Scapular Elevation and Depression PDF 1446 H/2024 A.D

# 1446 H/2024 A.D ## Scapular Elevation, and Depression **Manual Muscle Test 200 PHT** **Theoretical Part 7th Week** **(14th lecture)** Jazan University, College of Nursing and Health Sciences, Physical Therapy Department. ## **14th lecture_Theoretical Part : Scapular Elevation, and Depression.**...

# 1446 H/2024 A.D ## Scapular Elevation, and Depression **Manual Muscle Test 200 PHT** **Theoretical Part 7th Week** **(14th lecture)** Jazan University, College of Nursing and Health Sciences, Physical Therapy Department. ## **14th lecture_Theoretical Part : Scapular Elevation, and Depression.** **Objectives**: at the end of this lecture the student will be able to: 1. Identify the primary muscles involved in scapular elevation. 2. Identify the range of motion of scapular elevation. 3. Describe effect of weakness of scapular elevator muscles. 4. Identify the primary muscles involved in scapular depression. 5. Identify the range of motion of scapular depression. 6. Describe effect of weakness of scapular depressor muscles. **Content:** 1. Anatomy of primary muscles involved in elevation of scapula. 2. Range of motion of elevation of scapula. 3. Effect of weakness of scapular elevators. 4. Anatomy of primary muscles involved in scapular depression. 5. Range of motion of scapular depression. 6. Effect of weakness of scapular depressors. ## **Scapular Elevation Motion:** **Primary Muscles:** 1. Upper fibers of trapezius 2. Levator scapulae **Range of motion:** With full ROM the shoulder is brought up with a distance of approximately 3fingers separating it with the ear inferior lobe. **Limiting Factors of Range of Motion:** 1. Tension of costo-clavicular ligament. 2. Tension of the muscles depressing the scapula and clavicle: pectoralis minor, subclavius and trapezius (lower fibers) muscles. **Accessory muscles:** - Rhomboids major and minor. ## **Anatomy of Upper fibers of trapezius:** **Origin** * External occipital protuberances medial 1/3 of superior nucheal line * Ligamentum nucheal * Spinous process of 7th cervical vertebra. **Insertion** * Lateral 1/3 of clavicle. * Acromion process of scapula (Fig.1). **Nerve supply** * Accessory nerve (11 cranial nerve) * Anterior ramus of C2, 3 & 4. **Action** * **Bilateral Action**: Elevation of the scapula and extension of the cervical spine. * **Unilateral Action**: the upper fibers extend, laterally flex and rotate the head and joints of the cervical vertebrae so that the face turns towards the opposite side. **Figure. 1: Upper Fibers of Trapezius.** (A diagram detailing fibers of the trapezius muscle) ## **Anatomy of Levator Scapulae:** **Origin** * Transverse processes of the first four cervical vertebrae. **Insertion** * Medial border of scapula between superior angle and root of spine (Fig.2). **Nerve supply** * Dorsal scapular nerve. **Action** * **Bilateral Action**: extension of the cervical spine and scapular elevation. * **Unilateral Action**: it rotates and laterally flex the cervical vertebrae to the same side. **Figure. 2: Levator Scapulae.** (A diagram detailing the levator scapulae muscle) ## **Scapular Depression** **Primary Muscles:** * Lower fibers of trapezius **Accessory muscle** * Middle fibers of trapezius. **Range of motion:** The distance covered by the depressed scapula is equivalent to 3 – 4 fingers). ## **Limiting Factors of Range of Motion:** 1. Tension of interclavicular ligament and articular disc of sternoclavcular joint. 2. Tension of trapezius (upper fibers) levator scapulae and sternocleidomastoid (clavicular head). ## **Anatomy of Lower fibers of trapezius:** **Origin** * Spinous processes of 6th – 12th thoracic vertebrae. **Insertion** * Apex of spine of scapula (Fig.3). **Nerve supply** * Accessory nerve (11 cranial nerve) * Anterior ramus of C2, 3 & 4. **Action** 1. Depression of the scapula. 2. Stabilization when the middle and upper fibers are working. **Figure 3: Lower fibers of trapezius** (A diagram detailing the lower fibers of trapezius muscle)