Applied / clinical anatomy is the application of
anatomical knowledge to the diagnosis and treatment
1. Shoulder region of disease
2. Upper arm
3. Forearm
4. Hand
a. Scapula
1. Shoulder region b. Clavicle
c. 1st rib
Bones: d. Humerus – upper end
- Scapula
- Clavicle
- 1st rib
- Upper humerus
Flat, triangular bone that lies on posterior chest wall
Joints: between 2nd & 7th ribs.
- sternoclavicular 2 surfaces:
Posterior (dorsal surface):
- Acromioclavicular
Spine of scapula projects backwards. Lateral end of
- Shoulder
spine is free = ACROMION which articulates with
Muscles and fasciae clavicle at the acromioclavicular (AC) joint. Divides
scapula into supra and infra spinous fossae
Blood vessels
Glenoid cavity (fossa) lies at superolateral angle of
- Arteries scapulat & articulates with head of humerus at the
- Veins glenohumeral joint (shoulder joint). The supraglenoid
Nerves tubercle gives attachment (origin) to long head of
biceps brachii.
Muscle attachments – conventions
Coracoid process projects upwards and forward above
gelnoid cavity
Suprascapular notch is medial to the base of the
coracoid process
,Anterior (costal) surface
Concave, subscapular fossa – for origin of
subscapularis Long slender bone which lies horizontally across root
of neck.
Inferior angle
Articulates:
Easily palpated, marks
- Manubrium sterni & 1st costal cartilage
- level of 7th rib
- Acromion process of scapula
- T7 vertebra.
Scapula attaches important muscles & ligaments
Function:
- Strut that holds arm away from trunk
The posiiton of the scapula on the posterior wall of
- Transmits forces from upper limb to axial
the thorax is maintained by the tone and balance of
skeleton
the muscles attached to it. If one of these muscles is
- provides attachment for muscles
paralyzed, the balance is upset. Result? Winged
scapula or dropped shoulder
Winged scapula casued by paralysis of the serratus
anterior muscle. Origin: lateral surface of superor 8 or
9 ribs. Insertion: vertebral border and inferior angle of
scapula. Nerve: long thoracic nerve
Most commonly fractured bone in the body. Usually
occur as a result of a fall on the shoulder or
outstretched hand. Force transmitted along clavicle
which breaks at weakest point (junction of lateral 1/3
& medial 2/3). Close relationship of suprascapular
Dropped shoulder occurs with paralysis of the nerves to clavicle may result in their involvement in
trapezius. The upper portion of trapezius rotates and callus formation post fracture (chronic pain).
elevates the scapula. Spinal accessory nerve (XI), C3 &
C4 spinal nerves) 1. Lateral fragment
Depressed by weight of arm. Pulled medially and
anteriorly by strong adductor muscles of shoulder
joint, especially pectoralis major
2. Medial fragment
Tilted upwards by sternocleidomastoid
, Close relationship to lower nerves of brachial plexus Humerus articulates with:
and subclavian artery and vein. Small and flattened
- Scapula at shoulder joint
from above downwards.
- Radius & ulna at elbow joint
Scalenus anterior arises from C3/C4/C5 & is inserted
Head lies at upper end; forms 1/3 of sphere &
onto inner border (scalene tubercle*) & upper surface
articulates with glenoid cavity of scapula
of 1st rib.
Anatomical neck lies immediately below head
( ) Posterior attachment of scalenus anterior to 1st rib
lie: Greater & lesser tuberosities, lie below anatomical
neck, separated from each other by bicipital groove
- Subclavian artery
for tendon of long head of biceps
- Lower trunk of branchial plexus (they cross rib
& lie in contact with bone) Surgical neck is junction between upper end of
humerus & shaft
Subclavian vein also crosses 1st rib – anterior to the
artery
Lodges the long tendon of the biceps brachii
Transmits a branch of the anterior humeral circumflex
artery to the shoulder joint
Teres Major inserts on medial lip of groove
Latissimus Dorsi inserts on the floor of the groove
Pectoralis Major inserts on lateral lip of groove
(a lady between 2 majors)
GT = insertions of supraspinatus, infraspinatus and
teres major
LT = insertions of subscapularis
anatomical knowledge to the diagnosis and treatment
1. Shoulder region of disease
2. Upper arm
3. Forearm
4. Hand
a. Scapula
1. Shoulder region b. Clavicle
c. 1st rib
Bones: d. Humerus – upper end
- Scapula
- Clavicle
- 1st rib
- Upper humerus
Flat, triangular bone that lies on posterior chest wall
Joints: between 2nd & 7th ribs.
- sternoclavicular 2 surfaces:
Posterior (dorsal surface):
- Acromioclavicular
Spine of scapula projects backwards. Lateral end of
- Shoulder
spine is free = ACROMION which articulates with
Muscles and fasciae clavicle at the acromioclavicular (AC) joint. Divides
scapula into supra and infra spinous fossae
Blood vessels
Glenoid cavity (fossa) lies at superolateral angle of
- Arteries scapulat & articulates with head of humerus at the
- Veins glenohumeral joint (shoulder joint). The supraglenoid
Nerves tubercle gives attachment (origin) to long head of
biceps brachii.
Muscle attachments – conventions
Coracoid process projects upwards and forward above
gelnoid cavity
Suprascapular notch is medial to the base of the
coracoid process
,Anterior (costal) surface
Concave, subscapular fossa – for origin of
subscapularis Long slender bone which lies horizontally across root
of neck.
Inferior angle
Articulates:
Easily palpated, marks
- Manubrium sterni & 1st costal cartilage
- level of 7th rib
- Acromion process of scapula
- T7 vertebra.
Scapula attaches important muscles & ligaments
Function:
- Strut that holds arm away from trunk
The posiiton of the scapula on the posterior wall of
- Transmits forces from upper limb to axial
the thorax is maintained by the tone and balance of
skeleton
the muscles attached to it. If one of these muscles is
- provides attachment for muscles
paralyzed, the balance is upset. Result? Winged
scapula or dropped shoulder
Winged scapula casued by paralysis of the serratus
anterior muscle. Origin: lateral surface of superor 8 or
9 ribs. Insertion: vertebral border and inferior angle of
scapula. Nerve: long thoracic nerve
Most commonly fractured bone in the body. Usually
occur as a result of a fall on the shoulder or
outstretched hand. Force transmitted along clavicle
which breaks at weakest point (junction of lateral 1/3
& medial 2/3). Close relationship of suprascapular
Dropped shoulder occurs with paralysis of the nerves to clavicle may result in their involvement in
trapezius. The upper portion of trapezius rotates and callus formation post fracture (chronic pain).
elevates the scapula. Spinal accessory nerve (XI), C3 &
C4 spinal nerves) 1. Lateral fragment
Depressed by weight of arm. Pulled medially and
anteriorly by strong adductor muscles of shoulder
joint, especially pectoralis major
2. Medial fragment
Tilted upwards by sternocleidomastoid
, Close relationship to lower nerves of brachial plexus Humerus articulates with:
and subclavian artery and vein. Small and flattened
- Scapula at shoulder joint
from above downwards.
- Radius & ulna at elbow joint
Scalenus anterior arises from C3/C4/C5 & is inserted
Head lies at upper end; forms 1/3 of sphere &
onto inner border (scalene tubercle*) & upper surface
articulates with glenoid cavity of scapula
of 1st rib.
Anatomical neck lies immediately below head
( ) Posterior attachment of scalenus anterior to 1st rib
lie: Greater & lesser tuberosities, lie below anatomical
neck, separated from each other by bicipital groove
- Subclavian artery
for tendon of long head of biceps
- Lower trunk of branchial plexus (they cross rib
& lie in contact with bone) Surgical neck is junction between upper end of
humerus & shaft
Subclavian vein also crosses 1st rib – anterior to the
artery
Lodges the long tendon of the biceps brachii
Transmits a branch of the anterior humeral circumflex
artery to the shoulder joint
Teres Major inserts on medial lip of groove
Latissimus Dorsi inserts on the floor of the groove
Pectoralis Major inserts on lateral lip of groove
(a lady between 2 majors)
GT = insertions of supraspinatus, infraspinatus and
teres major
LT = insertions of subscapularis
