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Trapezius
- Proximal Attachment: Upper: skull and nuchal ligament; middle: upper thoracic SPs; lower: lower thoracic SPs
- Distal Attachment: Upper: lateral third of clavicle; middle: acromion process of scapula; lower: spine of scapula
- Innervation: Spinal accessory n. (CN XI) – motor; C3, C4 – sensory
- Main Actions: Upper: elevates clavicle and scapula, upward rotation of scapula; middle: retracts scapula; lower: depresse scapula, upward rotation of scapula
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Rhomboid Major
- Proximal Attachment: SP T2–T5
- Distal Attachment: medial border of scapula from level of spine to inferior angle
- Innervation: Dorsal scapular n. (C4, C5)
- Main Actions: retract and downwardly rotate scapula; fixes scapula against thoracic wall
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Rhomboid Minor
- Proximal Attachment: nuchal ligament; SPs C7–T1
- Distal Attahcment: Scapula above root of spine (smooth triangular area at medial end of scapular spine)
- Innervation: Dorsal scapular n. (C4, C5)
- Main Actions: Retract and downwardly rotate scapula; fixes scapula against thoracic wall
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Latissimus Dorsi
- Proximal Attachment: SPs on inferior 6 thoracic vertebrae, thoracolumbar fascia, iliac crest, inferior 3 to 4 ribs
- Distal Attachment: Floor of intertubercular groove of humerus
- Innervation: Thoracodorsal n. (C6–C8)
- Main Actions: Extends, ADducts, and internally rotates humerus
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Levator Scapulae
- Proximal Attachment: Posterior tubercles of TPs of C1–C4
- Distal Attachment: Medial border of scapula superior to root of scapular spine: superior angle of scapula
- Innervation: Dorsal scapular (C4–C5)
- Main Actions: Elevates and downwardly rotates scapula
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Rotator Cuff Muscles
- Supraspinatus
- Infraspinatus
- Subscapularis
- Teres Minor
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Supraspinatus
- Proximal Attachment: Supraspinous fossa of scapula
- Distal Attachment: Superior facet of greater tubercle of humerus
- Innervation: Suprascapular n. (C5–C6)
- Main Actions: ABduction of humerus during first 15 degrees; stabilises glenohumeral joint
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Infraspinatus
- Proximal Attachment: Infraspinous fossa of scapula
- Distal Attachment: Middle facet of greater tubercle of humerus
- Innervation: Suprascapular n. (C5–C6)
- Main Actions: Externally rotates humerus; stabilises glenohumeral joint
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Subscapularis
- Prosximal Attachment: Subscapular fossa
- Distal Attachment: Lesser tubercle of humerus
- Innervation: Upper and lower subscapular nerves (C5–C7)
- Main Actions: Interally rotates humerus; stabilises glenohumeral joint; weak ADduction of humerus
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Teres Minor
- Proximal Attachment: Middle part of lateral border of scapula
- Distal Attachment: Inferior facet of greater tubercle of humerus
- Innervation: Axillary n. (C5, C6)
- Main Actions: Externally rotates humerus; stabilises glenohumeral joint
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Teres Major
- Proximal Attachment: Posterior surface of inferior angle of scapula
- Distal Attachment: Medial lip of intertubercular groove of humerus
- Innervation: Lower subscapular n. (C5–C6)
- Main Actions: ADducts and medially rotates humerus; assists with extension of humerus. Independent of arm position
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Serratus Anterior
- "boxer's muscle"
- Proximal Attachment: External surfaces of lateral parts of 1st–8th ribs
- Distal Attachment: Anterior surface of medial border of scapula
- Innervation: Long thoracic n. (C5–C7)
- Main Actions: Protracts scapula, fixes scapula against thoracic wall, upwardly rotates scapula
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Pectoralis Major
- Proximal Attachment: Clavicular head: anterior surface of medial half of clavicle; sternocostal head: anterior surface of sternum, superior six costal cartilages, aponeurosis of external oblique muscle
- Distal Attachment: Lateral lip of intertubercular groove of humerus
- Innervation: Lateral and medial pectoral nerves: clavicular head (lateral: C5–C6); sternocostal head (medial: C7–T1)
- Main Actions: Horizontal ADduction, internal rotation, flexion (clavicular head), extension back to neutral (sternocostal head)
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Pectoralis Minor
- Proximal Attachment: 3rd–5th ribs near costal cartilages
- Distal Attachment: Coracoid process of scapula (medial border and superior surface)
- Innervation: Medial pectoral n. (C8–T1) (pierces)
- Main Actions: Depresses scapula, spabilises scapula against thoracic wall
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Deltoid
- Proximal Attachment: Anterior: lateral third of clavicle; middle: acromion; posterior: spine of scapula
- Distal Attachment: Deltoid tuberoity of humerus
- Innervation: Axillary n. (C5–C6)
- Main Actions: Anterior: flexes and internally rotates humerus, horizontally ADducts; middle: ABducts arm; posterior: extends and laterally rotates humerus, horizontally ABducts humerus
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Elevation of scapula
- Upper tapezius
- Levator scapulae
- Rhomboids
-
Depression of scapula
- Gravity
- Lower Trapezius
- Serratus Anterior (lower part)
- Pectoralis Minor
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Protraction of scapula
- Serratus Anterior
- (Pectoralis minor)
- (Pectoralis major)
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Retraction of scapula
- Middle Trapezius
- Lower Trapezius
- Rhomboids
-
Upward rotation of scapula
- Upper trapezius
- Lower trapezius
- Serratus anterior
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Downward Rotation of Scapula
- Gravity
- Levator scapulae
- Rhomboids
- Pectoralis minor
- (Latissimus dorsi)
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Pectoral Fascia
- superficial
- comes off clavicle and sternum
- is continuous with fascia over rectus abdominus and axillary fascia
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Clavopectoral/deltopectoral trianlge
- Between clavicle, deltoid, and pectoralis major
- Cephalic vein goes into triangle to drain into subclavian v.
- Where doctors will put a central line of pacemaker wires
-
Clavopectoral fascia
- Deep to pectoralis major, but superficial to pectoralis minor
- comes off clavicle
- is continuous into axilla - ligament keeps fascia pulled up and tight
-
Scapula
Sits between 2nd and 7th ribs
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Carpal Bones
- Scaphoid
- Lunate
- Triquetral/Triquetrum
- Pisiform
- Trapezium (um for the thumb)
- Trapezoid
- Capitate
- Hamate (Hook of Hamate)
- Sally Left The Party To Take Cathy Home
- or
- Some Lovers Try Positions That They Can't Handle (handle - hook of hamate)
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