Post on 07-Sep-2014
transcript
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