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Shoulder Girdle/Joint Shoulder Girdle/Joint LabLab
Josh AdetulaJosh Adetula
Deborah YangDeborah Yang
From Which joint is the From Which joint is the shoulder connected to the shoulder connected to the
spinal column?spinal column?• The shoulder is The shoulder is
connected to connected to the spinal the spinal column via the column via the scapulothoracic scapulothoracic joint.joint.
Which of the following Which of the following joints is NOT a part of the joints is NOT a part of the
shoulder complex?shoulder complex?• The Alatoaxial joint is not a part of the The Alatoaxial joint is not a part of the
shoulder complexshoulder complex
Where is the insertion of Where is the insertion of the Pectoralis minor?the Pectoralis minor?
• It is inserted at the coracoid process of It is inserted at the coracoid process of the scapula.the scapula.
Q: What is the function of Q: What is the function of the Levator Scapulae the Levator Scapulae
Muscle?Muscle?A.A. The Levator The Levator
Scapulae’s Scapulae’s Function is to Function is to elevate the elevate the scapula.scapula.
FlexionFlexion
• Movement of Movement of humerus straight humerus straight anteriorly from anteriorly from any point in the any point in the sagittal plane.sagittal plane.
ExtensionExtension
• Movement of the Movement of the humerus straight humerus straight posteriorly from posteriorly from any point in the any point in the sagittal planesagittal plane
AbductionAbduction
• Upward lateral Upward lateral movement of the movement of the humerus in humerus in frontal plane out frontal plane out to the side, and to the side, and away from the away from the body.body.
• Can be diagonal Can be diagonal or horizontalor horizontal
AdductionAdduction
• Downward Downward movement of the movement of the humerus in the humerus in the frontal plane frontal plane medially toward medially toward the body.the body.
• Can be diagonal Can be diagonal or horizontalor horizontal
RotationRotation
• Lateral movment Lateral movment of the humerus in of the humerus in the tranverse the tranverse plane along its plane along its long axis.long axis.
• There are 2 types: There are 2 types: Internal and Internal and ExternalExternal
Sternoclavicular JointSternoclavicular Joint
• Distal (also is Distal (also is medial) to the medial) to the most lateral edge most lateral edge of the deltoid. of the deltoid.
Q: Which Nerve Q: Which Nerve innervates the rhomboid innervates the rhomboid
muscle?muscle?
A.A. The rhomboid muscle is The rhomboid muscle is innervated by the dorsal scapula innervated by the dorsal scapula nervenerve
From which cord does the From which cord does the musclocutaneous nerve musclocutaneous nerve
originate?originate?• The nerve The nerve
originates from originates from the lateral cord the lateral cord of the brachial of the brachial plexus.plexus.
In which part of the In which part of the scapula does the humeral scapula does the humeral
head fit, to make the head fit, to make the glenohumeral joint?glenohumeral joint?
• The humeral head fits into the The humeral head fits into the glenoid cavity to make the glenoid cavity to make the glenohumeral joint.glenohumeral joint.
ScapulaScapula
1.1. Coracoid Process (A)Coracoid Process (A)2.2. Scapular Notch (J)Scapular Notch (J)3.3. Superior Margin (B)Superior Margin (B)4.4. Supraspinatus Fossa (L)Supraspinatus Fossa (L)5.5. Superior Angle (K)Superior Angle (K)6.6. Scapular Spine (C)Scapular Spine (C)7.7. Vertebral Margin (D)Vertebral Margin (D)8.8. Infraspinatus Fossa (H)Infraspinatus Fossa (H)9.9. Inferior Angle (I)Inferior Angle (I)10.10. Axillary Margin (E)Axillary Margin (E)11.11. Glenoid Cavity Margin (F)Glenoid Cavity Margin (F)12.12. Acromion Process (G)Acromion Process (G)
The Deltoid musle is…The Deltoid musle is…
• ……the main adductor of the the main adductor of the shoulder joint.shoulder joint.
If the long thoracic nerve gets If the long thoracic nerve gets injured, then which movement injured, then which movement of the shoulder girdle will be of the shoulder girdle will be
affected?affected?• Injury to the LTN Injury to the LTN
would greatly would greatly affected affected abduction.abduction.
Subclavius Muscle can be Subclavius Muscle can be strengthened by…strengthened by…
• The subclavius muscle can be The subclavius muscle can be strengthened by active depression.strengthened by active depression.
The origin of rhomboid The origin of rhomboid muscle is the spineous muscle is the spineous
process of…process of…• Its origin is the Its origin is the
spineous process spineous process of C7 to T5.of C7 to T5.
Left Scapula (seen in Left Scapula (seen in lateral view)lateral view)
1.1. Coracoid ProcessCoracoid Process
2.2. Glenoid CavityGlenoid Cavity
3.3. Scapular SpineScapular Spine
4.4. Acromion Acromion ProcessProcess
5.5. Infraspinatus Infraspinatus FossaFossa
6.6. Inferior AngleInferior Angle
Clavicle injury Clavicle injury results….results….
• When dealt a blow When dealt a blow to the medial end to the medial end of the clavicle, this of the clavicle, this will cause an AC will cause an AC separation (aka separation (aka dislocated dislocated shoulder), which shoulder), which tears up the joint tears up the joint capsule.capsule.
MuscleMuscle OriginOrigin InsertionInsertion ActionAction InnervationInnervationss
Pectoralis MinorPectoralis Minor Anterior Surfaces of the Anterior Surfaces of the 33rdrd to 5 to 5thth ribs ribs
Coracoid process of the Coracoid process of the scapulascapula
Abduction, Abduction, Depression, & Depression, & Downward Downward RotationRotation
Medial pectoral Medial pectoral nerve (C8 & T1)nerve (C8 & T1)
Serratus AnteriorSerratus Anterior Surface of the upper 9 Surface of the upper 9 ribs at the side of the ribs at the side of the chestchest
Anterior side of the Anterior side of the medial scapula medial scapula
Abduction & Abduction & Upward Upward RotationRotation
Long Thoracic Long Thoracic Nerve (C5 –C7)Nerve (C5 –C7)
Trapezius – upper Trapezius – upper fibersfibers
Base of skull, occ. Base of skull, occ. Protuberance, and Protuberance, and posterior ligaments of posterior ligaments of the neckthe neck
Posterior aspect of the Posterior aspect of the lateral 3lateral 3rdrd of the of the clavicleclavicle
Elevation & Elevation & Extension or Extension or Rotation at the Rotation at the head of the head of the neckneck
Spinal accessory Spinal accessory nerve and branches nerve and branches of C3 & C4of C3 & C4
Trapezius – middle Trapezius – middle fibersfibers
Spinous process of C7-T3Spinous process of C7-T3 Medial border of the Medial border of the acromion process and acromion process and upper border of upper border of scapular spinescapular spine
Elevation, Elevation, Adduction, & Adduction, & Upward Upward rotationrotation
Trapezius – lower Trapezius – lower fibersfibers
Spinous process of 4Spinous process of 4thth--1212thth thoracic vertebrae thoracic vertebrae
Triangular space at the Triangular space at the base of the scapular base of the scapular spinespine
Adduction, Adduction, Depression, & Depression, & Upward Upward rotationrotation
RhomboidsRhomboids Spinous processes of C7-Spinous processes of C7-T5T5
Medial border of Medial border of scapula, below scapula scapula, below scapula spinespine
Adduction, Adduction, downward downward rotation, & rotation, & ElevationElevation
Dorsal Scapula Dorsal Scapula Nerve (C5)Nerve (C5)
Levator ScapulaeLevator Scapulae Transverse processes of Transverse processes of C1-C4C1-C4
Medial border of Medial border of scapulascapula
ElevationElevation Dorsal Scapula Dorsal Scapula Nerve (C5) and Nerve (C5) and branches of C3 & C4branches of C3 & C4
MuscleMuscle OriginOrigin InsertionInsertion ActionAction InnervationInnervationss
Pectoralis majorPectoralis major Upper Fibers – medial half of Upper Fibers – medial half of front of claviclefront of clavicle
Lower Fibers- Anerior surface of Lower Fibers- Anerior surface of first 6 ribsfirst 6 ribs
Flat tendon 2 or 3 inches Flat tendon 2 or 3 inches wide to lateral lip of IT wide to lateral lip of IT groove of humerusgroove of humerus
Rotation, Rotation, Adduction, Adduction, Flexion, Flexion, Extension, & Extension, & AbductionAbduction
Lateral Pectoral Nerve Lateral Pectoral Nerve (C5, C6, C7)(C5, C6, C7)
SubscapularisSubscapularis Entire Anterior surface of Entire Anterior surface of subscapular fossasubscapular fossa
Lesser Tubercle of HumerusLesser Tubercle of Humerus Rotation Rotation (Internal)(Internal)
Medial Pectoral Nerve Medial Pectoral Nerve (C8, T1)(C8, T1)
CoracobrachialisCoracobrachialis Coracoid process of scapulaCoracoid process of scapula Middle of medial border or Middle of medial border or humeral shafthumeral shaft
Adduction Adduction (Horizontal & (Horizontal & Diagonal)Diagonal)
Upper and lower Upper and lower subscapular nerve subscapular nerve (C5, C6)(C5, C6)
DeltoidDeltoid Anterior - Anterior lateral C3Anterior - Anterior lateral C3
Middle – Acromion (lateral)Middle – Acromion (lateral)
Posterior – Spine of Scapula Posterior – Spine of Scapula (Inferior edge)(Inferior edge)
Deltoid Tuberosity on the Deltoid Tuberosity on the lateral humeruslateral humerus
Abduction Abduction Flexion, Flexion, AdductionAdduction
Axillary NerveAxillary Nerve
(C5, C6)(C5, C6)
SupraspinatusSupraspinatus Medial 2/3 of SSP FossaMedial 2/3 of SSP Fossa Superiorly on Greater Superiorly on Greater Tubercle of humerusTubercle of humerus
AbductionAbduction Suprascapula nerve Suprascapula nerve (C5)(C5)
Latissimus DorsiLatissimus Dorsi At Lumbar Vertebrae to Lower At Lumbar Vertebrae to Lower 6 Thoracic Vertebrae, back of 6 Thoracic Vertebrae, back of Sacrum, and Posterior crest of Sacrum, and Posterior crest of iliumilium
Medial side of IT groove of Medial side of IT groove of humerus, anterior to teres humerus, anterior to teres major insertionmajor insertion
Extension, Extension, Adduction, and Adduction, and Rotation Rotation (internal)(internal)
Thoracodorsal (C6, Thoracodorsal (C6, C7, C8)C7, C8)
Teres MajorTeres Major Inferior 3Inferior 3rdrd of lateral border of of lateral border of scapulascapula
Medial lip of IT groove of Medial lip of IT groove of humerus, posterior to humerus, posterior to latissimus dorsi insertionlatissimus dorsi insertion
Extension, Extension, Adduction, and Adduction, and Internal RotationInternal Rotation
Lower subscapular Lower subscapular nerve (C5, C6)nerve (C5, C6)
InfraspinatusInfraspinatus Medial aspect of infraspinatus Medial aspect of infraspinatus fossa, just below spine of fossa, just below spine of scapulascapula
Posteriorly on greater Posteriorly on greater tubercle of humerustubercle of humerus
External External rotation, rotation, Horizontal/DiagoHorizontal/Diagonal abduction,nal abduction,
Suprascapula nerve Suprascapula nerve (C5, C6)(C5, C6)
Teres MinorTeres Minor Posteriorly on upper and middle Posteriorly on upper and middle aspect of lateral border of aspect of lateral border of scapulascapula
Posteriorly on greater Posteriorly on greater tubercle of humerustubercle of humerus
External External rotation, rotation, Horizontal Horizontal abduction, and abduction, and diagonal diagonal adductionadduction
Axillary Nerve (C5, Axillary Nerve (C5, C6)C6)
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