Muscles Of The Shoulder Region. Learning Objectives: Shoulder Region It is the proximal part of upper limb. Surrounds the shoulder joint. Providing round counter at proximal end of upper extremity. Bony land marks are: spine of scapula, acrominon, Inferior angle of scapula. Muscles Of Shoulder Region Group of six muscles, converge from scapula on to the humerus and surround the shoulder joint, Includes: Deltoid. Supraspinatus. Infraspinatus. Teres Minor. Teres major. Subscapularis. Most of part of these muscles are under the cover of Deltoid and Trapezius. Deltoid: A powerful muscle. Has longer leaner origin. Has three groups of muscle fibers Anterior, Middle & Posterior. Tip: Principle abductor of the arm. But it cannot initiate this action. Assisted by the supraspinatus muscles. Deltoid Greek- delta triangular shaped Origin: Lateral 1/3 of clavicle, acromion process, scapular spine. Insertion: deltoid tuberosity at shaft of humerus. Nerve Supply: Axillary Nerve (C5-C6). Deltoid Tips: Deltoid consists of three groups of muscle fibers: Anterior Fibers: arising from clavicle, fibers are parallel. Posterior Fibers: arising from spine of scapula, parallel fibers. Middle fibers: arising from the acromion, multipennate, most powerful muscle fibers, having seven septa inside mass, make the muscle multipennate. Deltoid Actions: Anterior fibers: flexes and medially rotates shoulder. Middle fibers: Abducts the shoulder. Posterior fibers: extends and laterally rotates the shoulder. Tip: Anterior & Posterior fibers act like guy ropes to steady the arm in abducted position . Common site for Intramuscular Injection (IM) On lateral side of bulge of shoulder. Axillary nerve is under the cover of deltoid, It winds around the posteriolateral aspect of shaft of humerus below the 5-6 cm of acromion. If IM injection is given using wrong technique may produce damage to axillary nerve. Supraspinatus Latin- supra above spinatus spine Bipennate muscle. Provide great force pull to the muscle. Origin: Supraspinatus fossa of the scapula. Insertion: Greater tubercle of the humerus. Nerve Supply: Suprascapular nerve (C5-C6) Supraspinatus Action: Initiate the abduction at shoulder joint for first 15 degree. Assists deltoid muscle in abducting arm at shoulder. Stabilizes the head of the humerus. Tip: The supraspinatus is the only muscle in the rotator cuff groups that does not actually rotate the humerus Infraspinatus Latin- infra beneath spinatus spine Multipennate muscle. A bursa lies between the muscle and scapula, This bursa usually communicates with cavity of shoulder joint. Origin: Infrsapsinatus fossa of the scapula. Insertion: Greater tubercle of the humerus. Infraspinatus Nerve Supply: Suprascapular nerve from the brachial plexus (C5-C6). Action: Lateral rotation of the shoulder, and stabilizes the head of the humerus. Teres Minor Latin- teres round Origin: superior half of the lateral border. Insertion: Greater tubercle of the humerus. Nerve Supply: axillary nerve (C5 C6). Actions: Weak adductor of humerus, Laterally rotates the shoulder and Stabilizes the head of humerus on glenoid. Teres Minor Tip: It is synergist to Infraspinatus. Teres minor may sometimes fuse with infraspinatus. Teres Major Latin- teres round An offspring of subscapularis. It has migrated to the dorsal surface of Scapula. Origin: Inferior part of lateral border and inferior angle of the scapula. Insertion: medial lip intertubercular groove of the humerus. Teres Major Nerve Supply: lower subscapular nerve (C5 C6). Action: It extends the shoulder, medially rotates the shoulder, Adducts the shoulder. Tip: Its tendon can be transplanted posteriorly to provide lateral rotation.