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COLLEGE OF ALLIED HEALTH AND SCIENCE HERMIZAN HALIHANAFIAH Bsc Biomedicine (Hons) UKM PECTORAL GIRDLE
Pectoral/shoulder Girdle Upper Limb Pelvic Girdle Lower LImb
Pectoral Girdles <ul><li>Attach the bones of upper limb to the axial skeleton. </li></ul><ul><li>Consist  clavicle  and  s...
Pectoral Girdles
<ul><li>S shape </li></ul><ul><li>Also known as a collarbone </li></ul><ul><li>Classified as a long bone. </li></ul><ul><l...
<ul><li>It acts as a strut to keep the scapula in position so the arm can hang freely. </li></ul><ul><li>Palpable region b...
<ul><li>Covers the cervicoaxillary canal (passageway between the neck and arm), through which several important structures...
Clavicle
 
CLAVICLE
CLAVICLE
<ul><li>The medial end of the clavicle called sternal end is rounded shape articulate with clavicular notch of manubrium o...
Sternoclavicular Joint
Acromioclavicular Joint
<ul><li>The conoid tubercle on the inferior surface of the lateral end of the clavicle is a point attachment for the conoi...
SCAPULA <ul><li>Shoulder blade </li></ul><ul><li>Large bone </li></ul><ul><li>Triangular </li></ul><ul><li>Flat  </li></ul...
 
 
 
SCAPULA <ul><li>Situated in the superior part of the posterolateral aspect  of the thorax between the levels of the 2 nd  ...
Anterior View Posterior View
<ul><li>Consist 3 border; superior, lateral (axillary) and medial (vertebra) border. </li></ul><ul><li>Consist 3 angle; su...
<ul><li>Spine , runs diagonally across the posterior of the scapula separate supraspinous and infraspinous fossa. </li></u...
<ul><li>Acromion process articulate with the acromial extremity of clavicle to form  acromioclavicular joint . </li></ul><...
<ul><li>Medial (vertebral) border – the  thin edge  of the bone near to the vertebral column. </li></ul><ul><li>Lateral (a...
<ul><li>The superior edge of scapula , called superior border joins the vertebral border at the superior angle. </li></ul>...
<ul><li>At the lateral end of the superior border is projection of the anterior surface called  coracoid process , which t...
Movements of the Scapula
Movements of the Scapula
Elevation of Scapula Superior movement of the shoulder girdle; moving the scapula up.
Depression of Scapula Inferior movement of the shoulder girdle; moving the scapula down.
Movements of the Scapula
Upward Rotation of Scapula Rotary movement of the scapula; moving inferior angle of scapula laterally and upward
Downward Rotation of Scapula Rotary movement of the scapula; moving inferior angle of scapula medially and downward.
Movements of the Scapula
Abduction/Protraction of Scapula Forward movement away the midline of the body; moving the scapula away from the spine dur...
Adduction/Retraction of Scapula Backward movement toward the midline of the body; moving the scapula back toward the spine...
Movement of the Scapula  as a Whole <ul><li>Movement of the pec girdle serve to increase the range of movement (ROM) of th...
Pairing of Pec Girdle and  Shoulder Jt Movements Abduction (protraction) Horizontal adduction Adduction (retraction) Horiz...
Orientation Muscles of the  Pectoral Girdle <ul><li>Muscles of the thorax that move the pectoral girdle </li></ul><ul><ul>...
Muscles of the Thorax Move the Pectoral Girdle <ul><li>Anterior thoracic muscles </li></ul><ul><li>Subclavius </li></ul><u...
Muscles of the Thorax that Move the Humerus <ul><li>Axial muscles </li></ul><ul><li>Pectoralis major </li></ul><ul><li>Lat...
ORIGIN, INSERTION, ACTIONS AND NERVE SUPPLY
Subclavius Muscle <ul><li>Origin – 1 st  rib </li></ul><ul><li>Insertion – lower surface of clavicle </li></ul><ul><li>Act...
Pectoralis Minor <ul><li>Origin  </li></ul><ul><ul><li>2 nd  - 5 th  ribs, 3 rd  – 5 th  ribs or 2 nd  – 4 th  ribs. </li>...
Pectoralis Minor
Serratus Anterior <ul><li>Origin – Superior 8 or 9 ribs </li></ul><ul><li>Insertion – vertebral border and inferior angle ...
Fiber of Trapezius <ul><li>Consists 3 fibers </li></ul><ul><li>Superior or upper fiber, middle fiber and inferior or lower...
Upper / Superior  Fiber of Trapezius <ul><li>Origin – medial one third of  the superior nuchal line, external occipital pr...
Middle Fiber of Trapezius <ul><li>Origin – spinous process of T1 – T5 </li></ul><ul><li>Insertion – medial border of the a...
Lower / Inferior Fiber of Trapezius <ul><li>Origin – spinous process of T6-T12 </li></ul><ul><li>Insertion – spine of the ...
 
Levator Scapulae <ul><li>Origin – transverse process of Superior four or five cervical vertebrae. </li></ul><ul><li>Insert...
Rhomboid Major <ul><li>Origin – Spine of 2 nd  to 5 th  thoracic vertebrae </li></ul><ul><li>Insertion – vertebral border ...
Rhomboid Minor <ul><li>Origin – Spine of 7 th  cervical and 1 st  thoracic vertebrae. </li></ul><ul><li>Insertion – Verteb...
Clavicle origin of  Pectoralis Major <ul><li>Origin – medial half of anterior clavicle </li></ul><ul><li>Insertion – great...
Sternal origin of Pectoralis Major <ul><li>Origin – anterior surface of sternum, costal cartilage of 2 nd  -6 th  ribs. </...
Latissimus Dorsi <ul><li>Origin – Spines of inferior 6 thoracic vertebrae (T6-T12), lumbar vertebrae (L1-L5), crest of sac...
Latissimus Dorsi
Fiber of Deltoid <ul><li>Consists 3 fibers </li></ul><ul><li>Anterior, middle and posterior fibers. </li></ul><ul><li>Resp...
Anterior Fiber of Deltoid <ul><li>Origin – anterior border of the lateral one third of the clavicle </li></ul><ul><li>Inse...
Middle fiber of Deltoid <ul><li>Origin – lateral border and superior surface of the acromion process of the scapula </li><...
Posterior Fiber of Deltoid <ul><li>Origin – inferior lip of the crest of the spine of the scapula </li></ul><ul><li>Insert...
Rotator Cuff Muscles <ul><li>Consists 4 muscles </li></ul><ul><li>S – Supraspinatus </li></ul><ul><li>I – Infraspinatus </...
 
Supraspinatus Muscle <ul><li>Origin – supraspinous fossa of scapula </li></ul><ul><li>Insertion – Greater tubercle of hume...
Infraspinatus Muscle <ul><li>Origin – Infraspinous fossa of scapula </li></ul><ul><li>Insertion – Greater tubercle of hume...
Teres Minor <ul><li>Origin – Inferior lateral border of scapula </li></ul><ul><li>Insertion – Greater tubercle of humerus ...
Subscapularis Muscle <ul><li>Origin – subscapular fossa of scapula </li></ul><ul><li>Insertion – lesser tubercle of humeru...
Teres Major <ul><li>Origin – Inferior angle of scapula </li></ul><ul><li>Insertion – Intertubecular sulcus of humerus </li...
Coracobrachialis <ul><li>Origin - Coracoid process of scapula </li></ul><ul><li>Insertion - Middle of medial surface of sh...
Biceps Brachii <ul><li>Consists 2 head </li></ul><ul><li>Long head and short head of biceps </li></ul>
Short head of Biceps <ul><li>Origin – Coracoid process of scapula </li></ul><ul><li>Insertion – radial tuberosity of radiu...
Long head of Biceps <ul><li>Origin – Tubercle above the glenoid cavity of scapula (supraglenoid tubercle) </li></ul><ul><l...
Long head of Triceps <ul><li>Origin – tubercle below to glenoid cavity of scapula (infraglenoid tubercle) </li></ul><ul><l...
Sternomastoid / Cleidomastoid <ul><li>Join together to form sternocleidomastoid muscle </li></ul><ul><li>Origin  </li></ul...
<ul><li>Insertion – Mastoid process of the mastoid portion of temporal bone. </li></ul><ul><li>Action - Acting together, f...
 
 
 
Joints on Pectoral Girdle <ul><li>There is two type of joint: </li></ul><ul><li>Sternoclavicular joint </li></ul><ul><li>A...
 
Sternoclavicular Joint <ul><li>Articular components </li></ul><ul><ul><li>Between sternal end of clavicle and clavicular n...
 
 
Cont… <ul><li>Sternoclavicular joint strengthen by series of ligaments: </li></ul><ul><li>The Articular Capsule  </li></ul...
Sternoclavicular Ligaments
Articular Capsule <ul><li>The articular capsule surrounds the articulation and varies in thickness and strength.  </li></u...
Anterior Sternoclavicular Ligament <ul><li>The anterior sternoclavicular ligament is a broad band of fibers </li></ul><ul>...
Posterior Sternoclavicular Ligament <ul><li>The posterior sternoclavicular ligament is a similar band of fibers, covering ...
Interclavicular Ligament <ul><li>This ligament is a flattened band, which varies considerably in form and size in differen...
Costoclavicular Ligaments <ul><li>This ligament is short, flat, strong, and rhomboid in form.  </li></ul><ul><li>Attached ...
Acromioclavicular Joint <ul><li>Articular components </li></ul><ul><ul><li>Between acromion process of scapula and acromia...
 
<ul><li>Acromioclavicular joint strengthened by series of ligaments: </li></ul><ul><ul><li>Acromioclavicular ligaments </l...
Acromioclavicular Joint <ul><li>Coracoaromial ligament </li></ul><ul><ul><li>Controls anterior and posterior translation o...
 
Acromioclavicular Ligaments <ul><li>The AC ligaments surround and support the AC joint.  </li></ul><ul><li>Together, they ...
 
Coracoclavicular Ligaments <ul><li>The coracoclavicular ligaments, hold the clavicle down by attaching it to a bony knob o...
Clinical Condition <ul><li>Clavicle fracture </li></ul><ul><li>Frozen shoulder </li></ul><ul><li>AC joint injury </li></ul...
Clavicle Fracture <ul><li>This bone is usually fracture as a result of falling badly onto an outstretched arm or onto the ...
Frozen Shoulder  (Adhesive Capsulitis) <ul><li>This is a condition which affects the ability to move the shoulder, and usu...
AC Joint Injury <ul><li>Separation of the two bones forming this joint is caused by damage to the ligaments connecting the...
Shoulder Dislocation <ul><li>In most cases, the head of the humerus is forced forwards when the arm is turned outwards (ex...
Shoulder Dislocation
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Pectoral Girdle and Shoulder

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Transcript of "Pectoral Girdle and Shoulder"

  1. 1. COLLEGE OF ALLIED HEALTH AND SCIENCE HERMIZAN HALIHANAFIAH Bsc Biomedicine (Hons) UKM PECTORAL GIRDLE
  2. 2. Pectoral/shoulder Girdle Upper Limb Pelvic Girdle Lower LImb
  3. 3. Pectoral Girdles <ul><li>Attach the bones of upper limb to the axial skeleton. </li></ul><ul><li>Consist clavicle and scapula bones. </li></ul><ul><li>The pectoral girdles does not articulate with the vertebral column. Held in position by complex of muscle attachment. </li></ul>
  4. 4. Pectoral Girdles
  5. 5. <ul><li>S shape </li></ul><ul><li>Also known as a collarbone </li></ul><ul><li>Classified as a long bone. </li></ul><ul><li>Medial 2/3 convex anteriorly and lateral 1/3 concave anteriorly. </li></ul><ul><li>Situated lies horizontally in the superior and anterior part of the thorax, superior to the 1 st rib. </li></ul>CLAVICLE
  6. 6. <ul><li>It acts as a strut to keep the scapula in position so the arm can hang freely. </li></ul><ul><li>Palpable region because most of the region cover by skin (subcutaneous). </li></ul><ul><li>Have several function: </li></ul><ul><li>- rigid support for the scapula and upper limb suspended. This arrangement keep upper limb (arm) away from thorax – maximum ROM </li></ul>CLAVICLE
  7. 7. <ul><li>Covers the cervicoaxillary canal (passageway between the neck and arm), through which several important structures pass (brachial plexus, artery etc) </li></ul><ul><li>Transmits physical impacts from the upper limb to the axial skeleton. </li></ul><ul><li>Provide some muscles attachment. (Deltoid, subclavius, trapezius, pec major etc) </li></ul>CLAVICLE
  8. 8. Clavicle
  9. 10. CLAVICLE
  10. 11. CLAVICLE
  11. 12. <ul><li>The medial end of the clavicle called sternal end is rounded shape articulate with clavicular notch of manubrium of sternum to form sternoclavicular joints. </li></ul><ul><li>The lateral end of the clavicle called acromial extremity is broad and flat and articulate with acromion process of scapula to form acromioclavicular joint. </li></ul>CLAVICLE
  12. 13. Sternoclavicular Joint
  13. 14. Acromioclavicular Joint
  14. 15. <ul><li>The conoid tubercle on the inferior surface of the lateral end of the clavicle is a point attachment for the conoid ligament (coracoclavicular lig) . </li></ul><ul><li>The costal tuberosity on the inferior surface of the medial end is point attachment for the costoclavicular ligament. </li></ul>CLAVICLE
  15. 16. SCAPULA <ul><li>Shoulder blade </li></ul><ul><li>Large bone </li></ul><ul><li>Triangular </li></ul><ul><li>Flat </li></ul><ul><li>Irregular </li></ul>
  16. 20. SCAPULA <ul><li>Situated in the superior part of the posterolateral aspect of the thorax between the levels of the 2 nd and 7 th ribs. </li></ul><ul><li>The medial border of scapula lie about 5cm from the vertebral column. </li></ul>
  17. 21. Anterior View Posterior View
  18. 22. <ul><li>Consist 3 border; superior, lateral (axillary) and medial (vertebra) border. </li></ul><ul><li>Consist 3 angle; superior angle, inferior angle and lateral angle. </li></ul><ul><li>Consist 3 fossa; supraspinous and infraspinous fossa (posterior) and subscapular fossa (anterior). </li></ul>Scapula
  19. 23. <ul><li>Spine , runs diagonally across the posterior of the scapula separate supraspinous and infraspinous fossa. </li></ul><ul><li>The lateral end of spine projects as a flattened, expanded process called the acromion process . </li></ul>Scapula
  20. 24. <ul><li>Acromion process articulate with the acromial extremity of clavicle to form acromioclavicular joint . </li></ul><ul><li>Inferior to the acromion process is a shallow depression called glenoid cavity . </li></ul><ul><li>This cavity accepts the head of humerus to form glenohumeral joint . </li></ul>Scapula
  21. 25. <ul><li>Medial (vertebral) border – the thin edge of the bone near to the vertebral column. </li></ul><ul><li>Lateral (axillary border) – the thick edge closer to the arm. </li></ul><ul><li>Medial border join the lateral border at the inferior angle . </li></ul>Scapula
  22. 26. <ul><li>The superior edge of scapula , called superior border joins the vertebral border at the superior angle. </li></ul><ul><li>The scapular notch is a prominent indentation along the superior border through which the subscapular nerve passes. </li></ul>Scapula
  23. 27. <ul><li>At the lateral end of the superior border is projection of the anterior surface called coracoid process , which the tendons and muscle attach. </li></ul><ul><li>Superior and inferior to the spine are two fossae; supraspinous and i nfraspinous fossa , surfaces of attachment of muscles and tendons. </li></ul><ul><li>On the anterior surface is a slightly hollowed out area called subscapular fossa . </li></ul>Scapula
  24. 28. Movements of the Scapula
  25. 29. Movements of the Scapula
  26. 30. Elevation of Scapula Superior movement of the shoulder girdle; moving the scapula up.
  27. 31. Depression of Scapula Inferior movement of the shoulder girdle; moving the scapula down.
  28. 32. Movements of the Scapula
  29. 33. Upward Rotation of Scapula Rotary movement of the scapula; moving inferior angle of scapula laterally and upward
  30. 34. Downward Rotation of Scapula Rotary movement of the scapula; moving inferior angle of scapula medially and downward.
  31. 35. Movements of the Scapula
  32. 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.
  33. 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.
  34. 38. Movement of the Scapula as a Whole <ul><li>Movement of the pec girdle serve to increase the range of movement (ROM) of the shoulder jt. </li></ul><ul><li>Remember!!! – movements of the pectoral girdle accompany virtually to all movements of the shoulder joint. </li></ul>
  35. 39. Pairing of Pec Girdle and Shoulder Jt Movements Abduction (protraction) Horizontal adduction Adduction (retraction) Horizontal abduction Adduction (retraction) External rotation Abduction (protraction) Internal rotation Depression / downward rotation Extension Elevation / upward rotation Flexion Downward rotation Adduction Upward rotation Abduction Shoulder Girdle Shoulder Jt
  36. 40. Orientation Muscles of the Pectoral Girdle <ul><li>Muscles of the thorax that move the pectoral girdle </li></ul><ul><ul><li>Anterior thoracic muscles </li></ul></ul><ul><ul><li>Posterior thoracic muscles </li></ul></ul><ul><li>Muscles of the thorax that move the humerus. </li></ul><ul><ul><li>Axial muscles that move the humerus </li></ul></ul><ul><ul><li>Scapular muscles that move the humerus. </li></ul></ul>
  37. 41. Muscles of the Thorax Move the Pectoral Girdle <ul><li>Anterior thoracic muscles </li></ul><ul><li>Subclavius </li></ul><ul><li>Pectoralis minor </li></ul><ul><li>Serratus anterior </li></ul><ul><li>Posterior thoracic muscles </li></ul><ul><li>Fiber of trapezius </li></ul><ul><li>Levator scapulae </li></ul><ul><li>Rhomboid minor </li></ul><ul><li>Rhomboid major </li></ul>
  38. 42. Muscles of the Thorax that Move the Humerus <ul><li>Axial muscles </li></ul><ul><li>Pectoralis major </li></ul><ul><li>Latissumus dorsi </li></ul><ul><li>Scapular muscles </li></ul><ul><li>Fiber of deltoid </li></ul><ul><li>Rotator cuff </li></ul><ul><li>Teres major </li></ul><ul><li>Coracobrachalis </li></ul><ul><li>Long & short head of biceps </li></ul><ul><li>Long head of triceps </li></ul>
  39. 43. ORIGIN, INSERTION, ACTIONS AND NERVE SUPPLY
  40. 44. Subclavius Muscle <ul><li>Origin – 1 st rib </li></ul><ul><li>Insertion – lower surface of clavicle </li></ul><ul><li>Action </li></ul><ul><ul><li>Depression and move clavicle anteriorly </li></ul></ul><ul><ul><li>Helps stabilize pectoral girdle </li></ul></ul><ul><li>Nerve supply </li></ul><ul><ul><li>Subclavian nerve </li></ul></ul>Subclavius
  41. 45. Pectoralis Minor <ul><li>Origin </li></ul><ul><ul><li>2 nd - 5 th ribs, 3 rd – 5 th ribs or 2 nd – 4 th ribs. </li></ul></ul><ul><li>Insertion </li></ul><ul><ul><li>Coracoid process of scapula </li></ul></ul><ul><li>Action </li></ul><ul><ul><li>Abduction scapula and rotates it downward </li></ul></ul><ul><ul><li>Elevate the ribs during forced inhalation. </li></ul></ul><ul><li>Nerve supply </li></ul><ul><ul><li>Medial pectoral nerve </li></ul></ul>
  42. 46. Pectoralis Minor
  43. 47. Serratus Anterior <ul><li>Origin – Superior 8 or 9 ribs </li></ul><ul><li>Insertion – vertebral border and inferior angle of scapula </li></ul><ul><li>Action </li></ul><ul><ul><li>Abduction and rotates the scapula upward </li></ul></ul><ul><ul><li>Elevate ribs when scapula stabilized. </li></ul></ul><ul><ul><li>Also known as “boxer’s muscles” </li></ul></ul><ul><li>Nerve supply </li></ul><ul><ul><li>Long thoracic nerve </li></ul></ul>
  44. 48. Fiber of Trapezius <ul><li>Consists 3 fibers </li></ul><ul><li>Superior or upper fiber, middle fiber and inferior or lower fiber. </li></ul><ul><li>Important for move the scapula. </li></ul><ul><li>Nerve supply - accessory nerve and cervical spinal nerve . </li></ul>
  45. 49. Upper / Superior Fiber of Trapezius <ul><li>Origin – medial one third of the superior nuchal line, external occipital protuberance and ligamentum nuchae. </li></ul><ul><li>Insertion – posterior border of the lateral one third of the clavicle. </li></ul><ul><li>Action – scapular elevation </li></ul>
  46. 50. Middle Fiber of Trapezius <ul><li>Origin – spinous process of T1 – T5 </li></ul><ul><li>Insertion – medial border of the acromion process of scapula, and superior border of the spine of the scapula. </li></ul><ul><li>Action – scapular adduction . </li></ul>
  47. 51. Lower / Inferior Fiber of Trapezius <ul><li>Origin – spinous process of T6-T12 </li></ul><ul><li>Insertion – spine of the scapula </li></ul><ul><li>Action scapular depression and adduction </li></ul>
  48. 53. Levator Scapulae <ul><li>Origin – transverse process of Superior four or five cervical vertebrae. </li></ul><ul><li>Insertion – superior vertebral border of scapula </li></ul><ul><li>Action – Elevates scapula and rotates it downward. </li></ul><ul><li>Nerve supply – dorsal scapular nerve and cervical spinal nerve </li></ul>
  49. 54. Rhomboid Major <ul><li>Origin – Spine of 2 nd to 5 th thoracic vertebrae </li></ul><ul><li>Insertion – vertebral border of scapula inferior to spine of scapula </li></ul><ul><li>Action – elevates and adducts scapula and rotate it downward; stabilize scapula </li></ul><ul><li>Nerve – dorsal scapular nerve </li></ul>
  50. 55. Rhomboid Minor <ul><li>Origin – Spine of 7 th cervical and 1 st thoracic vertebrae. </li></ul><ul><li>Insertion – Vertebrae border of scapula superior to spine </li></ul><ul><li>Action – elevates and adducts scapula and rotate it downward; stabilize scapula </li></ul><ul><li>Nerve – dorsal scapular nerve </li></ul>
  51. 56. Clavicle origin of Pectoralis Major <ul><li>Origin – medial half of anterior clavicle </li></ul><ul><li>Insertion – greater tubercle and intertubercular sulcus of humerus </li></ul><ul><li>Action – Flexion, adduction and medial rotation arm at shoulder joint. </li></ul><ul><li>Nerve supply </li></ul><ul><ul><li>Medial and lateral pectoral nerve </li></ul></ul>
  52. 57. Sternal origin of Pectoralis Major <ul><li>Origin – anterior surface of sternum, costal cartilage of 2 nd -6 th ribs. </li></ul><ul><li>Insertion – greater tubercle and intertubercular sulcus of humerus </li></ul><ul><li>Action – extend arm at shoulder joint. </li></ul><ul><li>Nerve supply </li></ul><ul><ul><li>Medial and lateral pectoral nerve </li></ul></ul>
  53. 58. Latissimus Dorsi <ul><li>Origin – Spines of inferior 6 thoracic vertebrae (T6-T12), lumbar vertebrae (L1-L5), crest of sacrum and illiac crest of hip bone and inferior four ribs. </li></ul><ul><li>Insertion – Intertubecular sulcus of humerus </li></ul><ul><li>Action </li></ul><ul><ul><li>Extends, adduction and medial rotation arm at shoulder joint. </li></ul></ul><ul><li>Nerve supply - Thoracodorsal nerve </li></ul>
  54. 59. Latissimus Dorsi
  55. 60. Fiber of Deltoid <ul><li>Consists 3 fibers </li></ul><ul><li>Anterior, middle and posterior fibers. </li></ul><ul><li>Responsible for movements of the humerus at GH joint </li></ul><ul><li>Nerve supply – axillary nerve. </li></ul>
  56. 61. Anterior Fiber of Deltoid <ul><li>Origin – anterior border of the lateral one third of the clavicle </li></ul><ul><li>Insertion – deltoid tuberosity </li></ul><ul><li>Action – flexion and middle rotation arm at GH joint. </li></ul>
  57. 62. Middle fiber of Deltoid <ul><li>Origin – lateral border and superior surface of the acromion process of the scapula </li></ul><ul><li>Insertion – deltoid tuberosity </li></ul><ul><li>Action – abduction arm at GH joint </li></ul>
  58. 63. Posterior Fiber of Deltoid <ul><li>Origin – inferior lip of the crest of the spine of the scapula </li></ul><ul><li>Insertion – deltoid tuberosity </li></ul><ul><li>Action – extension and lateral rotation arm at GH joint. </li></ul>
  59. 64. Rotator Cuff Muscles <ul><li>Consists 4 muscles </li></ul><ul><li>S – Supraspinatus </li></ul><ul><li>I – Infraspinatus </li></ul><ul><li>T – teres minor </li></ul><ul><li>S – Subscapularis </li></ul><ul><li>Group of muscles that stabilize GH joint . </li></ul>
  60. 66. Supraspinatus Muscle <ul><li>Origin – supraspinous fossa of scapula </li></ul><ul><li>Insertion – Greater tubercle of humerus (anterior aspect) </li></ul><ul><li>Action – initially abduction (15 degrees) at shoulder joint, stabilizing shoulder joint </li></ul><ul><li>Nerve supply - Suprascapular nerve </li></ul>
  61. 67. Infraspinatus Muscle <ul><li>Origin – Infraspinous fossa of scapula </li></ul><ul><li>Insertion – Greater tubercle of humerus (posterior aspect) </li></ul><ul><li>Action – Laterally rotation and adduction arm at shoulder joint </li></ul><ul><li>Nerve supply - Suprascapular nerve </li></ul>
  62. 68. Teres Minor <ul><li>Origin – Inferior lateral border of scapula </li></ul><ul><li>Insertion – Greater tubercle of humerus (inferior aspect) </li></ul><ul><li>Action – Laterally rotation, extends and adduction arm at shoulder joint </li></ul><ul><li>Nerve supply – axillary nerve </li></ul>
  63. 69. Subscapularis Muscle <ul><li>Origin – subscapular fossa of scapula </li></ul><ul><li>Insertion – lesser tubercle of humerus </li></ul><ul><li>Action – Medial rotation arm at shoulder joint </li></ul><ul><li>Nerve supply – upper and lower subscapular nerve </li></ul>
  64. 70. Teres Major <ul><li>Origin – Inferior angle of scapula </li></ul><ul><li>Insertion – Intertubecular sulcus of humerus </li></ul><ul><li>Action </li></ul><ul><ul><li>Extends arm at shoulder joint </li></ul></ul><ul><ul><li>Assist in adduction and medial rotation of arm at shoulder joint. </li></ul></ul><ul><li>Nerve supply </li></ul><ul><ul><li>Lower subscapular nerve </li></ul></ul>
  65. 71. Coracobrachialis <ul><li>Origin - Coracoid process of scapula </li></ul><ul><li>Insertion - Middle of medial surface of shaft of humerus. </li></ul><ul><li>Action - Flexion and adduction arm at shoulder joint. </li></ul><ul><li>Nerve supply - Musculocutaneous nerve </li></ul>
  66. 72. Biceps Brachii <ul><li>Consists 2 head </li></ul><ul><li>Long head and short head of biceps </li></ul>
  67. 73. Short head of Biceps <ul><li>Origin – Coracoid process of scapula </li></ul><ul><li>Insertion – radial tuberosity of radius </li></ul><ul><li>Action – Flexion forearm at elbow joint, flexion arm at GH joint and supination at radioulnar joint. </li></ul><ul><li>Nerve supply - Musculocutaneous nerve </li></ul>
  68. 74. Long head of Biceps <ul><li>Origin – Tubercle above the glenoid cavity of scapula (supraglenoid tubercle) </li></ul><ul><li>Insertion – Radial tuberosity of radius </li></ul><ul><li>Action – flexion forearm at elbow joint, flexion arm at GH joint and supination forearm at radioulnar joint. </li></ul><ul><li>Nerve supply - Musculocutaneous nerve </li></ul>
  69. 75. Long head of Triceps <ul><li>Origin – tubercle below to glenoid cavity of scapula (infraglenoid tubercle) </li></ul><ul><li>Insertion – Olecranon of ulna </li></ul><ul><li>Action - Extends forearm at elbow joint , Extends arm at shoulder joint </li></ul><ul><li>Nerve supply - Radial nerve </li></ul>Posterior View
  70. 76. Sternomastoid / Cleidomastoid <ul><li>Join together to form sternocleidomastoid muscle </li></ul><ul><li>Origin </li></ul><ul><li>(i) Sternomastoid - upper part of the anterior surface of the manubrium of sternum. </li></ul><ul><li>(ii) Cleidomastoid - superior border and anterior surface of the medial third of the clavicle. </li></ul>
  71. 77. <ul><li>Insertion – Mastoid process of the mastoid portion of temporal bone. </li></ul><ul><li>Action - Acting together, flexes the neck, raises the sternum and assists in forced inspiration. </li></ul><ul><li>Nerve supply – accessory nerve (cranial nerve XI) </li></ul>Sternomastoid / Cleidomastoid
  72. 81. Joints on Pectoral Girdle <ul><li>There is two type of joint: </li></ul><ul><li>Sternoclavicular joint </li></ul><ul><li>Acromioclavicular joint </li></ul>
  73. 83. Sternoclavicular Joint <ul><li>Articular components </li></ul><ul><ul><li>Between sternal end of clavicle and clavicular notch of manubrium of sternum. </li></ul></ul><ul><li>Classification </li></ul><ul><ul><li>Synovial joint (planar) </li></ul></ul><ul><li>Movements </li></ul><ul><ul><li>Gliding, with limited movements in nearly every direction.(backward, upward, forward, downward, circumduction) </li></ul></ul>
  74. 86. Cont… <ul><li>Sternoclavicular joint strengthen by series of ligaments: </li></ul><ul><li>The Articular Capsule </li></ul><ul><li>The Anterior Sternoclavicular </li></ul><ul><li>The Posterior Sternoclavicular </li></ul><ul><li>The Interclavicular </li></ul><ul><li>The Costoclavicular </li></ul>
  75. 87. Sternoclavicular Ligaments
  76. 88. Articular Capsule <ul><li>The articular capsule surrounds the articulation and varies in thickness and strength. </li></ul><ul><li>In front and behind it is of considerable thickness, and forms the anterior and posterior sternoclavicular ligaments; but above, and especially below, it is thin and partakes more of the character of areolar than of true fibrous tissue. </li></ul>
  77. 89. Anterior Sternoclavicular Ligament <ul><li>The anterior sternoclavicular ligament is a broad band of fibers </li></ul><ul><li>Covering the anterior surface of the articulation </li></ul><ul><li>attached above to the upper and front part of the sternal end of the clavicle, and, passing obliquely downward and medialward, is attached below to the front of the upper part of the manubrium sternum. </li></ul>
  78. 90. Posterior Sternoclavicular Ligament <ul><li>The posterior sternoclavicular ligament is a similar band of fibers, covering the posterior surface of the articulation </li></ul><ul><li>attached above to the upper and back part of the sternal end of the clavicle, and, passing obliquely downward and medialward, is fixed below to the back of the upper part of the manubrium of sternum. </li></ul>
  79. 91. Interclavicular Ligament <ul><li>This ligament is a flattened band, which varies considerably in form and size in different individuals, </li></ul><ul><li>it passes in a curved direction from the upper part of the sternal end of one clavicle to that of the other, and is also attached to the upper margin of the sternum. </li></ul>
  80. 92. Costoclavicular Ligaments <ul><li>This ligament is short, flat, strong, and rhomboid in form. </li></ul><ul><li>Attached below to the upper and medial part of the cartilage of the first rib, it ascends obliquely backward and lateralward, and is fixed above to the costal tuberosity on the under surface of the clavicle. </li></ul>
  81. 93. Acromioclavicular Joint <ul><li>Articular components </li></ul><ul><ul><li>Between acromion process of scapula and acromial end of clavicle. </li></ul></ul><ul><li>Classification </li></ul><ul><ul><li>Synovial joint (planar) </li></ul></ul><ul><li>Movements </li></ul><ul><ul><li>Gliding and rotation of scapula on clavicle. </li></ul></ul><ul><ul><li>Rotation of scapula forward and backward upon clavicle. </li></ul></ul>
  82. 95. <ul><li>Acromioclavicular joint strengthened by series of ligaments: </li></ul><ul><ul><li>Acromioclavicular ligaments </li></ul></ul><ul><ul><li>Coracoclavicular ligaments </li></ul></ul><ul><ul><li>Coracoacromial ligaments. </li></ul></ul>Acromioclavicular Joint
  83. 96. Acromioclavicular Joint <ul><li>Coracoaromial ligament </li></ul><ul><ul><li>Controls anterior and posterior translation of the lateral clavicle </li></ul></ul><ul><li>Coracoclavicular ligament </li></ul><ul><ul><li>Control vertical stability; restrains superior and anterior displacements. </li></ul></ul><ul><li>Acromioclavicular ligament </li></ul><ul><ul><li>Provides stability across the joint; restrains posterior translation and displacement of the clavicle . </li></ul></ul>
  84. 98. Acromioclavicular Ligaments <ul><li>The AC ligaments surround and support the AC joint. </li></ul><ul><li>Together, they form the joint capsule. </li></ul><ul><li>The joint capsule is a watertight sac that encloses the joint and the fluids that bathe the joint. </li></ul>
  85. 100. Coracoclavicular Ligaments <ul><li>The coracoclavicular ligaments, hold the clavicle down by attaching it to a bony knob on the scapula called the coracoid process. </li></ul>
  86. 101. Clinical Condition <ul><li>Clavicle fracture </li></ul><ul><li>Frozen shoulder </li></ul><ul><li>AC joint injury </li></ul><ul><li>Shoulder dislocation </li></ul>
  87. 102. Clavicle Fracture <ul><li>This bone is usually fracture as a result of falling badly onto an outstretched arm or onto the shoulder. </li></ul><ul><li>The bone usually fractures in it's middle third and is very painful. </li></ul><ul><li>Athletes (physical impact), newborn, baby </li></ul>
  88. 103. Frozen Shoulder (Adhesive Capsulitis) <ul><li>This is a condition which affects the ability to move the shoulder, and usually only occurs on one side. </li></ul><ul><li>Sticky and inflammation of the shoulder joint. </li></ul><ul><li>Inflammation of the joint capsule – restricting movement of the head of humerus . </li></ul>
  89. 104. AC Joint Injury <ul><li>Separation of the two bones forming this joint is caused by damage to the ligaments connecting them. </li></ul><ul><li>The most common way of injuring the AC joint is by landing on the shoulder, elbow, or onto an outstretched hand. </li></ul>
  90. 105. Shoulder Dislocation <ul><li>In most cases, the head of the humerus is forced forwards when the arm is turned outwards (externally rotated) and held out to the side (abducted). </li></ul><ul><li>This causes an anterior dislocation, which make up approximately 95% of all shoulder dislocations. </li></ul>
  91. 106. Shoulder Dislocation
  92. 107. Thank You!!!!
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