UE: Bones, Axilla, Brachial Artery

Acromial end

laterally, contains the acromium facet which articulates withe the arcomium of the scapula.

landmarks of the clavicle

are typically found on the inferior side.

collar bone

clavicle

Clavicle is _ shape, and is _____ medially, and ____ laterally

S , convex, concave

Sternal end

Medially, contains the sternal facet, articulates with the manubruim of the sternum.

Conoid Tubercle

attachment site for conoid ligament

Trapezoid line

attachment site for the trapezoid ligament

Subclavian Groove

where the subclavius muscle orginates

Costoclavicular Ligament

the trapezoid and conoid ligament together

Spine of the Scapula

insertion for trapezius, continuous with the acromium

Supraspinatous fossa

attachment for the supraspinatous muscle

Coracoid Process

attachment for pec minor, coracobrachilais, bicep brachii short head

Infraglenoid Tubercle

attachment for tricep long head

glenoid fossa

articulates with the humerus

supreglenoid tubercle

attachment for bicep brachii long head

Subscapular fossa

attachment for the subscapularis

Inferior angle

a lateral border for the triangle of oscillation. Latissmus dorsi attaches here.

vertebral border

medial border of the scapula is known as the

greater tuberosity (tubercle) and the lesser tubercle

attachment for rotator cuff

anatomical neck

distal to the head of the humerus

surgical neck

important for shoulder replacement

Radial groove

The radial nerve runs through the

ulnar groove

Between the trochlea and medial epicondyle, where the ulnar nerve runs

radial fossa

recepticals for radius

coronoid fossa

space for ulna to articulate

Deltoid

O: lateral 3rd of scapula, spine of scapula, acromium

I: deltoid tuberosity

A: anterior (clavicular) flexion, medially rotate, Lateral (acromium) abduct, Posterior (spinal) lateral rotation and extension.

N +NR: Axillary C5, C6

Anterior portion of the deltoid (clavicular part) *unipennate* performs

flexion & medial rotation

Lateral aspect of the deltoid (acromium) *multipennate* performs

abduction

Posterior part fo the deltoid (Spianl part) *unipennate* performs

extend and laterally rotate the arm

When the deltoid is working all together is performs

abduction

Deltoid orentation is

multipennate

Deltoid raises the arm in abduction from

15 to 180

most commonly torn rotator cuff muscle

Supraspinatus:

Why: individual can’t initiate abduction

How to initiate abduction without a supraspinatus

shoulder hike (firing the the trapezius) or side bending

Rotator Cuff is made up of:

1. Supraspinatus

2. Infraspinatus

3. Teres minor

4. Subscapularis

Supraspinatus

O: supraspinatus fossa

I: superior facet of the greater tubercle of the humerus

A: abduction (0 to 15%)

N+R: suprascapular C5,C6

Infraspinatus

O: infraspinatus fossa

I: middle facet of the greater tubercle of the humerus

A: lateral rotation

N+R: Suprascapular C5,C6

Second most commonly injured rotator cuff

infraspinatus

Teres Minor

O: middle part of the lateral border of the scapula

I: inferior facet of the greater tubercle of the humerus

A: laterally rotate (minor)

N+R: Axillary C5, C6

Subscapularis

O: subscapular fossa

I: lesser tubercle of the humerus

A: adduction, medial rotation, hold head of humerus in the socket

N+R: Upper and lower subscapular C5,C6

Teres Major

O: Posterior surface of the inferior angle of the scapula

I: Medial crest of the intertubercular groove

A: Adduction, medial rotation

N+R: Lower subscapular C5,C6

What insets at the medial crest of the intertubercular groove

latissmus dorsi and teres major

Latissimus Dorsi

O: posterior iliac crest, SP T6 to T12, thoracolumbar fascia, inferior 3 to 4 ribs,

I: intertubcular groove

A: extension, medial rotation, adduction

N+R: thoracodorsal C6, C7,C8

Quadranglular Space

Triangular Space

Triangular Interval (hiatus)

Thoracodorsal Nerve, Thoracodorsal artery supplies

lay superficial to the subscapularis, supply the latissimus dorsi

Long thoracic nerve, lateral thoracic artery *superior thoracic artery supplies

serratus anterior

Suprascapular artery, suprascapular nerve

superscapular artery goes over the ligamnet, nerve goes under

Suprascapular artery, suprascapular nerve innervates

supraspinatus and infraspinatus

Axillary nerve, posterior humeral circumflex artery supply

deltoid, teres minor, teres major, triceps, cutaneous region of shoulder

radial nerve, deep radial artery supplies

posterior compartment of the brachium

muscle: artery + nerve

Military requires army and navy

Pectoralis Major

O: anteriomedial clavicle, anterior sternum, superior 6 costal catilage

I: anterior lateral crest of the intertubercular groove

A: adduction, medial rotation

N+R: lateral pectoral nerve (C5,C6,C7) and the medial pectoral nerve (C8,T1)

clavicular head (C5,C6)

sternocostal head (C7,C8,T1)

Pectoralis Minior

O: anterior surface of ribs 3,4,5 (near the costal cartilage)

I: medial superior aspect of the coracoid process of the scapula

A: stabilize the scapula (when reaching forward) * draws it inferior and anteriorly

N+R: Medial pectoral nerve (C8,T1)

Scapular Setting

Stabilizes teh scapula in place

Subclavius

O: junction of rib1 and costal cartilage meet

I: Inferior aspect of the middle third of the clavicle (subclavian groove)

A: depresses and stabilizes the clavicle

N+R: Nerve to subclavius (C5,C6)

C5, C6

If an individual comes into the clinic, unable to move their arm (shoulder girdle), what nerves are being effected? Name some muscles completely effected.

60 degress adduction

Test the pec major sternal head at

90 degree adduction

Test the pec major clavicular head at

deltopectoral triangle

cephalic vein sits in the

Serratus Anterior (boxer muscle)

O: external lateral aspect of ribs 1 to 8

I: anterior medial border of the scapula

A: protracts the scapula (brings it forward), upward rotation the scapula, hold the scapula against the thoracic wall.

N+R: Long thoracic C5,C6,C7