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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
The rhomboid major muscle may vary in its vertebral attachments, with the inferior most attachments varying anywhere between the third and sixth thoracic vertebrae (Macalister 1875; Mori 1964; Bakkum and Miller 2016). Rhomboideus major can also be divided into many discrete bundles (Macalister 1875; Bergman et al. 1988; Bakkum and Miller 2016). When fasciculated, it may connect with serratus anterior (Macalister 1875). The lower part of the muscle may be bilaminar (Macalister 1875). The rhomboid muscles may be fused (Macalister 1875; Mori 1964; Bergman et al. 1988). Together, the rhomboids can send slips to infraspinatus, latissimus dorsi, or teres major (Macalister 1875; Rickenbacher et al. 1985; Bergman et al. 1988; Bakkum and Miller 2016). Rhomboideus minimus, or rhomboid minus, refers to a slip that extends between the upper thoracic or lower cervical vertebral spines and the scapula and/or teres major fascia (Mori 1964; Bergman et al. 1988; Bakkum and Miller 2016).
Brachial Plexus Examination
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
Janice He, Bassem Elhassan, Rohit Garg
The dorsal scapular nerve and long thoracic nerve originate at the level of roots. The dorsal scapular nerve branches from C5 prior to its merging with C6 to form the upper trunk. It innervates the rhomboid major and minor and the levator scapulae. These cause scapular retraction and elevation respectively. The long thoracic nerve has contributions from C5 to C7 at the root level. This innervates the serratus anterior which provides scapular protraction.
Biotensegrity
Published in Kohlstadt Ingrid, Cintron Kenneth, Metabolic Therapies in Orthopedics, Second Edition, 2018
If high-force trauma can functionally detach rhomboid and lower trapezius muscles, perhaps lower-force trauma could cause a smaller injury to these same muscles. Our 15-year-old patient identifies the start of her shoulder issues as the minor injury she suffered while playing badminton at the age of 13. She describes rapidly throwing her arm to the left in effort to strike the shuttlecock. She felt a “pop” at the medial scapular border. From that time forward, swimming became gradually more difficult and painful until she could only swim 10 minutes at a time. Careful palpation along the medial scapular border revealed subtle crepitus and tenderness. Tenderness was also found at the left side of the thoracic posterior spinous processes, yet not the right. Prone strength testing of middle and lower trapezius was 2+/5, less than antigravity. Ultrasound examination of the scapular muscles revealed a small tear at the junction of left rhomboid major/minor (Figure 5.10/Video 5.7) at the medial scapular border and stretch injury to the lower trapezius/latissimus dorsi (Figure 5.11).
The relationship between thoracic posture and ultrasound echo intensity of muscles spanning this region in healthy men and women
Published in Physiotherapy Theory and Practice, 2023
Tamara Prushansky, Lihi Kaplan-Gadasi, Jason Friedman
However, whether variations in muscle composition, expressed by EI, can be identified in healthy, young adults due to habitual normal variation of muscle length or ability to change its length, remains unexplored. One venue for testing this question may be presented by the muscles that lie along the thoracic spine in healthy individuals, the multi-articular muscles: erector spinae (ES), lower trapezius (LT) and rhomboid major (RM), which may be influenced by the angular curvature of the thoracic kyphosis (TK). The normative range of the thoracic kyphosis angles is wide: 20°-50° (Prushansky et al., 2013) hence normal variations (i.e. not of pathological origin) of habitual relaxed TK posture as well as the range of change between a relaxed and upright posture may be manifested in those muscles’ EI.
Effect of reverse manual wheelchair propulsion on shoulder kinematics, kinetics and muscular activity in persons with paraplegia
Published in The Journal of Spinal Cord Medicine, 2020
Lisa Lighthall Haubert, Sara J. Mulroy, Philip S. Requejo, Somboon Maneekobkunwong, JoAnne K. Gronley, Jeffery W. Rankin, Diego Rodriguez, Kristi Hong
Session 2: Session two occurred on average 5 days (2–8 days) after the initial session. Wire electrodes were inserted into the ten test muscles. Mild electrical stimulation through the EMG wires with palpation of muscle belly contraction and/or tendon movement confirmed appropriate placement of electrodes. A 5-second period of EMG data collection initially occurred with participants seated in their own WCs, at rest, to record electronic noise inherent to the acquisition system. This served as a threshold for detection of myoelectric activity. EMG activity was then recorded for each muscle during a single 5-second maximum voluntary isometric contraction (MVC). MVCs were recorded with subjects seated in their WC and the trunk stabilized by the investigator in positions as previously described for sternal pectoralis major, anterior deltoid, supraspinatus, infraspinatus and serratus.31 The additional muscles were tested in the following positions: subscapularis in 0° of shoulder abduction and 90° of elbow flexion, pulling into resisted internal rotation; rhomboid major with the shoulder in 0° of shoulder abduction and the elbow fully flexed, resisting a flexion force at the distal humerus into scapular protraction; latissimus in 90° of shoulder flexion resisting a flexion force above the elbow; and triceps long head in 90° of shoulder abduction and 30° of elbow flexion resisting an elbow flexion force applied at the distal forearm. One to two minutes of rest was given between MVCs for each muscle.
Effect of bilateral ultrasound-guided erector spinae blocks on postoperative pain and opioid use after lumbar spine surgery: A prospective randomized controlled trial
Published in Egyptian Journal of Anaesthesia, 2021
Amr Samir Wahdan, Tarek Ahmed Radwan, Mostafa Mahmoud Mohammed, Ahmed Abdalla Mohamed, Atef Kamel Salama
At the end of block, the average duration to induce block was calculated from the time taken from the point of visualising and identifying rhomboid major, trapezius and erector spinae muscle at spinous process to the point of visualising the spread of local anaesthetic agent ultrasonographically into the fascial plane between the transverse process and erector spinae muscle. If there was an increase in heart rate (HR) and mean arterial blood pressure (MAP) more than 20% of pre-block baseline values after skin incision, the block was considered a failure. In case of block failure, the patient was excluded from the study and anaesthesia was conducted according to the protocol of Kasr Alainy hospitals for spine surgery anaesthesia.