Contents
Anatomy
General information
- This section is strictly limited to anatomy, you might be looking for clinical relevant information which is found under the clinical chapters -- muscles section, click here to go to that page
Position
- Deep
Origin
- 1-9th ribs
- Anterolateral aspect
Insertion
- Anterior aspect of medial limitatoin of scapula
Main function
- Scapula
- Protraction
- Upward rotation
- Lateral rotation of lower part
Secondary function
- Scapula
- Elevation
- Depression
Nerve innervation
- Segmental
- C5-C7
- Peripheral
- Long thoracic nerve
Arterial supply
- Dorsal scapular artery
Palpation
- Patient position
- Supine
- Patient is holding the arm flexed in a 90° position of the shoulder
- Palpate the lateral limitation of the pectoralis major muscle, and from that position localize the lateral limitation of latissimus dorsi
- Palpate the area between these two muscle in the axilla, while you feel for the ribs and serratus anterior
- Have the patient protract the scapula to feel for the contraction of the serratus anterior
Muscle length test
- Patient position
- Sitting or standing
- Ask the patient to lift the arm so that it is flexed to a 120° angle of the shoulder
- Consider if the patient's scapula is showing sufficent abduction (lateral rotation of inferior angle) in this position
- If there is not a sufficient abduction (lateral rotation) of the scapula in this positioin, have the patient rest their arm on the therapist's shoulder in the same position
- Pull the scapula forward and into normal position again
- The patient is then holding the arm in the same position
- If the scapula is pulled back into adduction it is probable that there is a shortening of the serratus anterior
Strength test
- Patient position
- Supine
- Ask the patient to hold the arm straight in front of the body - 90° flexion of the shoulder joint
- Ask the patient to form a fist
- Give resistance towards the patient's fist so that the have to press the arm upwards and the scapula is protracted