Upper Extremity Musculature

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Upper Extremity Musculature
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Shoulder Complex

• Scapula
• Clacivle
• Sternum
• Humerus
• Rib Cage
• Sternoclavicular Joint
• Acromioclavicular Joint
• Glenohumeral Joint
• Scapulothoracic Joint / Articulation

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Shoulder Girdle

• Motions available at the shoulder girdle are
  upward rotation, protraction, downward rotation,
  retraction, and scapular tilt (when the shoulder
  enters hyperextension)
• Scapulohumeral rhythm The first 30 degrees of
  shoulder joint motion is pure GH motion. After
  the initial 30 degrees, for every 2 degrees of
  shoulder flexion or abduction, the scapula must
  upwardly rotate 1 degree. This results in a 21
  ratio.

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Scapulothoracic Joint

• Articulation of scapula with thorax
• Not a true joint
• Muscles associated with ST Joint (shoulder
  girdle)
• Trapezius
• Rhomboid Major
• Rhomboid Minor
• Levator Scapulae
• Serratus Anterior
• Pectoralis Minor

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Trapezius
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Upper Trapezius

• Origin Occipital Bone, nuchal ligament on
  cervical spinous processes
• Insertion Lateral third of clavicle, acromion
  process
• Action Scapular elevation and upward rotation
• Innervation Spinal accessory (cranial nerve XI),
  C3-C4 sensory component

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Middle Trapezius

• Origin Spinous processes of C7 through T3
• Insertion Scapular spine
• Action Scapular retraction
• Innervation Spinal accessory ( cranial nerve XI),
  C3 and C4 sensory component

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Lower Trapezius

• Origin Spinous processes of middle and lower
  thoracic vertebrae
• Insertion Base of the scapular spine
• Action Scapular depression and upward rotation
• Innervation Spinal accessory ( cranial nerve
  XI), C3 and C4 sensory component

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Rhomboid Major Minor
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Rhomboids

• Origin Spinous processes of C7 through T5
• Insertion Medial border of scapula from level of
  spine to inferior angle
• Action Scapular retraction, elevation and
  downward rotation
• Innervation Dorsal scapular nerve (C5)

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Levator Scapulae
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Levator Scapulae

• Origin Transverse processes of C1 - C4 vertebrae
• Insertion Vertebral border of scapula between the
  superior angle and spine
• Action Scapular elevation and downward rotation
• Innervation Third and fourth cervical nerves and
  dorsal scapular nerve (C5)

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Serratus Anterior
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Serratus Anterior

• Origin Superolateral surfaces of upper 8 or 9
  ribs at the side of chest
• Insertion Vertebral border of scapula, anterior
  surface
• Action Scapular protraction and upward rotation
• Innervation Long thoracic nerve (C5, C6, C7)

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Pectoralis Minor
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Pectoralis Minor

• Origin 3rd to 5th ribs, anterior surface
• Insertion Coracoid process of the scapula
• Action Scapular depression, protraction, downward
  rotation, and tilt
• Innervation Medial pectoral nerve (C8, T1)