Shoulder & Pectoral Region Anatomy

Shoulder & Pectoral Region

• The presentation covers the anatomy of the shoulder and pectoral region.
• Learning objectives include identifying palpable landmarks, describing joints, muscles, blood supply, and their role in shoulder movements.
• The anatomy of the sternoclavicular joint and its role in shoulder movements is detailed.
• The glenohumeral (shoulder) joint, surrounding bursae, and movements are described.
• Muscles of the shoulder, their attachments, actions, and innervations are listed.
• The rotator cuff muscles and their role in supporting the glenohumeral joint are explained.
• Quadrangular and triangular spaces, including the triangular interval, and the structures passing through them are described.
• Blood supply and venous drainage of the shoulder, including the three primary vessels that supply collateral circulation, are noted.
• Features of the scapula, clavicle, and humerus on radiographs are identifiable.
• The position of the breast on the chest wall, related to the skin, superficial fascia, and pectoral muscles, is explained.
• Clavicle fracture presentation, including the mechanism, presentation, and treatment options are discussed.

Osteology and Joints

• This section focuses on the skeletal structures and joints related to the shoulder.
• The bones of the shoulder and their key features, including landmarks, are examined.
• The anatomy and function of various joints associated with the shoulder are discussed.

Surface Anatomy

• The anterior and posterior surface anatomy of the shoulder region are presented visually with labels.
• Diagrams or images show relevant muscles and features.
• Muscles like the Trapezius, Deltoid, Biceps Brachii, Pectoralis major, serratus anterior, and Triceps Brachii are among those illustrated, as well as related veins and nerves.

Anterior Osteology / Posterior Osteology

• Images illustrating the bones of the shoulder, including the humerus, clavicle, and scapula, along with their key landmarks, such as anatomical neck, greater tubercle etc.
• In the posterior osteology images, the scapula, clavicle, and humerus are labeled.

Learning Objectives

• Palpable landmarks for physical examination and clinical procedures are important.
• Sternoclavicular joint anatomy and its function in shoulder movements will be covered.
• Anatomy of the glenohumeral joint, including bursae and movements, will be described.
• Muscles of the shoulder and their actions and innervations are included.
• Key muscles of the rotator cuff are explained in relation to their impact on the glenohumeral joint.

Shoulder Separations (Acromioclavicular)

• Separation of the acromial end of the clavicle from the acromion process of the scapula.
• Common mechanisms are direct blows, during contact sports, with presentation of AC joint dislocation.

Glenohumeral Joint

• Structure, function, relationship of the glenoid fossa and humeral head

Glenohumeral Ligaments

• Coracohumeral ligament connects the coracoid process to the greater tubercle of humerus.
• Transverse humeral ligament helps to convert intertubercular sulcus into a canal.

Glenohumeral Joint Movements

• Describes flexion, extension, abduction, adduction, internal rotation, and external rotation.

Glenohumeral Joint Movement

• The ways in which the humerus moves in relation to the shoulder girdle, (i.e flexion, extension, abduction, etc.) to maintain function

Shoulder Dislocations

• Types and presentations, locations of dislocations.
• Dislocation of the head of the humerus from the glenoid fossa is discussed.
• Excessive extension and lateral rotation of the humerus can contribute to dislocations

Scapulothoracic Joint

• Explains that it is not a true synovial joint
• It connects the scapula to the thoracic cage, enabling its movement.
• Describes how the Serratus anterior muscle facilitates scapula retraction.

Scapulothoracic Joint Movement

• Discusses the movements of the scapula, including elevation, depression, abduction, adduction, downward rotation, and upward rotation.

Musculature

• The muscles of the shoulder region, including the Trapezius, Latissimus dorsi, Deltoid, Supraspinatus, Infraspinatus, Teres minor, Subscapularis, Pectoralis major, Pectoralis minor, and Serratus anterior, are examined.
• Detailed muscle attachments, actions, innervation, and blood supply are included.

Donor Images

• Images of anatomical structures are included, often used for visual reference or comparison.

Arteries

• Presentation of the major arteries in the shoulder region, including the subclavian, axillary, and their branches (thoracic, circumflex, etc.) are included.

Veins

• The superficial veins (cephalic, basilic, median cubital) draining the shoulder and arm region are noted.

Anatomy of the Breast

• The structure of the mammary gland (lobules, ducts, areola, nipple) is examined.
• The supportive tissues (Cooper ligaments, fatty tissue, connective tissues) are noted as components.

Blood Vessels of Breast

• Arterial supply to the breast (internal thoracic and lateral thoracic arteries) is detailed.
• Venous drainage of the breast (internal thoracic and lateral thoracic veins) are noted.

Breast Quadrants

• The breast is divided into quadrants for better description and location of abnormalities.

Breast Lymphatics

• The lymphatic drainage patterns in the breast region.
• Lymphatic pathways, directional flow, and associated nodes (axillary, parasternal, and some abdominal)

Breast Cancer

• Malignant tumors in the breast originate from mammary cells, usually adenocarcinomas that spread around the breast through the lymphatic vessels
• Key symptoms, such as changes to the nipple, skin dimpling, and treatment are described.

Spaces

• Suprascapular Notch: Containing the suprascapular nerve and artery
• Quadrangular Space: Containing the axillary nerve and posterior circumflex humeral artery
• Triangular Interval: Containing the radial nerve and deep artery of the arm

Rotator Cuff Tear

• Tears in the supraspinatus tendon are common, often resulting from repetitive use or overhead activity.
• Presentation and treatment are discussed

Rotator Cuff

• Defines the musculotendinous cuff around the glenohumeral (shoulder) joint and its crucial role in maintaining shoulder stability, protecting the joint, and blending with other tissues such as the joint capsule.
• The four muscles of the Rotator Cuff are described and their primary function in rotator arm movement. (Supraspinatus, Infraspinatus, Teres minor, Subscapularis)

Quiz Time

• A section used for review of the materials covered.

Anatomy Diagrams

• Images or diagrams showcasing the anatomy of the shoulder region, often labeled to identify specific structures, such as the muscles and nerves.