10-6-09 - Pectoral girdle Scapula Clavicle Pectoral Girdle...

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Pectoral girdle
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Scapula Clavicle
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Pectoral Girdle Anterior Muscles
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Serratus anterior Pectoralis minor
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Pectoral Girdle Posterior Muscles
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Levator scapulae Rhomboids – major and minor Trapezius Latissimus dorsi
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Scapula
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Synarthrodial joint Muscles – o Trapezius o Levator scapulae o Rhomboid major and minor o Serratus anterior o Pectoralis minor o Latissimus dorsi
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Trapezius
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Longest muscle in back Upper, middle and lower fibers O: - o Upper ligamentum nuchae from C1-7 spinous processes; o Middle T1-5 spinous processes o Lower - T6-12 spinous processes; I: o Upper – lateral third of the clavicle o Middle – acromion and spine of scapula o Lower – root of the spine of scapula N: accessory (cranial #11)
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Trapezius
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A: Upper – scapula elevation and upward rotation Middle – retraction Lower – scapula depression and upward rotation RA: neck extension when arms are fixated
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Trapezius
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Palpation Upper : R – prone, neck extended in neutral edge over plinth PF posterior aspect of the neck base of the skull over the shoulder to the clavicle Middle – patient prone, arms out to side PF – between scapulae ; allow only a partial contraction or skin wrinkles and palpation is difficult Lower –patient prone in total extension, arms out in front (superman position) PF – lower thoracic vertebrae to scapula
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Trapezius
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Comment Upper and lower fibers aid in upward rotation – allows hand to be placed above the head Patients who cannot upwardly rotate substitute by hyperextendingthe trunk Lower fibers may be poorly developed
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Levator scapulae
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O: C1-4 transverse processes I: superior angle to the root of the scapulae N: dorsal scapular A: scapula elevation and downward rotation RA: neck extension and lateral flexion when scapula is fixated Palpation R: scapula elevation PB (palpate between) – sternocleidomastoid (anterior) and trapezius (posterior) PP (Partially palpatable): lateral to the trapezius at base of neck
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Levator scapulae
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C: Levator scapulae holds up the weight of the shoulder arm complex and often ends up in spasm; to relieve spasm, bring both shoulders up towards the ears with maximal force and hold for a count of ten; In general “a weak muscle is a painful muscle” Spasms occur near the superior angle of the scapula; Deep friction massage can break spasm and pain cycle Most common muscle to be tender
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Rhomboids – Major and minor
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O: ligamentum nuchae, C7-T5 spinous processes I: posterior vertebral border of scapula N: dorsal scapular A: scapular elevation, retraction, and downward rotation Palpation R: downward rotation (“scratch your back”) PP: upper thoracic vertebrae to vertebral border of the scapula through the middle trapezius
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Rhomboids – Major and minor
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This note was uploaded on 02/11/2010 for the course AHS 234 taught by Professor Bial during the Fall '09 term at Nassau CC.

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10-6-09 - Pectoral girdle Scapula Clavicle Pectoral Girdle...

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