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Brachial Plexus Examination
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
Janice He, Bassem Elhassan, Rohit Garg
The serratus anterior provides the most stability to the scapula in the beginning of shoulder flexion with the elbow in extended posture. This can be used to test the serratus strength. With the elbow extended, patient is asked to initiate shoulder forward flexion and the examiner provides resistance to this motion. If there is weakness of serratus anterior, then the examiner would notice the scapular blade winging off the thoracic wall (Figure 12.3(b)). Thirdly, the push up test is a classic manoeuvre that is described extensively however this might not be as practical for a patient with brachial plexus injury. This test uses the same principle as scapular protraction against resistance. The patient is asked to push up against the wall while the examiner inspects for scapular thoracic abnormal motion (STAM) (Figure 12.3(c)).
General plastic
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
The serratus anterior (SA) muscle arises from the first to the eighth/ninth ribs; the upper half inserts into the deep aspect of the medial edge of the scapula, whilst the lower slips insert into the angle. When it contracts, it causes protrusion of the scapula and rotates the scapula upwards and outwards. It can be tested by pushing the outstretched hand against a wall – absence or denervation produces characteristic winging.
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
Serratus anterior muscle (Figure 11.1a) Innervation: Long thoracic nerve (C5-C7).Function: Abduction of scapula.Physical examination: The patient pushes against resistance (e.g., the examiner’s hand or a wall). If the serratus anterior is paralyzed, winging of the scapula can be observed.
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.
Elastofibroma dorsi: a case report of bilateral occurrence and review of literature
Published in Acta Chirurgica Belgica, 2021
Glenn De Weerdt, Veronique Verhoeven, Ina Vrints, Filip Thiessen, Thierry Tondu
The same patient presented again 4.5 years later, at the age of 53, with a similar subscapular tumor on the left hand side. New MRI investigation showed a mass, suggestive for ED, deep to the left anterior serratus muscle. On the right hand side no signs of recurrence were observed on imaging. An excision of the tumor was carried out via a procedure identical to that of the first operation on de right hand side. Since histopathological findings were similar to those of the contralateral mass, the diagnosis of ED, with a weight of 109 g and dimensions of 9.5 × 8×4 cm, was confirmed. This time the surgical procedure was complicated by development of a seroma too. Due to the volume of the fluid accumulation reoperation was necessary for drainage. A similar procedure was carried out. No complications were seen hereafter. The patient recovered well.
Scapula muscle exercises using the Neurac technique for a patient after radical dissection surgery: a case report
Published in Physiotherapy Theory and Practice, 2020
The patient’s pain level and SPADI scores were reduced, as well as increased shoulder ROM. These improvements in pain, SPADI scores, and shoulder ROM may be associated with an increase in the subacromial space (Ludewig and Cook, 2000; Roy, Moffet, Hébert, and Lirette, 2009). The upper trapezius is an agonist for scapula elevation and upward rotation (Bigliani, Perez-Sanz, and Wolfe, 1985; Wiater and Bigliani, 1999). The serratus anterior and lower trapezius muscles have a movement arm to induce torque on the scapula with upward rotation and posterior tilt (Ludewig and Cook, 2000; Roy, Moffet, Hébert, and Lirette, 2009), and function as a middle trapezius agonist during scapula retraction (Bigliani, Compito, Duralde, and Wolfe, 1996; Bigliani, Perez-Sanz, and Wolfe, 1985; Wiater and Bigliani, 1999). Increasing the strength of these muscles may lead to restored normal scapulohumeral rhythm and increased subacromial space during shoulder movements (Ludewig and Cook, 2000; McClure, Michener, and Karduna, 2006), which could contribute to improvements in shoulder pain, function, and ROM.