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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
Teres minor originates from the lateral margin of the scapula and inserts via a tendon onto the greater tubercle of the humerus (Standring 2016). Its insertion blends with the capsule of the shoulder joint (Standring 2016).
Examination of Pediatric Shoulder
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
The patient is asked to lie in a prone position and place their hand on the opposite posterior iliac crest. The patient is then instructed to extend and adduct the arm against resistance. Pain and/or weakness indicates a positive test for teres minor strain.
Musculoskeletal Ultrasound
Published in John McCafferty, James M Forsyth, Point of Care Ultrasound Made Easy, 2020
The shoulder is a ball-and-socket joint, with a supportive girdle of tendons and muscles allowing multi-directional movement (see Figure 7.10). Arguably the most important group of muscles at the shoulder are those of the rotator cuff. These muscles and tendons cross from the scapula to the bones of the forearm to support and facilitate movement at the shoulder. The supra- and infraspinatus muscles arise from the posterior surface of the scapula, extending across the glenohumeral joint to the humeral head. Teres minor is a smaller muscle, which passes inferior to the infraspinatus muscle from the lower border of the scapula to the humeral head. Finally, subscapularis arises from the anterior surface of the scapula and passes beneath the coracoid process to attach on the anterior surface of the humeral head. Together, these muscles and tendons make up the rotator cuff. Another important muscle of the arm is the biceps, whose tendons are an important part of shoulder movement. The tendon of the long head of the biceps attaches to the coracoid process, while the short head of the biceps tendon attaches to the anterior humeral head. Overlying all of these is a large superficial muscle, the deltoid. This muscle gives the shoulder its rounded shape, but is less often involved in pathology of the shoulder joint.
Shoulder abduction reconstruction for C5–7 avulsion brachial plexus injury by dual nerve transfers: spinal accessory to suprascapular nerve and partial median or ulnar to axillary nerve
Published in Journal of Plastic Surgery and Hand Surgery, 2022
Gavrielle Hui-Ying Kang, Fok-Chuan Yong
In C5–6 ± C7 brachial plexus avulsion injuries, shoulder abduction reconstruction by a single neurotization to the suprascapular nerve with the spinal accessory nerve alone had modest results (Narakas’drawings [1], Malessy et al [2], Chuang et al. [3]. Only a minority of patients achieved a mean shoulder glenohumeral joint abduction of 45° and external rotation up to 70° [2]. Shoulder abduction at the glenohumeral joint is more efficiently initiated by the supraspinatus muscle before 45°. Any further abduction in the coronal plane to 90° requires external rotation of the humerus for its head to clear the mechanical block of the acromial process. Beyond 90°, it is essentially the deltoid muscle (nerve supply from the axillary nerve) that works under the best mechanical conditions for abduction and external rotation [4,5]. The external rotator muscles of the shoulder joint include the infraspinatus (nerve supply from the suprascapular nerve) and the teres minor (nerve supply from the axillary nerve). Thus, where the infraspinatus may fail, the other shoulder external rotator muscle (the teres minor) can be reinnervated to initiate humeral external rotation for improvement of shoulder abduction range. Significant improvement in shoulder abduction and external rotation outcomes have been reported with the method of dual neurotization to the suprascapular nerve and the axillary nerve with nerve transfers from the spinal accessory nerve and nerve to triceps respectively [6,7].
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
In our study, we performed an MRI of the shoulder in patients with clinical evidence of IS, and we did not consider the necessity of additional exams (e.g. EMG) to confirm the diagnosis. We used the scoring system proposed by Ludig et al. [28], which allows for an easy assessment of the trophicity of the supraspinatus and infraspinatus muscles. At the clinical evaluation, infraspinatus muscle hypotrophy was found in all the subjects. A grade 1 lesion was found in one female athlete, and grade 2 lesions were reported in the other eight subjects. Together with infraspinatus muscle hypotrophy, one male athlete presented with teres minor hypertrophy. Teres minor hypertrophy could be secondary to the infraspinatus muscle weakness. Indeed, both of these muscles work as agonists in the external rotation of the shoulder. If one reduces its effectiveness, the other has to increase its size as a compensative mechanism. In all cases, a normal convex profile of the supraspinatus muscle was found, indicating distal compression of the suprascapular nerve.
The extent of brachial plexus injury: an important factor in spinal accessory nerve to suprascapular nerve transfer outcomes
Published in British Journal of Neurosurgery, 2020
Kevin Rezzadeh, Megan Donnelly, Dorice Vieira, David Daar, Ajul Shah, Jacques Hacquebord
In our results, we saw only a small difference in shoulder abduction outcomes between the C5–C6 injury and C5–C7 injury groups. The difference was stark in the global plexus group. In reference to shoulder external rotation, this motion is dependent on the infraspinatus and teres minor. Since the teres minor is innervated by the axillary nerve, this study also sought to control for any dual nerve transfers to the axillary nerve that may confound ER results.17,19,24 While limited in power, our study still showed a clear deterioration in MRC outcomes for external rotation with increasing extent of injury. However, similar to shoulder abduction, the difference in the C5–C7 group was only a few percentage points less than the C5–C6 group but stark in the global plexus group.