1、肩袖损伤英文版2肩袖损伤英文版Rotator CuffLong Head of Long Head of BicepsBicepsSubscapularisSubscapularisSupraspinatus,up facet of the humeral greater tuberosityInfraspinatus,middle facet of the humeral greater tuberosity Teres minor down facet of the humeral greater tuberosityInfraspinatus Humeral tuberosity3肩袖损
2、伤英文版4肩袖损伤英文版MRIInfraspinatusInfraspinatusTeres minorTeres minorSupraspinatusSupraspinatusInfraspinatusInfraspinatus5肩袖损伤英文版Pathophysiology Intrinsic Factors Vascular supply(?significance)Distal 1cm of supraspinatus tendon(early studies)Degenerative changes Age related Change in proteoglycan and coll
3、agen content in symptomatic tendons6肩袖损伤英文版Pathophysiology Extrinsic factors Impingement Acromial spursType III acromion and decreased geometric area of the supraspinatus outlet Coracoacromial ligament AC joint osteophytes Coracoid process Glenohumeral instability Accentuates abnormal loadingCan lea
4、d to internal impingement Repetitive use Tensile overload Muscle fatigue Microtrauma7肩袖损伤英文版MechanismTraumatic PitchingChronicPain and/or Pain and/or fatigue of cufffatigue of cuffRotator Cuff Rotator Cuff dysfunctiondysfunctionImpingement with Impingement with motionmotion8肩袖损伤英文版Diagnose1、History
5、Pain on the lateral aspect of the shoulder Stiffness,esp IR Cannot lie on that side Weakness,instability,crepitus Partial tears more sore and stiffer Acute tear may have inciting event9肩袖损伤英文版Diagnose2、Physical Exam Impingement testingNEER SIGNHawkins test10肩袖损伤英文版Diagnose2、Physical ExamSUBSCAPLULAR
6、IS 肩胛下肌SUPRASPINATUS 冈上肌冈上肌 Jobes Test11肩袖损伤英文版Diagnose2、Physical ExamINFRASPINATUS 冈下肌TERES MINOR 小圆肌Hornblowers sign:12肩袖损伤英文版Diagnose3、ImagingPlain radiographsUltrasoundMRI13肩袖损伤英文版 small(1 cm),medium(13 cm),large(35 cm),or massive(5 cm small(1 cm),medium(13 cm),large(35 cm),or massive(5 cm）15肩袖损伤英文版16肩袖损伤英文版17肩袖损伤英文版18肩袖损伤英文版19肩袖损伤英文版20肩袖损伤英文版21肩袖损伤英文版Treatment-surgery22肩袖损伤英文版23肩袖损伤英文版三角肌三角肌肱三头肌外侧头肱二头肌肱骨头24肩袖损伤英文版斜方肌冈上肌锁骨肩峰端三角肌大圆肌肩胛下肌背阔肌肩胛骨肱骨头肱三头肌25肩袖损伤英文版三角肌冈上肌肩峰斜方肌肱骨头肩胛骨肩胛下肌大圆肌肱三头肌长头背阔肌肱三头肌外侧头26肩袖损伤英文版肩胛下肌27肩袖损伤英文版28肩袖损伤英文版
