Gross and Musculoskeletal Anatomy Laboratory

I will continue O my God to do all my actions for the love of You.

1
De La Salle Health Sciences Institute College of Rehabilitation Sciences
Hernandez, Pamela Grace
OTRP
ANA1 Laboratory Organizer, AY 2014-2015
Anatomy of Shoulder and Scapula

ANATOMY OF THE SHOULDER AND SCAPULA

SCHEDULE: July 2, 2013 (8:00-11:00)
TIME ACTIVITY STUDENTS FACULTY
8:00-8:15
Checking of
attendance
Pre-lab quiz
Orientation
Distribution of
anatomy models
Students are expected to be in their respective classrooms at
12:50pm.
It is expected that by the time the faculty members stepped
inside their classrooms at 1:00pm, their sheets of paper are
already prepared for their pre-lab quiz.
Students are also expected to bring the following:
1. Bone set
2. McMinn, R. et.al. A Colour Atlas of Human Anatomy
3. Snell, R. Clinical Anatomy for Medical Students, and other
anatomy books
4. Yarns (multiple colors)
5. Scotch tape

Will check the attendance of the students
Will give, check and record the pre-lab quiz
Will orient the students regarding the general flow
of the laboratory session
Will distribute the anatomy models (joint, ligament
and muscle models)
8:15-9:45
Identification of
bony landmarks,
joints, ligaments
and muscles
Students will identify all the bony landmarks, joints, ligaments
and muscles in their anatomy models with the help of their
books.
Faculty members should be inside the classroom to
supervise the students while they identify the
different structures in their anatomy models.
Faculty members should assist the students how to
properly locate and identify structures when
needed.
9:45-10:30
Discussion and
checking of
worksheets
Students will identify and discuss the anatomical and/or
clinical significance of the different structures in the shoulder
and scapula.
Faculty in-charge will call any student in the group to
discuss a topic. Participation of the student will be
graded. Faculty in-charge should see to it that all
students will be given a chance to participate.
Simultaneous with discussion will be checking of
workheets
10:30-10:45
Review Reviews the anatomy of the shoulder and scapula Faculty in-charge should remain inside the classroom
in the whole duration of the review to supervise the
students.
Gross and Musculoskeletal Anatomy Laboratory

I will continue O my God to do all my actions for the love of You.

2
De La Salle Health Sciences Institute College of Rehabilitation Sciences
Hernandez, Pamela Grace
OTRP
ANA1 Laboratory Organizer, AY 2014-2015
Anatomy of Shoulder and Scapula

Preparation for
return
demonstration
Will keep all notes and prepare sheet of paper to be
submitted to his/her faculty.
All bags and cellphones should be stored inside the locker.
Any student caught with cellphones in their pockets will
automatically be disqualified to participate in the retdem.
Will proceed to the storage room and wait for their turn to be
called for the return demo.
Will collect the sheet of paper from the students
for the return demonstration.
Will prepare the materials to be used for the return
demonstration.
Structures to be identified will be provided by the
subject organizer
10:45
11:00
Return
demonstration
Students will wait for their turn to be called for the return
demo.
Laboratory facilitators should identify a faculty who
will serve as the caller and timer.
The caller/timer should also inspect the pockets of
the students before he/she allows the student to
enter the demonstration room.
Other laboratory facilitators will be inside the
demonstration room for the ret-dem.
Recommended time for the return demo

BONES OF THE SHOLDER AND SCAPULA
BONE STERNUM (24) CLAVICLE (16) SCAPULA (42) HUMERUS (Proximal-to-Mid
Humerus) (22)
BONY LANDMARKS

Identify the bony landmarks in
your bone models. As you
identify the bony landmarks,
describe its anatomical and/or
clinical significance.


1. Jugular notch
2. Clavicular notch
3. Notch for first costal
cartilage
4. Manubrium
5. Sternal angle and
manubriosternal joint
6. Body
7. Notches for second
costal cartilage
8. Notch for third costal
cartilage
9. Notch for fourth costal
cartilage
1. Acromial end of clavicle
2. Sternal end of clavicle
3. Shaft of clavicle
4. Impression for
costoclavicular ligament
5. Groove for subclavius
muscle
6. Conoid tubercle
7. Trapezoid line

1. Coracoid process
2. Suprascapular notch
3. Superior border
4. Supraspinous fossa
5. Superior angle
6. Spine
7. Medial border
8. Infraspinous fossa
9. Inferior angle
10. Lateral border
11. Neck
12. Margin of glenoid cavity
13. Acromial angle
14. Acromion
1. Head*
2. Anatomical neck
3. Lesser tubercle
4. Intertubercular groove*
5. Greater tubercle
6. Surgical neck
7. Deltoid tuberosity
8. Groove for radial nerve
9. Medial lip of
intertubercular groove
10. Lateral lip of
intertubercular groove
Gross and Musculoskeletal Anatomy Laboratory

I will continue O my God to do all my actions for the love of You.

3
De La Salle Health Sciences Institute College of Rehabilitation Sciences
Hernandez, Pamela Grace
OTRP
ANA1 Laboratory Organizer, AY 2014-2015
Anatomy of Shoulder and Scapula
10. Notch for fifth costal
cartilage
11. Notch for sixth costal
cartilage
12. Notch for seventh costal
cartilage
13. Xiphisternal joint
14. Xiphoid process









15. Subscapular fossa
16. Supraglenoid tubercle
17. Glenoid cavity
18. Infraglenoid tubercle
ATTACHMENTS

Identify the structures
attached to the bones
1. Sternocleidomastoid
2. Pectoralis major
3. Rectus abdominis
4. Sternohyoid
5. Sternothyroid
6. Area covered by right
pleura
7. Area covered by left
pleura
8. Area in contact with
pericardium
9. Transversus thoracis
10. Diaphragm
1. Trapezius
2. Deltoid
3. Pectoralis major
4. Sternocleidomastoid
5. Sternohyoid
6. Costoclavicular ligament
7. Subclavius muscle and
clavicpectoral fascia
8. Trapezoid ligament
9. Conoid ligament
1. Trapezius
2. Inferior belly of omhyoid
3. Supraspinatus
4. Levator scapulae
5. Rhomboid minor
6. Rhomboid major
7. Latissimus dorsi
8. Teres major
9. Teres minor and
intervening groove for
circumflex scapular
artery
10. Infraspinatus
11. Long head of triceps
12. Deltoid
13. Coraco-acromial ligament
14. Trapezoid ligament
1. Supraspinatus
2. Subscapularis
3. Teres major
4. Latissimus dorsi
5. Pectoralis major
6. Brachialis
7. Deltoid
8. Infraspinatus
9. Teres minor
10. Lateral head of triceps
11. Medial head of triceps
12. Coracobrachialis

Gross and Musculoskeletal Anatomy Laboratory

I will continue O my God to do all my actions for the love of You.

4
De La Salle Health Sciences Institute College of Rehabilitation Sciences
Hernandez, Pamela Grace
OTRP
ANA1 Laboratory Organizer, AY 2014-2015
Anatomy of Shoulder and Scapula
15. Conoid ligament
16. Superior transverse
scapular ligament*
17. Pectoralis minor
18. Coracobrachialis and
short head of biceps
19. Subscapularis
20. Serratus anterior
21. Pectoralis major
22. Sternocleidomastoid
23. Coracohumeral
ligament*
24. Long head of biceps



JOINTS AND LIGAMENTS OF THE SHOULDER AND SCAPULA

TRUE JOINTS
JOINTS BONY ARTICULATIONS MOVEMENTS LIGAMENTS MUSCLES/STRUCTURES/EVENTS CAUSING THE MOVEMENTS
Sternoclavicular
Joint
1. 2.
3.
4.
5.
6.
7.
8.
9.

10.Protraction:
11.Retraction:
12.Elevation:
13.Depression:
14. Axial Rotation: This movement of the clavicle in the SC joint
is mechanically linked with the overall kinematics of abduction
or flexion of the shoulder and cannot be independently
performed with the arm resting at the side. This axial rotation
occurs as the arm is elevated above 90 degrees where the SC
joint starts to reach maximum elevation. The upward rotation
of the clavicle is caused by the tightening of the AC ligaments
the trapezoid and the conoid which are attached to the
inferior surface of the clavicle and at right angles to each other.
Acromioclavicular 1. 2.Upward Rotation of 4. 6.Upward Rotation:
Gross and Musculoskeletal Anatomy Laboratory

I will continue O my God to do all my actions for the love of You.

5
De La Salle Health Sciences Institute College of Rehabilitation Sciences
Hernandez, Pamela Grace
OTRP
ANA1 Laboratory Organizer, AY 2014-2015
Anatomy of Shoulder and Scapula
Joint the Scapula at the
Acromioclavicular joint
3.Downward Rotation
of the Scapula at the
Acromioclavicular joint


Horizontal plane
rotational adjustments
Sagittal plane
rotational adjustments

5.



7.Downward rotation:




Horizontal plane adjustments:




Sagittal plane adjustments:





Glenohumeral
Joint
1. 2.

3.

4.
5.

6.

7.

8.Flexion:

9.Extension:

10.Abduction:

11.Adduction:

12.External Rotation:

13.Internal Rotation:



Gross and Musculoskeletal Anatomy Laboratory

I will continue O my God to do all my actions for the love of You.

6
De La Salle Health Sciences Institute College of Rehabilitation Sciences
Hernandez, Pamela Grace
OTRP
ANA1 Laboratory Organizer, AY 2014-2015
Anatomy of Shoulder and Scapula
FALSE/FUNCTIONAL JOINTS:
JOINTS LOCATION & STRUCTURE FORMING THE
JOINT
FUNCTIONS/MOVEMENTS MUSCLES/STRUCTURES/EVENTS CAUSING THE
MOVEMENTS
Scapulothoracic Joint 1.

2.Functions:







Movements:
3.
4.
5.
6.
7.Scapular Elevation:


8.Scapular Adduction:


9.Scapular Adduction and Depression:


10.Scapular Adduction and Downward Rotation:


11.Scapular Abduction and Upward Rotation:


Suprahumeral or
Subacromial
Joint
1.








2.
Bicipital Groove







Gross and Musculoskeletal Anatomy Laboratory

I will continue O my God to do all my actions for the love of You.

7
De La Salle Health Sciences Institute College of Rehabilitation Sciences
Hernandez, Pamela Grace
OTRP
ANA1 Laboratory Organizer, AY 2014-2015
Anatomy of Shoulder and Scapula
MUSCLES OF THE SHOULDER AND SCAPULA
MUSCLES CONNECTING THE UPPER LIMB TO THE THORACIC WALL (16 points)
NAME OF MUSCLE ORIGIN INSERTION NERVE SUPPLY ACTION
Pectoralis major Lateral lip of bicipital groove of
humerus
Medial and lateral pectoral
nerves from brachial plexus

Pectoralis minor Third, fourth, and fifth ribs Medial pectoral nerve from
brachial plexus
Depresses point of shoulder; if
the scapula is fixed, it elevates
the ribs of origin
Subclavius First costal cartilage Clavicle Nerve to subclavius from upper
trunk of brachial plexus

Serratus anterior Medial border and inferior angle
of scapula
Long thoracic nerve

MUSCLES CONNECTING THE UPPER LIMB TO THE VERTEBRAL COLUMN (20 points)
NAME OF MUSCLE ORIGIN INSERTION NERVE SUPPLY ACTION
Trapezius Upper fibers into lateral third of
clavicle; middle and lower fibers
into acromion and spine of
scapula
Spinal part of accessory nerve
(motor) and C3 and C4 (sensory)
Upper fibers elevate the scapula;
middle fibers pull scapula
medially; lower fibers pull medial
border of scapula downward
Latissimus dorsi Iliac crest, lumbar fascia, spines
of lower six thoracic vertebrae,
lower three or four ribs, and
inferior angle of scapula
Thoracodorsal nerve Extends, adducts, and medially
rotates the arm
Levator scapulae Transverse processes of first four
cervical vertebrae
Medial border of scapula


C3 and C4 and Dorsal scapular
nerve

Rhomboid minor


Dorsal scapular nerve Raises medial border of scapula
upward and medially
Rhomboid major Second to fifth thoracic spines Medial border of scapula Dorsal scapular nerve


Gross and Musculoskeletal Anatomy Laboratory

I will continue O my God to do all my actions for the love of You.

8
De La Salle Health Sciences Institute College of Rehabilitation Sciences
Hernandez, Pamela Grace
OTRP
ANA1 Laboratory Organizer, AY 2014-2015
Anatomy of Shoulder and Scapula



MUSCLES CONNECTING THE SCAPULA TO THE HUMERUS (24 points)
NAME OF MUSCLE ORIGIN INSERTION NERVE SUPPLY ACTION
Deltoid Lateral third of clavicle,
acromion, spine of scapula
Axillary nerve

Supraspinatus Supraspinous fossa of scapula Suprascapular nerve


Infraspinatus Infraspinous fossa of scapula Suprascapular nerve Laterally rotates arm and
stabilizes shoulder joint
Teres major Lower subscapular nerve Medially rotates and adducts
arm and stabilizes shoulder joint
Teres minor Axillary nerve Laterally rotates arm and
stabilizes shoulder joint
Subscapularis Upper and lower subscapular
nerves
Medially rotates arm and
stabilizes shoulder joint

THE AXILLLA (8 points)
WALLS OF THE AXILLA CONTENTS
WALL STRUCTURES FORMING THE WALL
ANTERIOR WALL
POSTERIOR WALL
MEDIAL WALL
LATERAL WALL
BASE




References:
Drake, L. et al, Grays Anatomy for Students
Gross and Musculoskeletal Anatomy Laboratory

I will continue O my God to do all my actions for the love of You.

9
De La Salle Health Sciences Institute College of Rehabilitation Sciences
Hernandez, Pamela Grace
OTRP
ANA1 Laboratory Organizer, AY 2014-2015
Anatomy of Shoulder and Scapula
Hislop, H. & Montgomery, J. Daniels and Worthinghams Muscle Testing Techniques of Manual Examination
Kapanji, A. The Physiology of the Joints
McMinn, R. et.al. A Colour Atlas of Human Anatomy
Moore, K. Clinically Oriented Anatomy
Neumann, D. Kinesiology of the Musculoskeletal System Foundations for Rehabilitation
Norkin, C. & Levangie, P. Joint Structure and Function A Comprehensive Analysis
Smith, L. Brunnstroms Clinical Kinesiology
Snell, R. Clinical Anatomy for Medical Students