Scapular muscles

This presentation shows Scapular muscles of upper limb

Transcript

1. SHOULDER REGION (Scapular Muscles)
2. Muscles of Shoulder Region A- Deltoid Muscle. B- Rotator Cuff Muscles (4 muscles). C- Teres Major Muscle.
3. Orientation
4. Anterior fibers of deltoid muscle Pectoralis major m. Delto-pectoral groove
5. Subscapularis m. Removed deltoid and pectoralis major muscles
6. Posterior fibers of deltoid muscle Supraspinatus muscle Infraspinatus muscle Teres minor m. Teres major m. Spine of scapula
7. Attachments of Scapular Muscles
8. 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).
9. 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.
10. Origin of subscapularis muscle Insertion of subscapularis muscle Deltoid tuberosity Origin of deltoid m. Insertion of teres major m.
11. 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.
12. (1) Deltoid Muscle
13. 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
14. 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
15. 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.
16. (2) Rotator Cuff Muscles
17. ROTATOR CUFF MUSCLES (Musculo- tendinous cuff) A- Subscapularis muscle. B- Supraspinatus muscle. C- Infraspinatus muscle. D- Teres minor muscle.
18. 1- Subscapularis Muscle
19. Subscapularis m. Lesser tuberosity of humerus Upper triangular space Quadrangular space
20. Action of subscapularis m. ➢Adducts and medially rotates the arm. ➢Supports (stabilize) the shoulder joint. Nerve supply: ➢Upper & lower subscapular nerves.
21. 2- Supraspinatus Muscle
22. Supraspinatus m. Deltoid (cut) Spine of scapula Greater tuberosity Subacromial bursa
23. Action of Supraspinatus m. ➢Abducts the arm from 0 to 15 degrees. ➢Supports (stabilize) the shoulder joint. Nerve supply: Suprascapular nerve.
24. 3- Infraspinatus Muscle
25. Deltoid (cut) Spine of scapula Infraspinatus m. Greater tuberosity Teres minor m. Teres major m. Back of scapular region
26. Action of Infraspinatus m. ➢Adducts and laterally rotates the arm. ➢Supports (stabilizes) the shoulder joint. Nerve supply: Suprascapular nerve.
27. 4- Teres Minor Muscle
28. Lower impression of Greater tuberosity Teres minor muscle
29. Action of Teres minor muscle: ➢Adducts and laterally rotates the arm. ➢Supports (stabilizes) the shoulder joint. Nerve supply: Axillary (circumflex) nerve.
30. Teres Major Muscle
31. Quadrangular space Teres major muscle Upper triangular space Lower triangular space Medial lip of bicipital groove
32. Latissimus dorsi m. Teres Major m. Medial lip of bicipital groove
33. Action of teres major m.: Adducts, medially rotates and extends the arm. Nerve supply: Lower subscapular nerve.
34. Spotting
35. Trapezius m. Latissimus dorsi m. Posterior fibers of deltoid m. Teres major m. Infraspinatus & teres minor covered with deep fascia.
36. Deltoid m. Infraspinatus m. Teres minor m. Teres major m. Spine of scapula
37. Deltoid m. (Cut) Spine of scapula Supraspinatus m. Infraspinatus m. Teres minor m. Teres major m.
38. Tissue Spaces of Shoulder Region 1- Quadrangular space. 2- Upper triangular space. N.B. Lower triangular space is present in arm.
39. Quadrangular space Upper triangular space Lower triangular space
40. Boundaries
41. 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
42. Deltoid (cut) Teres minor m. Teres major m. Long head of triceps Posterior View
43. Contents
44. Deltoid (cut) Axillary n. Posterior circumflex humeral art. Circumflex scapular art Radial n. Profunda brachii art
46. 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.
47. 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.
48. 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.
49. AXILLARY (CIRCUMFLEX) NERVE (C5,6)
50. Posterior cord Axillary (Circumflex) nerve
51. Posterior cord Axillary n. Subscapularis m. Quadrangular space
52. Deltoid (cut) Axillary n. Posterior circumflex humeral art. Anterior division of axillary n. Posterior division of axillary n. Upper lateral cutaneous br. Quadrangular space Course of Axillary n.
53. Branches of Axillary Nerve 1- Articular branch. 2- Anterior division that gives: a) Middle and anterior fibers of deltoid m. b) Skin covering lower ½ of anterior fibers of deltoid. 3- Posterior division that gives: a) Posterior fibers of deltoid. b) Teres minor m. c) Upper lateral cutaneous nerve of arm.
54. Injury of Axillary N. Causes: 1- Dislocation of shoulder j. 2- Fracture of surgical neck of humerus. 3- Badly adjusted crutch to armpit. Results: Motor loss: -Paralysis of deltoid and teres minor muscles. Sensory loss: -At skin over lower ½ of deltoid muscle. Disability & deformity: -Unable to abduct arm from 15 – 90 Degrees. -Arm is adducted. Late wasting changes: Wasting of deltoid, flat shoulder and prominent acromion.
55. SUPRASCPULAR NERVE
56. Suprascapular notch
57. Suprascapular n. Suprascapular lig. Suprascapular art. Shoulder j. Acromio- clavicular j. Course of suprascapular n. Axillary n.