PPT Tugas Ortooooooooooooooooooooooooooooooo.pptx

orthopaedi

1. PPT Tugas Orthopaedi dr. Egi Ghilman Islami Pembimbing : dr. Rhyan Darma Saputra, Sp.OT (K)., M.Kes PROGRAM PENDIDIKAN DOKTER SPESIALIS ILMU BEDAH FAKULTAS KEDOKTERAN U IVERSITAS SEBELAS MARET RSUD DR. MOEWARDI SURAKARTA 202 5

2. Laboratory post op

3. X-Ray Examination pre operative

4. X-Ray Examination pre operative

5. CT Scan

6. CT Scan

7. CT Scan

8. 1. Look: Inspeksi area fraktur: Perhatikan warna kulit , tanda-tanda inflamasi , dan adanya deformitas seperti angulasi atau pemendekan . Penilaian luka (jika ada): Lokasi, ukuran, perdarahan, bone expose, skin coverage, skin loss, dan tanda radang.

9. 2. Feel: Neurovaskularisasi distal: Periksa sensorik , nyeri tekan , suhu , dan nadi pada daerah yang terpengaruh untuk mengevaluasi aliran darah dan saraf . Krepitasi : Periksa adanya suara atau sensasi seperti tulang yang saling bergesek saat digerakkan . Nyeri tekan : Identifikasi daerah yang nyeri saat ditekan

10. 3. Move: Pergerakan aktif dan pasif : Evaluasi kemampuan pasien untuk menggerakkan lengan secara aktif dan pasif di semua bidang gerakan bahu ( fleksi , ekstensi , abduksi , adduksi , rotasi internal, dan eksternal )

11. Anatomy Os Scapula

12. The muscles that attach to the scapula allow it to perform six movements Elevation: The upper trapezius and levator scapulae raise the scapula Depression: The lower trapezius brings down the scapula Upward rotation: The upper and middle trapezius rotate the scapula during upper extremity abduction Downward rotation: The rhomboids rotate the scapula when reaching behind the back and downward Retraction (adduction): The rhomboids and middle trapezius separate the scapula from the thoracic wall, active when performing rowing motions Protraction (abduction): The serratus anterior brings the scapula against the thoracic wall, active when reaching forward

13. Blood Supply and Lymphatics Thryocervical trunk branches: 1. Transverse cervical artery - runs along the medial border of the scapula. May provide a deep (or descending) branch that is also known as the dorsal scapular artery. However, this artery more often branches off the subclavian artery. 2. Suprascapular artery - Mostly supplies supraspinatus and infraspinatus muscles.

14. Subclavian artery branches: Subscapular artery - Provides blood supply for subscapularis muscle as far as the inferior angle of the scapula Circumflex scapular artery - branch of the subscapular artery. Forms an anastomosis with the suprascapular artery and the deep branch of the transverse cervical artery.

15. - Venous drainage of the scapula: Primarily via the axillary vein and suprascapular veins Lymphatic drainage: Right scapula - Right lymphatic duct  Left scapula - Thoracic duct  The lymph nodes associated with the scapula include the axillary and the supraclavicular lymph nodes.

16. Muscle: The intrinsic muscles of the scapula attach directly to the surface of the bone. These muscles are the four members of the rotator cuff and act to stabilize the glenohumeral joint. These include: Supraspinatus Function: Initiation of arm abduction (first 15 degrees), stabilize glenohumeral joint Origin: Supraspinous fossa Insertion: Top of the greater tubercle Innervation: Suprascapular nerve (C5, C6)

17. Infraspinatus Function: Lateral rotation of the arm, stabilize glenohumeral joint Origin: Infraspinous fossa Insertion: Greater tubercle of humerus, between the supraspinatus and teres minor insertion Innervation: Suprascapular nerve (C5, C6) Teres minor Function: Lateral rotation of the arm, stabilize glenohumeral joint Origin: Lateral/axillary border and adjacent posterior aspect of the scapula Insertion: Inferior aspect of the greater tubercle on the humerus Innervation: Axillary nerve (C5, C6)

18. Subscapularis Function: Adduction and medial rotation of the arm, stabilize glenohumeral joint Origin: Subscapular fossa Insertion: Lesser tubercle of humerus Innervation: Subscapular nerves (C5, C6, C7)

19. The extrinsic muscles of the scapula attach to the processes of the scapula and affect motion at the glenohumeral joint: These include: Biceps brachii Function: Resists dislocation of the shoulder, major flexor of the forearm, supination of the forearm Origin: Short head: coracoid process Long head: supraglenoid tubercle Insertion: Radial tuberosity and forearm fascia (as bicipital aponeurosis) Innervation: Musculocutaneous nerve (C5, C6)

20. Triceps brachii Function: Resists dislocation of the shoulder, major extensor of the forearm Origin: Lateral head: above the radial groove, Medial head: below the radial groove Long head: infraglenoid tubercle of scapula Insertion: Olecranon process of ulna and fascia of the forearm Innervation: Radial nerve (C6, C7, C8)

21. Deltoid  Function: Anterior aspect is responsible for flexion and medial rotation of the arm Middle aspect is responsible for abduction of the arm (up to 90 degrees) The posterior aspect is responsible for extension and lateral rotation of the arm Origin: Lateral clavicle, acromion and scapular spine Insertion: Deltoid tuberosity Innervation: Axillary nerve (C5, C6)

22. Stabilizing muscles of the scapula include: Trapezius Function: Upper fibers elevate the scapula and rotate it during abduction of the arm (90 to 180 degrees) Middle fibers retract the scapula Lower fibers pull the scapula inferiorly. Origin: Skull, nuchal ligament and the spinous processes of C7 to T12 Insertion: clavicle, acromion and the scapular spine Innervation: Accessory nerve (Cranial nerve XI)

23. Levator scapulae Function: Elevates the scapula Origin: Transverse processes of the C1 to C4 vertebrae Insertion: Medial border of the scapula Innervation: C3, C4, and the Dorsal scapular nerve (C5) Serratus anterior Function: fixes the scapula into the thoracic wall, and aids in rotation and abduction of the arm (90 to 180 degrees) Origin: Surface of the upper eight ribs at the side of the chest Insertion: Along the entire anterior length of the medial border of the scapula Innervation: Long thoracic nerve (C5, C6, C7)

24. Rhomboid major Function: Retracts and rotates the scapula Origin: Spinous processes of T2 to T5 vertebrae Insertion: Inferomedial border of the scapula Innervation: Dorsal scapular nerve (C5) Rhomboid minor Function: Retracts and rotates the scapula Origin: Spinous processes of C7 to T1 vertebrae Insertion: Medial border of the scapula Innervation: Dorsal scapular nerve (C5)

25. Mohammed A. Miniato ; Andrew Mudreac ; Judith Borger. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Jul 24, 2023. Anatomy, Thorax, Scapula.