Upper Limb Regions• Shoulder• Arm & Forearm• Hand

Shoulder region

• Bones• Joints• Muscles• Vessels & Nerves

Shoulder Osteology

•Clavicle

•Scapula

•Humerus

Clavicle Sup.

S shape

Latin clavis = key, old Roman key was S-shaped

Clavicle Inf.

Ligaments attachment

Conoid: cone shape

Clavicle Ant.

Medial & lateral ends

Anterior

Posterior

korax = a crow

Glene: Greek = socket

acromion: Greek akros = Hill

Shoulder Separation

Ant. Lat.

Subacromial bursa

Bursitis

Shoulder X-ray, AP projection

1, Clavicle.2, Acromion.3, Greater tubercle.4, Lesser tubercle.5, Neck of Humerus. 6, Humerus. 7, Coracoid Process.8, Axillary border of

scapula. 9, Rib.

Shoulder region

• Bones• Joints• Muscles• Vessels & Nerves

Classifications of muscles that move the shoulder

• A. muscles connecting scapula to humerus• B. muscles connecting trunk to scapula• C. muscles connecting trunk to humerus

Biceps & Triceps tendons

A. muscles connecting scapula to humerus

1. Supraspinatus2. Infraspinatus3. Teres minor4. Subscapularis5. Teres major6. Coracobrachialis7. Deltoid

Short muscles

Quiz

supraspinatus

subscapularisinfraspinatus teres minor

Teres major• Origin:– Inf angle of scapula

• Insertion:– Med lip of groove

• Actions:– Internal rotation and

adduction of arm

Coracobrachialis

• Function:flex & adductthe shoulder joint

Deltoid

• Origin:– Clavicle, scapula

• Insertion:– Deltoid tuberosity of

humerus• Actions:– Abduction– Anterior deltoid: internal

rotation– Posterior deltoid:

external rotation

Classifications of muscles that move the shoulder

• A. muscles connecting scapula to humerus• B. muscles connecting trunk to scapula• C. muscles connecting trunk to humerus

B. muscles connecting trunk to scapula

1. Serratus anterior2. Levator scapula3. Rhomboid major4. Rhomboid minor5. Trapezius6. Pectoralis minor

Serratus Anterior• Origin:

– Ribs• Insertion:

– Medial border of scapula

• Actions:– Protraction and

rotation of scapula

Levator scapula• Origin:

– Cervical vertebrae• Insertion:

– Scapula• Action:

– Elevation of the scapula

Rhomboid major and minor• Origin:– Cervical and

Thoracic vertebrae

• Insertion:– Scapula

• Actions:– Retraction– Elevation

Trapezius

• Origin:– Occipital bone of skull,

cervical and thoracic vertebrae

• Insertion:– Clavicle and Scapula

• Actions:– Elevation– retraction

Pectoralis Minor• Origin:– Ribs

• Insertion:– Coracoid process

of scapula• Action:– Depression of

scapula

Classifications of muscles that move the shoulder

• A. muscles connecting scapula to humerus• B. muscles connecting trunk to scapula• C. muscles connecting trunk to humerus

C. muscles connecting trunk to humerus

• Pectoralis major• Latissimus dorsi

Pectoralis Major

• Origin:– Clavicle, sternum, upper

ribs• Insertion:– Crest of greater tubercle

and lat lip • Action:– Add, med rotation

Latissimus Dorsi

• Origin:– Vertebrae, sacrum,

ilium• Insertion:– Medial lip

• Actions:– Adduction and med

rotation of humerus

Latissimus Dorsi if humerus is fixed

• Covering th front and back of the trunk.• The pectoralis major and latissimus dorsi both adduct and medially rotate the

Humerus.