MSS

• 1) Illiiac crest, Lubar fascia, SP T2-T8, inferior angle of scapula and 3-4 inferior ribs
• 2) Medial to biciptial groove of humerus
• 3)Thorcodorsal n.
• 4) Thoracodorsal a.
• 5) extends, adducts and medially rotates arm

• 1) superior nuchal line, external occiptial protuberance, ligamentum nuchae, C7 and throracic vertebrae of lower segment
• 2) lateral clavicle, acromion and scapular spine
• 3) spinal accessory n. (CN XI)
• 4) transverse cervical a.
• 5) raises, retracts and rotates scapula

• 1) lower segment of lateral border of scapula
• 2) medial to bicipital groove of humerus
• 3) lower subscapular n. (C5, C6)
• 4)circumflex scapular a.
• 5)adducts and medially rotates arm

• 1) spines of T2-T5
• 2) medial border of scapula 
• 3) dorsal scapular (C4-5)
• 4)dorsal scapular a.
• 5)pulls scapula medially and raises medial border of scapula

• 1) C7 and T1
• 2) medial border of scapula
• 3)dorsal scapular n.
• 4) dorsal scapular a.
• 5)pulls scapula medially and raises medial border of scapula

• 1) transverse processes of C1-C4
• 2) Superomedial border of scapula
• 3) dorsal scapular n. C4, C5
• 4) dorsal scapular a.
• 5) raises scapula at medial border

• 1) Ribs 1-8
• 2) inferior angle and medial border of scapula
• 3) long thorasic n.
• 4) lateral thorasic a.
• 5) rotates scapula and pulls scapula around thoracic cage

• Rhomboid major
• rhomboid Minor
• Levator scapula

• latissimus dorsi
• teres major
• subscapularis
• deltoid

• Levator scapulae
• Rhomboid Major
• Rhomboid Minor

It is superficial to serratus anterior m.

i.e. Knife fights, mastectomy,

• Winged scapula (push hands against wall) 
• causes scapula to be away from thoracic wall
• upper limb may not be able to ABD above 90 degrees

No sensory loss noted

medial border of scapula, latismus dorsi and medially by trapezius m.

• Good area to listen to posterior segments of lungs.
• 6/7 intercostal space

expose by crossing arms over chest

border: external oblique m. latissimus dorsi and inliac crest

Herniations

C6, C7, C8

C4 and C5

C6 and C7

*sometimes C5

• 1) lateral clavicle
• 2) deltoid tuberosity and lateral shaft of humerus
• 3) axillary n.
• 4) posterior circumflex humeral a.
• 5) ABducts arm, with help of supraspinatus muscle; flex and medially rotates arm; extend and lateral rotates arm

• 1) subscapular fossa
• 2) lesser tubercle of humerus and adjacent capsul of shoulder joint
• 3) upper and lower subscapular n. (C5, C6)
• 4) subscapular a.
• 5) medially rotates arm, helps to stabilize shoulder joint

• 1) supraspinous fossa
• 2) greater tubercle and adjacent capsule of shoulder joint
• 3) suprascapular n. (C5, C6)
• 4) subscapular a.
• 5) ABducts arm at shoulder first 15 degrees then assists deltoid muscle and stabilizes shoulder joint

• 1) infraspinous fossa
• 2) greater tubercle of humerus and adjacent capsul of shoulder joint
• 3) suprascapular n. (C5, C6)
• 4) subscapular a. and Circumflex scapular a.
• 5) laterally rotates arm and stabilizes shoulder joint

• 1) superior part of lateral scapula
• 2) greater tubercle and adjacent capsul of shoulder joint
• 3) axillary n.
• 4) circumflex scapular a.
• 5) laterally rotates arm and stabilizes shoulder joint

C5, C6

All.

Deltoid, subscapularis, supraspinatus, infraspinatus, teres minor

Subscapularis

Supraspinatus

Infraspinatus

infraspinatus and teres minor

4, SITS

• Supraspinatus
• Infraspinatus
• Teres Minor
• Subscapularis

C5

• protects glenohumeral joint
• Gives joint stability
• Holds head of humerus in glenoid fossa during movements

collateral circulation is important if slow occulsion of the subclavian or proximal axillary aa. becomes necessory

allows good collateral circulation to develop

does not allow sufficient time for collateral circulation.  Surgical ligation of the axillary a. between subscapular a. and profunda brachii a. will cut off blood supply to arm

• Dorsal scapular a.
• Suprascapular a.
• Circumflex scapular a.
• Intercostal aa.

Bordered by Teres minor m. Teres Major m. Long head off triceps, humerus

has axillary n. Posterior circumflex humeral a.

Border: Teres major m., lateral and long heads of triceps

Contains: Profunda brachii a., radial n.

Border: Teres minor m., Teres major m., Long head of triceps

Contains: Circumflex scapular a.

Circumflex scapular a.

Infraspinatus and Teres minor

border: Obliquus capitis inferior and superior, rectus capitis major

Occipital a., greater and lesser occiptial nn., Suboccipital n., Transverse process of C1, spinous process of C2

Thyrocervical trunk, but highly variable

from third part of axillary a.

encircles head of humerus, helps with anastomoses

supplies deltoid,

encircles humerus

traverses quadrangular space with axillary n.

Supplies deltoid

• causes Deltoird m. to atrophy
• shoulder flattens compared to uninjured side, produces hollow inferior to acromion
• causes loss of sensation over lateral proximal arm
• ABduction of humerus from 15-90 degrees would be affected

Deltoid

• continual use of limb
• instability of glenohumeral joint
• Supraspinatus most commonly injured

Avascular, prone to wear, inability to initiate first 15 degrees of ABduction

Supraspinatus

Intercostal n. 4-6

medial mammary which comes from perforating branch, anterior intercostal a. and internal thoracic

Lateral mammary from the thorcodorsal a.

Posterior intercostal from the aorta

clavicle, sternum, 1-6 costal cartilages

Lateral lip of the intertubercule groove

ADduction and rotates medially of the humerus

medial pectoral nerve (C8,T1)

3-5 ribs near costal cartilages

coracoid process of scapula

Medial pectoral nerve

Lateral/medial pectoral nerve innervates the pectoralis major

Protacts and stabilizes scapula

first costal cartilage


Inferior surface of the clavical

superior trunk of brachial plexus (C5, C6)

Subsclavius

Ribs 1-8

Protracts and rotates scapula

Deltopectoral Triangle

• Deltoid branch of thoracoacromial trunk
• Cephalic Vein

Trapezium Trapezoid, Capitate (largest) Hamate (IV and V) Pisiform, Triquetrum, Lunate (Ulna), Scaphoid (radius)

Medial epicondyle of the humerus

• (Pass; Fail;Pass; Fail;Fail)
• Pronator teres
• Flexor carpi radialis
• Plamaris longus
• Flexor carpi ulnaris
• Flexor digitorum superficiallis

brachioradialis and Extensor carpi radialis longus, externsor carpi radialis brevis

Median and Ulnar Nerve

• Protonator Teres
• Flexor carpi radialus
• Palmaris Longus
• flexor carpi ulnaris
• Flexor digitorum superficialis

Flexor digitorum superficialais and Flexor carpi ulnaris

Flexor pollicis longus

pronator quadrates

Flexor digitorum profundus

lateral epicondyle of humerus

Radial n.

Anconeus, Brachioradialis, Extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris, extensor digitorum, extensor digiti minimi Abductor pollicis longus and extensor pollicis brevis

Extensor carpi radialis longus

second layer

Radial

extensor indicis

3; flexor pollicis brevis, ABductor pollics brevis, opponens pollicis