SHOULDER

Karl F. D. A. Tapales, MD

Shoulder Girdle

Key anatomic processes: Scapular spine Coracoid Acromion

Scapula

Ligaments

Scapula

Posterior aspect Triangular Covers ribs 2 to 7 2 inches from spinous process Its spine is opposite spinous process of T3

Shoulder Joints and Articulation

MUSCLES

Muscles connecting the upper limb to the vertebral column:

TrapeziusLatissimusboth rhomboidslevator scapulae

Muscles connecting the upper limb to the vertebral

column

MUSCLES

Muscles connecting the upper limb to the thoracic wall:

Both pectoralis musclesSubclaviusSerratus anterior

Muscles connecting the upper limb to the

thoracic wall

Muscles acting on shoulder joint itself:

DeltoidTeres majorFour rotator cuff muscles (supraspinatus,

infraspinatus, teres minor, subscapularis) – they depress and stabilize the humeral head against the glenoid.

Muscles acting on shoulder

joint itself

ROTATOR CUFF

Composed of 4 muscles:SupraspinatusInfraspinatusTeres minorSubscapularis

The Axilla

RANGE OF MOTION

Flexion 90 degrees

Extension 45 degrees

RANGE OF MOTION

Adduction45 degrees

Abduction 180 degrees

RANGE OF MOTION

Internal Rotation 55 degrees

40-45 degrees

External Rotation

Brachial Plexus

Five roots – C5 to T1Three trunks – upper, middle and lowerSix divisions – two from each trunkThree cords – posterior, lateral and medial (named

in relation to axillary arteryMultiple branches – preclavicular branches: dorsal

scapular nerve, long thoracic nerve, suprascapular nerve, nerve to the subclavius

Axillary Artery

Branches of Axillary Artery

Triangular and Quadrangular Spaces

Thank You!

References:Physical Examination of the Spine by Stanley hoppenfeld, MD

Review of Orthopedics, 5th Edition, by Mark D. MillerClinical Anatomy by Snell

Kaplan Notes