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Upper Limb Muscles
Published in Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Handbook of Muscle Variations and Anomalies in Humans, 2022
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo
Rhomboideus tertius is a rare variation of the rhomboid muscles. Jelev and Landzhov (2012–2013) document a case in which rhomboideus tertius is present bilaterally, originating from the spinous processes of the sixth, seventh, and (on the left side) eighth thoracic vertebrae and attaching to the inferior most part of the medial border of the scapula. The muscle was nearly 1.5 times as wide (40 mm) on the left side than on the right side (27 mm). Lee and Jung (2015) describe a similar case in which this muscle originates from the spinous processes of the fourth and fifth thoracic vertebrae on the left side and the spinous processes of the second through fifth thoracic vertebrae on the right side. This case also presented with asymmetry, as the right muscle was about 3.5 times as wide at origin (90.50 mm) than the left muscle (25.13 mm).
The neurological examination
Published in Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni, Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
Rhomboid major and minor muscles (Figure 11.1b) Innervation: Dorsal scapular nerve (C4 and C5).Function: Adduction; rotation of scapula.Physical examination: The patient places a hand on his or her back and pushes backward against resistance. (Arrow: Muscle bellies can be seen.)
Arthroscopic resection of the superomedial scapula and scapulothoracic bursectomy
Published in Andreas B. Imhoff, Jonathan B. Ticker, Augustus D. Mazzocca, Andreas Voss, Atlas of Advanced Shoulder Arthroscopy, 2017
Operative management of snapping scapula syndrome can be considered after a failure of prolonged non-operative treatment. In general, the optimal patients for surgical treatment are patients with isolated scapulothoracic symptoms with pain localized to the medial border of the scapula with or without crepitus. Patients should have had a temporary response to a local corticosteroid injection that provided significant relief. Operative treatment appears to be more reliable if a preoperative injection is used to confirm the diagnosis.8 Lehtinen et al. reported that a positive response to an injection with temporary relief should be present prior to surgical intervention.14 There should not be significant scapular winging associated with a neurologic injury. Associated cervical spine pathology, including posterior cervical facet arthritis, should have been ruled out as a source of referred pain. Muscle detachment of the rhomboids should also be ruled out as a potential etiology of pain, as this may result in significant dysfunction but requires surgical repair of the detached muscle.29
Intra and inter observer agreement in the mobility assessment of the upper thoracic costovertebral joints
Published in Physiotherapy Theory and Practice, 2023
Michael Cibulka, Justin Buck, Bria Busta, Erika Neil, Drake Smith, Reece Triller
Limited mobility of the costovertebral joints is a potential source of neck and upper thoracic pain (Fruth, 2006; Mastromarchi and May, 2021) as well as shoulder pain (Strunce, Walker, Boyles, and Young, 2009). Pain that develops unilaterally between the scapula and the spinous processes of the upper thoracic spine can arise from the costovertebral joints (Fruth, 2006; Young, Gill, Wainner, and Flynn, 2008). Because of its location, costovertebral pain is often misdiagnosed as rhomboid muscle strain, or described as trigger point pain (Erosa, Erosa, and Sperber, 2018; Fruth, 2006). Costovertebral pain is also related to anterior chest wall pain (i.e. costochondritis also called Tietze’s syndrome) as well as misdiagnosed as a cardiac event (Arroyo, Jolliet, and Junod, 1992; Aspegren, Hyde, and Miller, 2007; Preutu, 2001; Steinrücken, 1980). Inflammation of the costovertebral joints is more common than previously thought in patients with spinal pain (Chui et al., 2020). Decreased mobility of the costovertebral joint of the first rib is also considered as a cause of thoracic outlet syndrome (Kuwayama, Lund, Brantigan, and Glebova, 2017; Lindgren and Leino, 1988; Smith, 1979; Weinberg et al., 1972). Kuwayama, Lund, Brantigan, and Glebova (2017) recommend that in a physical therapy examination of patients with thoracic outlet symptoms testing the first rib with a spring test for mobility is imperative.
Reliability and discriminative validity of a screening tool for the assessment of neuromuscular control and movement control in patients with neck pain and healthy individuals
Published in Disability and Rehabilitation, 2022
Robby De Pauw, Eveline Van Looveren, Dorine Lenoir, Lieven Danneels, Barbara Cagnie
Similarly, the procedure for the adapted SHT of the axioscapular region consists of three parts. Participants were first positioned prone with 30° knee flexion and arms resting on the table in a neutral position (as depicted in Figure 2(A)). Both left and right side were tested. In the first part, the examiner manually positioned the scapula in a neutral scapular position which had to be maintained by the patient for three seconds. The lower trapezius muscle was palpated to detect muscle contraction. Additionally, substitution strategies (contraction of the Levator Scapulae, Rhomboids, and Latissimus Dorsi muscle) were assessed. During the second part, participants were instructed to reposition their scapula in a neutral position for five consecutive times with an in between rest period of 15 s. A score was computed based on substitution strategies such as breathing stop, excessive contraction of superficial musculature, and aberrant movement fluency. Lastly, endurance was only evaluated after successful completion of the first and second part of the assessment form, based on the performance of achieving a scapular neutral position for 10 times 10 s. Details on the procedure and assessment forms are included in Supplementary Appendix and a visual representation can be found in Figure 2. In an attempt to increase the reliability both forms include mainly yes/no statements.
Feasibility and significance of stimulating interscapular muscles using transcutaneous functional electrical stimulation in able-bodied individuals
Published in The Journal of Spinal Cord Medicine, 2021
Naaz Kapadia, Bastien Moineau, Melissa Marquez-Chin, Matthew Myers, Kai Lon Fok, Kei Masani, Cesar Marquez-Chin, Milos R. Popovic
The motor points and electrode positioning for FES for the various muscles were as follows (Fig. 1(a,b)): Serratus Anterior (SA): Electrode between the latissimus dorsi and the pectoralis major, on the muscular bulk of the serratus between the 4th and 9th ribs.Upper Trapezius (UT): On the superior aspect of the shoulder blade, away from the supero-medial angle of the scapula to limit stimulation of the levator scapulae muscle.Lower Trapezius (LT): Medially and in line with the muscle fibers next to the spine of T8-T12 vertebrae below the inferior tip of the scapula, to limit stimulation of the rhomboids.Anterior and middle deltoid: on the bulk of the muscle, one proximal and one distal.