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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 posterior cord gives off the upper subscapular nerve, the thoracodorsal nerve and the lower subscapular nerve. The upper and lower subscapular nerves innervate the upper and lower portions of the subscapularis respectively, which provides shoulder internal rotation. The lower subscapular nerve also innervates the teres major which is a shoulder adductor. The thoracodorsal nerve innervates the latissimus muscle, which helps to adduct, extend and internally rotate the shoulder (Table 12.1).
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
This muscle is a variation of subscapularis. When present, subscapularis minor originates from the upper axillary border of the scapula (Knott 1883a; Bergman et al. 1988) or the anterior and lateral surface of subscapularis (Breisch 1986; Pires et al. 2017). Its insertion is variable, with possible attachments to the shoulder joint capsule, the crest of the lesser tubercle of the humerus, the intertubercular sulcus, or just below the lesser tubercle (Knott 1883a; Aasar 1947; Bergman et al. 1988; Standring 2016; Pires et al. 2017). Although Staniek and Brenner (2012) suggested that the infraglenoid muscle described by them (and by Lee et al. 2019a) should be distinguished from subscapularis minor, this muscle is similar in morphology, origin, and insertion.
Surgery of the Shoulder
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Nick Aresti, Omar Haddo, Mark Falworth
Attention is turned to the glenoid. Abducting and externally rotating the arm brings the subscapularis muscle into better view. It is split along the border of its superior two-thirds and inferior third. This is extended towards the tendon and held apart using a Gelpi retractor.
Electromyographic analysis of select eccentric-focused rotator cuff exercises
Published in Physiotherapy Theory and Practice, 2022
Takumi Fukunaga, Karl F. Orishimo, Malachy P. McHugh
Surface EMG electrodes were attached to each participant’s skin on the side of the dominant arm, over 5 muscles: supraspinatus, infraspinatus, upper trapezius, lower trapezius, and middle deltoid. Out of the four muscles composing the rotator cuff, supraspinatus and infraspinatus were selected for study because most cases of rotator cuff disease involve the tendons of these two muscles and subscapularis muscle is difficult to study with surface EMG (McCrum, 2020). Before electrode attachment, each participant’s skin was prepared by shaving, cleaning with an alcohol pad, and lightly abrading with sandpaper. Disposable Ag/AgCl passive dual electrodes (2.0 cm inter-electrode distance; Noraxon, Scottsdale, AZ, USA) were placed over the 5 muscles at previously described sensor placement locations (Waite, Brookham, and Dickerson, 2010). Surface EMG data were sampled at 1000 Hz using a 16-channel BTS FREEEMG 1000 system (CMRR: >110 dB at 50–60 Hz; input impedance: >10 GΩ; BTS Bioengineering, Quincy, MA, USA).
Bilateral ultrasound findings in patients with unilateral subacromial pain syndrome
Published in Physiotherapy Theory and Practice, 2022
Anna Eliason, Marita Harringe, Björn Engström, Kerstin Sunding, Suzanne Werner
During the US examinations the patients were seated on a swivel chair with a low backboard, and the examiner was standing behind the patient. The tendons of supraspinatus, subscapularis, infraspinatus and the long head of biceps were visualized in both a longitudinal and transversal plane. Both the tendons of subscapularis and infraspinatus were evaluated dynamically during internal and external rotation with the forearm in supination and the elbow in 90° of flexion. The acromioclavicular joint was evaluated in terms of possible sprains and osteoarthritis. The supraspinatus tendon and the subdeltoid/subacromial bursae were evaluated dynamically during abduction with the arm slightly internally rotated. The supraspinatus tendon was examined with the patient’s palm placed on the posterior region of the iliac wing with the elbow flexed and directed posteriorly. The US examiner was blinded to arm dominance, the patient´s symptom as well as to the purpose of the study.
Shoulder magnetic resonance imaging findings in manual wheelchair users with spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2022
Omid Jahanian, Meegan G. Van Straaten, Brianna M. Goodwin, Ryan J. Lennon, Jonathan D. Barlow, Naveen S. Murthy, Melissa M.B. Morrow
The long head of the biceps tendon originates on the supraglenoid tubercle, curving over the humeral head and entering the bicipital groove between the supraspinatus and subscapularis tendons (the rotator cuff interval).23 In the region of the rotator cuff interval many structures are intimately associated with each other including the long head of the biceps, the superior subscapularis tendon, the anterior supraspinatus tendon, and ligaments of the shoulder.23 The medial border of the biceps pulley is formed by the attachment of the subscapularis tendon to the lesser tubercle of the humerus, therefore disruption of the subscapularis is commonly seen with medial subluxation of the biceps tendon.24 Surgeons often observe concomitant subscapularis and biceps tendon pathology at the time of treatment for supraspinatus and infraspinatus tears.24 Mehta and colleagues recently found that the prevalence of biceps disease was significantly related to the size of posterior/superior rotator cuff tears, thus highlighting the importance of reporting concomitant biceps disease with rotator cuff data.24