Pdf the scapula or shoulder blade is the bone that connects the clavicle to the humerus. The angle of the scapular tip was measured setting the vertex at the most prominent point of. Scapular anastomosis the pectoral girdle has a rich plexus of arterial vessels that anastomose around the scapula and its muscles known as the scapular anastomosis. Principles of bowel anastomosis linkedin slideshare.
Modest md department of otorhinolaryngologyhead and neck surgery, mayo clinic, rochester, minnesota, u. 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. Thoracodorsal and lateral thoracic artery in terms of size and ease of use, the thoracodorsal artery is. The scapular anastomosis is a system connecting certain subclavian artery and their corresponding axillary artery, forming a circulatory anastomosis around the scapula. A circulatory anastomosis is a connection an anastomosis between two blood vessels, such as between arteries arterioarterial anastomosis, between veins venovenous anastomosis or between an artery and a vein arteriovenous anastomosis. Posteriorly, the circumflex scapular artery, the perforating branch of the subscapular artery, is a potential site for arterial anastomosis. This anastomosis is a ring circulation around the scapula where it continues to the suprascapular artery via the circumflex scapular artery.
At about 120 of abduction of the arm, the greater tuberosity of the humerus comes into contact with the acromion. Each scapular has its own history, often associated with visions of jesus, mary, or angels. Start studying anatomy muscles of the shoulder region and arm. Learn vocabulary, terms, and more with flashcards, games, and other study tools.
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. Using 3d modeling and cadaveric dissection, we describe the approach and advantages of a known but less fre. Endtoend anastomoses after resection of injured arteries include, but are not limited to, interrupted and continuous suturing with, or without parachuting of the graft andor vessel. Advance your surgical expertise with atlas of advanced operative surgery. It runs along the suprascapular nerve and mostly supplies the supraspinatus and infraspinatus muscles. So i tried to make this part easy mentioning some mnemonic, flow charts, recent questions. Scapular tipthoracodorsal artery perforator free flap for. Anastomosis at the level of the elbow joint connecting the. Many times in new entrance exams this section of the anastomosis around scapula being asked. Arterial anastomosis around the scapula this point is labored because. The pectoral girdle has a rich plexus of arterial vessels that anastomose around the scapula and its muscles known as the scapular anastomosis. Series of photographs ac demonstrating a right hemimaxillary defect class ii reconstruction with the scapular angle osteomyogenous free flap and 8month followup photograph d showing excellent mucosalization of the intraoral portion of the flap.
The scapular flap has become an extremely valuable tool in reconstructing the head and neck. Anatomical relationship between arteries and veins in the scapular. Objectiveshypothesis discuss current techniques utilizing the scapular tip and subscapular system for free tissue reconstruction of maxillary defects and highlight the. Anatomy muscles of the shoulder region and arm flashcards. Scapulars religion, spiritualism, and occult the scapular emerged as part of the dress of monks in the early middle ages.
Enumerates the arteries that anastomosis around scapula. Anastomosis around the scapula free download as pdf file. Thoracodorsal and lateral thoracic artery in terms of size and ease of use, the thoracodorsal artery is, in our opinion, by far the most versatile of the group. 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. It functions to allow blood to flow around the elbow joint no matter which position the joint is in. Dec 17, 2018 the scapula or shoulder blade is the bone that connects the clavicle to the humerus. 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. Scapular anastomosis the transverse cervical artery from the subclavian, usually the first part, occasionally the third part, has a descending branch the dorsal scapular artery which accompanies the dorsal scapular nerve. Feb, 2017 many times in new entrance exams this section of the anastomosis around scapula being asked. In mandibular reconstruction, when a free flap is contraindicated a pedicled scapular flap has been described vascularized by the dsa.
The surgical anastomotic time using the new method was relatively short compared with the control group 81. Arterial anastomosis around the scapula upper limb gross anatomy usmle step 1 videos duration. You may not embed one of our images on your web page without a link back to our site. Describe the axillary artery distribution at scapula. The scapula forms the posterior of the shoulder girdle. The dorsal scapular artery dsa can be either a direct branch of the subclavian artery sca, or a branch of the transverse cervical artery tca. Circumflex scapular artery an overview sciencedirect. 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. Veins and lymphatics venous drainage of the scapular region is by veins that correspond to the arteries. Anastomoses between arteries and between veins result in a multitude of arteries and veins, respectively, serving the same volume of tissue. A simple and rapid vascular anastomosis for emergency. Bhanu prakash usmle, fmge and neet pg 67,429 views 4. Scapular anastomoses sa are a network of streams that generate variable arterial patterns of blood supply whose origins are from multiple. Anatomy upper limb scapulohumera arm musculoskeletal.
The dorsal scapular artery or descending scapular artery is a blood vessel which supplies the levator scapulae, rhomboids, and trapezius. The suprascapular and dorsal scapular arteries meet in the supraspinous fossa to form an anastomosis. Scapular reconstruction the scapular prosthesis is placed in a pocket between the serratus anterior and the rhomboids. Mnemonic for anastomosis around the scapula youtube. Overview of arterial supply to upper limb lecturio. The circumflex scapular artery can be dissected as it courses towards the triangular space and transposed into a more superficial location in the axilla.
Both the circumflex arteries form an anastomosing circle around the surgical neck of the humerus. The periarticular arterial anastomosis of the elbow consists of several arteries that supply the elbow joint and its supporting structures. Recurrent branches, in some cases double, arise from radial, ulnar and interosseous arteries and run upwards both anterior and posterior to the elbow joint, to anastomose with descending articular branches of the profunda brachii, and the ulnar collateral arteries. Deep branch of the transverse cervical artery which is a branch of the thyrocervical trunk 1 st part of subclavian a. Jan 19, 2017 arterial anastomosis around the scapula upper limb gross anatomy usmle step 1 videos duration. Since then, technical refinements of suture materials have made possible surgical reconstruction of most arteries, from the root of the aorta to microvascular anastomosis or repair of the smallest vessels, e. Circumflex scapular artery an overview sciencedirect topics. If you would like a large, unwatermarked image for your web page or.
The circumflex scapular artery branches from the subscapular artery from the third part of the axillary artery and becomes the third contributing part of the scapular anastomoses. Three types have been described, taking into account its length, calibre and form quain, 1844 or the positions of the origin and number of recurrent radial arteries ljubomudroff, 1927. While the circumflex scapular artery and infraspinous. Produces force couple with rotator cuff all muscles do slightly different job but together achieve one job. Scapular flap for maxillectomy defect reconstruction and preliminary results using three. A 22year old male presented with a transected femoral artery following a gunshot wound. Simply a narrow cloth with an opening for the head that hangs down a persons front and back, the monks scapular evolved from the aprons worn by agricultural laborers over their clothes. Dorsal scapular artery definition of dorsal scapular artery. Constrained total scapula reconstruction after resection.
Suprascapular artery a branch of the thyrocervical trunk, which in turn arises from the subclavian artery. Superiorly, the trapezius muscle is tenodesed to the deltoid muscle. Worn by nuns or monks, scapulars can indicate the religious order to which one belongs. Constrained total scapula reconstruction after resection of a. Scapular flap for maxillectomy defect reconstruction and. 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. He underwent a successful primary repair following limited segmental resection of the injured segment. Staplermade anastomosis this can be a sidetoside anastomosis with a straight sewing machine e.
The scapular anastomosis is a system connecting certain subclavian artery and their. It allows blood to flow past the joint in case of occlusion, damage, or pinching of the following scapular arteries. 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. 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. During the dissection of this flap, there is a risk of lesion of the tca, which could be fatal to the flap if the. This anastomosis helps preserve the upper limb during injury. Derived, at least in part, from anterior and middle scalene muscle fascia.
Atlas of advanced operative surgery 1st edition pdf free. Suprascapular artery branch of the thyrocervical trunk of the 1 st part of subclavian a. It functions to allow blood to flow around the scapula and shoulder joint if there is injury or occlusion. Scapulothoracic endoscopy for the painful snapping scapula. Dorsal scapular artery definition of dorsal scapular. The anatomical pattern of the anastomosis has been classified into 2 or 3 types depending on different morphological details. 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 the scapular anastomosis happens at 2 sites.
May 11, 2020 the suprascapular and dorsal scapular arteries meet in the supraspinous fossa to form an anastomosis. The disadvantages include the same depth issues in performing the anastomosis as in the thoracodorsal vessels. 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. Deep branch of the transverse cervical artery which is a branch of the. It courses around the lateral border of the scapula to enter the infraspinous fossa. Anastomosis around the scapula three arteries take part in.
Arterial anastomosis around the scapula upper limb gross. The circumflex scapular artery, a branch of the subscapular artery, divides into a. The transverse cervical artery from the subclavian, usually the first part, occasionally the third part, has a descending branch the dorsal scapular artery which accompanies the dorsal scapular nerve. Subgroup analysis of cancer patients showed leak rate of 1. Scapular dyskinesis would be characterised by dysrhtythmia premature or excessive scapular elevation or protraction, nonsmooth or stuttering motion on elevation or lowering or rapid downward rotation during lowering andor winging medial border or inferior scapular angle posteriorly displaced from the thorax. Surgical treatment involves excision of the bursae, as well as partial scapulectomy of the superomedial impinging region. Intestinal anastomosis is a very important procedure to a general surgeon in clinical practice, and it has been carried out using a variety of techniques and suture materials for over 100 years.
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 the scapular anastomosis happens at 2 sites. Fine sutures on atraumatic needles are best for arterial anastomosis. Congenital absence of the circumflex scapular artery is uncommon but has been. The angle of the scapular tip was measured setting the vertex at the most prominent point of the tip and considering a radius of 3 cm.
The scapula or shoulder blade is the bone that connects the clavicle to the humerus. Arterial anastomosis of the elbow radiology reference. It runs down the vertebral border of the scapula to its inferior angle. The scapular tip was classified in type 1 or type 2 based on the absence or presence of the bony protuberance corresponding to the insertion of the teres major muscle, respectively. Scapulars article about scapulars by the free dictionary. Arterial supply and anastomotic pattern of the infraspinous fossa focusing on the surgical significance. May 12, 2020 several arteries form an anastomosis to supply blood to the posterior scapular region. Three arteries take part in the anastomosis around the scapula. The angular vessels were used to reach the neck for anastomosis in midfacial reconstruction n 2, to carry a separate second bone flap in. The scapular free flap elrikrh journal of plastic surgery i 982 35, 27 c 1982 the trustees of british association of plastlc surgeons 0007.
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