1. Scapular Region
Dr. Sama-ul-Haque
Dr. Rania Jabr

2. Scapular Region
artmiller.medicalillustration.com

3. Objectives
Know the principal muscles of the scapular and scapulo-humeral regions.
Understand the mechanism of scapular rotation in relation with shoulder movements.

4. Bones of the shoulder region: The SCAPULA

5. Anterior acromion anatomical neck coracoid process Lesser tubercule
glenoid cavity
surgical neck
anatomical neck
Greater tubercule
Lesser tubercule
bicipital groove

6. Posterior Acromioclavicular joint Supraspinous Fossa anatomical neck
Infraspinous Fossa
Radial Groove
Deltoid Tuberosity
surgical neck
anatomical neck
Acromioclavicular joint
Spine

7. Muscles of The Shoulder Region
Posterior view
These muscles connect scapula to humerus (move humerus through shoulder joint).
Deltoid.
Supraspinatus.
Infraspinatus.
Teres minor.
Teres major.
Subscapularis. 2 1 3 4 5
Anterior view 6

8. Surface Anatomy Spine Acromion (of scapula Trapezius muscle
Infraspinatus
muscle
Triangle of
ascultation
Teres major
muscle
Teres minor
muscle

9. Deltoid Action: Nerve supply:
Lateral third of clavicle, acromion, spine of scapula
Deltoid tuberosity of humerus
Nerve supply:
Axillary nerve
Action:
Anterior fibers : Flexion, medial rotation
Middle fibers: abduct arm from 15°- 90°.
Posterior fibers : Extension, lateral rotation

10. D Abductors of shoulders: Supraspinatus 0-15 degree.
Deltoid degree.
Trapezius & serratus anterior: abduction degree.

11. 4 Rotator cuff muscles: stabilize the shoulder joint.
Supraspinatus, Infraspinatus,
Subscapularis, Teres minor
Subscapularis
Subscapularis
Anterior view
Supraspinatus
Infraspinatus
Superior view
Teres Minor
Posterior view

12. Rotator Cuff Muscles

13. Supraspinatus Infraspinatus: Origin: supraspinous fossa.
Insertion: greater tuberosity of humerus.
Nerve supply: suprascapular nerve.
Action: abduction of humerus from 0° - 15°.
Infraspinatus:
Origin: infraspinaous fossa.
Insertion: greater tuberosity of humerus.
Nerve supply: suprascapular nerve.
Action: lateral rotation of humerus.

14. Teres minor Teres major: Origin: lateral border of scapula
Insertion: greater tuberosity of humerus.
Nerve supply: axillary nerve.
Action: lateral rotation of humerus.
Teres major:
Origin: lateral border of scapula
Insertion: bicipital groove of humerus (med lip)
Nerve supply: lower subscapular nerve.
Actions: extension, adduction & medial rotation of humerus (swimming).

15. Subscapularis Origin: subscapular fossa.
Insertion: lesser tuberosity of humerus.
Nerve supply: upper & lower subscapular nerves.
Action: medial rotation of humerus.

16. Transverse scapular ligament
Attach to suprascapular notch
Subscapular nerve (C5,6) below it and Subscapular artery above it,

17. Serratus anterior Upper 8 ribs Nerve supply: Action:
Front of the medial border of scapula.
Upper 8 ribs
Nerve supply:
Long thoracic nerve.
Action:
Depression & protraction of the scapula (boxing)
Raising the arm above 90 degree (climbing).
Accessory muscle of respiration

18. Injury of long thoracic nerve
Subscapularis
en.wikipedia.org/wiki/Serratus_anterior_muscle
Injury of long thoracic nerve: Winged Scapula:
Cause; Paralysis of serratus anterior as it is
"big swing muscle" or "boxer's muscle”
Antagonist of Rhomboids

20. Complete abduction at the shoulder joint requires
superior rotation of the scapula so that the glenoid
fossa faces superiorly.
Glenoid fossa

21. Glenoid fossa: trapezius &
Superior rotation of
Glenoid fossa: trapezius &
serratus anterior
Scapula rotates when we move
our arms to allow more range of motion at the shoulder joint

22. Trapezius
Rhomboids
Deltoid
Teres Major
Latissimus
Dorsi

23. Posterior scapula