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Diseases of the Peripheral Nerve and Mononeuropathies
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Diana Mnatsakanova, Charles K. Abrams
Entrapment sites (Figure 25.25): Suprascapular notch.Spinoglenoid notch.Supraspinatus muscle abducts the upper arm up to 30 degrees (deltoid takes over abduction at that point).Infraspinatus muscle assists in external rotation of the upper arm at the shoulder.
Upper Limb
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The larger portion of the scapula (Plate 4.7a and b) is formed by intramembranous ossification, while the outer parts are mainly formed by endo-chondral ossification. Along the superolateral portion of the scapula are the acromion, suprascapular notch (bridged by the superior transverse scapular ligament), and supraspinous fossa. The scapular spine extends from the acromion to divide the supraspinous fossa and infraspinous fossa (located superior and inferior to the spine, respectively). On the lateral aspect is the glenoid fossa (or glenoid cavity, deepened by the cartilaginous glenoid labrum), which articulates with the humerus. The supraglenoid tubercle lies just superior to this cavity, while the infraglenoid tubercle lies inferior. Inferior to the glenoid cavity is the lateral border of the scapula, which, when followed medially, becomes the inferior angle of the scapula. The medial (vertebral) border of the scapula will become the superior angle of the scapula when followed superiorly. The coracoid process lies inferior to the acromion and just medial to the glenoid cavity (this process is the remnant of a bone present in our fish ancestors, the coracoid bone).
Peripheral nerve disorders
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Michael Fox, David Warwick, H. Srinivasan
The suprascapular nerve, which arises from the upper trunk of the brachial plexus (C5, 6), runs through the suprascapular notch to supply the supra- and infraspinatus muscles. It may be injured in fractures of the scapula, dislocation of the shoulder, by a direct blow or sudden traction, or simply by carrying a heavy load over the shoulder.
Anatomical aspects of the selective infraspinatus muscle neurotization by spinal accessory nerve
Published in Journal of Plastic Surgery and Hand Surgery, 2021
Radek Kaiser, Aneta Krajcová, Michal Makel, Gautham Ullas, Veronika Němcová
SSN arises from the upper trunk of the brachial plexus which is formed by the union of the ventral rami of the C5 and C6 and rarely from C4 root. The nerve passes across the posterior triangle of the neck parallel to the inferior belly of the omohyoid muscle and deep to the trapezius muscle. It then runs along the superior border of the scapula, passes through the suprascapular notch inferior to the superior transverse scapular ligament and enters the supraspinous fossa. It then passes beneath the supraspinatus, relatively fixed on the floor of the supraspinatus fossa, and curves around the lateral border of the spine of the scapula through the spinoglenoid notch to the infraspinous fossa. In 84%, there were no more than two motor branches to the supraspinatus muscle and in 48% the infraspinatus muscle had three or four motor branches of the same size [11]. The mean diameter of the suprascapular nerve at the suprascapular notch is 2.48 ± 0.6 mm [12].
Impact of shoulder subluxation on peripheral nerve conduction and function of hemiplegic upper extremity in stroke patients: A retrospective, matched-pair study
Published in Neurological Research, 2021
Xiangzhe Li, Zhiwei Yang, Sheng Wang, Panpan Xu, Tianqi Wei, Xiaomeng Zhao, Xifeng Li, Yanmei Zhang, Ying Li, Na Mei, Qinfeng Wu
The suprascapular nerve originates from the brachial plexus and it crosses the suprascapular notch and the transverse scapular ligament to innervate the supraspinatus and infraspinatus [30]. Through the X-ray in comparing the position of bilateral scapulae and glenohumeral joints in stroke patients, Culham et al. [26] concluded that the scapulae on the hemiplegic side were generally downward rotation, downward displacement, and outward displacement during the period of flaccid paralysis, so the occurrence of the SS could be more easily. Anatomically, the downward rotation, downward displacement, and outward displacement of the scapula may cause the higher tension of the suprascapular nerve, then lead to pull injury. In the case of scapulothoracic dissociation, excessive traction force and prolonged pull on the infraclavicular brachial plexus may cause the injury of the axillary and suprascapular nerves, and have an adverse effect on the spontaneous recovery of the nerve lesions [31]. However, the exact injury mechanism is still unclear.
Did the prevalence of suprascapular neuropathy in professional volleyball players decrease with the changes occurred in serving technique?
Published in The Physician and Sportsmedicine, 2021
Daniele Mazza, Raffaele Iorio, Piergiorgio Drogo, Edoardo Gaj, Edoardo Viglietta, Giuseppe Rossi, Edoardo Monaco, Andrea Ferretti
If the suprascapular nerve is compressed proximally at the suprascapular notch, atrophy of both the supraspinatus and infraspinatus muscles will be found. Furthermore, proximal entrapment is usually accompanied by pain in the posterior region of the shoulder. Differently, distal entrapment at the spinoglenoid notch will result in selective atrophy of the infraspinatus muscle known as infraspinatus syndrome (IS) [9]. In IS, no further symptoms other than isolated muscle atrophy were reported. Indeed, at the spinoglenoid notch, the sensory branches have yet to leave the nerve [32]. In our study, none of the volleyball players complained of shoulder pain; in recent literature, IS has been considered a totally asymptomatic condition [16,18,19,23,29,32]. External rotation weakness assessed with specific text or dynamometric exams may be the only suspicion finding. Each case of hypotrophy in our study was accompanied by external rotation weakness as compared to the contralateral side. This is in line with the study of Witvrouw et al. [19] who found a significant reduction in external rotation strength of the affected side.