Please enable JavaScript.

Coggle requires JavaScript to display documents.

Fascia (Book: Functional atlas of the human fascial system, by Carla…

- - - - Occurs after node dissection due to breast cancer
      - Findings: pain, odema, decreased ROM, neuro ssx's & palpable cords in axilla
    - - Superficial axillary fascia isn't continuous - allows passage of nerves, etc
      - It's the epimysium around a mm & the loose connective tissue that allows the mm to glide freely relative to other structures such as deep & superficial fascia p262
      - There are no actual collateral or annular ligaments at the elbow as the tissues are all part of a complex tissue apparatus p262
    - - Prox compression due to coracobrachialis = motor & sensory ssx's
      - Distal compression occurs lateral to the biceps tendon at the mm tendon junction as the nerve becomes the lat anterbrachial anterior nerve = only sensory ssx's
        May also occur below the biceps aponeurosis @ lacertus fibrosus
      - Text reflexes & neuro to determine cause
      - Don't confuse with lateral epicondylosis
      - Cause - repeated elbow extension &/or forearm pronation
    - - Acute = fracture or dislocation of humerus
      - Chronic = repeated ohead throwing leading to densification of axillary fascia
      - Content of space = axillary nerve & post circumflex humeral artery
      - Ssx's = pain, paraesthesia at regimental patch, deltoid atrophy & weakness (LMN ssx's). Deltoid is usually more affected than teres minor
    - - Deep fibres attach to lesser tuberosity but supf fibres help form the transverse humeral lig alongside the supraspinatus tendon. There is NO transverse humeral ligament!
      - Rigid subscapularis may lead to compression at the intertubercular groove & consequential biceps tendinopathy.
    - - 5% of should complaints involve compression of teres minor nerve which presents as localised pain & atrophy. This may be due to a strong fascial sling around infraspin & teres minor
      - Insertions = traps, rhoms, teres major = "true aponeurotic fascia" as it perceives and distributes tensions at the scap
    - - attachments = lev scap, rhoms, clavicle, pec fascia & infraspin fascia + partially over spine of scap
      - compression of suprascap nerve occurs due to thickening of the distal 1/3 of supraspin fascia at the supraglenoid notch.
        
        Diagnosing Suprascapular Neuropathy in Patients With Shoulder Dysfunction: A Report of 5 Cases
        Physical Therapy, Volume 84, Issue 4, 1 April 2004, Pages 359–372, https://doi.org/10.1093/ptj/84.4.359
        Suprascapular neuropathy (SSN) may be overlooked or mistaken for other conditions such as subacromial impingement syndrome (SAIS), rotator cuff injury, cervical radiculopathy, or brachial plexopathy.1–6 The signs and symptoms of SSN include shoulder weakness, atrophy, and diffuse aching or burning pain at the shoulder, which often includes the posterolateral aspect of the shoulder in the region of the scapula.1–5,7 However, painless cases, which involved denervation of the infraspinatus muscle only, also have been reported.8
        Although SSN is uncommon, it should be considered in the differential diagnosis of patients with shoulder pain and weakness.1–5,7 Suprascapular neuropathy has been reported in 10 patients (0.4%) in a series of 2,520 patients with shoulder pain,6 but some authors7 have speculated that this condition is so frequently misdiagnosed that it is probably the cause in 1% to 2% of patients with shoulder pain.
    - - Superficial fascia = cutaneous nerves, dermatomal pattern
      - Deep fascia = motor nerve, peripheral motosr nerves
      - "Fasciatome referral" = deep fascial connections b/w diff mm's that involve the same direction of movement & the lines of force in fascia are used to explain the basis for referred pain
    - - can occur anywhere along the course of the nerve
      - Prox forearm = under supinator mm (Arcade of Frohse fascia), involves the posterior interosseous branch. Aetiology = potentially repetitive supination & pronation
      - Distal arm (laterally) = b/w brachialis & brachiorad by the fibrous arcade within the lateral head of triceps
    - - Function is to lift the elbow capsule to prevent impingement during elbow extension
    - - Exacerbated by elbow & wrist extension
      - Aetiology = repeated pro/sup
    - - Richly innervated - play a role in peripheral motor coordination & proprioception
      - Flexor retinaculum is an extension of the deep fascia.
      - Transverse carpal ligament is a true ligament
  - - - p289 - in the lower lx supf fascia adheres to deep fascia at joints, midline ant thigh region, tibial crest, septum between gastrocs
      - Posterior knee support p335 - mm slips from biceps fem to popliteus tendon, arcuate pop ligament & lateral condyle of femure
      - Medial knee support p335 = sart, grac, semiten, semimem, gastrocs
      - Sartorius has expansions laterally to the ITB, therefore it affects the knee medially and laterally with TFL in assoc with the hip p338
    - - Inc tightness
      - Fibrosis
      - Thickening
      - Attenuated retinaculum
      - Bony changes at the insertion or the retinaculum itself