0:00

Now to give you an idea of some

0:02

of the anatomic considerations when dealing

0:05

with these an various structures.

0:07

Let's start with the biceps tendon shown on the right

0:11

that most of the time the biceps, the tendon

0:14

of the long head of the biceps as both a bony

0:18

and soft tissue attachment.

0:20

It arises from a bump known as the sup, glenoid tubercle,

0:24

and also from the superior glenoid labum.

0:28

Now, it can have a single attachment rather than a dual

0:31

attachment, but most of the time, as shown on the right,

0:34

you will see both attachments.

0:37

More importantly, I think

0:38

for diagnosis is the anatomy in the transverse plane,

0:42

which I show with the image on your left.

0:45

If you look at this image I'm showing you in the yellow

0:47

arrows, the extent of the superior labum,

0:50

and I'm showing you the biceps tendon to point out

0:53

that in most of us, the attachment is located

0:56

postero superiorly rather than anthro superiorly.

1:01

Now, there are some variants such as a sub-label recess

1:04

with knowledge of that fact becomes important.

1:07

Right? As I go over the criteria for pathology,

1:10

you'll understand exactly what I mean.

1:15

Now, even more important is the way

1:17

that the biceps labral complex attaches

1:20

to the superior margin of the glenoid to the cartilage

1:23

and to the bone, and two types

1:25

of attachment have been described in the slab type.

1:29

The biceps labral attachment is a very tight attachment

1:32

with no space or a minimal space.

1:36

But if you look at the menis type of attachment shown here,

1:40

the biceps and labrum are separated from the articular

1:44

cartilage by a small recess.

1:47

We'll talk about it, the sub labral recess or sucus,

1:50

and you can see it's shape, it's thin, it curves kind

1:54

of medially beneath the labrum to reach the area

1:58

of the biceps tendon.

2:00

We have more diagnostic difficulties

2:02

with the menis type than we do with the slab type.