Muscles of the back and scapular muscles

This presentation shows Muscles of the back and scapular muscles

Transcript

1. Muscles of the Back & Scapular Region
2. Orientation of Muscles of the Back
3. Trapezius m. Latissimus dorsi m. Levator scapulae m. Rhomboideus minor m. Rhomoboideus major m. Superficial back muscles & deltoid Removed trapezius and deltoid muscles Posterior fibers of deltoid Supraspinatus m. Infraspinatus m. Teres minor m. Teres major m.
4. Spotting
5. Trapezius m. Latissimus dorsi m. Posterior fibers of deltoid m. Teres major m. Infraspinatus & teres minor covered with deep fascia. Auscultation triangle
6. Deltoid m. Infraspinatus m. Teres minor m. Teres major m. Spine of scapula
7. Deltoid m. (Cut) Spine of scapula Supraspinatus m. Infraspinatus m. Teres minor m. Teres major m. Rhomboideus minor Rhomboideus major Levator scapulae Latissimus dorsi Trapezius is removed
8. Muscles of the Back
9. MUSCLES OF THE BACK A- Superficial Muscles: Trapezius and Latissimus dorsi. B- Deep Muscles: Rhomboideus major, Rhomboideus minor and levator scapulae
10. Trapezius Muscle
12. Trapezius m.
13. Origin of Trapezius m.
14. External occipital protuberance Superior nuchal line Spine of C7 Spines of thoracic vertebrae
15. Medial 1/3 of Superior nuchal line External occipital protuberance Ligamentum nuchae Spine of C7 Thoracic spines & supraspinous lig.
16. Insertion of Trapezius m.
17. Posterior border of lateral 1/3 of clavicle Medial margin of acromion Upper lip of crest of spine Tubercle at the crest near the root of the spine
18. Upper fibers Posterior border of lateral 1/3 of clavicle Middle fibers Medial border of acromion & upper lip of the crest Lower fibers Tubercle at crest of the spine near the root of the spine
19. Nerve Supply Motor: Spinal accessory nerve. Sensory: C3,4
20. Action of Trapezius
21. Action of upper fibers Action of middle fibers Action of lower fibers
22. Action of Trapezius Upper fibers: ➢Elevation of scapula (with levator scapulae) & suspends shoulder. ➢Upward rotation of scapula (with lower fibers) (abduction of arm above 90 degrees). Middle fibers: ➢Retracts scapula. Lower fibers: ➢Upward rotation of scapula (abduction of arm above 90 degrees).
23. Triangles Related to Trapezius M.
24. Posterior triangle of neck Auscultation triangle Trapezius Scapula Latissimus dorsi m.
25. Latissimus Dorsi Muscle
26. Latissimus dorsi m. Teres major m.
27. Lower 6 thoracic spines Lumbar fascia Iliac crest Lower 4 ribs Inferior angle Teres major m. Dr. Sherif Fahmy
28. Latissimus dorsi m. Teres major m. Insertion of latissimus dorsi m. into bicipital groove Posterior axillary fold
29. Triangles related to Latissimus dorsi Muscle 1- Auscultation triangle. 2- Lumbar triangle.
30. Iliac crest Auscultation triangle External oblique m. Lumbar triangle Latissimus dorsi muscle Dr. Sherif Fahmy
31. Nerve Supply ➢Nerve to latissimus dorsi (thoraco-dorsal nerve) (C5,6,7).
32. Action of Latissimus Dorsi Muscle ➢Adducts, extends and medially rotates the arm at shoulder joint. ➢Deep expiratory muscle.
33. Deep Muscles of The Back
34. Deep Muscles 1- Levator scapulae. 2- Rhomboideus (Rhomboid) Minor. 3- Rhomboideus (Rhomboid) major
35. Spine Medial border
36. Trapezius m. Levator scapulae m. Rhomboideus minor m. Rhomboideus major m.
37. Deep Muscles of the Back Levator scapulae m. Rhomboideus minor m. Rhomboideus major m. Transverse processes of upper 4 cervical vertebrae Lig. Nuchae, Spines of C7 & T1 Spines of T2-5) Dr. Sherif Fahmy
38. Nerve Supply of Deep muscles All are supplied by: -Dorsal scapular nerve (C5). -C3,4 to levator scapulae (sensory).
39. Elevation of scapula Downwards rotation of scapula Retraction of scapula
40. Action of Deep Muscles of the Back All muscles : Downward rotation of the scapula. Extra action: Levator scapulae: elevates the scapula. Rhomboides minor & major: Retracts the scapula.
41. SHOULDER REGION (Scapular Muscles)
42. Muscles of Shoulder Region A- Deltoid Muscle. B- Rotator Cuff Muscles (4 muscles). C- Teres Major Muscle.
43. Orientation
44. Anterior fibers of deltoid muscle Pectoralis major m. Delto-pectoral groove
45. Subscapularis m. Removed deltoid and pectoralis major muscles
46. Posterior fibers of deltoid muscle Supraspinatus muscle Infraspinatus muscle Teres minor m. Teres major m. Spine of scapula
47. Attachments of Scapular Muscles
48. Origin of shoulder muscles: ▪ One muscle from clavicle & scapula: ➢Deltoid. ▪ 3 muscles from fossae of scapula: ➢Subscapularis. ➢Supraspinatus. ➢Infraspinatus. ▪ 2 muscles from back of lateral border of scapula: ➢Teres minor (upper 2/3). ➢Teres major (lower 1/3).
49. Insertion of Muscles of Shoulder: ▪ 5 muscles are inserted in humeral tuberosities: ➢Deltoid in deltoid tuberosity. ➢Subscapularis in lesser tuberosity. ➢Supraspinatus, infraspinatus and teres minor in greater tuberosity. ▪ One muscle is inserted in medial lip of bicipital groove. ➢Teres Major muscle.
50. Origin of subscapularis muscle Insertion of subscapularis muscle Deltoid tuberosity Origin of deltoid m. Insertion of teres major m.
51. Origin of supraspinaus m. Origin of infraspinatus m. Origin of teres minor Origin of teres major Insertion of supraspinatus m. Insertion of infraspinatus m. Insertion of teres minor m. Deltoid tuberosity Origin of Deltoid m. Insertion of teres major m.
52. (1) Deltoid Muscle
53. Anterior border of lateral 1/3 of clavicle Anterior fibers of deltoid Lateral border of acromion Middle fibers of deltoid Origin of anterior & middle fibers of deltoid m. Dr. Sherif Fahmy
54. Lateral border of acromion Middle fibers of deltoid Lower lip of crest of the spine Posterior fibers Deltoid tuberosity Origin of middle & posterior fibers of deltoid Deltoid tubercle Dr. Sherif Fahmy
55. Action of Deltoid Muscle Anterior fibers: Flexes and medially rotates the arm. Middle fibers: Abduct the arm from 15 to 90 degrees Posterior fibers: Extends and laterally rotates the arm. Nerve supply: Axillary (Circumflex) n.
56. (2) Rotator Cuff Muscles
57. ROTATOR CUFF MUSCLES (Musculo- tendinous cuff) A- Subscapularis muscle. B- Supraspinatus muscle. C- Infraspinatus muscle. D- Teres minor muscle.
58. 1- Subscapularis Muscle
59. Subscapularis m. Lesser tuberosity of humerus Upper triangular space Quadrangular space
60. Action of subscapularis m. ➢Adducts and medially rotates the arm. ➢Supports (stabilize) the shoulder joint. Nerve supply: ➢Upper & lower subscapular nerves.
61. 2- Supraspinatus Muscle
62. Supraspinatus m. Deltoid (cut) Spine of scapula Greater tuberosity Subacromial bursa
63. Action of Supraspinatus m. ➢Abducts the arm from 0 to 15 degrees. ➢Supports (stabilize) the shoulder joint. Nerve supply: Suprascapular nerve.
64. 3- Infraspinatus Muscle
65. Deltoid (cut) Spine of scapula Infraspinatus m. Greater tuberosity Teres minor m. Teres major m. Back of scapular region
66. Action of Infraspinatus m. ➢Adducts and laterally rotates the arm. ➢Supports (stabilizes) the shoulder joint. Nerve supply: Suprascapular nerve.
67. 4- Teres Minor Muscle
68. Lower impression of Greater tuberosity Teres minor muscle
69. Action of Teres minor muscle: ➢Adducts and laterally rotates the arm. ➢Supports (stabilizes) the shoulder joint. Nerve supply: Axillary (circumflex) nerve.
70. Teres Major Muscle
71. Quadrangular space Teres major muscle Upper triangular space Lower triangular space Medial lip of bicipital groove
72. Latissimus dorsi m. Teres Major m. Medial lip of bicipital groove
73. Action of teres major m.: Adducts, medially rotates and extends the arm. Nerve supply: Lower subscapular nerve.
74. Tissue Spaces of Shoulder Region 1- Quadrangular space. 2- Upper triangular space. N.B. Lower triangular space is present in arm.
75. Quadrangular space Upper triangular space Lower triangular space
76. Boundaries
77. Subscapularis m. Teres major m. Long head of triceps Surgical neck of humerus Shaft of humerus Capsule of shoulder j. Medial head of triceps m. Lateral border of scapula Anterior View
78. Deltoid (cut) Teres minor m. Teres major m. Long head of triceps Posterior View
79. Contents
80. Deltoid (cut) Axillary n. Posterior circumflex humeral art. Circumflex scapular art Radial n. Profunda brachii art
82. Relations of Deltoid Muscle Deep relations: 1- Bones: upper end of humerus and coracoid process and coraco-acromial arch. 2- Muscles: subscapularis, supraspinatus, infraspinatus, teres minor, coracobrachialis, biceps and tendons of pectoralis major and minor muscles. 3- Nerves: circumflex nerve. 4- Vessels: Anterior and posterior circumflex humeral arteries. Superficial relations: - Skin, fascia and supra-clavicular nerve. Anterior border: -is separated from pectoralis major muscle by delto-pectoral groove.
83. Anterior fibers of deltoid m (cut) Corcoid process Subscapularis m. Coraco-brachialis m Short head of biceps brachii m. Long head of bicepes Pectoralis major m. (cut) Capsule of shoulder j. Subdeltoid bursa Corac-acromial lig. Deep relations of anterior fibers of deltoid Tendon of pectoralis minor m.
84. Supraspinatus m. Deltoid (cut) Infraspinatus m. Teres minor m. Teres major m. Deep relations of posterior fibers of deltoid m. Main trunk of axillary n. Circumflex scapular art.