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Neuroanatomy
Published in Ibrahim Natalwala, Ammar Natalwala, E Glucksman, MCQs in Neurology and Neurosurgery for Medical Students, 2022
Ibrahim Natalwala, Ammar Natalwala, E Glucksman
The following diagram is a schematic representation of the brachial plexus. It shows the roots C5-T1; note the contribution to the phrenic nerve that innervates the diaphragm (‘C 3,4, 5 keep the diaphragm alive’). The dorsal scapular nerve supplies the rhomboid muscles and levator scapulae muscle. The suprascapular nerve supplies supraspinatus and infraspinatus (two of the rotator cuff muscles; teres minor is supplied by the axillary nerve and subscapularis by the upper and lower subscapular nerves). The long thoracic nerve of Bell innervates the serratus anterior muscle and a lesion of this nerve results in winging of the scapula (‘C 5, 6, 7 bells of heaven’). The axillary nerve supplies the deltoid muscles; this nerve is commonly injured in shoulder dislocations; always check the sensation over the ‘regimental badge area’ before attempting shoulder reduction to assess if damage has already occurred.
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 Skin and Muscles of the Back
Published in Gene L. Colborn, David B. Lause, Musculoskeletal Anatomy, 2009
Gene L. Colborn, David B. Lause
Having first reflected the trapezius, identify the levator scapulae, rhomboideus minor and the rhomboideus major muscles. Cut the rhomboideus major and minor at their origins from the spines and the supraspinous ligaments of the lower cervical and upper thoracic vertebrae. Clean the fascia from these muscles so that their fibers can be seen clearly. In some specimens the line of cleavage between the two rhomboid muscles can be unclear. As necessary, consult the summary description of the muscles of the back (Table 2:1) to learn the exact attachments of these two muscles and then separate them accordingly.
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.
Surfer’s myelopathy: A review of etiology, pathogenesis, evaluation, and management
Published in The Journal of Spinal Cord Medicine, 2021
Jason Gandhi, Min Yea Lee, Gunjan Joshi, Sardar Ali Khan
Correct prone paddling posture requires an extension of the lumbar and thoracic spine so as to raise the upper chest off the deck of the surfboard and allow for an ergonomic paddling stroke.11 Cervical and lumbar musculature strains are relatively common, possibly due to sustained isometric contraction of those muscles while paddling.11 For instance, surfing after prolonged periods of inactivity often leads to burning muscular pain in the trapezius and rhomboid muscles.11 Similarly, hyperextension of the neck, to compensate for an inadequate lumbar extension during surfing, can exacerbate neck soreness.11 Fortunately, most neck and back spasms caused by overuse resolve spontaneously, but physical therapy can also improve acute symptoms.12 A proper warm-up before surfing (especially in cold water) and regular stretching of the low back, hamstrings, and hip flexors may help prevent this common problem.13
Infrared thermography reveals effect of working posture on skin temperature in office workers
Published in International Journal of Occupational Safety and Ergonomics, 2018
Roope Lasanen, Markus K.H. Malo, Olavi Airaksinen, Jari Karhu, Juha Töyräs, Petro Julkunen
Temperatures for all locations in the upper back increased significantly (p < 0.05) with both postures during a working day (Table 1). The sEMG measurements showed that there was no significant change in muscle activity between the first and last working hours of the day when working in the traditional posture (Table 1). Instead, there was a significant (p < 0.05) reduction in muscle activity between the first and last working hours in the left neck extensor, right trapezius, left rhomboid and right rhomboid muscles when working in the upright posture.