1. Flexion (anterior) and abduction 2. Abduction 3. Extension (posterior) and abduction Also medially and laterally rotates humerus

Superficial Back and Shoulder Flashcards by Lucia Guerrero

How many sacral vertebrae?

fused

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How many coccygeal vertebrae?

1-3

fused

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What makes up the shoulder girldle?

Scapula and clavicle

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Distal attachments of the Trapezius muscle

Spine of the scapula
Acromion
Lateral 1/3 of clavicle

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Actions of the Trapezius muscle

Retracts
Elevates (shrugging) and
Depresses scapula

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Innervation of the Trapezius muscle

Spinal accessory nerve

Cranial nerve XI

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Arterial supply of the Trapezius muscle

Superficial branch of transverse cervical artery

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Superficial branch of transverse cervical artery also supplies

Rhomboids

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Rhomboids
Names
Where do they arise and attach?

Rhomboid major and minor
Arise from medial border of scapula
Attach to upper thoracic vertebrae

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What can be used to differentiate the rhomboids?

The beginning of the spine of the scapula

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Which rhomboid is located more inferiorly?

Rhomboid major

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Nerve supply to the rhomboids

Dorsal scapular nerve

Comes primarily from cervical spinal nerve C5

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Action of the rhomboids

Retraction and rotation of the scapula

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Levator scapulae comes from

attaches to

the superior angle of the scapula and attaches into the sides (transverse processes) of cervical vertebrae

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Function of levator scapulae

Elevates the scapula

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Nerve supply of levator scapulae

Dorsal scapular nerve

Comes primarily from cervical spinal nerve C5

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Test for rhomboids

Tell patients to put hands in gluteal region and move elbows close to each other

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Triangle of auscultation

On medial side of inferior angle of scapula

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Deltoid attachments

Same attachments as trapezius
Lateral 1/3 of clavicle
Acromion
Spine of scapula

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Deltoid actions

Flexion (anterior) and abduction
Abduction
Extension (posterior) and abduction

Also medially and laterally rotates humerus

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Deltoid does NOT participate in the abduction of the shoulder joint for

15 degrees

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Deltoid test

Abduct the arm beyond 15 degrees against your hand

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Abduction beyond 90 degrees must be accomplished by

rotation of the scapula

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Serratus anterior
arises from
attaches to

arises from ribs 1-8 on the side

goes underneath the scapula and inserts on medial border

Serratus anterior actions

Holds scapula in place against thoracic wall

Winged scapula indicates loss of function of

Serratus anterior

Serratus anterior nerve supply

long thoracic nerve C5, 6 and 7 wing your way to heaven

Winged Scapula test

Ask patient to push against wall | Normal- wont wing out

Full abduction muscles

Supraspinatus Deltoid Serratus anterior and trapezius

Supraspinatus abduction

0-15 degrees

Deltoid abduction

15-90 degrees

Serratus anterior and trapezius abduction

Rotation of scapula

Climbing muscles

Teres major and Latissimus dorsi

Teres major | Attachments

Attaches from lateral border of scapula to medial lip of bicipital groove on humerus Attaches posteriorly Round shape

Latissimus dorsi | Attachments

Attaches from dorsum of back (T6-L5 and lumbosacral fascia) to floor of bicipital groove Attaches anteriorly

Climbing muscles actions

Important when you bring your body closer to your arms Monkey bars Cant use axillary crutches These muscles may be used to adduct the arm and elevate the body Medial rotation of the humerus

Latissimus dorsi innervation

Thoracodorsal nerve | Middle subscapular nerve

Teres major innervation

Lower subscapular nerve

Rotator cuff muscles

Supraspinatus Infraspinatus Teres minor Subscapularis

What do the rotator cuff muscles do?

Surround the head of the humerus | Participate in the rotation of the glenohumeral joint

Subscapularis muscle | Attachments

On anterior surface of the scapula | Attaches to the lesser tuberosity of the humerus

Subscapularis muscle action

Medially rotates humerus

Subscapularis dislocation

Will become stretched and taut if the head of the humerus is dislocated posteriorly

Infraspinatus and teres minor location

Located on the posterior aspect and lateral border of the scapula

Infraspinatus and teres minor attachment

Attach into the greater tuberosity of the humerus

Infraspinatus and teres minor action

Lateral rotation of the humerus

Infraspinatus and teres minor dislocation

Will become stretched and taut if the head of the humerus is dislocated anteriorly

Supraspinatus | Rotation

does not participate in the rotation of the humerus

Supraspinatus location

Arises from within the supraspinous fossa Its tendon will pass inferior to the acromion process and attach into the superior facet of the greater tuberosity of the humerus

Supraspinatus function

initiates the motion of abduction of the arm initial phase 0-15 degrees

Subacromial bursa

positioned between the acromion and the supraspinatus muscle protects the muscle from rubbing against the acromion process

Injuries of rotator cuff muscle

Each of the rotator cuff muscles may be stretched and torn if the head of the humerus is moved in the opposite direction

Posterior dislocation

Subscapularis gets stretched

Anterior dislocation

Infraspinatus gets stretched

Dislocation in the superior direction

Acromion process and the associated acromioclavicular ligaments prevent this

Most commonly torn rotator cuff muscle

Supraspinatus

Subacromial bursa | Location

positioned between the acromion and the tendon of supraspinatus may be continuous with the subdeltoid bursa

Subdeltoid bursa | Location

Positioned between the greater tubercule of the humerus and the deltoid muscle Terms used interchangeably

Subacromial bursa is in communication with

synovial sac of glenohumeral joint may be a separate entity