Interactive Transcript
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Alright, so we're, uh, we're continuing on our discussion
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of the rotator cuff and, uh, we're gonna summarize the major
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components of the cuff, of which there are actually six.
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And we're gonna point each one of these out to you.
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We've got the supraspinatus, the infraspinatus,
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the teres minor, the biceps and its long head, the
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coraco humeral ligament, and the capsule itself.
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So those are the six.
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So when you look at the rotator cuff, you're gonna,
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you're gonna work your way right down that checklist.
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So here we have a sagittal drawing of a shoulder.
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This would be anterior.
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This would be posterior.
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So here's the supraspinatus.
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Here's the infraspinatus.
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And this little slit in between is
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known as the posterior interval.
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And then on the next cut, headed from
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lateral to medial, here's the supraspinatus.
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There's the infraspinatus.
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This little slit, this fibroelastic membrane slit, It's the
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interface between the two, and that's the subscapularis,
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and between the subscapularis and the supraspinatus
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will be the anterior interval, which means there also
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has to be a far posterior interval, so some people call
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this the posterior, middle, and anterior intervals.
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But on this cut we have subscapularis, supraspinatus,
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infraspinatus, and if you're very familiar with the
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anatomy, you may note that the biceps is slipping
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down from the intra to the extra-articular space.
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We're going to show it to you a lot
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better when we move on to our actual case.
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So now let's go a little bit more
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medial to the level of the glenoid.
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And there is the coracohumeral ligament.
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This is known as the extra-articular
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portion of the coracohumeral ligament.
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Which contributes the deepest fibers of
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the rotator cuff blending with the capsule.
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Now we're coronal and we're in the back.
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So, since we're in the back, you're
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seeing infraspinatus and teres.
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I also, when I'm looking at the rotator
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cuff, look at the trapezius to see if
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there is weakness of the shrug mechanism.
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And I look at the deltoid to see
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if there is weakness of abduction.
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Usually, patients that aren't picking up their
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arm have a lot of atrophy and fatty replacements.
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Then we move forward.
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We get the back portion of the supraspinatus and its tendon.
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We move forward even more.
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We have the anterior portion of the
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supraspinatus and the subscapularis.
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So then we go to the axial projection.
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We're up high.
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We see the supraspinatus and its
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fibers arcing back a little bit.
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And we have the infraspinatus
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fibers arcing forward a little bit.
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We come down a little more.
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It's hard for me to control.
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There's a little bit of the biceps being volume average.
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We'll focus on that in our cases.
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There's the coracohumeral ligament, which forms
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the anterior boundary of the rotator interval and
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contributes the deepest fibers of the rotator cuff.
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Here's the inps in the back, and then finally
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as we get down low or lower, we see the
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subscapularis very nicely with its tendon.
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That's very broad and the infraspinatus coming
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in from the back, mostly muscular in this position.
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So again, six components of the cuff.
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This is just a very cursory look at them anatomically.
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Supraspinatus.
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Infraspinatus.
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Teres minor.
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Biceps and its long head.
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Labral anchor complex.
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Coracohumeral ligament and capsule.
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Those are the six on your rotator cuff checklist.
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