Abos - Shoulder And Humerus: General Knowledge - Surigcal Approaches: Key Points

Front 1

With shoulder arthroscopy, what is a common reason of interscalene block failure?

Back 1

Inadequate anesthesia of T2
dermatome

Front 2

What surgical site does this correspond to?

Back 2

Posterior arthroscopy portal

Front 3

An interscalene block administered at the time of surgery may also lead to
palsy of what nerve?

Back 3

Phrenic nerve

Front 4

What is the lateral approach to the shoulder?

Back 4

Deltoid splitting approach

Front 5

How far distal to the acromion can the deltoid be safely split? Why?

Back 5

No more than 5 cm
With further split, axillary nerve at risk

Front 6

What is the interval for the posterior shoulder approach?

Back 6

lnfraspinatus
Teres minor

Front 7

With the posterior approach, what should be avoided? Why?

Back 7

Avoid dissecting below teres minor (within quadrangular space) Axillary nerve and posterior humeral circumflex arteries at risk

Front 8

With the deltopectoral approach, which vein is at risk?

Back 8

Cephalic

Front 9

Excessive medial retraction for exposure may injure what structure?

Back 9

Musculocutaneous nerve

Front 10

What two structures should be protected at inferior edge of subscapularis?

Back 10

Axillary nerve
Anterior circumilex artery and veins

Front 11

For the anterolateral approach, what is the proximal interval?

Back 11

Deltoi
Pectoralis major

Front 12

What is the distal interval?

Back 12

Brachialis split

Front 13

Why does the distal approach work? What nerves supply the brachialis?

Back 13

Brachialis is duly innervated
Musculocutaneous and radial nerves

Front 14

For the posterior approach, what is the proximal interval?

Back 14

Deltoid
Triceps

Front 15

How much of the humerus can be accessed proximally?

Back 15

Up to 8 cm

Front 16

For the anterolateral approach to the distal humerus, what is the interval?

Back 16

Brachialis
Brachioradialis

Front 17

What structure is at risk?

Back 17

Radial nerve

Front 18

For the lateral approach to the distal humerus, what is the interval?

Back 18

Brachioradialis
Triceps

Front 19

Then how does the deeper dissection proceed?

Back 19

Lift extensor carpi radialis longus and brevis (ECRL and ECRB) off
Work anterior to epicondyle and lateral collateral ligament (LCL)