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The soft tissue components of the biceps pulley system include: •Subscapularis •Supraspinatus •The coracohumeral ligament (CHL) •The superior glenohumeral ligament (SGHL) The subscapularis has superficial and deep fibers that envelope the groove, creating the “roof” and “floor”. They also coalesce with those from the supraspinatus and SGHL/CHL complex. They... show more

Gonzalo Serrano-Belmar.

9,442 subscribers

52,076 Aufrufe • vor 2 Jahren •via X (Twitter)

Anya Rossi• Live Now

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Profilbild von Suvinay Saxena

Suvinay Saxenavor 2 Jahren

Beautiful ❤️

Profilbild von Ben

Benvor 2 Jahren

Really appreciate your scans and illustrations! Fantastic resource for learning US. Keep them coming! 🙌

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Instability of the long head of the biceps tendon (LHBT) is almost always associated with other shoulder pathologies, mainly pathology of the rotator cuff (supraspinatus and subscapularis tear). Therefore, every time we find RC tears, we must explore the stability of the LHBT. The most critical stabilizers are the SGHL, CHL, and the intertwining fibers of the supraspinatus and subscapularis. Here is a case with a high-grade subscapularis tear with continuity of the most superficial fibers/transverse humeral ligament that limits retraction,associated with medial dislocation of the LHBT. With an extension, abduction, and internal rotation maneuvers of the shoulder, we reposition the tendon in the bicipital groove, with subsequent re-dislocation due to external rotation, showing a marked exit snapping, very painful. We can add important dynamic information. #mskrad #MedTwitter

Instability of the long head of the biceps tendon (LHBT) is almost always associated with other shoulder pathologies, mainly pathology of the rotator cuff (supraspinatus and subscapularis tear). Therefore, every time we find RC tears, we must explore the stability of the LHBT. The most critical stabilizers are the SGHL, CHL, and the intertwining fibers of the supraspinatus and subscapularis. Here is a case with a high-grade subscapularis tear with continuity of the most superficial fibers/transverse humeral ligament that limits retraction,associated with medial dislocation of the LHBT. With an extension, abduction, and internal rotation maneuvers of the shoulder, we reposition the tendon in the bicipital groove, with subsequent re-dislocation due to external rotation, showing a marked exit snapping, very painful. We can add important dynamic information. #mskrad #MedTwitter

Gonzalo Serrano-Belmar.

31,636 Aufrufe • vor 2 Jahren

Morton's neuroma occurs at the terminal bifurcation of the common plantar digital nerve. The deep transverse metatarsal ligament connects the metatarsals. Below the ligament, we find the nerve, and above the ligament, the bursa. And distal to the anterior free edge of the ligament, the neuroma. It is at this level that the nerve makes a pronounced dorsal turn at the distal free edge of the ligament. We can see this demonstrated in the video/illustration. This explains one of the theories; entrapment between the plantar soft tissues and the ligament. The dorsal approach for me is the best 👍 . We avoid the thick plantar skin. Compressing with the finger on the plantar side and sliding it also lets us differentiate the distinct components, where the ligament remains immobile. We can also mobilize the nerve and see how it imprints against the anterior free edge of the ligament, understanding the pathomechanism. Finally, the Mulder maneuver always helps. #mskrad

Morton's neuroma occurs at the terminal bifurcation of the common plantar digital nerve. The deep transverse metatarsal ligament connects the metatarsals. Below the ligament, we find the nerve, and above the ligament, the bursa. And distal to the anterior free edge of the ligament, the neuroma. It is at this level that the nerve makes a pronounced dorsal turn at the distal free edge of the ligament. We can see this demonstrated in the video/illustration. This explains one of the theories; entrapment between the plantar soft tissues and the ligament. The dorsal approach for me is the best 👍 . We avoid the thick plantar skin. Compressing with the finger on the plantar side and sliding it also lets us differentiate the distinct components, where the ligament remains immobile. We can also mobilize the nerve and see how it imprints against the anterior free edge of the ligament, understanding the pathomechanism. Finally, the Mulder maneuver always helps. #mskrad

Gonzalo Serrano-Belmar.

36,698 Aufrufe • vor 3 Jahren

The Medial Collateral Ligament has a deep component made up of two ligaments—the meniscofemoral ligament (MFL) and the meniscotibial ligament (MTL). The MFL is the most frequently injured, with its most likely site to rupture at the femoral insertion (+/- 80%). The MFL primarily provides stabilization against external rotation. But!!, it also plays an essential role in anchoring the meniscus peripherally, so its rupture may impair the function of the meniscus. Next!! Dynamic Ultrasound!! #mskrad

The Medial Collateral Ligament has a deep component made up of two ligaments—the meniscofemoral ligament (MFL) and the meniscotibial ligament (MTL). The MFL is the most frequently injured, with its most likely site to rupture at the femoral insertion (+/- 80%). The MFL primarily provides stabilization against external rotation. But!!, it also plays an essential role in anchoring the meniscus peripherally, so its rupture may impair the function of the meniscus. Next!! Dynamic Ultrasound!! #mskrad

Gonzalo Serrano-Belmar.

72,255 Aufrufe • vor 2 Jahren

Continuation of previous MRI case. A 14-year-old boy with persistent discomfort and occasional joint effusion 3 months after a medial knee sprain of the deep component (same injury 3 years ago). We have already seen the MRI. Ultrasound confirms a residual proximal tear of the deep MFL LCM with an insufficient ligament. Dynamic maneuvers with knee valgus in slight flexion demonstrated an insufficient ligament with meniscal hypermobility with the meniscus penetrating the joint with the knee valgus. The deep MCL component STABILIZES THE MENISCUS!! We can provide essential information for decision-making with dynamic US. #mskrad

Continuation of previous MRI case. A 14-year-old boy with persistent discomfort and occasional joint effusion 3 months after a medial knee sprain of the deep component (same injury 3 years ago). We have already seen the MRI. Ultrasound confirms a residual proximal tear of the deep MFL LCM with an insufficient ligament. Dynamic maneuvers with knee valgus in slight flexion demonstrated an insufficient ligament with meniscal hypermobility with the meniscus penetrating the joint with the knee valgus. The deep MCL component STABILIZES THE MENISCUS!! We can provide essential information for decision-making with dynamic US. #mskrad

Gonzalo Serrano-Belmar.

40,599 Aufrufe • vor 2 Jahren

Does 'lasting change' include urging black people to have the 'Covid' fake vaccine which has killed and maimed fantastic numbers of people, Lenny? Trump and Farage are serving the same system that 'you must have the jab' was serving and they agreed with. 'Left' and 'Right' serve the same system while thinking they are different. Only in emphasis, not service to tyranny.

Does 'lasting change' include urging black people to have the 'Covid' fake vaccine which has killed and maimed fantastic numbers of people, Lenny? Trump and Farage are serving the same system that 'you must have the jab' was serving and they agreed with. 'Left' and 'Right' serve the same system while thinking they are different. Only in emphasis, not service to tyranny.

David Icke

41,768 Aufrufe • vor 3 Monaten

Steve Kerr said he’s “concerned” about the increase in soft tissue injuries across the NBA. His medical staff believes the increased pace paired with the schedule has led to it. “They believe the wear and tear, the speed, the pace, the mileage is factoring into these injuries.”

Steve Kerr said he’s “concerned” about the increase in soft tissue injuries across the NBA. His medical staff believes the increased pace paired with the schedule has led to it. “They believe the wear and tear, the speed, the pace, the mileage is factoring into these injuries.”

Anthony Slater

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Lutnick: The states run these elections. If they want to use the U.S. Mail they are going to get a code, a barcode from the U.S. Postal service and they are going to put that on the envelope, and we will have one envelope per vote.

Lutnick: The states run these elections. If they want to use the U.S. Mail they are going to get a code, a barcode from the U.S. Postal service and they are going to put that on the envelope, and we will have one envelope per vote.

Acyn

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Are we expecting the people at the very top of the system, who have long since corrupted and taken near total control of the system, to use the system to release evidence against themselves, and then use the system that they control, to punish themselves?

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Leavitt: Recent photos of the president has shown minor bruising on the back of his hand. This is consistent with minor soft-tissue irritation from frequent handshaking and use of aspirin

Leavitt: Recent photos of the president has shown minor bruising on the back of his hand. This is consistent with minor soft-tissue irritation from frequent handshaking and use of aspirin

Acyn

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From #SevenBypasses: “Infinitesimal forces drive the needle forward and the wall backward, the needlepoint pierces the tissue with a haptic “pop” that transmits through the instruments, fires the fingertips’ sensory receptors, and stimulates the faintest of perception of a bite. The needle glides through the tissue until the driver meets the microforceps to fully consume the bite. The microforceps then exits the arterial lumen, gently lifts the second wall with its fine tips, and the cycle repeats. Another collision of infinitesimal forces and another haptic pop as the needle pierces and glides and bites. With a squeeze of the microforceps and a release of the driver, the driver circles around to counter-sweep the tissue off the back end of the needle and the needle completes its bite...”

From #SevenBypasses: “Infinitesimal forces drive the needle forward and the wall backward, the needlepoint pierces the tissue with a haptic “pop” that transmits through the instruments, fires the fingertips’ sensory receptors, and stimulates the faintest of perception of a bite. The needle glides through the tissue until the driver meets the microforceps to fully consume the bite. The microforceps then exits the arterial lumen, gently lifts the second wall with its fine tips, and the cycle repeats. Another collision of infinitesimal forces and another haptic pop as the needle pierces and glides and bites. With a squeeze of the microforceps and a release of the driver, the driver circles around to counter-sweep the tissue off the back end of the needle and the needle completes its bite...”

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Leavitt: "Recent photos of the president have shown minor bruising on the back of his hand. This is consistent with minor soft tissue irritation from frequent hand-shaking and the use of aspirin."

Leavitt: "Recent photos of the president have shown minor bruising on the back of his hand. This is consistent with minor soft tissue irritation from frequent hand-shaking and the use of aspirin."

Aaron Rupar

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Solar System Motion. The Solar System moves not only around the Sun, but also along with the Sun along a complex trajectory within the Milky Way galaxy. The Sun orbits the center of the galaxy and also moves relative to other stars in the direction of the constellation Cygnus.

Solar System Motion. The Solar System moves not only around the Sun, but also along with the Sun along a complex trajectory within the Milky Way galaxy. The Sun orbits the center of the galaxy and also moves relative to other stars in the direction of the constellation Cygnus.

Black Hole

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The moment of the attack and the inability of the American air defense system to stop the missiles that bombarded the petrochemical complex.

The moment of the attack and the inability of the American air defense system to stop the missiles that bombarded the petrochemical complex.

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🚨 Russian partisans burned the control system with the radar of the S-300 air defense system The "Liberator" movement explained what was destroyed: The S-300 complex consists of 3 parts. 1. Radar for detecting targets at low altitudes. 2. The actual control system with radar illumination and guidance to air targets. 3. Up to 6 launchers designed to destroy air targets. 💪 The partisans of the "Liberator" destroyed the most important part of the complex, that is, the brain. Accordingly, the entire S-300 complex turns into a pile of iron until a new control system is installed. The cost of the destroyed control system starts from 160 million dollars. The uniqueness of the action is that it is exclusive, hand-made and to destroy the installation and disable the complex, not a couple of missiles at a couple of million dollars each were spent, but 5 liters of gasoline, with a total cost of a couple of hundred rubles.

🚨 Russian partisans burned the control system with the radar of the S-300 air defense system The "Liberator" movement explained what was destroyed: The S-300 complex consists of 3 parts. 1. Radar for detecting targets at low altitudes. 2. The actual control system with radar illumination and guidance to air targets. 3. Up to 6 launchers designed to destroy air targets. 💪 The partisans of the "Liberator" destroyed the most important part of the complex, that is, the brain. Accordingly, the entire S-300 complex turns into a pile of iron until a new control system is installed. The cost of the destroyed control system starts from 160 million dollars. The uniqueness of the action is that it is exclusive, hand-made and to destroy the installation and disable the complex, not a couple of missiles at a couple of million dollars each were spent, but 5 liters of gasoline, with a total cost of a couple of hundred rubles.

PS01 □

134,992 Aufrufe • vor 1 Jahr

Trigger finger: ultrasound diagnosis and treatment Patient with stiffness in the first finger of the right hand, especially in the morning, which is accompanied by a sensation of clicking or crunching when moving the finger, associated with sensitivity and a lump in the palm at the level of the metacarpophalangeal joint. An ultrasound study shows a diffuse increase in the thickness of the flexor tendon, observing the tendon snapping at the level of pulley A1 in a dynamic study when the tendon slides. Initially, infiltration of 1 cc of trigon and 1 cc of 2% mepivacaine into the tendon sheath is performed under ultrasound control to subsequently proceed to fenestration of the pulley until the tendon is released. Sometimes, it can be associated with physiotherapy to unload the muscles in the forearm, performing proximal peritendinous infiltration of the first finger's flexor muscle to prevent the pathology's recurrence.

Trigger finger: ultrasound diagnosis and treatment Patient with stiffness in the first finger of the right hand, especially in the morning, which is accompanied by a sensation of clicking or crunching when moving the finger, associated with sensitivity and a lump in the palm at the level of the metacarpophalangeal joint. An ultrasound study shows a diffuse increase in the thickness of the flexor tendon, observing the tendon snapping at the level of pulley A1 in a dynamic study when the tendon slides. Initially, infiltration of 1 cc of trigon and 1 cc of 2% mepivacaine into the tendon sheath is performed under ultrasound control to subsequently proceed to fenestration of the pulley until the tendon is released. Sometimes, it can be associated with physiotherapy to unload the muscles in the forearm, performing proximal peritendinous infiltration of the first finger's flexor muscle to prevent the pathology's recurrence.

sergio serrano belmar

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.Howard Lutnick: The states run these elections. If they want to use the U.S. Postal Service, they're going to get a barcode from the USPS, and they're going to put that on the envelope, and we will have one envelope per vote — none of this stuff where there's no certainty.

.Howard Lutnick: The states run these elections. If they want to use the U.S. Postal Service, they're going to get a barcode from the USPS, and they're going to put that on the envelope, and we will have one envelope per vote — none of this stuff where there's no certainty.

Rapid Response 47

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Robotic endoscopy in action! Mounted over the scope, the robot has an arm that is controlled externally, with the ability to rotate, flex and grasp tissue. This enables countertraction to assist with complex resection of neoplastic GI lesions.

Robotic endoscopy in action! Mounted over the scope, the robot has an arm that is controlled externally, with the ability to rotate, flex and grasp tissue. This enables countertraction to assist with complex resection of neoplastic GI lesions.

Keith Siau

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#BREAKING: Legendary #Maddow: “That news comes on the heels of the Trump administration also having to give in and give up on this inexplicable bizarre plan they had to go down to the bottom of the ocean, the deep sea off the coast of Oregon, Washington state, Alaska, North Carolina and in between Greenland and Iceland to go send ships into water thousands of feet deep, to then retrieve and destroy expensive American deep sea instruments that we have maintained in those deep sea locations for a decade to do complex monitoring of ocean currents and other stuff that is important not just for weather but for fisheries…this is a system that has been in place for a decade…it’s supposed to last another 25 years. It cost us hundreds of millions of dollars to build this system. For some reason the Trump administration decided they would instead spend millions of your dollars to go out and disable and destroy the system, to retrieve the instruments from the deep sea floor, haul them up to the surface and turn them into scrap. Why did they want to do that? I don’t know, but they will now not be able to do that because the Senate passed a bipartisan bill blocking them from doing that and rather than continuing to fight to do it, the Trump administration caved…”🤦‍♀️

#BREAKING: Legendary #Maddow: “That news comes on the heels of the Trump administration also having to give in and give up on this inexplicable bizarre plan they had to go down to the bottom of the ocean, the deep sea off the coast of Oregon, Washington state, Alaska, North Carolina and in between Greenland and Iceland to go send ships into water thousands of feet deep, to then retrieve and destroy expensive American deep sea instruments that we have maintained in those deep sea locations for a decade to do complex monitoring of ocean currents and other stuff that is important not just for weather but for fisheries…this is a system that has been in place for a decade…it’s supposed to last another 25 years. It cost us hundreds of millions of dollars to build this system. For some reason the Trump administration decided they would instead spend millions of your dollars to go out and disable and destroy the system, to retrieve the instruments from the deep sea floor, haul them up to the surface and turn them into scrap. Why did they want to do that? I don’t know, but they will now not be able to do that because the Senate passed a bipartisan bill blocking them from doing that and rather than continuing to fight to do it, the Trump administration caved…”🤦‍♀️

Emoluments Clause

85,498 Aufrufe • vor 22 Tagen

FOR THOSE INTERESTED IN THE SUPRASCAPULAR NERVE CASE AND HOW TO LOCATE IT. Normal Anatomy: To TRACK the SUPRASCAPULAR NERVE with ultrasound, start at the supraclavicular fossa. A high-frequency linear probe is used to identify the SUPERIOR TRUNK of the brachial plexus, which is seen as a “honeycomb” structure BETWEEN THE ANTERIOR AND MIDDLE SCALENE MUSCLES. Locate the suprascapular nerve as a small branch from the superior trunk, then follow it laterally and posteriorly beneath the OMOHYOID MUSCLE. Continue tracing it toward the suprascapular notch, which passes under the superior transverse scapular ligament. KEY LANDMARKS include the scapular spine and coracoid process. Look for signs of hourglass constriction, such as nerve flattening, hypoechoic areas, or fascicular swelling. Proper alignment and dynamic scanning are essential for clear visualization. #mskrad

FOR THOSE INTERESTED IN THE SUPRASCAPULAR NERVE CASE AND HOW TO LOCATE IT. Normal Anatomy: To TRACK the SUPRASCAPULAR NERVE with ultrasound, start at the supraclavicular fossa. A high-frequency linear probe is used to identify the SUPERIOR TRUNK of the brachial plexus, which is seen as a “honeycomb” structure BETWEEN THE ANTERIOR AND MIDDLE SCALENE MUSCLES. Locate the suprascapular nerve as a small branch from the superior trunk, then follow it laterally and posteriorly beneath the OMOHYOID MUSCLE. Continue tracing it toward the suprascapular notch, which passes under the superior transverse scapular ligament. KEY LANDMARKS include the scapular spine and coracoid process. Look for signs of hourglass constriction, such as nerve flattening, hypoechoic areas, or fascicular swelling. Proper alignment and dynamic scanning are essential for clear visualization. #mskrad

Gonzalo Serrano-Belmar.

22,521 Aufrufe • vor 1 Jahr

Here’s exactly how to do it: (Follow along with the video below 👇🏼) ⸻ 👁️ Nervous System Reset: Eye + Vagus Fascia Release your middle fingers beside the inner corners of your eyes, on the soft tissue. Inhale deeply through the nose. 2.While inhaling, gently trace your fingers around the eyes, following the bone. Feel into the tissue move slowly. 3.On the exhale, slide your hands back, pulling the fascia gently toward your ears. This unwinds stored fear and resets the nervous system. Repeat 6 times.

Here’s exactly how to do it: (Follow along with the video below 👇🏼) ⸻ 👁️ Nervous System Reset: Eye + Vagus Fascia Release your middle fingers beside the inner corners of your eyes, on the soft tissue. Inhale deeply through the nose. 2.While inhaling, gently trace your fingers around the eyes, following the bone. Feel into the tissue move slowly. 3.On the exhale, slide your hands back, pulling the fascia gently toward your ears. This unwinds stored fear and resets the nervous system. Repeat 6 times.

Jules Horn

12,870 Aufrufe • vor 1 Jahr