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Shoulder surgery an illustrated textbook 1st Edition
Nikolaus Wülker Digital Instant Download
Author(s): Nikolaus Wülker, Michel Mansat, Freddie H. Fu
ISBN(s): 9781853175633, 1853175633
Edition: 1
File Details: PDF, 234.68 MB
Year: 2001
Language: english
Shoulder Surgery
Shoulder Surgery:
An Illustrated Textbook

Edited by

Nikolaus Wülker
Professor, Orthopädische Klinik der Medizinischen Hochschule
Hannover, Germany

Michel Mansat
Professor, Service de Chirurgie Orthopédique
Hôpital Purpan
Toulouse, France

Freddie H Fu
MD
David Silver Professor and Chairman
Department of Orthopaedic Surgery
University of Pittsburgh
Pittsburgh, Pennsylvania, USA

MARTIN DUNITZ
© Martin Dunitz Ltd 2001

First published in the United Kingdom in 2001 by

Martin Dunitz Ltd

The Livery House
7-9 Pratt Street
London NW1 OAE

All rights reserved. No part of this publication may be repro-

duced, stored in a retrieval system, or transmitted, in any form
or by any means, electronic, mechanical, photocopying,
recording, or otherwise, without the prior permission of the
publisher or in accordance with the provisions of the
Copyright Act 1988 or under the terms of any licence permit-
ting limited copying issued by the Copyright Licensing
Agency, 90 Tottenham Court Road, London W1P 0LP.

A CIP record for this book is available from the British

Library.

ISBN 1 85317 563 3

Distributed in the United States by:

Blackwell Science Inc.
Commerce Place, 350 Main Street
Maiden, MA 02148, USA
Tel: 1-800-215-1000

Distributed in Canada by:

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Tel: 1-204-224-4068

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Brazil
Composition by Scribe Design, Gillingham, Kent, UK
Printed and bound in Hong Kong by Imago.
Contents

Contributors vii 11.4 Fatty degeneration o f t o r n rotator

Preface xi cuff muscles 210
Acknowledgements xii Daniel Goutallier, J e a n Marie Postel and
J a c q u e s Bernageau
1 Clinical a n a t o m y 1 11.5 Reliability o f c l i n i c a l r o t a t o r c u f f
Bernhard Tillmann and Wolf Petersen testing 212
2 Applied b i o m e c h a n i c s 31 Luc Favard
Nikolaus Wülker 11.6 I m a g i n g o f full-thickness r o t a t o r
3 Surgical e x p o s u r e s 55 cuff ruptures 215
Manfred Pfahler J a c q u e s Bernageau and Daniel
4 Clinical evaluation 69 Goutallier
Maximilian Rudert and Nikolaus wülker 11.7 Functional treatment 219
5 Conventional imaging o f the shoulder 89 Dominique F Gazielly
Denise Galy-Fourcade, Jean-Jacques Railhac, 11.8 Full-thickness r o t a t o r c u f f tears:
Nicolas Sans, Thierry Jarlaud and Hèléne decompression and
Chiavassa debridement 222
6 Computed tomography and magnetic François M Kelberine
r e s o n a n c e imaging 103 11.9 Surgical repair 225
Mario Randelli, PierLuigi Gambrioli, Simonetta Daniel Mole
Failoni and Mauro Gallazzi 11.10 Latissimus d o r s i t e n d o n t r a n s f e r 2 2 8
7 Shoulder ultrasonography 119 Alois Lustenberger and Christian
Achim Hedtmann and Hanns Fett Gerber
8 Diagnostic a r t h r o s c o p y 131 11.11 Teres major transfer 230
André Gächter Michel Mansat
9 Subacromial disorders 143 11.12 Supra- a n d infraspinatus
Nikolaus Wülker and Anna K Vocke advancement 231
10 Arthroscopic subacromial Daniel Goutallier, J e a n Marie Postel and
decompression 187 Roseline Boudon
Dieter Kohn 11.13 Pectoralis major transfer 233
11 Rotator cuff tears 201 Michel Mansat
Daniel Goutallier 11.14 T h e t r a p e z i u s flap 234
11.1 Epidemiology, pathophysiology and Daniel Goutallier and J e a n Marie Postel
o u t c o m e o f rotator cuff tears 202 11.15 Subscapularis r u p t u r e repair 235
Thomas Bardin and Daniel Goutallier Alois Lustenberger and Christian Gerber
11.2 Biomechanics o f cuff tears 205 11.16 D e l t o i d flap 236
Olivier Gagey Bernard Augereau
11.3 Pathology o f cuff tears 208 11.17 Authors' preferred method o f
Daniel Goutallier, J e a n Marie Postel and treatment 238
Marie-Catherine Voisin Daniel Goutallier and J e a n Marie Postel
vi Contents

12 Long biceps tendon 243 25 Scapular fractures 503

Laurent Nové-Josserand and Gilles Walch Ernst Wiedemann, Ekkehard Euler and Klaus-
13 Calcifying tendinitis 26l Jügen Pfeifer
Jochen F Loehr and Hans K Uhthoff 26 Fractures in children 521
14 Degenerative arthritis 273 Lutz von Laer and Anna K Vocke
14.1 Primary osteoarthritis of the 27 Rehabilitation 543
glenohumeral joint - surgical 27.1 Definitions and principles 543
treatment 273 Michel Revel and Jean Delprat
Pierre Mansat and Michel Mansat 27.2 Unstable shoulder: microtraumatic
14.2 Shoulder osteoarthritis: the instability 545
rheumatologist's viewpoint 281 Jean Delprat and Patrice Determe
Arnaud Constantin and Bernard 27.3 Recurrent dislocations 547
Maziéres Jean-Louis Jully
14.3 The hyperostotic shoulder 289 27.4 Rotator cuff surgery 550
Bernard Fournié Jean-Pierre Liotard
15 Rheumatoid arthritis 293 27.5 Total shoulder replacement 558
Ian G Kelly Jean Noül Heuleu
16 Glenohumeral and scapulothoracic 27.6 The stiff shoulder 561
arthrodesis 309 Michel Revel
Charles A Rockwood, Jr, David J Clare, 27.7 Isokinetic evaluation 566
Michael A Wirth and Gordon I Groh Patrick Middleton
17 The frozen shoulder 317 27.8 Clinical scoring system for
Leesa M Galatz and Robert J Neviaser functional assessment 569
18 Osteonecrosis of the humeral head 331 Jean-Louis Leroux and Jean-Louis Jully
Spyros N Panos and David M Dines 28 Tumors of the shoulder 575
19 Glenohumeral joint instability: open Rodolfo Capanna, Barbara Gluckert, Leonardo
treatment 349 Martelli, Iris Mancini and Gaetano Bacci
Nikolaus Wülker and Antje Kniesch 29 Amputations 595
20 Arthroscopic treatment of shoulder Burkhard Wippermann and Hanns-Eberhard
instability 419 Schratt
Richard B Caspari and Larry R Padgett 30 Athlete's shoulder 603
21 The acromioclavicular joint 437 Torsten Wredmark
Chris Martin and Evan L Flatow 31 Septic shoulder conditions 619
22 Sternoclavicular disorders 451 Riley J Williams and Answorth A Allen
Mark D Miller and Damian M Rispoli 32 The paediatric shoulder 633
23 Proximal humerus fractures 463 Alain Gilbert
Ulrich Bosch and Werner J Kasperczyk 33 Shoulder palsy in adults after peripheral
24 Clavicle fractures 487 nerve injuries 643
Simon M Lambert, Ralph Hertel and Franz T Jean-Yves Alnot
Ballmer
Index 653
Contributors
Answorth A Allen MD Prof.Dr. Ulrich Bosch Jean Delprat
Orthopaedic Surgery Unfallchirurgische Physical Medicine and
Hospital for Special Surgery Klinik der Medizinischen Rehabilitation
Cornell University Medical Center Hochschule Réhabilitation Centre St Michel
310 E. 71st Street Carl-Neuberg-StraBe 1 8, rue Furgole
New York, NY 10021 30625 Hannover 31000 Toulouse
USA Germany France

Jean-Yves Alnot Roseline Boudon Dr Patrice Determe

Centre de Chirurgie Orthopédique Service d'Orthopédie et Service d'Orthopédie et
et Traumatologique Traumatologie Traumatologie
Hôpital Bichat Hôpital Henri Mondor Hôpital Purpan
46, rue Henri Huchard 51, avenue du Maréchal De Lattre F-31059 Toulouse
75877 Paris Cedex 18 de Tassigny France
France 94010 Creteil
France David M Dines MD
Bernard Augereau The Hospital for Special Surgery
Service d'Orthopédie Rodolfo Capanna 535 East 70th Street
Hôpital Rothschild Chairman, Department of New York, NY 10021
33, boulevard de Picpus Orthopaedics and Traumatology USA
75012 Paris Bone Tumor Center
France Centro Traumatologico Ortopedico Priv.-Doz. Dr. med.
Largo Palagi 1 Ekkehard Euler
Gaetano Bacci MD 50139 Florence Chirurgische Klinik und Poliklinik
Chairman, Oncology Department Italy Ludwig-Maximilians-Universität
Istituto Ortopedico Rizzoli München
Bologna Richard B Caspari MD Nussbaumstr. 20
Italy 80336 Munich
Hélène Chiavassa Germany
Franz T Ballmer Service d'Imagerie Médicale
Klinik für Orthopädische Chirurgie Centre Hospitalier Universitaire Simonetta Failoni
Universität Bern Purpan Department of Radiology
Inselspital 31059 Toulouse Cedex Istituto Ortopedico G. Pini
3010 Bern France Milan
Switzerland Italy
David J Clare MD
Thomas Bardin Department of Orthopaedic Surgery Luc Favard
Clinique de Rhumatologie University of Texas Health Science Service d'Orthopédie et
Centre Viggo Petersen Center Traumatologie I
6, rue Guy-Patin 7703 Floyd Curl Drive Centre Hospitalier Universitaire
75010 Paris San Antonio, TX 78284-7774 Trousseau
France USA 37044 Tours Cedex 1
France
Jacques Bernageau Arnaud Constantin
Service de Radiologie Service de Rhumatologie Dr. med. Hanns Fett
Hôpital Lariboisière Hôpital de Rangueil Orthopaedic Department
2, rue Ambroise-Paré 1, avenue Jean-Poulhès St Elisabeth-Krankenhaus Straubing
75010 Paris 31403 Toulouse Cedex 4 20459 Hamburg
France France Germany
viii Contributors

Evan L Flatow MD Dominique F Gazielly Jean Noël Heuleu

Professor of Orthopedic Surgery Shoulder Unit Rehabilitation Centre La
and Chief of Shoulder Surgery 13, place del ' H ô t e lde Ville Châtaingnerie
Mt Sinai Medical Center 42000 St Étienne 95180 Menucourt
New York, NY France France
USA
Prof. Dr. med. Thierry Jarlaud
Bernard Fournie Christian Gerber Service d'Imagerie Médicale
Service de Rhumatologie Department of Orthopaedic Surgery Centre Hospitalier Universitaire
Hôpital Purpan Hospital Balgrist Purpan
Place du Docteur Baylac University of Zurich 31059 Toulouse Cedex
31059 Toulouse Cedex Forchsstrasse 340 France
France 8008 Zurich
Switzerland Jean-Louis Jully
Prof. Dr. med. André Gächter Head Team Physician
Kantonsspital St Gallen L'Arbizon Rehabilitation Centre
Professor Alain Gilbert
Klinik für Orthopädische Chirurgie 65200 Bagnières
Institut de la Main
Rohrschacher Strasse France
6, square Jouvenet
9007 St Gallen 75016 Paris
Switzerland Prof. Dr. med.
France
Werner J Kasperczyk
Olivier Gagey Caritasklinik St Theresia
Barbara Glückert
Service d'Orthopédie Rheinstraße 2
Centro Traumatologico Ortopedico
Hôpital de Bicetre 66113 Saarbrücken
Policlinico Сareggi
78, rue du Général Leclerc Germany
Largo Palagi 1
94275 Le Kremlin Bicetre Cedex
50139 Florence François M Kelberine
France
Italy
Service de Chirurgie Orthopédique
Leesa M Galatz MD et d'Arthroscopie
Instructor Daniel Goutallier Hôpital Jacques de la Roque
Department of Orthopaedic Surgery Service de Chirurgie Orthopédique
Avenue des tamaris
Washington University School of Hôpital Henri Mondor
13616 Aix-en-Provence
Medicine 51, avenue de Lattre de Tassigny
France
St Louis, MO 94010 Creteil
USA France Ian G Kelly FRCS FRCPS
University of Glasgow
Mauro Gallazzi MD Gordon I Groh MD and Department of Orthopaedic
Department of Radiology Blue Ridge Bone and Joint Clinic Surgery
Istituto Ortopedico G. Pini 129 McDowell Street Glasgow Royal Infirmary
Milan Asheville, NC 28801 Glasgow G4 0SF
Italy USA UK
Denise Galy-Fourcade Priv.-Doz. Dr. med. Dr Antje Kniesch
Service d'Imagerie Médicale Achim Hedtmann Orthopädische Klinik der
Centre Hospitalier Universitaire Klinik Fleetinsel Medizinischen Hochschule Hannover
Purpan Admiralitätsstraße 3 Heimchenstraße 1-7
31059 Toulouse Cedex 20459 Hamburg 30625 Harmover
France Germany Germany

Pier Luigi Gambrioli Dr. Ralph Hertel Prof.Dr.med. Dieter Kohn

Department of Orthopaedic Surgery
Shoulder Surgery Centre Orthopädische Universitäts- und
University of Bern
Istituto Ortopedico G. Pini Poliklinik
Inselspital
Milano 66421 Homburg-Saar
ЗО10 Bern
Italy Germany
Switzerland
Contributors ix

Prof.Dr. Lutz von Laer Pierre Mansat MD

Kinderspital Basel Service de Chirurgie Orthopédique Laurent Nové-Josserand
Abteilung der Kindertraumatologie Hôpital Purpan Clinique Saint-Charles
Römergaße 8 31059 Toulouse Cedex 25, rue de Flesselles
4005 Basel France 69001 Lyon
Switzerland France
Leonardo Martelli
Simon M Lambert BSC FRCS Centro Traumatologico Ortopedico Larry R Padgett MD
FRCSEd(Ortho) Policlinico Careggi Orthopedic Research of Virginia
Southampton University Hospital Largo Palagi 1 Richmond, VA 23294
Pretremona Road 50139 Florence USA
Southampton SO16 6YD Italy
UK Spyros N Panos MD
Chris Martin Department of Orthopaedic Surgery
Jean-Louis Leroux Alta View Sports Medicine Long Island Jewish Medical Center
Service de Rhumatologie 9844 South 1300 East, Suite 100 New Hyde Park
Hôpital Caremeau Sandy, UT 84094 and Albert Einstein College of
30000 Nîmes USA Medicine
France New York
Professor Bernard Mazières USA
Jean Pierre Liotard Service de Rhumatologie
Physical Medicine and Hôpital Rangueil Dr.med. Wolf Petersen
Rehabilitation 1, avenue Jean-Poulhès Anatomisches Institut der Christian-
9, rue saint Eusèbe 31054 Toulouse Cedex 4 Albrechts-Universität
69003 Lyon France Olshausenstr. 40
France 24098 Kiel
Patrick Middleton MD Germany
Priv.Doz. Dr.med. Jochen F Head Team Physician
Loehr Physical Medicine and Priv.Doz. Dr.med. Manfred
Schulthess Klinik Rehabilitation Pfahler
Lengghalde 2 Centre Européen de Rééducation Orthopädische Klinik und Poliklinik
8008 Zurich du Sportif der Ludwig-Maximilians-Universität
Switzerland 40130 Capbreton Marchioninistraße 15
France 81377 Munich
Alois Lustenberg Germany
Department of Orthopaedic Surgery Mark D Miller MD
Hospital Balgrist Clinical Associate Professor, USUHS Prof. Dr. med.
University of Zurich 10 MOG/SGOSO Klaus-Jürgen Pfeifer
Forchsstrasse 340 USAF Academy, CO 80840 Institut für Radiologische Diagnostik
8008 Zurich USA Ludwig-Maximilians-Universität
Switzerland Daniel Molé München
Iris Mancini Clinique de Traumatologie et Nussbaumstr. 20
Bone Bank Medical Director d'Orthopédie 80336 Munich
Policlinico Careggi 49, rue Hermite Germany
Largo Palagi 1 54042 Nancy
50139 Florence France Jean Marie Postel
Italy Service d'Orthopédie et
Robert J Neviaser MD Traumatologie
Professor Michel Mansat George Washington University Hôpital Henri Mondor
Service de Chirurgie Orthopédique Department of Orthopaedics 51, avenue du Maréchal De Lattre
Hôpital Purpan 2150 Pennsylvania Avenue, NW de Tassigny
31059 Toulouse Cedex Washington DC 20037 94010 Creteil
France USA France
X Contributors

Jean-Jacques Railhac Nicolas Sans Priv.-Doz. Dr. med. E Wiedemann

Service d'Imagerie Médicale Service d'Imagerie Médicale Chirurgische Klinik und Poliklinik
Centre Hospitalier Universitaire Centre Hospitalier Universitaire Ludwig-Maximilians-Universität
Purpan Purpan München
31059 Toulouse Cedex 31059 Toulouse Cedex Nussbaumstr. 20
France France 80336 München
Germany
Professor Mario Randelli Priv.-Doz. Dr.
Istituto Clinica Humanitas Hanns-Eberhard Schratt Riley J Williams III
Via Manzoni 56 Unfallchirurgische Klinik der Sports Medicine and Shoulder
20089 Rozzano Medizinischen Hochschule Service
Italy Carl-Neuberg-Straße 1 Hospital for Special Surgery
30623 Hannover Cornell University Medical Center
Prof.Dr.med. Herbert Resch Germany 310 E. 71st Street
Landeskrankenanstalten Salzburg New York, NY 10021
Unfallchirugie Prof.Dr.med. Bernhard Tillmann USA
Müllner-Hauptstraße 48 Anatomisches Institut der Christian-
5020 Salzburg Albrechts-Universität Prof. Dr.med.
Austria Olshausenstr. 4 0 Burkhard Wippermann
24098 Kiel Unfallchirurgische Klinik der
Dr Michel Revel Germany Medizinischen Hochschule
Service de Réhabilitation Carl-Neuberg-Straße 1
Hôpital Cochin Hans K Uhthoff MD 30623 Hannover
27, rue du Faubourg St Jacques Ottawa General Hospital Germany
75014 Paris 501 Smyth Road
France Ottawa, ON KlH 8L6 Michael A Wirth
Canada Department of Orthopaedic Surgery
Damian M Rispoli MD University of Texas, Health Science
Department of Orthopaedics Dr. Anna K Vocke Center
Wilford Hall Medical Center Kinderspital Basel 7703 Floyd Curl Drive
59 MDW/MKFO Abteilung der Kindertraumatologie San Antonio, TX 78284-7774
2220 Berquist Drive, Suite 1 Römergaße 8 USA
Lackland AFB, TX 78236-5300 4005 Basel
USA Switzerland Professor
Torsten Wredmark
Charles A Rockwood, j r MD Marie-Catherine Voisin Department of Orthopedic Surgery
Department of Orthopaedic Surgery Service d'Anatomo-Pathologie Section of Trauma
University of Texas Health Science Hôpital Henri Mondor Huddinge Hospital, Karolinska
Center 51, avenue du Maréchal De Lattre Institute
7703 Floyd Curl Drive de Tassigny 141 86 Huddinge
San Antonio, TX 78284-7774 94010 Creteil Sweden
USA France
Prof.Dr. Nikolaus Wülker
Dr.med. Maximilian Rudert Gilles Walch Orthopädische Klinik der
Orthopädische Klinik der Clinique Orthopédique Emile de Medizinischen Hochschule
Medizinischen Hochschule Vialar Heimchenstraße 1-7
Hannover 116, rue Antoine Charriai 30601 Hannover
Heimchenstraße 1-7 69003 Lyon Germany
30625 Hannover France
Germany
Preface
The world of shoulder surgery has come together at a end of each chapter allows the reader with an even more
rapid pace. Co-operation between European shoulder detailed interest to obtain additional information.
surgeons has largely consolidated, and so have relations Traditionally, shoulder surgery has been highly
with shoulder surgeons in other parts of the world, developed in Europe and much of what is now commonly
particularly in the United States of America. Knowledge employed technique originated in this part of the world.
and experience are now largely shared at courses and However, much was written in the local language, in
congresses and in an international shoulder journal. particular in German and in French, and is only poorly
Shoulder Surgery: An Illustrated Textbook is part of this accessible to English and international readers. The editors
transatlantic, international endeavour. It strives to represent made a particular effort to include European authors for
the current practice of shoulder surgery throughout the topics where particular achievements were made here.
world. The truly international nature of this volume is Much previously unknown information can be found in
evidenced by the large number of authors from Europe the many chapters in this book written by European
and from the United States of America. This allowed the authors, who made a considerable effort to present their
best author for each topic to be chosen irrespective of material in their non-native language.
geographical location or country of origin. The long list of Illustrations add significant information and appeal to
contributors bears witness to the many surgeons who every textbook. Many photographs and drawings were
invested their valuable time into this project. supplied by the authors. In addition, Andrea Rosenmeier
Many years after shoulder surgery was generally added a great number of detailed computer drawings to
recognized as a subspecialty of orthopaedic surgery, this highlight a range of chapters, from biomechanics to
field has by no means become static. New developments clinical examination and surgical technique. She is
have recently occurred in particular with respect to thanked in this place.
shoulder joint replacement and arthroscopy, which are Last, but not least, this textbook would not have been
rapidly changing and evolving with respect to their possible without the support of Martin Dunitz Publishers.
indications, technique and design. In this book, a The team in London around Clive Lawson not only kept
number of international experts focus on standard the entire material organized, but helped to correct errors
treatment regimens used by the orthopaedic surgeon in the text and drawings - something that would seem
with a particular interest in the shoulder. Surgical to be unavoidable with a project of this scope.
technique is described in detail, but each chapter also
contains a comprehensive description of the aetiology, Nikolaus Wülker
pathogenesis, diagnosis and treatment alternatives of the Michel Mansat
respective condition. A complete list of references at the Freddie H Fu
Acknowledgements
Figures 1.11, 1.13, 1.40 and 1.41 are reproduced
from Leonhardt H, Tillmann B, Töndury G, Zilles K
(eds) (1988, 1998) Rauber/Kopsch, Anatomie des
Menschen (Georg Thieme: Stuttgart), by kind
permission of the publishers.
1 Clinical anatomy
Bernhard Tillmann and Wolf Petersen

Introduction wide mobility of the shoulder joint receives a large

expansion due to the movements of the shoulder girdle.
In human beings the upper extremity is of service for The combined movements of the shoulder joint and of
grasping and touching movements. Within the scope of the shoulder girdle joints allow abduction of the arm
those functions the wide mobility of the shoulder joint over more than 90° (above the horizontal). During the
creates the range of motion that is neccessary for daily normal course of movements in the scapular region
living or sports activities. The posterior displacement of autonomous motions are possible neither in the shoul-
the scapula and the retrotorsion of the humeral head der joint nor in the joints of the shoulder girdle.
enable grasping movements as well as motion to lateral Kinematic and electromyographic investigations demon-
and posterior (Figure 1.1). strate that the supportive movements of the shoulder
In the scapular region the shoulder joint and shoulder girdle start in the initial phase of every elevation of the
girdle combined with the fibrous joints form a functional arm (Freedman and Munro 1966, Bateman 1978,
unit. In addition, two slide bearings are significant for Basmajian 1980, Tillmann and Tichy 1986, Tillmann
the kinematics of the shoulder: the subacromial space or 1998). In the elevation of the shoulder in the frontal
'subacromial secondary joint' (Figure 1.2) and the 'scapu- plane up to 150°, for example, 90° of the range of
lothoracic articulation' (Figure 1.3). The shoulder joint is motion is allotted to the shoulder joint and 30° to each
the centre of the articulations of the shoulder region. The shoulder girdle joint, these being linked mechanically.

sf ac
ss cp
gc
la hh cl
ac
if an ac)
sab
gt
sst
sn gl
sdb
gc
dm
mm
Im

la ar
bh

ac

sab
sst

Figure 1.1 Figure 1.2

Thoracic skeleton, shoulder girdle and humerus of a man, Frontal section through a right shoulder joint in the plane of
lateral dorsal view. ac, acromion; an, anatomical neck; bh, the acromioclavicular joint (acj). ac, acromion; ar, axillary
body of humerus; cp, coracoid process; gc, glenoid cavity; recess; cl, clavicle; dm, deltoid muscle; gc, glenoid cavity; gl,
gt, greater tubercle; hh, humeral head; ia, inferior angle of glenoid labrum; sab, subacromial bursa; sdb, subdeltoid
scapula; if, infraspinous fossa; I, first rib; la, lateral angle of bursa; sst, supraspinatus tendon. Insert: histological section
scapula; lm, lateral margin; mm, medial margin; sf, of acromion (ac), subacromial bursa (sab) and supraspinatus
supraspinous fossa; sn, surgical neck; ss, spine of scapula; X, tendon (sst). The bottom side of the acromion is covered by
tenth rib. Specimen of the anatomical collection; Christian- loose connective tissue. Toluidine blue staining.
Albrechts University, Kiel, Germany.
2 Bernhard Tillmann and Wolf Petersen

Developmental anatomy
The joints of the scapular region develop in various ways
and at various times. Regarding its developmental mode
the shoulder joint belongs to the so called
Abgliederungs-joints (Tillmann 1984a): these joints
sam develop as discontinuities in skeletal anlage (structure).
The anlage of humerus and scapula is chondrified at
scm gl
stage 18 (approximately 44 days).
dm The homogenous interzone of the shoulder joint
ism
appears at the end of the seventh week (stage 19)
(O'Rahilly and Gardner 1957). At the same time the anlage
of ligaments such as the superior transverse ligament of
scapula and coracoacromial ligament becomes condensed
within the embryonal tissue (Gardner 1973). The anlage
of the glenoid labrum appears at the end of the seventh
week (stage 20) (Gardner 1973). The labrum as well as
the intra-articular part of the long-head biceps tendon
Figure 1.3 originate from the mesenchymal tissue of the middle zone
Horizontal section through a left shoulder, inferior aspect. of the three-layered interzone. The anlage of the joint
Note the loose, fatty tissue (arrow) between serratus anterior capsule and the glenohumeral ligaments become visible
muscle (sam) and subscapularis muscle (scm) (so-called during the eighth week (Gardner 1973) (Figure 1.5).
scapulo-thoracic-articulation). The tendon of the subscapularis During this time also the anlage of the rotator cuff muscles
muscle crosses the long head biceps tendon (lbt) in the appears. In the posterior part of the shoulder joint the
intertubercular groove (arrowhead). cp, coracoid process; dm, articular joint capsule inserts to the top of the glenoid
deltoid muscle; gl, glenoid labrum; ism, infraspinatus muscle. labrum; in the anterior part of the shoulder joint the artic-
ular joint capsule is attached to the base of the glenoid
labrum. Cavitation of the shoulder joint begins during the
seventh week with a loosening of the intermediate layer
The fibrous joints greatly influence the control of the of the interzone. A clearly visible cavitation is found at
shoulder girdle joint (Table 1.1). The range of motion of the end of the eighth week (stage 23) (Figure 1.5). The
the sternoclavicular joint and the acromioclavicular joint joint cavity is completely formed at the beginning of the
is limited by ligaments. The costoclavicular ligament fetal stage (approximately 10 weeks). The synovial bursae
accomplishes an important stabilizing function because around the shoulder joint are discernible during week 8
it connects trunk and shoulder girdle (Figure 1.4). (Gardner and Gray 1953).

Table 1.1 Articulations of the shoulder region

I. Diarthrosis 1. Sternoclavicular joint

2. Acromioclavicular joint
3. Glenohumeral joint

II. Synarthroses (solid joints) 1. Interclavicular ligament

2. Costoclavicular ligament
3. Coracoacromial ligament
3a. Trapezoid ligament
3b. Conoid ligament
4. Superior transverse scapular ligament

III. Slide bearings Subacromial and subdeltoid bursae - subacromial space (so-called subacromial
secondary joint)
Loose connective tissue between the subscapularis muscle and the serratus anterior
muscle (so-called scapulathoracic articulation)
Clinical anatomy 3

cal tl ccl scj icl Figure 1.4

Joints of the shoulder girdle. (a)
ventral aspect; (b) superior aspect.
acl, acromioclavicular joint; cal,
coracoacromial ligament; ccl,
costoclavicular ligament; cl, conoid
acl ligament; ghj, glenohumeral joint
cl (capsule); icl, interclavicular
ligament; lhb, long head biceps
tendon; scj, sternoclavicular joint;
lhb
sdb, subdeltoid bursa; stl, superior
transverse scapular ligament; tl,
trapezoid ligament. Note the divided
coracoacromial ligament on the left
side in b (arrows). Specimen of the
anatomical collection, Christian-
Albrechts University, Kiel, Germany.

(a)

icl scj

sdb ghj
cal
acl stl

(b)

Figure 1.5
Frontal section through the shoulder joint of a 8-week-old
human embryo. In the periphery the cavitation of the
articular space is visible. Between the supraspinatus tendon
(sst) and the anlage of the acromion (ac) the first origin of
the subacromial bursa (arrow) is just present. gl, glenoid
labrum; hu, humerus; sc, scapula. HE staining.
Other documents randomly have
different content
 Marketing - Complete Guide
Spring 2022 - University

Prepared by: Teaching Assistant Jones

Date: July 28, 2025

Topic 1: Fundamental concepts and principles

Learning Objective 1: Comparative analysis and synthesis
• Study tips and learning strategies
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Learning Objective 2: Learning outcomes and objectives
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Learning Objective 3: Historical development and evolution
• Best practices and recommendations
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Learning Objective 4: Current trends and future directions
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Learning Objective 5: Interdisciplinary approaches
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 5: Diagram/Chart/Graph]
Example 5: Interdisciplinary approaches
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 6: Comparative analysis and synthesis
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Practice Problem 7: Assessment criteria and rubrics
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Definition: Case studies and real-world applications
• Theoretical framework and methodology
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Best practices and recommendations
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Summary 2: Study tips and learning strategies
Definition: Learning outcomes and objectives
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Important: Best practices and recommendations
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Ethical considerations and implications
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
[Figure 13: Diagram/Chart/Graph]
Practice Problem 13: Critical analysis and evaluation
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Important: Practical applications and examples
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
[Figure 15: Diagram/Chart/Graph]
Important: Current trends and future directions
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 16: Comparative analysis and synthesis
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Note: Assessment criteria and rubrics
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Research findings and conclusions
• Key terms and definitions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
[Figure 19: Diagram/Chart/Graph]
Note: Best practices and recommendations
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Summary 3: Research findings and conclusions
Key Concept: Comparative analysis and synthesis
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Research findings and conclusions
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Remember: Problem-solving strategies and techniques
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Learning outcomes and objectives
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 24: Diagram/Chart/Graph]
Note: Literature review and discussion
• Theoretical framework and methodology
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Comparative analysis and synthesis
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Practice Problem 26: Fundamental concepts and principles
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 27: Diagram/Chart/Graph]
Note: Study tips and learning strategies
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Remember: Problem-solving strategies and techniques
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Case studies and real-world applications
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Lesson 4: Research findings and conclusions
Practice Problem 30: Literature review and discussion
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 31: Diagram/Chart/Graph]
Note: Study tips and learning strategies
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Practice Problem 32: Research findings and conclusions
• Research findings and conclusions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Note: Literature review and discussion
• Research findings and conclusions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Important: Research findings and conclusions
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Comparative analysis and synthesis
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 36: Diagram/Chart/Graph]
Remember: Comparative analysis and synthesis
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Best practices and recommendations
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
[Figure 38: Diagram/Chart/Graph]
Example 38: Comparative analysis and synthesis
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Note: Assessment criteria and rubrics
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Appendix 5: Learning outcomes and objectives
Example 40: Case studies and real-world applications
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 41: Best practices and recommendations
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 42: Diagram/Chart/Graph]
Example 42: Problem-solving strategies and techniques
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Key Concept: Literature review and discussion
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Practice Problem 44: Study tips and learning strategies
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
[Figure 45: Diagram/Chart/Graph]
Note: Ethical considerations and implications
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 46: Diagram/Chart/Graph]
Important: Assessment criteria and rubrics
• Key terms and definitions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 47: Experimental procedures and results
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Remember: Best practices and recommendations
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Problem-solving strategies and techniques
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 50: Diagram/Chart/Graph]
Section 6: Best practices and recommendations
Note: Fundamental concepts and principles
• Research findings and conclusions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Note: Theoretical framework and methodology
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Research findings and conclusions
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 53: Study tips and learning strategies
• Theoretical framework and methodology
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 54: Research findings and conclusions
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Important: Key terms and definitions
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 56: Diagram/Chart/Graph]
Note: Learning outcomes and objectives
• Case studies and real-world applications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 57: Diagram/Chart/Graph]
Example 57: Literature review and discussion
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Literature review and discussion
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
[Figure 59: Diagram/Chart/Graph]
Practice Problem 59: Best practices and recommendations
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Summary 7: Critical analysis and evaluation
Note: Assessment criteria and rubrics
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Critical analysis and evaluation
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Note: Experimental procedures and results
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Note: Research findings and conclusions
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Assessment criteria and rubrics
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Note: Key terms and definitions
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 66: Diagram/Chart/Graph]
Key Concept: Comparative analysis and synthesis
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Note: Key terms and definitions
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Example 68: Key terms and definitions
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Research findings and conclusions
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 70: Diagram/Chart/Graph]
Unit 8: Research findings and conclusions
Key Concept: Case studies and real-world applications
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Case studies and real-world applications
• Key terms and definitions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 72: Historical development and evolution
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Note: Fundamental concepts and principles
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 74: Diagram/Chart/Graph]
Note: Assessment criteria and rubrics
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Critical analysis and evaluation
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 76: Diagram/Chart/Graph]
Remember: Fundamental concepts and principles
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Definition: Interdisciplinary approaches
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Problem-solving strategies and techniques
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Literature review and discussion
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice 9: Case studies and real-world applications
Definition: Learning outcomes and objectives
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Comparative analysis and synthesis
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Experimental procedures and results
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 83: Fundamental concepts and principles
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 84: Practical applications and examples
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Remember: Critical analysis and evaluation
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 86: Diagram/Chart/Graph]
Important: Theoretical framework and methodology
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Study tips and learning strategies
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
[Figure 88: Diagram/Chart/Graph]
Definition: Historical development and evolution
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
[Figure 89: Diagram/Chart/Graph]
Key Concept: Case studies and real-world applications
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Module 10: Case studies and real-world applications
Note: Ethical considerations and implications
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Key Concept: Comparative analysis and synthesis
• Study tips and learning strategies
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 92: Diagram/Chart/Graph]
Definition: Case studies and real-world applications
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Fundamental concepts and principles
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Definition: Problem-solving strategies and techniques
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
[Figure 95: Diagram/Chart/Graph]
Example 95: Case studies and real-world applications
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Definition: Key terms and definitions
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Note: Experimental procedures and results
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 98: Diagram/Chart/Graph]
Note: Problem-solving strategies and techniques
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 99: Diagram/Chart/Graph]
Key Concept: Literature review and discussion
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Chapter 11: Critical analysis and evaluation
Remember: Study tips and learning strategies
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Experimental procedures and results
• Study tips and learning strategies
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Ethical considerations and implications
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Theoretical framework and methodology
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
[Figure 104: Diagram/Chart/Graph]
Key Concept: Research findings and conclusions
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 105: Practical applications and examples
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Key Concept: Key terms and definitions
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Key terms and definitions
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Comparative analysis and synthesis
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Theoretical framework and methodology
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 110: Diagram/Chart/Graph]
Section 12: Current trends and future directions
Practice Problem 110: Fundamental concepts and principles
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Problem-solving strategies and techniques
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 112: Diagram/Chart/Graph]
Definition: Current trends and future directions
• Key terms and definitions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Practice Problem 113: Statistical analysis and interpretation
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
[Figure 114: Diagram/Chart/Graph]
Important: Comparative analysis and synthesis
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Problem-solving strategies and techniques
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 116: Diagram/Chart/Graph]
Important: Best practices and recommendations
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 117: Diagram/Chart/Graph]
Practice Problem 117: Fundamental concepts and principles
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Interdisciplinary approaches
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 119: Diagram/Chart/Graph]
Important: Learning outcomes and objectives
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Appendix 13: Literature review and discussion
Key Concept: Current trends and future directions
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Remember: Problem-solving strategies and techniques
• Theoretical framework and methodology
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Practice Problem 122: Assessment criteria and rubrics
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 123: Practical applications and examples
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Case studies and real-world applications
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Practice Problem 125: Assessment criteria and rubrics
• Theoretical framework and methodology
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Theoretical framework and methodology
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Problem-solving strategies and techniques
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Practical applications and examples
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 129: Diagram/Chart/Graph]
Remember: Case studies and real-world applications
• Research findings and conclusions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Background 14: Practical applications and examples
Key Concept: Interdisciplinary approaches
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Assessment criteria and rubrics
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Critical analysis and evaluation
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Definition: Historical development and evolution
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
[Figure 134: Diagram/Chart/Graph]
Practice Problem 134: Theoretical framework and methodology
• Key terms and definitions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Definition: Study tips and learning strategies
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Important: Fundamental concepts and principles
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 137: Diagram/Chart/Graph]
Important: Problem-solving strategies and techniques
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 138: Diagram/Chart/Graph]
Note: Fundamental concepts and principles
• Study tips and learning strategies
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Definition: Practical applications and examples
• Best practices and recommendations
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Review 15: Current trends and future directions
Definition: Statistical analysis and interpretation
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
[Figure 141: Diagram/Chart/Graph]
Practice Problem 141: Best practices and recommendations
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
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