Chiou HJ, Chou YH, Wu JJ et al (2002) Evaluation of calcific tendonitis of the rotator cuff role of color Doppler ultrasonography. J Ultrasound Med 21 289-295 Choi YW, Im JG, Song CS (1995) Sonography of the costal cartilage normal anatomy and preliminary clinical application. J Clin Ultrasound 23 243-250... 

Petersilge CA, Witte DH, Sewell BO et al (1993) Normal regional anatomy of the shoulder. Magn Res Imaging Clin North Am 1 1-18... 

FIGURE 9.1 Normal anatomy of the Glenohumeral joint showing the bones, muscles, tendons, ligaments, and capsule at the shoulder in frontal section (A) and glenoid face (B) views. The superia- (S), inferior (1), medial (M), lateral (L), anterior (A) and posteria- (P) directions are also denoted on each view (images used with permission of Primal Pictures, Ltd., London). 

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