scholarly journals MORPHOLOGY AND MORPHOMETRY OF SCAPULAR ACROMION PROCESS SARASWATI MEDICAL COLLEGE, UNNAO

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Manoj Bhavanidatta Joshi
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Glenohumeral Joint ◽  
Type I ◽  
Joint Replacements ◽  
Medical College ◽  
Glenohumeral Ligaments ◽  
Mean Width ◽  
Morphology And Morphometry

Introduction: The shoulder joint is the most important joint in human body and limitation of this joint movements affects the quality of life. The most common problem of joint replacements is the loosening of the shoulder joint. Rotator cuff muscles, static factors of the glenohumeral ligaments, the labrum and the joint capsule play a important role in stability of the glenohumeral joint. Morphometry of the acromion process is of significant importance and is commonly involved in impingement syndrome of the shoulder joint. As during surgery on shoulder joint the variations of the acromion process must be kept in mind and shape and various distances of the acromion process might benefit the orthopaedic operations. Material and Methods: A total of 100 unpaired dry scapula were isolated from the department of Anatomy. Two groups were made according to the side of the scapula and were equally divided into 50 right and 50 left scapula each. Bones were segregated and inspected individually. The shape of the acromion process of scapulae was recorded according to the Bigliani-Morrison-April classification. Dimensions were measured, using a vernier calipers including the size of the scapula and the acromion process. Results: Mean length of scapula on right side was 12.98±1.00 and of left side was 13.06± 1.20 cm. Mean Width of right scapulae was 9.56± 0.66 and of left was 9.78±0.59 cm. Mean length of acromion of right and left scapulae was observed as 4.01±0.52 and 4.21±0.67 cm respectively. Mean Acromiocoracoid distance on right was observed as 3.11±0.44 cm and on left side as 3.87±0.45 cm. 48 % of the acromion process of scapulae were quadrangular, 34 % were boot shaped 8% were leaf shaped and rest 10% were other various shapes. Type I scapulae were 33%, type II as 21% and 46% were type III. Conclusion: Features and dimensions of acromion process are associated with the pathology of the rotator cuff also role in it plays a significant role in stability of the shoulder joint. These measurements are useful for orthopedicians while performing procedures on shoulder joint. Keywords: Scapula, acromion process, shoulder joint, Morphometry

scholarly journals Anatomy and Biomechanic of the Shoulder

2019 ◽  
Vol 7 (11_suppl6) ◽  
pp. 2325967119S0046
Author(s):  
Troydimas Panjaitan
Keyword(s):  
Rotator Cuff ◽  
Humeral Head ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Central Component ◽  
Subscapularis Tendon ◽  
Glenoid Fossa ◽  
Greater Tuberosity ◽  
Glenohumeral Ligaments ◽  
Shoulder Complex

The shoulder is one of the most complex joints of the human body. Consequently, they are susceptible to injury and degeneration. Mechanical shoulder pathology typically results when overuse, extremes of motion, or excessive forces overwhelm intrinsic material properties of the shoulder complex resulting in tears of the rotator cuff, capsule, and labrum. The fundamental central component of the shoulder complex is the glenohumeral joint. It has a ball-and-socket configuration with a surface area ratio of the humeral head to glenoid fossa of about 3:1 with an appearance similar to a golf ball on a tee. Overall, there is minimal bony covering and limited contact areas that allow extensive translational and rotational ability in all three planes. The glenohumeral joint has 2 groups of stabilizers, which are static (passive) and dynamic (active) restrains. Static stabilizers include the concavity of the glenoid fossa, glenoid fossa retroversion and superior angulation, glenoid labrum, the joint capsule, and glenohumeral ligaments, and a vacuum effect from negative intra-articular pressure. Dynamic stabilization is merely the coordinated contraction of the rotator cuff muscles that create forces that compress the articular surfaces of the humeral head into the concave surface of the glenoid fossa. During upper extremity movement, the effects of static stabilizers are minimized and dynamic or active stabilizers become the dominant forces responsible for glenohumeral stability The simple act of arm elevation is a complex task that occurs via the combination of glenohumeral and scapulothoracic motion, together known as scapulohumeral rhythm. In the first 1200, glenohumeral arm abduction, the supraspinatus and deltoid work together and create a force couple that promotes stability, while raising the arm (deltoid contraction). In addition, the humerus must undergo 450 external rotation to not only clear the greater tuberosity posteriorly but also loosen the inferior glenohumeral ligament (IGHL) to allow maximum elevation. There are several anatomical updates regarding the rotator cuff and capsular footprint. The footprint of the supraspinatus on the greater tuberosity is much smaller than previously believed, and this area of the greater tuberosity is actually occupied by a substantial amount of the infraspinatus. The superior-most insertion of the subscapularis tendon extends a thin tendinous slip, which attaches to the fovea capitis of the humerus. The teres minor muscle inserts to the lowest impression of the greater tuberosity of the humerus and additionally inserts to the posterior side of the surgical neck of the humerus.

The Relationship Between In-Vivo Glenohumeral Joint Motion and Joint Morphology in Rotator Cuff Repair Patients and Healthy Control Subjects

2011 ◽  
Author(s):  
Cathryn D. Peltz ◽  
Kristin Ciarelli ◽  
Jeffrey A. Haladik ◽  
Michael J. McDonald ◽  
Nicole Ramo ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Glenohumeral Joint ◽  
Rotator Cuff Tears ◽  
Joint Motion ◽  
Healthy Control ◽  
The Relationship ◽  
Cuff Repair

Rotator cuff tears are a common condition that adversely affect function and quality of life. Altered glenohumeral joint (GHJ) motion is believed to contribute to the development of rotator cuff tears. Previous research has demonstrated relationships between in-vivo joint motion and bony morphology (particularly in the knee [e.g., 1]), and similar relationships have been reported in cadaveric shoulder studies [2, 3]. However, the extent to which these relationships exist under in-vivo conditions or if these relationships are altered in shoulders with pathologic conditions is not known. Thus, the objective of this study was to assess the relationship between glenoid/humerus morphology and in-vivo GHJ motion in healthy control shoulders and rotator cuff repair patients. We hypothesized that a relationship exists between glenoid/humerus morphology and GHJ motion in healthy control shoulders, but that this relationship is altered in rotator cuff patients.

Biomechanical Analysis of Normal, Injured and Implanted Shoulder Joint

2014 ◽  
Vol 1030-1032 ◽  
pp. 2309-2312
Author(s):  
Aydin Azizi ◽  
Ali Ashkzari
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
Shoulder Joint ◽  
Glenohumeral Joint ◽  
Total Shoulder Arthroplasty ◽  
Biomechanical Analysis ◽  
Collateral Ligaments ◽  
Degree Of Stability ◽  
High Degree

The biomechanics of the glenohumeral joint depend on the interaction of both static and dynamic stabilizing structures. The combined effect of these stabilizers is to support the multiple degrees of motion within the glenohumeral joint. Total shoulder arthroplasty requires release of contracted tissues, repair of rotator cuff defects, reconstruction of normal skeletal anatomy with proper sizing, and positioning of components. Arthroplasty of the shoulder is unlike arthroplasty of the hinge joints when the collateral ligaments afford a high degree of stability and is even distinct from the hip when bony conformity is large and range of motion is less. The goal of this paper is biomechanical analyses of normal, injured and implanted shoulder joint.

Ligamentous Restraints to External Rotation of the Humerus in the Late-Cocking Phase of Throwing

2000 ◽  
Vol 28 (2) ◽  
pp. 200-205 ◽  
Author(s):  
John E. Kuhn ◽  
Michael J. Bey ◽  
Laura J. Huston ◽  
Ralph B. Blasier ◽  
Louis J. Soslowsky
Keyword(s):  
Rotator Cuff ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Coracoacromial Ligament ◽  
Glenohumeral Ligament ◽  
Coracohumeral Ligament ◽  
Potential Source ◽  
Glenohumeral Ligaments ◽  
Inferior Glenohumeral Ligament ◽  
Glenohumeral Capsule

The late-cocking phase of throwing is characterized by extreme external rotation of the abducted arm; repeated stress in this position is a potential source of glenohumeral joint laxity. To determine the ligamentous restraints for external rotation in this position, 20 cadaver shoulders (mean age, 65 16 years) were dissected, leaving the rotator cuff tendons, coracoacromial ligament, glenohumeral capsule and ligaments, and coracohumeral ligament intact. The combined superior and middle glenohumeral ligaments, anterior band of the inferior glenohumeral ligament, and the entire inferior glenohumeral ligament were marked with sutures during arthroscopy. Specimens were mounted in a testing apparatus to simulate the late-cocking position. Forces of 22 N were applied to each of the rotator cuff tendons. An external rotation torque (0.06 N m/sec to a peak of 3.4 N m) was applied to the humerus of each specimen with the capsule intact and again after a single randomly chosen ligament was cut (N 5 in each group). Cutting the entire inferior glenohumeral ligament resulted in the greatest increase in external rotation (10.2° 4.9°). This was not significantly different from sectioning the coracohumeral ligament (8.6° 7.3°). The anterior band of the inferior glenohumeral ligament (2.7° 1.5°) and the superior and middle glenohumeral ligaments (0.7° 0.3°) were significantly less important in limiting external rotation.

Scapula, clavicle, and proximal humerus

2020 ◽  
pp. 37-48 ◽  
Author(s):  
David J. Green
Keyword(s):  
Comparative Analysis ◽  
Rotator Cuff ◽  
Shoulder Joint ◽  
Glenohumeral Joint ◽  
Functional Anatomy ◽  
Pectoral Girdle ◽  
East African ◽  
Australopithecus Africanus ◽  
Horizontal Orientation ◽  
Joint Morphology

This chapter describes parts of four scapulae, two clavicles, and three proximal humeri, and provides information on the functional anatomy of the Sterkfontein hominin pectoral girdle and shoulder joint. The clavicle resembles that of other hominins, which indicates a more horizontal orientation than in apes. Comparative analysis of these scapulae, though, suggests that the glenohumeral joint of Australopithecus africanus is more cranially oriented than typical for humans, perhaps even more so than seen in East African early hominins. This morphology may also indicate features of dorsal scapular shape, which could impact potential areas of attachment as well as line of action of dorsal rotator cuff muscles. The glenohumeral joint morphology and orientation implies the possibility of more arboreality in the A. africanus locomotor repertoire.

Mechanoreceptors in the medial and lateral glenohumeral ligaments of the canine shoulder joint

2007 ◽  
Vol 20 (04) ◽  
pp. 291-295
Author(s):  
A. Spadari ◽  
C. Bombardi ◽  
A. Casadio Tozzi ◽  
N. De Sordi ◽  
M. L. Lucchi ◽  
...  
Keyword(s):  
Shoulder Joint ◽  
Proprioceptive Information ◽  
Type I ◽  
Joint Stability ◽  
Pacinian Corpuscles ◽  
Mechanical Restraint ◽  
Glenohumeral Ligaments ◽  
Sensory Structures ◽  
Tendon Organ

SummaryIn order to have a better understanding of the role of ligaments in canine shoulder joint stability, the presence of mechanoreceptors in the medial (MGHL) and lateral (LGHL) glenohumeral ligaments was detected by means of a modified gold chloride stain. Three morphologically distinct mechanoreceptors were identified: Ruffini receptors (type I endings), Pacinian corpuscles (type II endings) and Golgi tendon organ-like receptors (type III endings). These receptors are mainly localized at each end of the ligaments and are prevalently in their glenoid portion. In particular, in the MGHL the highest density was at the cranial arm of the insertion into the scapula. The variety of mechanoreceptors in canine shoulder ligaments might indicate an afferent function in providing the CNS with joint proprioceptive information. Therefore, besides acting as passive mechanical stabilizers, the MGHL and the LGHL may serve as sensory structures, contributing actively to joint stability. Ligamentous injuries which occur in shoulders not only affect mechanical restraint but also alter the proprioceptive input to the CNS by means of disruption of the mechanoreceptors.

Arthroscintigraphy in Suspected Rotator Cuff Rupture

1998 ◽  
Vol 37 (08) ◽  
pp. 272-278 ◽  
Author(s):  
S. Gratz ◽  
G. Köster ◽  
T. Behr ◽  
R. Vosshenrich ◽  
E. Grabbe ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Clinical Signs ◽  
Diagnostic Efficiency ◽  
Rotator Cuff Rupture ◽  
Lower Viscosity ◽  
Rotator Cuff Lesion ◽  
Shoulder Region ◽  
Degenerative Alterations ◽  
Additional Value

Summary Aim: In order to evaluate the diagnostic efficiency of arthroscintigraphy in suspected rotator cuff ruptures this new imaging procedure was performed 20 times in 17 patients with clinical signs of a rotator cuff lesion. The scintigraphic results were compared with sonography (n = 20), contrast arthrography (n = 20) and arthroscopy (n = 10) of the shoulder joint. Methods: After performing a standard bone scintigraphy with intravenous application of 300 MBq 99m-Tc-methylene diphosphonate (MDP) for landmarking of the shoulder region arthroscintigraphy was performed after an intraarticular injection of 99m-Tc microcolloid (ALBURES 400 μCi/5 ml). The application was performed either in direct combination with contrast arthrography (n = 10) or ultrasound conducted mixed with a local anesthetic (n = 10). Findings at arthroscopical surgery (n = 10) were used as the gold standard. Results: In case of complete rotator cuff rupture (n = 5), arthroscintigraphy and radiographic arthrography were identical in 5/5. In one patient with advanced degenerative alterations of the shoulder joint radiographic arthrography incorrectly showed a complete rupture which was not seen by arthroscintigraphy and endoscopy. In 3 patients with incomplete rupture, 2/3 results were consistant. A difference was seen in one patient with a rotator cuff, that has been already revised in the past and that suffered of capsulitis and calcification. Conclusion: Arthroscintigraphy is a sensitive technique for detection of rotator cuff ruptures. Because of the lower viscosity of the active compound, small ruptures can be easily detected, offering additional value over radiographic arthrography and ultrasound, especially for evaluation of incomplete cuff ruptures.

Health-related quality of life one year after surgical treatment of the type I chronic aortic dissection

2019 ◽  
Vol 38 (1) ◽  
Author(s):  
Oksana Kamenskaya ◽  
Asya Klinkova ◽  
Irina Loginova ◽  
Alexander Chernyavskiy ◽  
Dmitry Sirota ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Aortic Dissection ◽  
Type I ◽  
Health Related Quality ◽  
Chronic Aortic Dissection ◽  
Related Quality ◽  
Health Related ◽  
One Year

The concept of motivation for effective credit risk management

2020 ◽  
Vol 26 (11) ◽  
pp. 2567-2593
Author(s):  
M.V. Pomazanov
Keyword(s):  
Risk Management ◽  
Economic Modeling ◽  
Type I ◽  
Credit Risk Management ◽  
Curve Modeling ◽  
Business Functions ◽  
The Common ◽  
Lending Decisions ◽  
The One

Subject. The study addresses the improvement of risk management efficiency and the quality of lending decisions made by banks. Objectives. The aim is to present the bank management with a fair algorithm for risk management motivation on the one hand, and the credit management (business) on the other hand. Within the framework of the common goal to maximize risk-adjusted income from loans, this algorithm will provide guidelines for ‘risk management’ and ‘business’ functions on how to improve individual and overall efficiency. Methods. The study employs the discriminant analysis, type I and II errors, Lorentz curve modeling, statistical analysis, economic modeling. Results. The paper offers a mechanism for assessing the quality of risk management decisions as opposed to (or in support of) decisions of the lending business when approving transactions. The mechanism rests on the approach of stating type I and II errors and the corresponding classical metric of the Gini coefficient. On the ‘business’ side, the mechanism monitors the improvement or deterioration of the indicator of changes in losses in comparison with the market average. Conclusions. The study substantiates the stimulating ‘rules of the game’ between the ‘business’ and ‘risk management’ to improve the efficiency of the entire business, to optimize interactions within the framework of internal competition. It presents mathematical tools to calculate corresponding indicators of the efficiency of internally competing entities.

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