Scapular and Pectoral Regions Flashcards
is the sternum part of the pectoral girdle?
no
what are the three joints of the shoulder complex?
- sternocalvicular jt
- acromioclavicular jt
- glenohumeral jt
what are the movements of the glenohumeral jt?
flexion, extension, abduction, adduction, med/lat rotation, circumduction
muscles of pectoral girdle
- deltoid m
- teres major m
- supraspinatus m
- infraspinatus m
- teres minor m
- subscapularis m
muscles of rotator cuff
- supraspinatus
- infraspinatus
- teres minor
- subscapularis
A and N of deltoid m
A: abducts humerus, flexes, extends, and rotates humerus
N: axillary n, post circumflex humeral vessels
A and N of teres major m
A: medially rotates and extends humerus
N: lower (inferior) subscapular n, and scapular vessels
A and N of supraspinatus
A: abducts humerus (1st 15 degrees) *still helps even when deltoid takes over)
N: suprascapular n and vessels, dorsal scapular vessels
A and N of infraspinatus
A: laterally rotates humerus
N: suprascapular n and vessels, subscapular vessels
A and N of teres minor m
A: lateral rotation of humerus
N: axillary n, suprascapular and subscapular vessels
A and N of subscapularis
A: medial rotation of humerus
N: upper and lower subscapular nn, subscapular vessels
protection of shoulder region
deltoid provides outer muscular support
rotator cuff gives inner muscular support (helps prevent upward displacement of humerus)
location of subacromial/deltoid bursa
inferior to acromion and deltoid but superior to supraspinatus
issues with subacromial/deltoid bursa
can become continuous with jt capsule bc attrition of supraspinatus tendon (tendon wears away with age, if capsule ruptures (continuous w/ bursa) = painful shoulder movement and limited movement
borders of quadrangular space
sup: teres minor
inf: teres major
med: long head of triceps
lat: surgical neck of humerus
contents of quadrangular space
axillary n, post circ humeral vessels
borders of triangular space
sup: teres minor
inf: teres major
lat: long head of triceps
contents of triangular space
circumflex scapular vessels
borders of triangular interval
sup: teres major
med: long head of triceps
lat: lateral head of triceps
contents of triangular interval
radial n and profunda brachii a
neurovascular supply of shoulder region
suprascapular n and a
dorsal scapular n and a
accessory n and transverse cervical a
upper and lower subscapular nn and subscapular a
suprascapular n and a, and supply
n: ventral rami of C5-C6 *runs under superior trans scap lig
a: thyrocervical trunk *runs over sup trans scap lig
s: supra/infraspinatus mm
dorsal scapular n and trans cervical a: n, a, supply
n: ventral rami of C5
a: deep trans cerv a *both run II to vertebral border of scapula
s: levator scapulae and rhomboid mm
accessory n and trans cervical a: n, a, supply
n: CN XI
a: superficial trans cervical a, br of thyrocervical tr.
s: trapezius mm
upper and lower subscapular nn and subscapular a: n, a, s
n: post cord of brachial plexus (vent rami C5-C6)
a: axillary a -> subscapular a (splits to thoracodorsal and circumflex scapular a)
S: subscapularis m
lower supplies teres minor
what exhibits collateral circulation in the scapular region, and where?
axillary a, ligates between thyrocervical tr and subscapular a
what does collateral circulation in the scapular region do?
blood flow in subscapular a reverses, allows blood to flow to UL
ligate anywhere distal to subscapular a and blood cannot flow
pectoral region
m attachment between UP and anterior chest
mm of pectoral region
pec minor pec major (clavicular and sternocostal heads)
pec major m
A: adducts and medially rotates humerus
N: med and lat pectoral nn and thoracoacromial vessels
pec minor m
A: protracts scapula
N: medial pectoral n and thoracoacromial vessels
arterial supply of pectoral regions
- internal thoracic (mammary) a
- lateral thoracic (external mammary) a
- thoracoacromial a
internal thoracic (mammary) a
br of subclavian a, descends across intercostal spaces lateral to sternum
supplies ant thorax, med pec region and med breast
lateral thoracic a
br of axillary a (deep to pec minor), runs with long thoracic n
supplies lat thorax, lat pec region, lat breast
thoracoacromial a
br of axillary a (under pec minor)
sends 4 brs
4 branches of thoracoacromial a
- acromial a: supplies upper shoulder region
- clavicular a: clavicle region
- pectoral a: upper pec region
- deltoid a: lower shoulder region
pectoral region innervation
- cutaneous nn
- medial pectoral n
- lateral pectoral n
- long thoracic n
cutaneous nn
general sensory, T1-T6, lat and ant cutaneous brs of intercostal nn
medial pectoral n
medial cord of BP, from vent rami (C8-T1), pierces pec minor m to enter pec major, supplies pec minor and part of major
lateral pectoral n
lat cord of BF, ventral rami (C5-C6), runs above pec minor m to enter pec major, supplies remainder of pec major
long thoracic n
from vent rami (C5-C7), supplies serratus ant , superficially, damage to long thoracic n can occur during mastectomy -> winged scapula