Objectives Take a general knowledge about surface anatomy Identify the subregions of the shoulder and their important surface landmarks Study the muscles of the pectoral lateral thoracic and ID: 1014180
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1. Muscles of the shoulder region:Objectives:Take a general knowledge about surface anatomyIdentify the sub-regions of the shoulder and their important surface landmarksStudy the muscles of the pectoral, lateral thoracic and axio-scapular regionsSummarize the movements of the scapulaGray’s anatomy for students pp: 702-704 + 712-716Al-Mustansiriyah universityCollege of medicineDept. of human anatomyDr. ahmed almusawi
2. Surface AnatomyParasternal line
3. Surface Anatomy
4. Surface AnatomyT1T2,3T7
5. Subregions: Pectoral, Axilla, shoulder and scapularPectoral region (Ant.): Closely related to the breastAxilla (Lat.): Related to the neck
6. Subregions: Shoulder4. Scapular region (post.):Related to the back4. posterior scapular regionoccupies the posterior aspect of the scapula and is located deep to the trapezius and deltoid musclesthe supraspinatus, infraspinatus, teres minor, and teres major muscles3. The shoulder is the area of upper limb attachment to the trunk
7. Movements of the scapulaAdduction = RetractionAbduction = ProtractionElevation = UpDepression = DownLateral rotation= inferior angle moves outwardsMedial rotation= inferior angle moves inwards
8. Pectoralis major2 heads:Clavicular (separated from deltoid by deltopectoral groove)SternocostalMost powerful shoulder adductor (sternocostal head)Flexes extended shoulder (clavicular head)Rotates shoulder mediallyForms anterior wall of axillaSupplied by 2 pectoral nerves (medial & lateral)
9. Pectoralis minor & SubclaviusP. minor: depresses, protracts & medially rotate scapulaSubclavius (stabilizes sternoclavicular joint)Both covered by clavipectoral fascia (pierced by artery, vein & nerve)
10. Serratus anteriorHas 8 digitationsPowerful protractor (swimmers muscle)Keep the medial border and inferior angle opposed to costal surface
11. Deltoidacts on shoulder (forms ball of shoulder)Has 3 parts: Anterior (flexion + medial rotation)Middle (abduction)Posterior (extension + lateral rotation)i.e. performs all shoulder movements except adductionSeparated from trapezius by line of origin
12. Posterior axio-scapular muscles (superficial)Trapezius: has three parts:Upper fibers: elevateMiddle fibers: retractLower fibers: DepressLatissimus dorsi:Extends the flexed shoulder (climbers muscle)Spins from posterior to anteriorDeep fibers attach to inferior scapular angleUpper+Lower: rotate laterally
13. Posterior axio-scapular muscles (Deep)Levator scapulae: only muscle from transverse processes .Rhomboid major & Rhomboid minor: retractors & elevatorsInsertion of the three muscles is along the medial scapular border posteriorly from above downwards.All three are supplied by the same nerve: dorsal scapular nerve
14. Dorsal scapular regionSupraspintus InfraspinatusTeres MinorTeres Major
15.
16. Gateways
17. ANTERIORPOSTERIOR
18. Levator scapulaeUpper trapeziusRhomboidsSerratus anteriorPectoralis minorDepressionLower trapeziusLatissimus dorsiPectoralis minorSerratus anterior
19. Middle trapeziusRhomboidsLatissimus dorsi
20. Upper+Lower trapeziusLower serratus anteriorRhomboid major & minorLevator scapulaePectoralis minorLatissimus dorsi
21. Muscles Muscles connect the scapula and clavicle to the trunk:1. trapezius2. levator scapulae3. and rhomboidsmuscles connect the clavicle, scapula, and body wall to the proximal end of the humerus1. pectoralis major2. pectoralis minor3. latissimus dorsi4. teres major5. and deltoid