scapular region
DESCRIPTION
Scapular Region. Dr. Nivin Sharaf (MD). Objectives. Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles, external rotators, internal rotators Be familiar with principal muscles of the scapular , scapulo -humeral region - PowerPoint PPT PresentationTRANSCRIPT
Scapular Region
Dr. Nivin Sharaf(MD)
Objectives
• Know the landmarks of the bony structures of the shoulder/axillary regions
• Know the rotator cuff muscles, external rotators, internal rotators
• Be familiar with principal muscles of the scapular , scapulo-humeral region
• Scapular rotation in relation with shoulder movements
Surface Anatomy
• Spine
Acromion (of scapula
Teres minormuscle Teres major
muscle
Infraspinatusmuscle
Triangle ofascultation
Trapezius muscle
AnteriorScapula.-angles, borders-glenoid cavity, -acromion, -coracoid process, -Subscapular fossa
Humerus.-Head,-Surgical neck-Anatomical neck-Greater tubercle-Lesser tubercle-Intertubercular (bicipital) groove
PosteriorClavicle.Acromioclavicular joint
Scapula.- Spine - Acromion- Supraspinous fossa- Infraspinous fossa
Humerus. - Head - Anatomical neck, - Surgical neck, - Deltoid tuberosity- Spiral (radial) groove.
Scapular Fracture
Movements of the shoulder joint (Review):
Abduction / adductionFlexion / extension
Rotation – internal (medial)- external (lateral)
Movements of the scapula (Thoracoappendicular):(increase range of movement of upper limb)Protraction / RetractionElevation / DepressionRotation: Superior / Inferior
Circumduction
Superior rotation of Glenoid fossa:
- Powerful muscles pull on bony struts.
Scapula rotates when we move our arms to allow more range of motion at the shoulder joint
Complete abduction at the shoulder joint requires superior rotation of the scapula so that the glenoid fossa faces superiorly.
Glenoid fossa
Deltoid
• Clavicular origin, acromial, and scapular origins, attach all to deltoid tuberosity
• Anterior fibers flexes• Posterior fibers extends and
laterally rotates• Middle fibers abducts the arm• Innervation C5,6 Axillary nerve
Delta= TriangleDeltoid=triangular in shape Principal abductors= Deltoid, supra spinatus
Subdeltoid / Subacromial bursa.
Bursa: a closed sac or envelope, lined with synovium and containing fluid, usually in areas subject to friction.
Rotator cuff muscles stabilize the shoulder joint.Supraspinatus, Infraspinatus,Subscapularis, Teres minor
Rotator Cuff Muscles SITSBecause the scapula is triangular deep bone, paddedwith thick muscles, injuries leading to scapular fractures Will be so severe , and most commonly we will have lots of multiple, or serious other fraactures
Transverse scapular ligament
• Runs between Subscapular nerve (C5,6) and artery, which supply supra and infra spinatus ms• Artery above, nerve below• Army un over the bridge, navy sail under the bridge
Serratus Anterior
Winged Scapula: (long thoracic nerve)
Subscapularis
"big swing muscle" or "boxer's muscle”Antagonist of RhomboidsAccessory muscle of respiration
Posterior view:- Trapezius- Latissimus Dorsi- Deltoid
Rhomboids:- minor and major- retract / inferior rotate scapula
Teres major:- inserts near latissimus dorsi- adduct / medially rotate arm
Rhomboids retract, so injury to the dorsal scapular nerve will make the
scapula further away from the midline on the affected side
Posterior scapula
References
• Clinically Oriented anatomy “Keith Moore” sixth edition
• http://www.meddean.luc.edu/lumen/meded/grossanatomy/dissector/labs/ue/pect_scap/scap1a.html
• www.medicalstudents.com
Thank you