Upper Limb
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno in Understanding Human Anatomy and Pathology, 2018
The deltoid and teres minor are both innervated by the axillary nerve after it emerges from the quadrangular space (Table 4.1; Plate 4.7b). The superior border of the quadrangular space is the inferior border of the teres minor, the lateral border is the surgical neck of the humerus, the medial border is the long head of the triceps brachii, and the inferior border is the superior border of the teres major. This quadrangular space should not be confused with the two triangles of the back, the triangle of auscultation, and the lumbar triangle. The triangle of auscultation (Plate 4.6) is bounded by the latissimus dorsi, trapezius, and rhomboid major, and is clinically important as a site where relatively thin musculature makes it easier to hear the sounds produced by the lungs with a stethoscope. The lumbar triangle is bounded by the latissimus dorsi, external oblique, and iliac crest and, in rare cases, is the site of a lumbar hernia. In many mammals, the deltoid has three heads, which can sometimes be distinguished in humans; the anterior, lateral, and posterior fibers are respectively involved in flexion, abduction, and extension of the arm. However, contraction of the full muscle in humans mainly contributes to a single function: the abduction of the arm, particularly after the supraspinatus begins arm abduction (i.e., mostly after first 15°). The function of the teres minor—lateral rotation of the arm—is similar to one of the functions of the more posterior (dorsal) head of the deltoid of many mammals, so in a way the teres minor of humans kept one of the original functions of the deltoid complex.
Deltoid and Scapular Regions
Gene L. Colborn, David B. Lause in Musculoskeletal Anatomy, 2009
In addition to the quadrangular space of the axilla, noted and dissected earlier, a second so-called “space” seen in the scapular region is of some significance anatomically and surgically. This is the triangular space of the axilla (Fig. 5:8). The circumflex scapular artery passes through this space, giving branches to the overlying skin of the area before turning around the lateral border of the scapula and passing deep to the infraspinatus. The circumflex scapular artery originates from the subscapular artery, one of the three branches of the third part of the axillary artery.
Upper limb
Aida Lai in Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Boundaries of quadrangular space– med.: long head of triceps brachii– sup.: inf. margin of subscapularis– lat.: surgical neck of humerus– inf.: sup. margin of teres major
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
The distal nerve transfer (with either a partial median or ulnar nerve) to the axillary nerve was performed via an anterior axillary approach. The axillary nerve was identified anteriorly at the inferior border of the subscapularis muscle just before it entered the quadrangular space. (Figure 1) Zhao et al. [14] reported that although the nerve has not yet divided into branches at this level, two fascicular groups can be identified: one lateral and one medial. They are enclosed within an outer-epineurium. The lateral fascicular group continues as the anterior branch of the axillary nerve while the medial fascicular group continues as the posterior branch. A vessel loop was similarly placed around the nerve for later identification, after the prepared donor nerve is ready for coaptation to the axillary nerve. For the neurorrhaphy, the recipient fascicular groups of the axillary nerve were prepared by performing a transverse partial outer-epineurotomy on the anterior wall of the nerve and neurotomy of the fascicular groups. The posterior wall of the outer-epineurium was kept intact, such that there would be minimal retraction of the fascicular groups at their cut ends (Figure 2) – which facilitated the nerve coaptation.
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 SS after stroke often manifests as the humeral head to downward subluxation [26]. In the early stage of stroke, due to the weak deltoid and supraspinatus on the HUE, combined with the effect of gravity, the humeral head could not be effectively fixed into the glenoid, which may lead to the occurrence of SS [1,27]. The results of this study suggest that, after stroke, SS may lead to more severe abnormal peripheral nerve conduction on the HUE compared with non-SS stroke patients. It has been confirmed that neurological complications were manifested in 5.4–55% among all shoulder dislocations [28]. In traumatic inferior shoulder dislocation, it has been reported that 29% of the patients experienced a neurological injury, and the axillary nerve is particularly often damaged, probably due to the overload as it goes across the quadrangular space [29]. However, the whole characteristics that the impacts of SS on the HUE peripheral nerves remain unclear.
Related Knowledge Centers
- Axillary Nerve
- Subscapularis Muscle
- Teres Major Muscle
- Triangular Space
- Axillary Space
- Triangular Interval
- Teres Minor Muscle
- Triceps
- Surgical Neck of The Humerus
- Posterior Humeral Circumflex Artery