Anatomy and Functions of muscles and joints
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9. Fractures of Clavicle
Location
Medial two third and lateral one third
junction
Complications
Nerve entrapments supraclavicular nerve
Mostly need little treatment
10. Non Fracture Conditions of Clavicle
Compressions due to narrow space
Brachial plexus
Subclavian Artery and Vien
21. Axilla
• Pyramidal in shape
• Apex in neck
• Four walls
• Contains vessles, nerves and lymphatics
22. Walls of Axilla
• Anterior wall
• By the pectoralis major, subclavius, and pectoralis minor muscles
• Posterior wall
• By the subscapularis, latissimus dorsi, and teres major muscles
from above down
• Medial wall
• By the upper four or five ribs and the intercostal spaces covered by the
serratus anterior muscle
• Lateral wall
• By the coracobrachialis and biceps muscles in the bicipital groove of
the humerus
26. Pectoralis Minor Muscle
• Origin
• 3rd
4th
and 5th
ribs
• Insertion
• Coracoid process of scapula
• Nerve Supply
• Medial pectoral nerve from B.P C7
• Function
• Depress the shoulder / Elevate the ribs
31. Trapezius Muscle
• Origin
• Ligamentum nuchae of occipital bone, 7th
spine and all thoracic
vertebrae
• Insertion
• Lateral third of clavicle, acromion and spine of scapula
• Nerve Supply
• Spinal part of accesory nerver IX
• Function
• Upper fibers elevate scapula
• Middle fibers pull the scapula medially
• Lower fibers pull scapula downwards
33. Latismus Dorsi Muscle
• Origin
• Iliac crest, lumbar fascia, spines of lower six thoracic vertebrae,
lower three or four ribs, and inferior angle of scapula
• Insertion
• Floor of bicipital groove of humerus
• Nerve Supply
• Thoracodorsal nerve C7
• Function
• Extends, adducts, and medially rotates the arm
35. Rhomboid Major Muscle
• Origin
• 2nd
to 5th
thoracic spines
• Insertion
• Medial border of scapula
• Nerve Supply
• Dorsal scapular nerve
• Function
• Raises medial border of scapula upward and medially
36. Rhomboid Minor Muscle
• Origin
• Ligamentum nuchae and spines of seventh cervical
and first thoracic vertebrae
• Insertion
• Medial border of scapula
• Nerve Supply
• Dorsal scapular nerve
• Function
• Raises medial border of scapula upward and medially
38. Levator scapulae Muscle
• Origin
• Transverse processes of first four cervical vertebrae
• Insertion
• Medial border of scapula
• Nerve Supply
• dorsal scapular nerve
• Function
• Raises medial border of scapula
39. Deltoid Muscle
• Origin
• Lateral third of clavicle, acromion, spine of scapula (same as
insertion of trapezius)
• Insertion
• Middle of lateral surface of shaft of humerus
• Nerve Supply
• Axillary nerve C5
• Function
• Anterior fibers medially rotate and flex arm
• Posterior fibers extend and laterally rotate arm
• Middle fibers abducts the arm
41. Supraspinatus Muscle
• Origin
• Supraspinous fossa of scapula
• Insertion
• Greater tuberosity of humerus
• Nerve Supply
• Suprascapular nerve C5
• Function
• Abducts arm and stabilizes the shoulder
42. Infraspinatus Muscle
• Origin
• Infraspinous fossa of scapula
• Insertion
• Greater tuberosity of humerus
• Nerve Supply
• Suprascapular nerve C5
• Function
• Laterally rotates arm and stabilizes shoulder
43. Teres minor Muscle
• Origin
• Upper two thirds of lateral border of scapula
• Insertion
• Greater tuberosity of humerus
• Nerve Supply
• Axillary nerve
• Function
• Laterally rotates arm and stabilizes shoulder joint
45. Teres Major Muscle
• Origin
• Lower third of lateral border of scapula
• Insertion
• Medial lip of bicipital groove of humerus
• Nerve Supply
• Lower subscapular nerve C6
• Function
• Medially rotates and adducts arm and stabilizes
shoulder joint
51. First Part of the Axillary Artery
• This extends from the lateral border of the first rib to
the upper border of the pectoralis minor
• Relations
• Anteriorly: The pectoralis major and the skin. The
cephalic vein crosses the artery
• Posteriorly: The long thoracic nerve (nerve to the
serratus anterior)
• Laterally: The three cords of the brachial plexus
• Medially: The axillary vein
52. Second Part of the Axillary Artery
• This lies behind the pectoralis minor muscle
• Relations
• Anteriorly: The pectoralis minor, the pectoralis major,
and the skin
• Posteriorly: The posterior cord of the brachial plexus,
the subscapularis muscle, and the shoulder joint
• Laterally: The lateral cord of the brachial plexus
• Medially: The medial cord of the brachial plexus and the
axillary vein
53. Third Part of the Axillary Artery
• This extends from the lower border of the pectoralis minor to the
lower border of the teres major
• Relations
• Anteriorly: The pectoralis major for a short distance; lower down
the artery it is crossed by the medial root of the median nerve
• Posteriorly: The subscapularis, the latissimus dorsi, and the teres
major. The axillary and radial nerves also lie behind the artery
• Laterally: The coracobrachialis, the biceps, and the humerus. The
lateral root of the median and the musculocutaneous nerves
Medially: The ulnar nerve, the axillary vein, and the medial
cutaneous nerve of the arm
54.
55.
56. Quadrangular Space
• The quadrangular space is an intermuscular space,
located immediately below the shoulder joint.
• It is bounded above by the subscapularis and capsule of
the shoulder joint
• Below by the teres major muscle.
• Medially by the long head of the triceps
• Laterally by the surgical neck of the humerus.
• The axillary nerve and the posterior circumflex humeral
vessels pass backward through this space
57.
58. Triangular Space
• Teres minor above
• Teres major below
• Long head of tricepes laterally
• Circumflex scapular atery pass through it