scapular region dr. sama-ul-haque dr. rania jabr
TRANSCRIPT
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Scapular Region
Dr. Sama-ul-Haque Dr. Rania Jabr
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Scapular Region
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Objectives
Know the principal muscles of the scapular and scapulo-humeral regions.
Understand the mechanism of scapular rotation in relation with shoulder movements.
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Bones of the shoulder region: The SCAPULA
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Anterior
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Posterior
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These muscles connect scapula to humerus (move humerus through shoulder joint).
1. Deltoid.2. Supraspinatus.3. Infraspinatus.4. Teres minor.5. Teres major.6. Subscapularis.
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Posterior view
Anterior view
Muscles of The Shoulder Region
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• Spine
Acromion (of scapula
Teres minormuscle
Teres majormuscle
Infraspinatusmuscle
Triangle ofascultation
Trapezius muscle
Surface Anatomy
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Deltoid
Nerve supply:Axillary nerve
Action:Anterior fibers : Flexion, medial rotation Middle fibers: abduct arm from 15°- 90°.Posterior fibers : Extension, lateral rotation
Lateral third of clavicle, acromion, spine of scapula
Deltoid tuberosity of humerus
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D
Abductors of shoulders:1. Supraspinatus 0-15 degree.2. Deltoid 15-90 degree.3. Trapezius & serratus anterior: abduction 90-180 degree.
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4 Rotator cuff muscles: stabilize the shoulder joint.Supraspinatus, Infraspinatus,Subscapularis, Teres minor
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Rotator Cuff Muscles
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Supraspinatus
Infraspinatus:
Origin: supraspinous fossa.Insertion: greater tuberosity of humerus.Nerve supply: suprascapular nerve.Action: abduction of humerus from 0° - 15°.
Origin: infraspinaous fossa.Insertion: greater tuberosity of humerus.Nerve supply: suprascapular nerve.Action: lateral rotation of humerus.
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Origin: lateral border of scapulaInsertion: greater tuberosity of humerus.Nerve supply: axillary nerve.Action: lateral rotation of humerus.
Origin: lateral border of scapulaInsertion: bicipital groove of humerus (med lip)Nerve supply: lower subscapular nerve.Actions: extension, adduction & medial rotation of humerus (swimming).
Teres minor
Teres major:
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Origin: subscapular fossa.Insertion: lesser tuberosity of humerus.Nerve supply: upper & lower subscapular nerves.Action: medial rotation of humerus.
Subscapularis
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Transverse scapular ligament
• Attach to suprascapular notch• Subscapular nerve (C5,6) below it and Subscapular artery above it,
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Nerve supply: • Long thoracic nerve.Action:• Depression & protraction of
the scapula (boxing) • Raising the arm above 90
degree (climbing).• Accessory muscle of
respiration
Serratus anterior
Upp
er 8
ribs
Front of the medial border of scapula.
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Injury of long thoracic nerve: Winged Scapula:
Subscapularis
Cause; Paralysis of serratus anterior as it is "big swing muscle" or "boxer's muscle”Antagonist of Rhomboids
Injury of long thoracic nerve
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Complete abduction at the shoulder joint requires superior rotation of the scapula so that the glenoid fossa faces superiorly.
Glenoid fossa
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• Superior rotation of Glenoid fossa: trapezius &
serratus anterior
Scapula rotates when we move our arms to allow more range of motion at the shoulder joint
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Posterior scapula
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