Veins and lymphatics venous drainage of the scapular region is by veins that correspond to the arteries. Winner of the standing ovation award for best powerpoint templates from presentations magazine. Anastomotic revision was performed secondary to venous compromise on pod 6 and resulted in flap salvage. A point roughly one finger breadth below the mid point of the scapula on its lateral aspect marks the triangular space. Oct 26, 2011 routine screening revealed a sigmoid adenocarcinoma. You may not embed one of our images on your web page without a link back to our site. Novel use of a hip spacer to perform reconstruction following extraarticular scapula resection for sarcoma. It allows blood to flow past the joint in case of occlusion, damage, or pinching of the following scapular arteries.
Of 323 flaps, 19 flaps with 1 successful venous anastomosis were reexplored in the operating room 6%. To check medial rotation at shoulder joint done by subscapularis muscle. Scapular anastomosis upper limb gross anatomy, dr bhanu. Anomalous suprascapular foramen in adult indian scapula.
And finally took part in the anastomosis around the scapula. Aug 08, 2018 the arterial anastomosis around scapula is principally created between the branches of the first part of the subclavian and the third part of the axillary arteries. Axillary artery and anastomoses around scapula anatomy. Quizlet flashcards, activities and games help you improve your grades. Search help in finding arteries of scapular anastomosis online quiz version. The scapula or shoulder blade is the bone that connects the clavicle to the humerus. Free thoracodorsal, perforatorscapular flap based on the. Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. At the princess margaret hospital, the angular scapular angle osteomyogenous flap is the preferred reconstructive modality for okay et al 7 class ii and iii defects. Dorsal scapular artery anastomoses with intercostal arteries.
On the costal surface of the scapula, most nutrient foramina were found directly inferior to the suprascapular notch. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that todays audiences expect. Anatomy of scapula vibhuti nautiyal mpt musculoskeletal 2. Sep 01, 1987 the scapular flaps have, since their description by dos santos 1980, become a popular source of free skin transfer hamilton and morrison, 1982. Mar 05, 2016 37 microsurgical anastomosis of the scapula bone. If the dorsal scapular artery is a branch of the transverse cervical, it arises at the superior angle of the scapula and descends vertically along the medial border of the scapula. Pdf the scapula or shoulder blade is the bone that connects the clavicle to the humerus.
Increasing the flow output by yshaped microvascular anastomosis. Scapular girdle movements can be described as scapula movements. It must include the triangular space within its border so the pedicle vessel is captured in the flap. The arterial anastomosis around scapula is principally created between the branches of the first part of the subclavian and the third part of the axillary arteries. Anastomosis around the scapula free download as pdf file.
No major complica tions were observed at the donor. Winged scapula is caused by paralysis of the serratus anterior or trapezius muscles due to damage to the long thoracic or accessory nerves, resulting in loss of strength and range of motion of the shoulder. Basic principles in microvascular anastomosis and free tissue. Blood is brought to the scapular region by a network of arteries, which form the scapular anastomosis.
The scapula is outlined and an elliptical incision is used to mark the flap. We aimed to determine the at risk area for the circumflex scapular artery and its anastomosis with the suprascapular artery during posterior approach to the scapula. It takes origin from the first eight ribs and courses along the rib cage to insert along the medial aspect of the scapula. Pdf anomalous sub scapulosuprascapular arterial trunk.
Microsurgical anastomosis of the scapula bone plastic. Scapula position and humeral rotation can affect injury risk during humeral elevation. Nov, 2020 the suprascapular and dorsal scapular arteries meet in the supraspinous fossa to form an anastomosis. Scapular flap for maxillectomy defect reconstruction and. The scapula the dorsal surface of the scapula is divided into two regions by the spine of the scapula right side 11. Scapular free vascularised bone flaps for mandibular.
Arterial anastomosis of the elbow radiology reference. While the circumflex scapular artery and infraspinous branch of the suprascapular artery anastomose with each other, they also join with branches of the dorsal scapular artery that pierce the infraspinatus muscle to enter the infraspinous fossa. It functions to allow blood to flow around the elbow joint no matter which position the joint is in. The scapula is a thin sheet of bone that functions mainly as a site of muscle attachment figs 23, see putz, figs. The laterally based vascular pedicle was ideally positioned for facial vessel anastomosis.
There are three 3 anastomosis around shoulder joint. The bone is surrounded and supported by a complex system of muscles that work together to help you move your arm. He underwent resection with primary anastomosis and was found to have stage iia colon cancer. Arterial anastomosis around the scapula this point is labored because. Scapulothoracic endoscopy for the painful snapping scapula. Tikhofflinberg operation for the treatment of locally advanced. The scapula forms the posterior of the shoulder girdle. This anastomosis helps preserve the upper limb during injury. Ppt scapular dyskinesis powerpoint presentation free. It functions to allow blood to flow around the scapula and shoulder joint if there is injury or occlusion. Conclusions the angular vessels can reliably supply the scapula. Scapular anastomosisthe pectoral girdle has a rich plexus of arterial vessels that anastomose around the scapula and its muscles known as the scapular anasto. The extensive arterial anastomosis at the scapular region provides a collateral circulation, so if one vessel is blocked or damaged, many others can provide blood to the region.
Because this nerve damage can happen in a variety of ways, initial diagnosis may be overlooked. The scapula the region below the scapular spine is the infraspinous fossa right side 12. By printing out this quiz and taking it with pen and paper creates for a good variation to only playing it online. The periarticular arterial anastomosis of the elbow consists of several arteries that supply the elbow joint and its supporting structures. If you would like a large, unwatermarked image for your web page or blog, please purchase the appropriate license. If normal scapular movements are disrupted by abnormal scapular muscle firing patterns, weakness, fatigue, or injury, the shoulder complex functions less efficiency and injury risk increases. Our new crystalgraphics chart and diagram slides for powerpoint is a collection of over impressively designed datadriven chart and editable diagram s guaranteed to impress any audience. Scapular arterial network anastomosis around the scapula occurs in 3 fossae.
Osseous structures of interest are the scapula, humerus and. Oct 12, 2016 for tm, the contralateral scapula tip was positioned with its natural concavity recreating facial contour. While the circumflex scapular artery and infraspinous branch of the suprascapular artery anastomose with each other, they also join with branches of the dorsal. The scapular region is on the superior posterior surface of the trunk and is defined by the muscles that attach to the scapula shoulder blade. Chimeric scapular tip flap for the reconstruction of extensive defects. This paper discusses the anatomical structures involved in several variations of winged.
Anastomosis of scapula unit 1 includes spaces study. Excess lymphedematous tissue causes excessive oxidative stress in lymphedema. This new resource picks up where other surgical references leave off, providing highly visual, stepbystep guidance on more than 100 advanced and complex procedures in both general and subspecialty areas. Chart and diagram slides for powerpoint beautifully designed chart and diagram s for powerpoint with visually stunning graphics and animation effects.
Oct 26, 2018 the scapular waist comprises the scapula, clavicle, humerus and outer, together constitute the shoulder, a joint formed by 5 joints. If the axillary artery is cut or ligated, an adequate collateral blood supply will arrive to the arm via the dorsal scapular artery, and its anastomosis with the circumflex scapular artery. Contributing branches arise from as proximal as the first part of the subclavian artery, to as distal as the third part of the axillary artery. The scapula, along with the clavicle and the manubrium of the sternum, make up the pectoral shoulder girdle which connects the upper limb of the appendicular skeleton to the axial skeleton. The suprascapular and dorsal scapular arteries meet in the supraspinous fossa to form an anastomosis. Threedimensional topography of scapular nutrient foramina. Thoracoacromial artery, clavicular branch, acromial branch, deltoid branch, pectoral branch 1, 2, 3 indicate 1st, 2nd, and 3rd parts of axillary artery, levator scapulae muscle, dorsal scapular artery, supraspinatus muscle cut, superior transverse scapular ligament and superior scapular suprascapular notch spine of scapula, infraspinatus muscle cut, teres minor muscle cut, teres major. All anastomoses were performed with the facial vessels and there was no need to use arterial or vein graft. This anastomosis is a ring circulation around the scapula where it continues to the suprascapular artery via the circumflex scapular artery. The scapula the region above the scapular spine is the supraspinous fossa posterior view right side. Anatomy large, flat and triangular bone placed on the posterolateral aspect of the thoracic cage has two surfaces, three borders, three angles and three processes 3.
Pdf tenyear experience of free flaps in head and neck. This is a free printable worksheet in pdf format and holds a printable version of the quiz scapula. Oct 12, 2015 chronic painful snapping scapula is characterized by inflammation and scarring of 1 or more bursae in the infraserratus space and is often refractory to conservative treatment. Isotonic exercises exercises will target both the rotator cuff muscles and key scapular stabilizers. This flap is an original technique, it is pedicled on the dorsal scapular vessels with harvesting of the medial border of the scapula and the. This popularity is due to their ability to provide thin skin cover up to 12 x 24 cm with predictable vessel size and minimal donor site morbidity, provided it is closed directly.
Circumflex scapular lateral border of scap also see anastomosis between 1. All of these muscles are exercised and most exercises are done bilaterally, with special care given to the specific muscles or tendons that have been injured. Neither the vertebral column nor the thoracic cage is discussed here see chapters on the anatomy of the cervical and thoracic spine. Advance your surgical expertise with atlas of advanced operative surgery.
Bhanu prakash upper limb sure success series email protected proceum pvt. Atlas of advanced operative surgery 1st edition pdf. The ossified superior transverse scapular ligament presented as an oblique bony ridge, fan shaped in appearance. If the axillary artery is cut or ligated, an adequate collateral blood supply will arrive to the arm via the dorsal scapular artery, and its. He declined chemotherapy as part of a clinical trial, and eight months later was found to have an isolated metastasis in his right scapula. The scapular anastomosis is a system connecting certain subclavian artery and their corresponding axillary artery, forming a circulatory anastomosis around the. Suprascapular artery an overview sciencedirect topics. Jul 28, 2020 one patient had partial necrosis of the skin paddle of the latissimus dorsi flap, which was treated conservatively.
The upper portion of the serratus anterior insertion is spread along the medial border of the scapula, while the lower portion inserts into the inferior angle of the scapula. Anastomosis of scapula unit 1 includes spaces study guide by philagust includes 7 questions covering vocabulary, terms and more. The scapular anastomosis allows for collateral blood flow when lying supine and. After complete exposure of the angular artery, the inferior scapular angle was grasped with a backhaus clamp and displaced anterolaterally. Isolated metastasis of colon cancer to the scapula. Transverse cervical artery dorsal scapular artery the. Musculocutaneous nerve supplies skin of anterolateral. Pdf increasing the flow output by yshaped microvascular. Mar 16, 2016 the scapula the dorsal surface of the scapula is divided into two regions by the spine of the scapula right side 11. Use of the angular vessels over the circumflex scapular vessels increases the bone pedicle length by a mean length of 6. The pectoral girdle has a rich plexus of arterial vessels that anastomose around the scapula and its muscles known as the scapular anastomosis. Download fulltext pdf download fulltext pdf read fulltext.
Tikhofflinberg operation for the treatment of locally advanced chondrosarcoma of the scapular girdle region. The subscapular artery, the largest branch of the axillary artery, arises from the third part of the axillary artery at the lower border of the subscapularis muscle, which it follows to the inferior angle of the scapula, where it anastomoses with the lateral thoracic and intercostal arteries, and with the descending branch of the dorsal scapular artery a. The scapular free flap journal of plastic, reconstructive. If an injury or condition causes these muscles to become weak or imbalanced, it can alter the position of the scapula at rest or in. Arterial anastomosis around the scapula deranged physiology. In the past, maxillary reconstruction with the traditional scapular flap based on the subscapular system was limited by the short pedicle length and more frequent need for vein grafts. The update includes links to tables listing new codes and other changes and is available in two formats.
Chimeric thoracodorsal artery perforator tap flap e scapula flap for. The success for each type of arterial anastomosis is shown in table 3. Anatomical terminology edit on wikidata the scapular anastomosis is a system connecting certain subclavian artery and their corresponding axillary artery, forming a circulatory anastomosis around the scapula. Pdf chimeric thoracodorsal artery perforator tap flap.
The vasculature and anastomosis around the scapula is extremely intricate making surgical treatment complicated. Lymphaticovenous anastomosis lva supermicrosurgery is currently emerging as the firstline surgical intervention for lymphedema. Anatomical basis of the vascular risk related to the. Anastomosis around shoulder joint, anatomy slideshare. The fibula free flap has become the dominant free flap for all mandible reconstructions, except in case of severe peripheral vascular disease.
For every 3 of abduction of the arm, a 2 abduction occurs in the shoulder joint and a 1 abduction occurs by rotation of the scapula. Compared with scapular protraction, scapular retraction. The dorsal scapular artery or descending scapular artery is a blood vessel which supplies the levator scapulae, rhomboids, and trapezius. Musculocutaneous nerve supplies skin of anterolateral forearm. Dec 17, 2018 the scapula or shoulder blade is the bone that connects the clavicle to the humerus. The scapula region offers the unique possibility of allowing the harvest of one or two softtissue flaps in combination with a vascularized bone graft sieverberg, banis, and acland, 1985. The dorsal scapular artery may be an additional branch from the third part of the subclavian 34% of individuals. The scapular anastomosis is a system connecting certain subclavian artery and their corresponding axillary artery, forming a circulatory anastomosis around the scapula. Neither anastomosis complications nor infections were encountered. Surgical treatment involves excision of the bursae, as well as partial scapulectomy of the superomedial impinging region. Successful flap reconstruction in patients undergoing 1 venous anastomosis was 323 of 345 93.
Ppt scapular dyskinesis powerpoint presentation free to. Scapular anastomosis wikimili, the free encyclopedia. Oct 01, 2019 the circumflex scapular branch was initially preserved, to maintain the option of including an osseous component based on the circumflex scapular artery, in case the angular branch was absent or injured. In these cases we propose to use the pedicled osteomuscular dorsal scapular flap as an alternative technique. Axillary artery and anastomoses around scapula variant image id.
This is an online quiz called arteries of scapular anastomosis there is a printable worksheet available for download here so you can take the quiz with pen and paper. No data are available regarding the changes in serum proteins correlating to oxidative stress and antioxidant capacity before and after lva. The scapula, also known as the shoulder blade, is a flat triangular bone located at the back of the trunk and resides over the posterior surface of ribs two to seven. Origin second intercostal nerve supplies skin of axilla and medial aspect of proximal arm important points to remember lift off test. The scapula, or shoulder blade, is a large triangularshaped bone that lies in the upper back. The naaccr icdo3 implementation work group highly recommends all users read the guidelines which contain important coding information related to the 2021 update. It allows blood to flow past the joint in case of occlusion, damage, or. At about 120 of abduction of the arm, the greater tuberosity of the humerus comes into contact with the acromion. Tcml hand written notes and chart available on tcml facebook page.
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