Transcript Bone Injection Gun – B.I.G.

Adult Bone Injection Gun
B.I.G.
Humeral Head Location
Long bone Anatomy and
physiology
• Cortical bone (Compact bone) – Hard bone
• Cancellous bone (Spongy bone) – Medulary cavity.
• Meshwork occupied by bone marrow, fat tissue,
nerves and blood vessels.
• Production of blood cells and provision of a vascular
supply to the bone itself.
• Blood comes out of the
bone through venous sinusoids
to outgoing veins
into the circulation.
Humerus - Anatomy
• Long bone – The longest bone in the upper
extremity.
• Body, Two extremities
• Upper extremity – Head, Lesser and Greater
tubercle, neck.
• Intertubercular Canal.
• Muscles, Ligaments and other tissues around.
Shoulder Anatomy
Looking at the
Shoulder Front to
Back (AP) we
need to locate 2
major landmarks
Shoulder Anatomy
The Acromion and
the Coracoid
Process
Shoulder Anatomy
Draw an Imaginary
line between these
two points
Shoulder Anatomy
In the middle of
that line draw
another line down,
toward the Elbow.
This is the Humeral
Head
Shoulder Anatomy
We will be looking
for the Greater
Tubercle, which is
palpable.
Locating the Humeral Head
First thing first – Anatomical
position….
Positioning of the patient
• Position the patients
hand on top of the
Umbilicus – this is
called Abduction.
• Try to keep patient
laying straight on his
back with arm close as
possible to body- this is
called a Supine
position
When adducting the arm, the Humeral Head
rotates and the GT moves forward…
Why do we rotate the arm ?
1. To protect nerves, tendons and
blood vessels.
2. To maximum expose the GT.
Locations:
• Acromion – Coracoid
• Clavicle
Acromion – Coracoid
approach (1):
Reminder:
The shoulder should be
Adducted.
The palm of the hand
should be placed on the
Umbilicus.
Acromion – Coracoid
approach (2):
Draw the imaginary line
connecting the Acromion and
the Coracoid Process.
Acromion – Coracoid
approach (3):
From the midpoint of the line,
go 2 fingers Distally (This is
the Humeral Head)
Acromion – Coracoid
approach (4):
In certain patients the area
where the Humeral Head is
closest to the skin is one
finger Anteriorly (Toward the
Chest)
Clavicular approach (1)
Follow the Clavicle to the
Lateral end of the
Acromion
Clavicular approach (2)
Go 2 fingers Distally (Toward
the Elbow),
This is the Humeral Head
Clavicular approach (3)
In certain patients the area
where the Humeral Head is
closest to the skin is one
finger Anteriorly (Toward the
Chest)
Feel the Greater Tubercle.
Clavicular approach (4)
Summary:
Draw the imaginary line
connecting the Acromion
and the Coracoid Process.
From the midpoint of the line,
go 2 fingers Distally (This is
the Humeral Head)
In certain patients, in addition:
Go one finger Anteriorly (Toward
the Chest)
Location
*Once located the
insertion site, confirm
the exact position, by
verifying the Greater
Tubercle’s outer
margins.