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Ultrasound Guidance for BoNT Injections: Muscle Review Handout PreCourse 4 AACPDM 2013

Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

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Page 1: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

Ultrasound Guidance for BoNT Injections: Muscle Review Handout

Pre‐Course 4 AACPDM 2013

Page 2: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

Pectoralis Major/MinorPectoralis Major/Minor

Page from Ultrasound Guided Chemodenervation Procedures, Text and AtlasDemos Medical 2012

Page 3: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

Biceps/BrachialisBiceps/BrachialisTransverse Scan, Out of Plane Inejction

Biceps, Transverse Mid ArmOut of Plane InjectionInejction Out of Plane Injection

Page 4: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

BrachioradialisBrachioradialis

Transverse Scan Out of Plane Transverse ScanTransverse Scan, Out of Plane Transverse Scan

Page 5: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

Flexor Forearm, ProximalFlexor Forearm, Proximal

Page from Ultrasound Guided Chemodenervation Procedures, Text and AtlasDemos Medical 2012

Page 6: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

Flexor ForearmFlexor ForearmTransverse Scan, Proximal ForearmForearm

Flexor forearm Transverse

Page 7: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

FCRFCRTransverse Scan,  Out of Plane Injection Out of Plane InjectionInjection Out  of Plane Injection

FCR TV

Page 8: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

Pronator TeresPronator Teres

Transverse Scan Localization Localization Pronator TeresTransverse Scan, Localization Localization Pronator Teres

:

Page 9: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

FDSFDSFDS Transverse Transducer Location Forearm transverse AROMLocation Forearm transverse, AROM

FDS Tv 

Page 10: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

FDPFDP

Typical Approach for FCU/FDP Longitudinal Scan: FDPTypical Approach for FCU/FDP Longitudinal Scan:,FDP

FDP FCU LA OP

Page 11: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

Flexor Pollicis LongusFlexor Pollicis LongusLongitudinal Scan

Longitudinal Scan AROMLongitudinal Scan AROM

Page 12: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

Neck MusclesNeck Muscles

Pages From Ultrasound Guided Chemodenervation Procedures, Text and Atlas, Demos Medical Publishing,  Used with Permission

Page 13: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

ScalenesScalenes

Pages From Ultrasound Guided Chemodenervation Procedures, Text and Atlas, Demos Medical Publishing,  Used with Permission

Page 14: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

Salivary GlandSalivary Gland

Pages From Ultrasound Guided Chemodenervation Procedures, Text and Atlas, Demos Medical Publishing,  Used with Permission

Page 15: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

IliopsoasIliopsoas

Illustration from Ultrasound Guided Chemodenervation, Text and AtlasDemos Medical Publishing. Used with Permission

Page 16: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

Iliopsoas, DistalIliopsoas, DistalTransverse, Proximal Thigh/Distal to Inguinal Crease Transverse Ultrasound ImageThigh/Distal to Inguinal Crease Transverse Ultrasound Image

Psoas Distal Palpation

Page 17: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

Iliopsoas; DistalIliopsoas; Distal

Transverse ScanTransverse Scan

Page 18: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

AdductorsAdductorsAdductors, Transverse, Out of plane injection Add Longusplane injection, Add Longus

Page 19: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

Semimembranosis, Longitudinal ScanSemimembranosis, Longitudinal Scan

• Injection In PlaneInjection, In Plane

Page 20: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

Semimembranosis, Transverse ScanSemimembranosis, Transverse Scan

Injection Out of Plane InjectionPicture Link: Semitendinosis Tv DF  Injection, Out of Plane Injection09.png

Page 21: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

Medial, Lateral Gastrocnemiusl b lSoleus, Tibialis Post

Page 22: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

Gastrocnemius lateral, Soleus Tibialis lPosterior Doppler

Doppler US Jpg 4 y oSoleus, Tibialis Posterior, Transverse Junction of Middle 1/3 Distal 1/3 calfDoppler US Jpg, 4 y.o. Junction of Middle 1/3:Distal 1/3  calf

Page 23: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

Soleus/Tibialis Posterior 4 y.o. ChildSoleus/Tibialis Posterior 4 y.o. ChildTransverse Lower‐Middle 1/3 of Posterior Calf Out of Plane Injection SoleusPosterior Calf Out of Plane Injection, Soleus

Page 24: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

FDL Tibialis PostFDL Tibialis Post

Page 25: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

Tibialis Posterior/Flexor Digitorum( )Longus (FDL)

Anterior Longitudinal FDL AROMLongitudinal Localization AROM Tibialis PosteriorAnterior, Longitudinal FDL AROM Tibialis Posterior

Page 26: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

Tibialis PosteriorTibialis Posterior

Page 27: Ultrasound Guidance for BoNT Injections: Muscle …Ultrasound Guidance for BoNT Injections: Muscle Review Handout Pre‐Course 4 AACPDM 2013 Pectoralis Major/Minor Page from Ultrasound

Flexor Hallicus Brevis, Flexor DigitorumBrevis