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Questions and Answers
Which part of the deltoid muscle is activated primarily during shoulder flexion?
What action primarily activates the middle portion of the trapezius muscle?
Where can the infraspinatus muscle be palpated?
Which component of the deltoid muscle is associated with abduction of the shoulder to 90 degrees?
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How are the fibers of the lower trapezius muscle oriented?
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Which bony landmark is notably widened in a lateral and posterior direction during clavicle palpation?
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Which muscle is described as being above the spine of the scapula?
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What is the primary action of the posterior deltoid muscle?
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What action primarily activates the Teres Major during palpation?
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Which maneuver best identifies the Sternal Head of the Pectoralis Major?
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What is the primary action that activates the Subscapularis muscle during palpation?
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Which muscle can be palpated by sliding fingers on the anterior surface of the scapula?
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What joint classification does the scapulothoracic joint belong to?
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What is the primary function of the scapulothoracic complex in relation to shoulder movements?
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Which of the following movements is NOT performed by the scapula?
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When palpating the medial border of the scapula, how far is it approximately from the spinous processes?
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Which landmark of the scapula corresponds with the thoracic spinous process of the 3rd vertebrae?
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The lateral border of the scapula is most distinctly palpable at which of the following locations?
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What defines the scapulothoracic complex as not being a true anatomical joint?
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Which of the following shoulder girdle movements involves bringing the scapula closer to the midline of the body?
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During upward rotation of the scapula, what anatomical structure primarily facilitates this motion?
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Study Notes
Clavicle Palpation
- Start at the inferior aspect of the clavicle medially and follow it laterally until it starts to disappear
- Do not get lost in the anterior V notch
- Palpate the superior aspect of the clavicle laterally and posteriorly
- Note that the clavicle becomes more posterior and wider in this direction
- You will meet the line you drew before on the superior edge of the spine of the scapula which goes to the posterior V notch
Muscles and Tendons
-
Deltoid Muscle:
- Shoulder muscle composed of anterior, middle, and posterior bundles
- Inserts on the deltoid tuberosity of the humerus
- Anterior deltoid is activated during flexion to 90 degrees
- Middle deltoid is activated during abduction to 90 degrees
- Posterior deltoid is activated during horizontal abduction
-
Supraspinatus:
- Rotator cuff muscle
- Located above the spine of the scapula
- Palpate in the supraspinatus fossa during abduction
-
Infraspinatus:
- Rotator cuff muscle
- Located below the spine of the scapula
- Find the medial and lateral scapular borders
- Palpate in the infraspinatous fossa during external rotation with the arm in 90 degrees of abduction
-
Trapezius Muscle:
- Composed of three parts: Upper, Middle, and Lower
- Upper Trapezius: easily palpated when the subject shrugs the shoulders; can be activated unilaterally by resisting lateral flexion of the neck
- Middle Trapezius: activated by asking the subject to horizontally abduct the shoulder when in prone (T’s); fibers run transversely to insert on the acromion and the crest of the spine of the scapula
- Lower Trapezius: subject in prone, and the arms elevated to approximately 120 degrees, ask the subject to lift the arm up (Y’S); fibers run obliquely, upward and outward attaching to the scapular spine
- Composed of three parts: Upper, Middle, and Lower
-
Clavicle:
- Palpate the medial end of the clavicle
- Palpate the jugular notch of the sternum
- Palpate the clavicular notch of the sternum
Scapulothoracic Complex
- Not a true anatomical joint but a crucial relationship between the scapula and thorax
- Scapular movements are linked to movements of the sternoclavicular, acromioclavicular, and glenohumeral joints
- Demonstrate the available motions of the scapula along the bony thorax:
- Elevation of scapula
- Depression of scapula
- Protraction of scapula
- Retraction of scapula
- Upward rotation of scapula
- Downward rotation of scapula
Bony Reference Points
-
Scapula: Triangular bone that rests upon the thoracic cage, in resting position it covers ribs two to seven
- Medial Border: lies approximately 2 inches from the spinous processes; palpate inferiorly to the inferior angle; palpate superiorly to the superior medial angle (not as distinct as the inferior angle; important clinically as a site of referred pain in cervical spine dysfunctions)
- Lateral Border: from the inferior angle of the scapula, move laterally to palpate the lateral border of the scapula; this border disappears as you move superiorly (covered by latissimus dorsi and teres major)
- Spine of the Scapula: lies across from T3 (Thoracic Spinous Process of 3rd vertebrae); should feel a smooth triangular area at the start of the spine of the scapula; trace the spine of the scapula (pinch top and bottom w/fingers) until it terminates laterally to the acromion process; palpate scapular spine from underneath (inferior edge); follow it to the posterior corner of the acromion
Muscles and Tendons
- Teres Major: in prone with arm off side of table ask your subject to internally rotate arm; fibers of both the Teres Major and Latissimus dorsi will contract—muscle fibers closest to the lateral board of the scapula are the Teres Major
- Rhomboid Major and Minor muscle: prone with arm behind back and dorsum of the hand resting lightly on the sacrum; ask your subject to lift the hand
-
Pectoralis Major: muscle has 2 heads
- Clavicular Head: in supine, abduct the arm to 90 degrees with the elbow flexed to 90; ask the subject to ADDUCT the arm horizontally; palpate the clavicular head under the clavicle
- Sternal Head: place the shoulder in FULL flexion; ask the subject to reach over to the opposite hip (adduction and internal rotation); palpate in the axilla fold
- Subscapularis: in supine, forearm on forehead to protract scapula; slide your fingers on the anterior surface of the scapula between the latissimus dorsi and rib cage; to activate muscle, ask subject to internally rotate the shoulder
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Description
This quiz covers the anatomy and palpation techniques of the clavicle and associated shoulder muscles. Focus on the deltoid and rotator cuff muscles, and understand their functions and palpation points. Perfect for students or professionals studying human anatomy.
