# OVERVIEW #
USU Shoulder (Ultrasound Utility Shoulder) is a newly created tutorial iPad application for ultrasound-guided local anesthetic injection in the human shoulder. The practice of ultrasound-guided injection has recently increased in the pain clinic because of the high resolution and handiness of the device.
Although the aid of an ultrasound device enables safer and more efficient blocking than the traditional palpitation methods, knowledge and skill about ultrasound anatomy have been required. This app should be helpful for this procedure not only as an easy and handy tutorial for anesthesiologists but also as an illustrating tool for patients at the bedside. We recommend this app also for doctors, nurses, students, teachers, and anyone who is interested in the shoulder anatomy and the ultrasound images.
In a screen of the start page, the interface of this app is divided into three frames: left, middle, and right. The left frame corresponds to the anatomical drawing of the anterior, right lateral, posterior, and superior aspects. The middle frame and the right frame are the ultrasound images and the selection screen, respectively. There are two select tabs; "basic information" and "ultrasound anatomy" in the right frame tabs.
SHOCK ABSORBER
There are two types of shock absorber, a double and a single barreled shock absorber type, when a humerus is elevated.
Anatomical shoulder joint (glenohumeral joint between glenoid and humeral
head) has a double barreled shock absorber, which has brachii tubular bursa and subscapularis bursa. Functional shoulder joint (between deltoid and rotator cuff) has a single barreled shock absorber, which is subcoracoid bursa, subacrominal bursa, and subdeltoid bursa.
PROBE POSITION
Probe position are divided into five parts to describe the ultrasound anatomy of the shoulder joint.
Position 1 is placed between a greater tubercle and a lesser tubercle biceps to check the brachii tubular bursa. Position 2 is placed between a lesser tubercle and a subscapular fossa to check the subscapularis bursa. Position 3 is placed between a lesser tubercle and a coracoid process to check the subcoracoid bursa. Position 4 is placed between a greater tubercle and a acromion to check the subacrominal bursa.
Position 5 is placed between a infraspinous fossa and a humeral head to check the subdeltoid bursa and the glenohumeral joint.
STILL IMAGES
To see the still image of selected organs, tap the one of "1,2,3,4 or 5"
which is probe position tab in the middle frame, so that the "bone, joint, nerve and muscle" tabs with the subdivision of "individual names" appear in the right frame.
Any organ can be additively selected at the right frame and then the selected organs simultaneously highlighted with different colors in both the middle and left frames.
MOVIES
The "intraarticular injection" tab appears in the right frame, when the "Movie" tab in the middle frame is tapped.