Shoulder Flashcards
anterior axisappendicalar muscles
pectoralis major
Pectoralis minor
Subclavius
Serratus anterior
Pectoralis major origin
Clavicular head anterior surface of clavicle
Sternocostal head anterior surface of sternum,upper 6 costal cartilage,aponeurosis of external oblique
Pectoralis major insertions
Lateral lip of intertubercular of humerus
Nerve supply pec major
Lateral medial pec nerve
Pec major action
Adduct,medial rotate of humerus
Clav head:FLEXION of humerus
Ster head:ext to its normal position
Active in deep inspiration
Pec minor origin
345 rib near costal cartilage
Pec minor insertion
Medial border of corocoid process of scapula
Nerve supply of pec minor
Medial pec nerve
Pec minor action
Protraction:scapula forward with surratus ant
Depress the shoulder :rotate the scapula with levator scapulae and rhomboids
Active in forced respiration
Subclavius
Origin :junction of 1st rib and its costal cartilage
Insertion inferior surface of midday.e third of clavicle
Nerve subclavian
Action. anchor and depress
Clavipectoral fascia def structures piercing it
Deep fascinating btw pec minor and subclavius
Cephalic vein
Lateral pectoral nerve
Thoracoacromial artery
Lymphatic vessels
Serratus anterior origin
Upper 8 9 ribs
Serratus anterior insertion
Anterior( vent) medial surface of scapula
1superior scapula angle
Next 2 or 3 almost entire medial border of scapula
Lower 4 or 5 inferior angle: dorsal surface near its tip
Serratus anterior innervation
Long thoracic nerve
Serratus anterior action
Protract (forward) with pec minor
Abduct raise arm above head with trapezius
Active in forced respiration
What if serratus anterior is paralyzed
Winging of scapula
Discovered when pushing scapula wing
Superficial axioqppendicular muscles
Trapezius
Latissimus dorsi
Deep pos axioappendicular muscles
Levator scapulae
Rhomboids
Scapulohumeral miuscles
Deltoid
Teres major
Rotatur cuff:
Teres min
Supraspinatous
Infraspina
Subscapularis
Trapezius origin
Medial third of superior unchallenged line
External occipital protuberance
Ligaments nuchae
Spinous and it’s supraspinous c7 to t12
Trapezius insertion
Descending fibers. Lateral third of clavicle
Mid2dle
medial acromion
Superior lip of scapula crest
Ascending tuberculosis crest of scapula spine
Trapezius nerve
Spinal part of Accessory nerve
Trapezius action
Elevate scapula with levator scapulae
Fo2 w t7t. Rotate scapula forward with serratus anterior so that arm can be raised above head
Sup elevate
Middle retract scapula fix the shoulder
T7t depress shoulder
Latissimus dorsi origin
From this point of the lower six thoracic vertebrae anterior to trapezius
From post layer of thoraculumbar fascia
Outer lip of illicit crest
3 or 4 lower ribs
Outer inferior of Scapula
Latissimus dorsi insertion
Floor of intertuberculur surface of humerus
Lat dorsi innervation
Thoracodorsal nerve
Action of latissimus
Addiction
Extension
Medial rotation
Pull trunk upward and forward
Deep inspiration
Lumbar triangle
Lateral external oblique
Base Iliad crest
Medial latissimus
Triangle of ascultation
Above trapezius
Below latissimus
Lateral scapula
Floor 6 7 intercostal spaces and rhomboid major
Rhomboid major is exposed in triangle
Levator scapulae origin
Post tranv3rse process of c1 to c4
Levator insertion
Btwn superior angle and medial end of scapula spine
Levator nerve
Branches of 3 and 4cervical spinal nerve and 5 through dorsal scapular nerve
Levator action
Elevate scapula with trapezius
Rhomboid minor origin and insertion
Ligamentun and spines of C7 and t1 vertebrae
Medial end of spine of scapula
Rhomboid major origin and insertion
2 to 5 thoracic ligaments and spines
Root of spine and inferior angle of scapula
Nerve and action of rhomboids
Dorsal scapular nerve
Retract –> squaring of shoulders
Deltoid origin
Ant sup of lateral third of clavicle
Lateral superior surface of acromion
Lower edge of scapular spine
Deltoid insertion
Deltoid tuberusity at Lateral middle of humerus shaft
Deltoid innervation and action
Axillary nerve
Ant fibers flexion and medial rotation
Of arm. With pec major
Middle fibers abduct arm
Pos fibers extension and lateral rotation of arm with latissimus and tere major
Deltopectoral groove
Btwn deltoid and pec major
Contains
Cephalic vein
Deltoid branch of thoracoacromial artery
Deltopectoral lymph nodes
Supraspinatous origin
from medial twothirdof supra spinous fossa & fascia
supraspinatus
insertion
under acromion into tendonabove shoulder joint f at highest facet ofgreater tubercleof humerus
tendon blend into articular
capsule
supraspinatus
nerve &
action
supra scapular nerve
The conventional view is that
supraspinatus initiates
abduction of the shoulder (from
0 to 18 degrees) and assists
deltoid in abduction thereafter.
However, there is evidence that
both supraspinatus and deltoid
are involved throughout the
range of abduction, including
initiation of the movement.
• As part of the rotator cuff,
supraspinatus helps to stabilize
the head of the humerus in the
glenoid fossa during
movements of the
glenohumeral joint.
The tendon of supraspinatus is separated from the coracoacromial
ligament, acronion & deltoid
by subacromial
bursa if inflamed abduction of
shoulderpainful
infraspinatus origin
Origin: from the medial twothirds
of the infraspinous fossa,
and from the deep surface of
the infraspinous fascia.
infraspinatus insertion
Its fibres converge to
a tendon which glides under the
lateral border of the spine of the
scapula, and then passes across
the posterior aspect of the
capsule of the shoulder joint to
be attached to the middle facet
on the greater tubercle of the
humerus.
The tendon is sometimes
separated from the capsule by a
bursa, which may communicate
with the joint cavity.
infraspinatus nerve &
action
Innervation: by the suprascapular nerve, C5 and 6.
Action: Infraspinatus is a lateral rotator of the humerus.
Together with supraspinatus, subscapularis and teres
minor, it helps to stabilize the head of the humerus in
the glenoid fossa during shoulder movements.
sub scapularis
origin
Origin: from the medial two-thirds
of the subscapular fossa. Other
fibres arise from tendinous
intramuscular septa, which are
attached to ridges on the bone,
and from the aponeurosis which
covers the muscle.
Subscapularis
insertion
Insertion: The fibres converge
laterally into a broad tendon
which is attached to the lesser
tubercle of the humerus and the
front of the articular capsule.
The tendon is separated from the
neck of the scapula by the large
subscapular bursa, which
communicates with the shoulder
joint.
. innervation &
action of subscapularis
Innervation: by the upper and lower subscapular nerves,
C5, 6.
Action: Subscapularis is a medial rotator of the humerus.
Together with supraspinatus, infraspinatus and teres
minor, it helps to stabilize the head of the humerus in the
glenoid fossa during shoulder movements.
Teresmajor origin.
insertion
Origin: from the oval area on the dorsal surface of the
inferior scapular angle.
Insertion: to the medial lip of the intertubercular sulcus
(bicipital groove) of the humerus.
nerve &actionTeres major
Innervation: by the lower subscapular nerve, C5, 6 and 7.
• Action: Teres major draws the humerus backwards and rotates
it medially. (Moore: Adducts and medially rotates arm).
Teres major can be palpated posterior to the posterior axillary
fold during adduction of the humerus against resistance.
Teres minor Origin & insertion
Origin: from the upper twothirds
of a flattened strip on the
dorsal surface of the scapula
adjoining its lateral border.
Insertion: It runs upwards and
laterally. The upper fibres end in
a tendon attached to the lowest
facet on the greater tubercle of
the humerus. The lower fibres
are attached directly into the
humerus distal to this facet and
above the origin of the lateral
head of triceps.
The tendon passes across, and
blends with, the lower posterior
surface of the capsule of the
shoulder joint.
nerve & action of Teres minor
.
Innervation: by the axillary
nerve, C5 and 6.
Action: Teres minor acts as
a lateral rotator and weak
adductor of the humerus.
Together with
supraspinatus, infraspinatus
and subscapularis, it helps
stabilize the head of the
humerus in the glenoid
fossa during shoulder
movements.
action
of rotator cuff
during
movementof the glenohumeral (shoulder) joint is to hold the humeral head
in the glenoid cavity of the scapula
quadrangular
space boundaries
Above: by subscapularis, the
capsule of the shoulder joint
and teres minor.
• Below: teres major.
• Medially: the long head of
triceps.
• Laterally: the surgical neck
of the humerus.
• The axillary nerve and the
posterior circumflex artery
and vein pass through this
space.
The upper triangular space is
bounded:
Above by subscapularis anteriorly,
teres minor posteriorly,
• Below: teres major.
• Laterally: the long head of triceps.
The circumflex scapular artery
passes through this space.
The lower triangular space is
bounded:
Above by the teres major.
• Medially: the long head of triceps.
• Laterally: the humerus.
The radial nerve and the profunda
brachii vessels pass through this
space.
