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Shoulder & P ectoral R egions,

Muscles OF. Shoulder & P ectoral R egions,. Objectives. Identify the bony components of the shoulder girdle including the clavicle, scapula and humerus Describe how primary muscles are responsible for the following shoulder motion: adduction, abduction, flexion, extension.

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Shoulder & P ectoral R egions,

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  1. Muscles OF Shoulder & Pectoral Regions,

  2. Objectives • Identify the bony components of the shoulder girdle including the clavicle, scapula and humerus • Describe how primary muscles are responsible for the following shoulder motion: adduction, abduction, flexion, extension

  3. Surface Anatomy

  4. Surface Anatomy

  5. Bony Skeleton • Axial? • Appendicular • Can you name some? • Shoulder Girdle..

  6. Bony Skeleton

  7. Shoulder Girdle

  8. Anterior Scapula. -angles, borders -glenoid cavity, -acromion, -coracoid process, -Subscapular fossa Humerus. -Head, -Surgical neck -Anatomical neck -Greater tubercle -Lesser tubercle -Intertubercular (bicipital) groove acromion anatomical neck coracoid process Lesser tubercule Greater tubercule surgical neck bicipital groove glenoid cavity

  9. Posterior Clavicle. Acromioclavicular joint Scapula. - Spine - Acromion - Supraspinous fossa - Infraspinous fossa Humerus. - Head - Anatomical neck, - Surgical neck, - Deltoid tuberosity - Spiral (radial) groove. Acromioclavicular joint Supraspinous Fossa anatomical neck surgical neck Spine Deltoid Tuberosity Infraspinous Fossa Radial Groove

  10. Pectoral Girdle • Direct : Clavicle , scapula from the trunk Pectoralis minor, trapezius, rhomboids… Most will be discussed in the scapular region lecture • Indirect : muscles of the great axillary folds as Pectoralis Major, and Latismusdorsi

  11. Movements of the shoulder joint (Scapulohumeral): Abduction / adduction Flexion / extension Rotation – internal (medial) - external (lateral) Movements of the scapula (Thoracoappendicular): (increase range of movement of upper limb) Protraction / Retraction Elevation / Depression Rotation: Superior / Inferior Circumduction

  12. Name the action

  13. We need MUSCLES for all that!! Muscles are named by either their attachments “Sternohyoid” , location ”Pectoralis”, action “levator”, shape ”quadratus”,direction of fibers “rectus” Will make our life easier memorizing all the names.. Nerve supply of the muscles tells us the story about it’s embryological origin..please pay attention in the embryology classes and enjoy the integration

  14. Pectoralis minor - deep to pec. major - protraction of scapula - guide to axilla • Pectoralis Major: 2 parts • - Together (adduction, medial rotation) • Clavicular head (flexion) • Sternocostal head (extension) • (common insertion: lateral lip of intertubercular groove) Clavicular Sternocostal

  15. Poland Syndrome Congenital Absence of Pectoralis Major Partial or complete absence

  16. Trapezius: • 3 parts • Superior fibres elevate • (insert lateral 1/3 of clavicle) • Middle fibres retract • (insert acromion) • Inferior fibres depress • (insert spine of scapula) • - Acting together, the • superior and inferior • fibres will rotate scapula. Superior Middle Inferior

  17. Latissimus Dorsi: • -(inserts floor of intertubercular groove) • Extends, adducts and • medially rotates • humerus. Butterfly swimming, Crutch Climbing a tree

  18. Deltoid: 3 parts • Anterior (flexion, med. rotation) • Middle (abduction) • Posterior (extension, lat. rotation) • (common insertion: deltoid tuberosity) Posterior Anterior Deltoid

  19. Posterior view: - Trapezius - Latissimus Dorsi - Deltoid Trapezius Rhomboids Deltoid Rhomboids: - minor and major - retract / inferior rotate scapula Teres Major Latissimus Dorsi Teres major: - inserts near latissimus dorsi - adduct / medially rotate arm

  20. Shoulder Flexion Anterior Arm. – Biceps brachi – Coracobrachialis Coracobrachialis Biceps Actions: Biceps – supination + flexion (shoulder, elbow) Coracobrachialis – weak flexion / adduction (shoulder)

  21. Shoulder Extension • Posterior Arm. • Triceps • (3 heads) • -long head extends • shoulder. • Action: Extension Axillary Nerve Teres minor Deltoid Long Lateral Triceps Medial

  22. Key Muscles that act across the Shoulder Joint. Adduction – pectoralis major, lattisimus dorsi. Abduction – deltoid, supraspinatus. Flexion – pectoralis major, deltoid (anterior), – coracobrachialis, biceps. Extension – latissimus dorsi, deltoid (posterior); – pectoralis major from flexed position - triceps (long head). Medial Rotation – subscapularis, pectoralis major, deltoid (anterior), – latissimus dorsi, teres major; Lateral Rotation – infraspinatus, teres minor, deltoid (posterior).

  23. Dermatomes

  24. Case • 9 Years old boy fell on his shoulder while playing on the monkey bars, he is experiencing pain, and inability to Lift his left arm this is his X-ray What’s your diagnosis?

  25. Clavicle Fractures

  26. Fracture Clavicle

  27. Glossary • Pectoral: Worn on the chest or breast • Girdle: Something that encircles like a belt

  28. References • www.medicalstudents.com • www.google.com • www.dcfirst.com/surface_arm_muscle_anatomy_posters.html • http://etl2.library.musc.edu/surface_anatomy/core/structures/003.html • http://www.shoulderdoc.co.uk/article.asp?section=902 • http://depts.washington.edu/msatlas/105.html

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