Download Shoulder Girdle Muscular Anatomy

Shoulder Girdle Muscular Anatomy
Shoulder Girdle Retraction (Adduction)
Rhomboid Major
Origin
Spinous processes of T2 to T5
Insertion
Medial border of scapula
Action
Scapulae retraction, medial scapula rotation
Nerve Supply
Dorsal Scapular Nerve
Palpation
Side lying, with arm hanging over edge of bed
to abduct scapulae. Palpate obliquely
downwards and lateral from spinous process
to medial scapula border
Origin
Spinous process of C7 to T1
Insertion
Upper medial border of scapula
Action
Scapulae retraction, medial scapula rotation
Nerve Supply
Dorsal Scapula Nerve
Palpation
Side lying, with arm hanging over edge of bed
to abduct scapulae. Palpate obliquely
downwards and lateral from spinous process
to medial scapula border
Rhomboid Minor
Shoulder Girdle Muscular Anatomy
Shoulder Girdle Retraction (Adduction)
Trapezius
Origin
Medial superior nuchal line, external
occipital protuberance, ligamentum nuchae
and the spinous process of C7-T12
Insertion
Posterior aspect of the lateral clavicle, medial
acromion and the upper border of the spine
of the scapula
Action
Upper fibres- elevation, neck extension,
ipsilateral lateral flexion, lateral rotation of
the scapula
Middle fibres- shoulder retraction
Lower fibres- depression, lateral rotation of
the scapula
Nerve Supply
Accessory nerve (11 Cranial Nerve)
Palpation
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Shoulder Girdle Muscular Anatomy
Shoulder Girdle
Protraction
(Abduction)
Serratus Anterior
Pectoralis Minor
Origin
Outer surface of the upper 8-9 ribs and the
intercostal fascia
Insertion
Costal surface of the medial border of the
scapula
Action
Scapular protraction, scapular upward
rotation, stabilises scapular to prevent medial
border winging
Nerve Supply
Long thoracic nerve
Palpation
Side lying with arm resting on therapist
shoulder. Therapist standing caudad
facing cephalad. Palpate from axilla along
chest wall
Origin
Outer surface of the 3rd,4th and 5th ribs and
the intercostal fascia
Insertion
Upper surface ad medial border of the
coracoid process of the scapula
Action
Anterior tilt of scapula
Nerve Supply
Medial pectoral and Lateral pectoral nerves
Palpation
1)Side lying with arm resting on therapist
shoulder. Therapist pulls models arm
forward to allow therapists hand to be
placed posterior to pec major and directly
onto caudal end of pec minor on the 5th
rib
2)In high sitting ask client to place hand
behind back. Then ask them to further
extend the shoulder whilst the therapist
palpates 3rd, 4th and 5th ribs below the
coracoids process.
Shoulder Girdle Muscular Anatomy
Shoulder Girdle Elevation
Levator Scapulae
Origin
Transverse process of C1-4
Insertion
Medial margin of the scapula between
superior angle and spine of scapula
Action
Elevation, shoulder retraction, neck
extension, ipsilateral lateral flexion, medial
scapular rotation
Nerve Supply
Ventral rami of C3-4
Palpation
Supine, ipsilateral cervical rotation, hand
behind back. Palpate anterior to upper
trapezius fibres and follow down onto
superior angle of scapulae
Shoulder Muscular Anatomy
Glenohumeral Abduction
Supraspinatus
Origin
Medial two thirds of the supraspinous fossa
Insertion
Upper facet of the greater tubercle of the
humerus
Action
First 20° of abduction, stabilise humeral head
into glenoid
Nerve Supply
Suprascapular nerve
Palpation
Tendon- place model into glenohumeral
maximal extension, medial rotation and
adduction. Tendon can be palpated anterior
to the acromion
Deltoid
Origin
Anterior- anterior border of lateral third of
clavicle
Middle- lateral margin of the acromion
process
Posterior- lower lip of the crest of the spine
of the scapula
Insertion
Deltoid tuberosity
Action
Abduction, flexion, extension, medial
rotation, lateral rotation, horizontal
abduction, horizontal adduction
Nerve Supply
Axillary Nerve
Palpation
Shoulder Muscular Anatomy
Glenohumeral Flexion
Pectoralis Major
Origin
Clavicular head: Medial half of the anterior
surface of clavicle.
Sternal head: Anterior surface of the
manubrium ad bod of sternum, anterior
aspect of upper six costal cartilages and
anterior past of the 6th rib and aponeurosis
of external oblique
Insertion
Lateral lip of intertubercular groove
Action
Adduction and medial rotation. Flexion to
horizontal. Extension to neutral
Nerve Supply
Posterior primary rami of C1
Palpation
Biceps Brachii
Origin
Long head: Supraglenoid tubercle of the
scapula and glenoid labrum
Short head: coracoid process of the scapula
Insertion
Posterior part of the radial tuberosity and
bicipital aponeurosis
Action
Shoulder flexion, stabilise humeral head into
glenoid. Elbow flexion and supination
Nerve Supply
Musculocutaneous nerve
Palpation
Long head tendon: 0° adduction, 20°
medial rotation. Palpate the tendon in
triangle bounded by medial deltoid,
inferior clavicle and lateral pectoralis
major
Shoulder Muscular Anatomy
Glenohumeral Flexion
Coracobrachialis
Origin
Coracoid process of scapula
Insertion
Medial side of the shaft of the humerus
Action
Adduction and flexion
Nerve Supply
Musculocutaneous nerve
Palpation
Supine, 90° abduction and forearm
supination. Therapist’s places fingers medial
surface of the upper arm posterior to biceps
brachii. Resist horizontal adduction to
confirm palpation
Shoulder Muscular Anatomy
Glenohumeral Extension
Latissimus Dorsi
Origin
Thoracolumbar fascia, spinous process of
T6-S5. Outer lip of iliac crest, outer surface
of lower 3-4 ribs and inferior angle of
scapula
Insertion
Floor of the intertubercular groove
Action
Extension, medial rotation and adduction.
Scapular retraction
Nerve Supply
Thoracodorsal nerve
Palpation
Teres Major
Origin
Dorsal surface of the scapular and inferior
angle
Insertion
Medial lip of intertubercular groove of
humerus
Action
Adduction, medial rotation and extension
Nerve Supply
Lower subscapular nerve
Palpation
Prone with arm off side of table. Grasp lat
dorsi between your fingers and thumb.
Move medially to scapula lateral border.
Medial muscle fibres to lat dorsi is teres
major
Shoulder Muscular Anatomy
Glenohumeral Extension
Triceps (Long Head)
Origin
Infraglenoid tubercle of the scapula and the
adjacent glenoid labrum
Insertion
Proximal surface of the olecranon of the ulna
Action
Shoulder adduction and extension. Elbow
extension
Nerve Supply
Radial Nerve
Palpation
Shoulder Muscular Anatomy
Glenohumeral Lateral Rotation
Teres Minor
Origin
Upper two thirds of lateral border of
scapula
Insertion
Inferior facet of greater tubercle
Action
Lateral rotation
Nerve Supply
Axillary nerve
Palpation
Tendon: Patient prone on elbows, 90°
shoulder flexion, 10° shoulder adduction and
20° lateral rotation. Palpate deep to deltoid
and inferior to infraspinatus
Origin
Medial two thirds of infraspinous fossa of
scapula
Insertion
Middle facet of greater tubercle of humerus
Action
Lateral rotation
Nerve Supply
Suprascapular nerve
Palpation
Tendon: Patient prone on elbows, 90°
shoulder flexion, 10° shoulder adduction and
20° lateral rotation. Palpate deep to deltoid
Infraspinatus
Shoulder Muscular Anatomy
Glenohumeral Medial Rotation
Subscapularis
Origin
Medial two third of subscapular fossa
Insertion
Lesser tubercle of humerus
Action
Medial rotation and adduction
Nerve Supply
Upper and Lower subscapular nerve
Palpation
Supine, passively flexion, abduction and
protraction of the arm. Palpate the lateral
border of the scapular anteriorly
Tendon: 0° adduction, medial/lateral
rotation. Palpate deep into the
deltopectoral triangle
Muscular Anatomy Summary
Shoulder Girdle
Rhomboid Major
Retraction
Rhomboid Minor
Trapezius
Serratus Anterior
Protraction
Pectoralis Minor
Trapezius (Upper Fibres)
Elevation
Levator Scapulae
Trapezius
Upward Rotation
Serratus Anterior
Rhomboid Major
Rhomboid Minor
Downward Rotation
Pectoralis Minor
Levator Scapulae
Posterior Tilt
Trapezius (Lower Fibres)
Anterior Tilt
Pectoralis Minor
Glenohumeral
Pectoralis Major
Deltoid
Flexion
Biceps Brachii
Coracobrachialis
Supraspinatus
Abduction
Deltoid
Latissimus Dorsi
Teres Major
Extension
Deltoid
Triceps (Long Head
Coracobrachialis
Adduction
Pectoralis Major
Latissimus Dorsi
Teres Major
Subscapularis
Teres Major
Medial Rotation
Latissimus Dorsi
Pectoralis Major
Deltoid
Teres Major
Lateral Rotation
Infraspinatus
Deltoid