Loading presentation...

Present Remotely

Send the link below via email or IM

Copy

Present to your audience

Start remote presentation

  • Invited audience members will follow you as you navigate and present
  • People invited to a presentation do not need a Prezi account
  • This link expires 10 minutes after you close the presentation
  • A maximum of 30 users can follow your presentation
  • Learn more about this feature in our knowledge base article

Do you really want to delete this prezi?

Neither you, nor the coeditors you shared it with will be able to recover it again.

DeleteCancel

Make your likes visible on Facebook?

Connect your Facebook account to Prezi and let your likes appear on your timeline.
You can change this under Settings & Account at any time.

No, thanks

Shoulder Anatomy

No description
by

Matthew Resciniti

on 19 August 2011

Comments (0)

Please log in to add your comment.

Report abuse

Transcript of Shoulder Anatomy

Shoulder Anatomy Nerves Vasculature Accessory nerve - innervates the trapezius muscle. Paralysis of this muscle will result in a marked drooping and down turning of the affected shoulder at rest because of the loss of the ability of the trapezius to elevate and upwardly rotate the scapula. The latter loss will also prevent the patient from abducting their arm above the horizontal ( shoulder level). Dorsal Scapular nerve - innervates the rhomboideus muscles. Any attempt to retract the scapula will be accompanied by a marked upward rotation of the shoulder because the rhomboideus can no oppose the upward rotation on the scapula exerted by the trapezius. The patient will have difficulty retracting the scapula against resistance on the affected side. Long thoracic nerve -
Innervates the serratus anterior muscle. Active contraction of this muscle results in scapula protraction and upward rotation.
When the scapula is passively protracted by action of the pectoralis major muscle on the humerus , the serratus anterior acts to stabilize the scapula and keep it applied to the thoracic wall. Such action occur when a boxer throws a jab or a cross.
Paralysis of the serratus anterior prevents the scapula from moving smoothly across the thoracic wall resulting in a bowing out of the medial border of the scapula. This condition is called "winged" scapula. In addition, the ability to actively upwardly rotate the shoulder is diminished and the patient can not abduct the humerus above the horizontal. Suprascapular nerve - innervates the supraspinatus and infraspinatus muscles. Paralysis of this nerve will result is weakness of the rotator cuff muscles resulting in pain form impingement and an inability of the patient to begin shoulder abduction. Such patients tend to swing the affected limb away from their side in order to provide momentum to start abduction. Axillary nerve - innervates the deltoid and teres minor muscles. Since the deltoid plays a major role in movement of the glenohumeral joint, paralysis will cause a loss &/or weakness of most shoulder functions. Symptoms of deltoid paralysis include:
loss or roundness to the shoulder and a very visible acromion process
inability to abduct the glenohumeral joint more than a few degrees away from the side.
inability to laterally rotate the humerus
weakened movements of glenohumeral flexion and extension
loss of sensation just below the point of the shoulder C5, C6 root damage ( Erb's palsy) - axons from the C5 and C6 ventral rami innervate the following muscles acting on the shoulder girdle:
deltoid, supraspinatus, infraspinatus , teres minor, subscapularis. Lesion to these roots will result in paralysis of these muscles. Elevation

Trapezius- upperAccessory
Levator scapulae N. to L. scapulae C 3,4
Rhomboideus major* Dorsal scapular C (4),5
Rhomboideus minor* Dorsal scapular C (4),5 Depression

Latissimus dorsi1 Thoracodorsal C 7
Pectoralis major - sternal head1 Pectoral Nerves C 6, 7,8
Pectoralis minor Medial pectoral C 8, T1 Upward Rotation

Serratus anterior Long thoracic C 5, 6, 7
Trapezius- Accessory Downward Rotation

Latissimus dorsi Thoracodorsal C 7
Pectoralis major Pectoral Nerves C 6, 7,8,
Pectoralis minor Medial pectoral C 8, T1
Levator scapulae N. to L. scapulae C 3,4

Protraction

Serratus anterior Long thoracic C 5, 6, 7
Pectoralis minor Medial pectoral C 8, T 1
Pectoralis major 1 Pectoral Nerves C 6, 7,8,

Retraction

Trapezius Accessory
Rhomboideus major Dorsal scapular C (4),5
Rhomboideus minor Dorsal scapular C (4),5 Sensation

Dermatones Motion of the Glenohumeral Joint

Flexion

Deltoid - anterior Axillary C 5
Pectoralis major - clavicular head Lateral Pectoral C 5, 6
Coracobrachialis* Musculocutaneous C 5, 6, 7

Extension

Deltoid -posterior Axillary C 5
Latissimus dorsi Thoracodorsal C 7
Teres major Lower subscapular C 5, 6

Abduction

Supraspinatus Suprascapular C 5, 6
Deltoid - anterior Axillary C 5

Adduction

Latissimus dorsi Thoracodorsal C 7
Pectoralis major - sternal head Pectoral nerves C 6, 7, 8, 1

Inward Rotation

Subscapularis Upper subscapular C 5, 6
Deltoid - anterior Axillary C 5

Outward Rotation

Infraspinatus Suprascapular C 5, 6
Teres minor Axillary C 5
Deltoid - posterior Axillary C 5 passes through scalenus medius passes through the suprascapular notch inferior to the superior transverse scapular ligament pierces coracobrachialis flexor carpi ulnaris, flexor digitorum profundus (ulnar half), abductor digiti minimi, flexor digiti minimi brevis, opponens digiti minimi, ulnar 2 lumbricals, palmar & dorsal interossei, adductor pollicis triceps brachii, anconeus, brachioradialis, extensor carpi ulnaris, extensor carpi radialis longus & brevis, extensor digitorum, extensor digiti minimi, supinator, abductor pollicis longus, extensor pollicis longus & brevis, extensor indicis pronator teres, flexor carpi radialis, palmaris longus, flexor digitorum superficialis, flexor digitorum profundus (radial half), flexor pollicis longus, pronator quadratus, abductor pollicis brevis, flexor pollicis brevis, opponens pollicis, radial 2 lumbricals Axillary - (shoulder & upper limb)
(continuation of the subclavian lateral to the 1st rib)
1st part: superior thoracic;
2nd part: thoracoacromial, lateral thoracic;
3rd part: ant. & post. humeral circumflex, subscapular intercostal spaces 1 & 2 laterally pectoral br., clavicular br., acromial br., deltoid br. pectoralis major & minor, subclavius, deltoid, shoulder joint circumflex scapular, thoracodorsal serratus anterior & adjacent muscles, skin & fascia arm muscles near surgical neck of humerus passes through quadrangular space with axillary nerve Klumpke's palsy
a lower brachial plexus injury; occurs when a person grabs something to break a fall or a baby's arm is pulled too much during delivery; the dorsal and ventral roots of the spinal nerves that form the inferior trunk of the brachial plexus (C8 and T1) may be avulsed; the short muscles of the hand are affected, and a clawhand results radial nerve/Saturday night palsy
The radial nerve is often injured when the humerus fractures at mid-shaft; wrist drop is a common clinical manifestation. The deep branch of the radial nerve can be injured by deep puncture wounds to the forearm. The deep branch of the radial nerve is responsible for extending the thumb and the MP joints. Neither deep nor superficial radial nerve injury causes much sensory loss, but cutting the superifical leaves a coin-shaped area distal to the bases of the 1st and 2nd metacarpals without sensation. The End
Full transcript