Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the...
-
Upload
kerrie-armstrong -
Category
Documents
-
view
222 -
download
3
Transcript of Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the...
![Page 1: Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles,](https://reader030.fdocuments.net/reader030/viewer/2022032707/56649e4d5503460f94b43fe1/html5/thumbnails/1.jpg)
Scapular Region
Dr. Nivin Sharaf(MD)
![Page 2: Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles,](https://reader030.fdocuments.net/reader030/viewer/2022032707/56649e4d5503460f94b43fe1/html5/thumbnails/2.jpg)
Objectives
• Know the landmarks of the bony structures of the shoulder/axillary regions
• Know the rotator cuff muscles, external rotators, internal rotators
• Be familiar with principal muscles of the scapular , scapulo-humeral region
• Scapular rotation in relation with shoulder movements
![Page 3: Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles,](https://reader030.fdocuments.net/reader030/viewer/2022032707/56649e4d5503460f94b43fe1/html5/thumbnails/3.jpg)
Surface Anatomy
• Spine
Acromion (of scapula
Teres minormuscle
Teres majormuscle
Infraspinatusmuscle
Triangle ofascultation
Trapezius muscle
![Page 4: Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles,](https://reader030.fdocuments.net/reader030/viewer/2022032707/56649e4d5503460f94b43fe1/html5/thumbnails/4.jpg)
AnteriorScapula.-angles, borders-glenoid cavity, -acromion, -coracoid process, -Subscapular fossa
Humerus.-Head,-Surgical neck-Anatomical neck-Greater tubercle-Lesser tubercle-Intertubercular (bicipital) groove
![Page 5: Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles,](https://reader030.fdocuments.net/reader030/viewer/2022032707/56649e4d5503460f94b43fe1/html5/thumbnails/5.jpg)
PosteriorClavicle.Acromioclavicular joint
Scapula.- Spine - Acromion- Supraspinous fossa- Infraspinous fossa
Humerus. - Head - Anatomical neck, - Surgical neck, - Deltoid tuberosity- Spiral (radial) groove.
![Page 6: Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles,](https://reader030.fdocuments.net/reader030/viewer/2022032707/56649e4d5503460f94b43fe1/html5/thumbnails/6.jpg)
Scapular Fracture
![Page 7: Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles,](https://reader030.fdocuments.net/reader030/viewer/2022032707/56649e4d5503460f94b43fe1/html5/thumbnails/7.jpg)
Movements of the shoulder joint (Review):
Abduction / adductionFlexion / extension
Rotation – internal (medial)- external (lateral)
Movements of the scapula (Thoracoappendicular):(increase range of movement of upper limb)Protraction / RetractionElevation / DepressionRotation: Superior / Inferior
Circumduction
![Page 8: Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles,](https://reader030.fdocuments.net/reader030/viewer/2022032707/56649e4d5503460f94b43fe1/html5/thumbnails/8.jpg)
Superior rotation of Glenoid fossa:
- Powerful muscles pull on bony struts.
Scapula rotates when we move our arms to allow more range of motion at the shoulder joint
![Page 9: Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles,](https://reader030.fdocuments.net/reader030/viewer/2022032707/56649e4d5503460f94b43fe1/html5/thumbnails/9.jpg)
Complete abduction at the shoulder joint requires superior rotation of the scapula so that the glenoid fossa faces superiorly.
Glenoid fossa
![Page 10: Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles,](https://reader030.fdocuments.net/reader030/viewer/2022032707/56649e4d5503460f94b43fe1/html5/thumbnails/10.jpg)
Deltoid
• Clavicular origin, acromial, and scapular origins, attach all to deltoid tuberosity
• Anterior fibers flexes• Posterior fibers extends and
laterally rotates• Middle fibers abducts the arm• Innervation C5,6 Axillary nerve
Delta= TriangleDeltoid=triangular in shape Principal abductors= Deltoid, supra spinatus
![Page 11: Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles,](https://reader030.fdocuments.net/reader030/viewer/2022032707/56649e4d5503460f94b43fe1/html5/thumbnails/11.jpg)
Subdeltoid / Subacromial bursa.
Bursa: a closed sac or envelope, lined with synovium and containing fluid, usually in areas subject to friction.
![Page 12: Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles,](https://reader030.fdocuments.net/reader030/viewer/2022032707/56649e4d5503460f94b43fe1/html5/thumbnails/12.jpg)
Rotator cuff muscles stabilize the shoulder joint.Supraspinatus, Infraspinatus,Subscapularis, Teres minor
![Page 13: Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles,](https://reader030.fdocuments.net/reader030/viewer/2022032707/56649e4d5503460f94b43fe1/html5/thumbnails/13.jpg)
Rotator Cuff Muscles SITS
Because the scapula is triangular deep bone, paddedwith thick muscles, injuries leading to scapular fractures Will be so severe , and most commonly we will have lots of multiple, or serious other fraactures
![Page 14: Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles,](https://reader030.fdocuments.net/reader030/viewer/2022032707/56649e4d5503460f94b43fe1/html5/thumbnails/14.jpg)
Transverse scapular ligament
• Runs between Subscapular nerve (C5,6) and artery, which supply supra and infra spinatus ms• Artery above, nerve below• Army un over the bridge, navy sail under the bridge
![Page 15: Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles,](https://reader030.fdocuments.net/reader030/viewer/2022032707/56649e4d5503460f94b43fe1/html5/thumbnails/15.jpg)
Serratus Anterior
Winged Scapula: (long thoracic nerve)
Subscapularis
"big swing muscle" or "boxer's muscle”Antagonist of RhomboidsAccessory muscle of respiration
![Page 16: Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles,](https://reader030.fdocuments.net/reader030/viewer/2022032707/56649e4d5503460f94b43fe1/html5/thumbnails/16.jpg)
Posterior view:- Trapezius- Latissimus Dorsi- Deltoid
Rhomboids:- minor and major- retract / inferior rotate scapula
Teres major:- inserts near latissimus dorsi- adduct / medially rotate arm
![Page 17: Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles,](https://reader030.fdocuments.net/reader030/viewer/2022032707/56649e4d5503460f94b43fe1/html5/thumbnails/17.jpg)
Rhomboids retract, so injury to the dorsal scapular nerve will make the
scapula further away from the midline on the affected side
Posterior scapula
![Page 18: Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles,](https://reader030.fdocuments.net/reader030/viewer/2022032707/56649e4d5503460f94b43fe1/html5/thumbnails/18.jpg)
References
• Clinically Oriented anatomy “Keith Moore” sixth edition
• http://www.meddean.luc.edu/lumen/meded/grossanatomy/dissector/labs/ue/pect_scap/scap1a.html
• www.medicalstudents.com
![Page 19: Scapular Region Dr. Nivin Sharaf(MD). Objectives Know the landmarks of the bony structures of the shoulder/axillary regions Know the rotator cuff muscles,](https://reader030.fdocuments.net/reader030/viewer/2022032707/56649e4d5503460f94b43fe1/html5/thumbnails/19.jpg)
Thank you