The Upper Limb: Pectoral (Shoulder) Girdle

Upper Limb Divisions

1. Pectoral (Shouldar) Girdle incomplete bony ring formed by Scapula & Clavicle 2. Arm between shoulder & elbow contain the Humerus 3. Forearm between elbow & wrist contain Ulna & Radius 4. Hand contain carpals, metacarpals & phalanges

Bones of Pectoral Girdle

Clavicle: long bone Scapula: flat bone

Bone of The Arm

Humerus: long

Clavicle

S shaped bone (resilience)

medial 2/3 convex anteriorly , lateral 1/3 concave ant. Sternal end (rounded) manubrium & 1st rib Acromial end (flat) acromion

importance of the clavicle:

Connects upper limb to axial skeleton (strut) Protects neurovascular bundle that supply the upper limb Transmits shocks from upper limb to axial skeleton

Clinical: Fractures of Clavicle

Common indirect impact to upper limb Between middle & lateral thirds Medial part / lateral -Shoulder drop -Medial rotation of humerus

Scapula (shoulder blade)

Triangular flat bone 3 borders 3 angles 2 surfaces:

Anterior (costal) surface

2nd 7th ribs

Posterior (spinous) surface

Left Scapula (Posterior Aspect)

1.Coracoid Process
3. Superior border 4. Supraspinous Fossa 6. Scapular Spine

7.Medial border
8.Infraspinous Fossa 9.Inferior Angle 10.Lateral border 11.Glenoid Cavity Margin 12.Acromion Process

Humerus (brachial bone)

The arm bone Articulates with: Scapula (shoulder joint) Radius & Ulna (elbow joint)

Upper part 1. Head (1/3 of sphere)

2. Anatomical Neck
3. Lesser Tubercle 4. Intertubercular Groove 5. Greater Tubercle 6. Surgical Neck

7. Deltoid Tuberosity

Joints of Pectoral Girdle

3 Joints: Sterno-clavicular joint Acromio-clavicular joint

Gleno-humeral joint (Shouldar joint)

Joint Questions
1. What is the type of that joint? 2. What are the articular surfaces of that joint?

3. What are the supporting ligaments?

4. What kind of movement is available? 5. Any special characteristics of the joint?

Sterno-Clavicular Joint
Type: Synovial (saddle shaped, or double plane)

Surfaces: sternal end of clavicle

Manubrium & 1st costal cartilage

Movements:
ant., post., sup. & inf.

Characteristics: Articular disc

Shock absorber

GlenoHumeral (Shoulder) Joint

Type: Synovial (ball & socket)
Articulations: Head of humerus Glenoid cavity of scapule Ligaments:

1. Fibrous Capsule
2. Gleno-humeral lig.(3) 3. Coraco-humeral lig.

4. Transverse humeral lig.

Movements: Circumduction Includes?? Characteristics: The fibrous capsule is Weak inferiorly due to:

1. penetrated inferiorly by tendon of long head of triceps

2. Joint is surrounded (stabilized) by group of muscles called: Rotator Cuff muscles

*except inferiorly

Muscles of The Shoulder Region:

Thoraco-appendicular Muscles & Scapulo-humeral Muscles

Anterior Thoracoappend. Muscles

Pectoralis Major Pectoralis Minor Serratus Anterior Subclavius

Pectoralis Major
Fan shape muscle
Origin: Clavicular & sternocostal heads Insertion: Humerus

Innervation: Medial & Lateral pectoral nerves

Action: Adduction of humerus

Pectoralis Minor
triangular shaped muscle
Origin: 3rd, 4th & 5th ribs Insertion: Coracoid process

Innervation: Medial pectoral nerves

Action: Depress scapula, elevate ribs

Pectoralis Major & Minor

Serratus Anterior Muscle

Serrated border
Origin: Outer surfaces of upper 8 ribs

Insertion: Medial border of scapula

Innervation: Long thoracic n. Action: Pulls scapula forward along the ribs Keeps the scapula in contact to thoracic cage

Clinical: Winged Scapula

Medial border of scapula hangs away from thoracic wall
1. Damage to serratus anterior m. 2. Injury to long thoracic n.

During fights

Winged Scapula

Subclavius
Small muscle that extends: Middle 1/3 of clavicle 1st costal cartilage Innervation: Nerve to subclavius Action: Depresses the clavicle

Posterior Thoracoappendicular Muscles

Only names to be able to distinguish them in the lab Trapezius Latissimus dorsi m. Levator scapulae Rhomboid major Rhomboid minor

Scapulo-humeral Muscles
Read the table in your book for innervation, origin, insertion & main action Deltoid Teres Major Teres Minor Supraspinatus Infraspinatus subscapularis

Rotator Cuff Muscles

4 muscles that inserted around shoulder joint & form a musculotendinous cuff Cover the joint from 3 directions: Superior: supraspinatus Anterior: subscapularis Posterior: infraspinatus & teres minor Fxn. Stabilize shoulder joint

Anterior

Superior

Posterior