Pectoral Girdle and Shoulder

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Text of Pectoral Girdle and Shoulder

  • 1. COLLEGE OF ALLIED HEALTH AND SCIENCE HERMIZAN HALIHANAFIAH Bsc Biomedicine (Hons) UKM PECTORAL GIRDLE

2. Pectoral/shoulder Girdle Upper Limb Pelvic Girdle Lower LImb 3. Pectoral Girdles

  • Attach the bones of upper limb to the axial skeleton.
  • Consistclavicleandscapulabones.
  • The pectoral girdles does not articulate with the vertebral column. Held in position by complex of muscle attachment.

4. Pectoral Girdles 5.

  • S shape
  • Also known as a collarbone
  • Classified as a long bone.
  • Medial 2/3 convex anteriorly and lateral 1/3 concave anteriorly.
  • Situated lies horizontally in the superior and anterior part of the thorax, superior to the 1 strib.

CLAVICLE 6.

  • It acts as a strut to keep the scapula in position so the arm can hang freely.
  • Palpable region because most of the region cover by skin (subcutaneous).
  • Have several function:
  • - rigid support for the scapula and upper limb suspended. This arrangement keep upper limb (arm) away from thorax maximum ROM

CLAVICLE 7.

  • Covers the cervicoaxillary canal (passageway between the neck and arm), through which several important structures pass (brachial plexus, artery etc)
  • Transmits physical impacts from the upper limb to the axial skeleton.
  • Provide some muscles attachment. (Deltoid, subclavius, trapezius, pec major etc)

CLAVICLE 8. Clavicle 9. 10. CLAVICLE 11. CLAVICLE 12.

  • The medial end of the clavicle called sternal end is rounded shape articulate with clavicular notch of manubrium of sternum to form sternoclavicular joints.
  • The lateral end of the clavicle called acromial extremity is broad and flat and articulate with acromion process of scapula to form acromioclavicular joint.

CLAVICLE 13. Sternoclavicular Joint 14. Acromioclavicular Joint 15.

  • The conoid tubercle on the inferior surface of the lateral end of the clavicle is a point attachment for the conoid ligament (coracoclavicular lig) .
  • The costal tuberosity on the inferior surface of the medial end is point attachment for the costoclavicular ligament.

CLAVICLE 16. SCAPULA

  • Shoulder blade
  • Large bone
  • Triangular
  • Flat
  • Irregular

17. 18. 19. 20. SCAPULA

  • Situated in the superior part of the posterolateral aspectof the thorax between the levels of the 2 ndand 7 thribs.
  • The medial border of scapula lie about 5cm from the vertebral column.

21. Anterior View Posterior View 22.

  • Consist 3 border; superior, lateral (axillary) and medial (vertebra) border.
  • Consist 3 angle; superior angle, inferior angle and lateral angle.
  • Consist 3 fossa; supraspinous and infraspinous fossa (posterior) and subscapular fossa (anterior).

Scapula 23.

  • Spine , runs diagonally across the posterior of the scapula separate supraspinous and infraspinous fossa.
  • The lateral end of spine projects as a flattened, expanded process called theacromion process .

Scapula 24.

  • Acromion process articulate with the acromial extremity of clavicle to formacromioclavicular joint .
  • Inferior to the acromion process is a shallow depression calledglenoid cavity .
  • This cavity accepts the head of humerus to formglenohumeral joint .

Scapula 25.

  • Medial (vertebral) border thethin edgeof the bone near to the vertebral column.
  • Lateral (axillary border) thethick edgecloser to the arm.
  • Medial border join the lateral border at theinferior angle .

Scapula 26.

  • The superior edge of scapula , called superior border joins the vertebral border at the superior angle.
  • The scapular notch is a prominent indentation along the superior border through which the subscapular nerve passes.

Scapula 27.

  • At the lateral end of the superior border is projection of the anterior surface calledcoracoid process , which the tendons and muscle attach.
  • Superior and inferior to the spine are two fossae;supraspinousand i nfraspinous fossa , surfaces of attachment of muscles and tendons.
  • On the anterior surface is a slightly hollowed out area calledsubscapularfossa .

Scapula 28. Movements of the Scapula 29. Movements of the Scapula 30. Elevation of Scapula Superior movement of the shoulder girdle; moving the scapula up. 31. Depression of Scapula Inferior movement of the shoulder girdle; moving the scapula down. 32. Movements of the Scapula 33. Upward Rotation of Scapula Rotary movement of the scapula; moving inferior angle of scapula laterally and upward 34. Downward Rotation of Scapula Rotary movement of the scapula; moving inferior angle of scapula medially and downward. 35. Movements of the Scapula 36. Abduction/Protraction of Scapula Forward movement away the midline of the body; moving the scapula away from the spine during protraction of the shoulder girdle. 37. Adduction/Retraction of Scapula Backward movement toward the midline of the body; moving the scapula back toward the spine during retraction of the shoulder girdle. 38. Movement of the Scapulaas a Whole

  • Movement of the pec girdle serve to increase the range of movement (ROM) of the shoulder jt.
  • Remember!!! movements of the pectoral girdle accompany virtually to all movements of the shoulder joint.

39. Pairing of Pec Girdle andShoulder Jt Movements Abduction (protraction) Horizontal adduction Adduction (retraction) Horizontal abduction Adduction (retraction) External rotation Abduction (protraction) Internal rotationDepression / downward rotation ExtensionElevation / upward rotation FlexionDownward rotation AdductionUpward rotation Abduction Shoulder Girdle Shoulder Jt 40. Orientation Muscles of thePectoral Girdle

  • Muscles of the thorax that move the pectoral girdle
    • Anterior thoracic muscles
    • Posterior thoracic muscles
  • Muscles of the thorax that move the humerus.
    • Axial muscles that move the humerus
    • Scapular muscles that move the humerus.

41. Muscles of the Thorax Move the Pectoral Girdle

  • Anterior thoracic muscles
  • Subclavius
  • Pectoralis minor
  • Serratus anterior
  • Posterior thoracic muscles
  • Fiber of trapezius
  • Levator scapulae
  • Rhomboid minor
  • Rhomboid major

42. Muscles of the Thorax that Move the Humerus

  • Axial muscles
  • Pectoralis major
  • Latissumus dorsi
  • Scapular muscles
  • Fiber of deltoid
  • Rotator cuff
  • Teres major
  • Coracobrachalis
  • Long & short head of biceps
  • Long head of triceps

43. ORIGIN, INSERTION, ACTIONS AND NERVE SUPPLY 44. Subclavius Muscle

  • Origin 1 strib
  • Insertion lower surface of clavicle
  • Action
    • Depression and move clavicle anteriorly
    • Helps stabilize pectoral girdle
  • Nerve supply
    • Subclavian nerve

Subclavius 45. Pectoralis Minor

  • Origin
    • 2 nd- 5 thribs, 3 rd 5 thribs or 2 nd 4 thribs.
  • Insertion
    • Coracoid process of scapula
  • Action
    • Abduction scapula and rotates it downward
    • Elevate the ribs during forced inhalation.
  • Nerve supply
    • Medial pectoral nerve

46. Pectoralis Minor 47. Serratus Anterior

  • Origin Superior 8 or 9 ribs
  • Insertion vertebral border and inferior angle of scapula
  • Action
    • Abduction and rotates the scapula upward
    • Elevate ribs when scapula stabilized.
    • Also known as boxers muscles
  • Nerve supply
    • Long thoracic nerve

48. Fiber of Trapezius

  • Consists 3 fibers
  • Superior or upper fiber, middle fiber and inferior or lower fiber.
  • Important for move the scapula.
  • Nerve supply - accessory nerve and cervical spinal nerve .

49. Upper / SuperiorFiber of Trapezius

  • Origin medial one third ofthe superior nuchal line, external occipital protuberance and ligamentum nuchae.
  • Insertion posterior border of the lateral one third of the clavicle.
  • Action scapular elevation

50. Middle Fiber of Trapezius

  • Origin spinous process of T1 T5
  • Insertion medial border of the acromion pr