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【创伤骨科解剖系列】肩胛骨周围肌肉  

2017-02-05 22:34:42|  分类: 创伤骨科解剖 |  标签: |举报 |字号 订阅

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一、肩胛骨是怎么与胸壁连接的?
第一组1.Serratus Anterior
ORIGIN:   Superior: the 1st and 2nd ribs; Intermediate: the 2nd and 3rd ribs; Inferior: the 4th and 9th ribs. 
INSERTION:   Medial margin of the costal surface of the scapula. 
ACTION:   Superior external rotation of the scapula; draws the scapula internally and forwards; Lowers the arm from a raised position; Elevation of the ribs. 
NERVE SUPPLY:   Long thoracic nerve and the brachial plexus (C5-C7). 
ARTERIAL SUPPLY:   Lateral thoracic artery.
【创伤骨科解剖系列】肩胛骨周围肌肉 - 骨科小将 - 骨科小将

Clinical app

“Winging” of the scapula

Because the long thoracic nerve passes down the lateral thoracic wall on the external surface of the serratus anterior muscle, just deep to skin and subcutaneous fascia, it is vulnerable to damage (seeFig. 7.31C). Loss of function of this muscle causes the medial border, and particularly the inferior angle, of the scapula to elevate away from the thoracic wall, resulting in characteristic “winging” of the scapula, on pushing forward with the arm. Furthermore, normal elevation of the arm is no longer possible.

【创伤骨科解剖系列】肩胛骨周围肌肉 - 骨科小将 - 骨科小将
【创伤骨科解剖系列】肩胛骨周围肌肉 - 骨科小将 - 骨科小将
第二组
2.Rhomboid major/minor
ORIGIN:   Spinous processes of the vertebrae C6-7(minor)/ T1-4(major). 
INSERTION:   Medial margin of the scapula inferior to the spine. 
ACTION:   Stabilization, retraction, elevation and internal rotation of the scapula. 
NERVE SUPPLY:   Dorsal scapular nerve (C4-C5). 
ARTERIAL SUPPLY:   Dorsal scapular artery.
【创伤骨科解剖系列】肩胛骨周围肌肉 - 骨科小将 - 骨科小将
 3.Levator scapulae 斜方肌深面
 ORIGIN:   Transverse process of vertebrae C1-C4. 
INSERTION:   Superior angle to the medial border of the scapula. 
ACTION:   Involved in flexing the head and neck laterally.
NERVE SUPPLY:   Dorsal scapular nerve (C5); C3 nerve; C4 nerve. 
ARTERIAL SUPPLY:   Transverse cervical artery; ascending cervical artery
【创伤骨科解剖系列】肩胛骨周围肌肉 - 骨科小将 - 骨科小将
【创伤骨科解剖系列】肩胛骨周围肌肉 - 骨科小将 - 骨科小将
第三组:
4.Subclavius
ORIGIN:   Costal cartilage and the 1st rib. 
INSERTION:   Acromial end of the clavicle. 
ACTION:   Draws the clavicle downward and forward; elevation of the 1st rib. 
NERVE SUPPLY:   Subclavian nerve. 
ARTERIAL SUPPLY:   Clavicular branch of the thoracoacromial artery.
【创伤骨科解剖系列】肩胛骨周围肌肉 - 骨科小将 - 骨科小将
 5.Pectoralis minor
ORIGIN:   3rd to 5th ribs.  
INSERTION:   Coracoid process of the scapula. 
ACTION:   Pulls the scapula medially, forwards and downwards; aids in respiration. 
NERVE SUPPLY:   Medial and lateral pectoral nerves (C6 - T1).
ARTERIAL SUPPLY:   Pectoral branch of the thoracoacromial artery; deltoid branch of thoracoacromial artery.
【创伤骨科解剖系列】肩胛骨周围肌肉 - 骨科小将 - 骨科小将
其他
6.Trapezius
ORIGIN:  
Descending: the external occipital protuberance, ligamentum nuchae and spinous process of the C1-C7 vertebrae;
Transverse: the aponeurosis of the spinous processes at the T1-T4 vertebrae;
Ascending: the spinous processes of the T5-T12 vertebrae. 
INSERTION:  
Descending: the lateral one-third of the clavicle;
Transverse:  the medial side of the acromion;
Ascending: the upper crest and tubercle of the scapular spine. 
ACTION:   Retraction, superior rotation, elevation and depression of the scapula. 
NERVE SUPPLY:   Accessory nerve (CN XI), C3-C4. 
ARTERIAL SUPPLY:   Transverse cervical artery.
【创伤骨科解剖系列】肩胛骨周围肌肉 - 骨科小将 - 骨科小将
【创伤骨科解剖系列】肩胛骨周围肌肉 - 骨科小将 - 骨科小将
 
 
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