Muscles of the Scapula/Arm

Business Address: 85 Barnes Road, Suite 101 Wallingford, CT 06492 Education: 2006-2008 Connecticut Center for Massage Therapy 75 Kitts Lane Newington, CT Degree: Massage Therapist 1990-1994 The National College of Chiropractic 200 East Roosevelt Road Lombard, IL 60148-4593 Completed 380 hours of study in Chiropractic Orthopedics

1988-1989 New York Chiropractic College Post Office Box 167 Glen Head, NY 11545 Degree: Certified Chiropractic Sports Physician

1986-1988 Palmer College of Chiropractic 1000 Brady Street Davenport, Iowa 52803 Degree: Doctor of Chiropractic, Summa Cum Laude

Undergraduate: 1980-1983 University of Vermont Burlington, VT 05401 Degree: Bachelor of Arts, Biology

Email Address: jpcjmc@aol.com Cell Phone: 203-605-7800 Office Number: 203-294-1700 Fax Number: 203-294-1710

1. Be familiar with the language, basic terminology, and basic concepts of Western anatomy and physiology.

2. Be able to identify the attachments and actions of major muscles.

3. Appreciate the role of massage therapy in facilitating health and healing.

4. Gain palpatory literacy.

Muscle flashcards are a requirement for AP1 Muscles

Buy them or create your own. Review the cards before class and every

week thereafter. Add the new muscles learned each week to the ones you have reviewed the week before.

Do not wait for the week of the exam to review the muscles.

Satisfactory attendance Satisfactory grade of 70% on the two in

class written exams Satisfactory grade of 70% on the two

muscle palpation examinations Satisfactory and timely completion of all

assignments including the Muscle Assignment

Satisfactory level on Professional Competencies Contract

Mid term exam is Week 4 The current date is November 12 Written exam is first followed by the

palpation practical The Final exam is Week 8 The current date is December 17 The Muscle Assignment is due the week of

the final exam.

Select 4 muscles For each muscle, list the following:

attachment, actions, and explain how the muscle is involved in a specific daily activity

You may also describe in detail a massage stroke that utilizes the action.

Have fun with this and ask if you have any questions.

Muscle AttachmentsMuscle AttachmentsA muscle attaches to a bone

either by a tendon or an aponeurosis

They are made of the same type of tissue but only differ in their shape

A tendon is round and cordlikeAn aponeurosis is broad and flat

in shape

NamingNaming MuscleMuscle AttachmentsAttachmentsMuscle attachments can be named

anatomically or physiologicallyAnatomically, muscle attachments are

named by their anatomical location. For example the attachments can be called medial and lateral attachments or proximal and distal attachments.

Physiologically, muscle attachments can be named by their physiology or what they do. For example, the attachment that moves is called the insertion and the attachment that is fixed is called the origin.

Origin and InsertionOrigin and InsertionThese terms were used more in the

past than they are today.The problem is that the attachment

that is fixed or mobile can reverse. i.e., the attachment that is usually fixed moves; the attachment that usually moves, is fixed.

The origin will usually be the more proximal attachment

The insertion is usually the more distal attachment

Line of Pull for a MuscleLine of Pull for a MuscleIf a muscle’s fibers have one line

of pull and the line of pull is perfectly in one plane, then the muscle will have one action.

Example: Brachialis

Line of Pull for a MuscleLine of Pull for a MuscleIf a muscle’s fibers have one line

of pull and the line of pull is in more than one plane( on oblique plane), then the muscle will have more than one action.

The muscle will have one action for each plane that its line of pull is within assuming that the joint crossed allows these actions.

i.e. : coracobrachialis

Line of Pull for a MuscleLine of Pull for a Muscle If the muscle’s fibers have more

than one line of pull, then the muscle will have more than one action. It will have at least one action for each line of pull

i.e.: Deltoid

Reverse ActionsReverse ActionsA term used to describe when the

attachment of a muscle that usually stays fixed does the moving and the attachment that usually moves stays fixed.

See appendix C page 716 in The Muscular System Manual

Reverse Action of Biceps Reverse Action of Biceps Brachii at the elbow jointBrachii at the elbow joint

Usually the forearm flexes at the elbow joint. The reverse action would be the arm flexing at the elbow joint instead, such as when doing a pull-up

Reverse action is always possible. There are always two different actions theoretically possible for every muscle

Reverse Action of the Reverse Action of the QuadricepsQuadricepsUsually we think of the quadriceps

causing extension of the leg at the knee joint. The thigh is fixed and the leg is moving at the knee joint.

Extension of the thigh at the knee joint would be the reverse, such as getting up out of a chair. The knee joint is still extending, but the thigh is moving instead of the leg.

Types of ContractionsTypes of ContractionsConcentric: shortening with toneEccentric: lengthening with toneIsometric: staying the same

length, with tone

Roles of MusclesRoles of MusclesA muscle does not act alone.

Muscles work in groups, and there are many roles that a muscle can assume within these groups

Muscles can contract for a number of reasons. To determine the role of the muscle know the action in question

Mover (agonist): the muscle that causes the action in question.

Antagonist: a muscle that causes the opposite action of the action in question

Five Steps to Learning Five Steps to Learning MusclesMusclesPlease review pages 9 and 10 in your

manual. This is an excellent guide on how to learn the muscles

Muscles on the anterior of the body with vertical fibers will cause flexion

Muscles on the posterior of the body with vertical fibers will cause extension

Muscles on the lateral side of the body with vertical fibers will cause abduction

SUPRASPINATUSSUPRASPINATUSP: Supraspinous Fossa of the scapulaD: Greater tubercle of the humerus

1. Abducts the arm at the shoulder jointPart of the rotator cuff muscle group

InfraspinatusP: Infraspinous fossa of the scapula

D: Greater tubercle of the humerus

1. Laterally rotates the arm at the shoulder joint

Part of the rotaor cuff muscle group

Teres minorP: Superior lateral border of the scapula

D: Greater tubercle of the humerus

1. Laterally rotates the arm at the shoulder joint

Part of the rotator cuff muscle group

SubscapularisP: Subscapular fossa of the scapula

D: Lesser tubercle of the humerus

1. Medially rotates the arm at the shoulder joint

Part of the rotator cuff muscle group

Teres MajorP: Inferior lateral border of the scapula

D: Medial lip of the bicipital groove of the humerus

1. Medially rotates the arm at the shoulder joint

2. Adducts the arm at the shoulder joint

3. Extends the arm at the shoulder joint

DeltoidP: Lateral clavicle, acromion process, and the spine of the scapula

D: Deltoid tuberosity of the humerus

1. Abducts the arm at the shoulder joint (entire muscle)

2. Flexes the arm at the shoulder joint (anterior deltoid)

3. Extends the arm at the shoulder joint (posterior deltoid)

4. Medially rotates the arm at the shoulder joint (anterior deltoid)

5. Laterally rotates the arm at the shoulder joint (posterior deltoid)

CoracobrachialisP: Coracoid process of the scapula

D: Medial shaft of the humerus

1. Flexes the arm at the shoulder joint

2. Adducts the arm at the shoulder joint

Biceps BrachiiP: Long head: Supraglenoid

tubercle of the scapula

Short head: Coracoid process of the scapula

D: Radial tuberosity

1. Flexes the forearm at the elbow joint (entire muscle)

2. Supinates the forearm at the radioulnar joints (entire muscle)

3. Flexes the arm at the shoulder joint (entire muscle)

BrachialisP: Distal ½ of the anterior shaft of the humerus

D: Ulnar tuberosity

1. Flexes the forearm at the elbow joint

Triceps BrachiiP: Long head: Infraglenoid tubercle of the scapula

Lateral head: Posterior shaft of the humerus

Medial head: Posterior shaft of the humerus

D: Olecranon process of the ulna

1. Extends the forearm at the elbow joint

Vineyard in Rome, Italy

Back Topographic Anatomy

Superficial Muscles of Back

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Client prone with arm resting on table.Place palpating hand just superior to spine of

the scapula in the supraspinous fossa.Ask client to perform very short ROM of

abduction of the arm and feel for contraction of the muscle.

To palpate distal attachment palpate the bicipital groove and move posterior to the greater tubercle.

Client prone with the arm resting on the table and the forearm off the table.

Therapist seated at side of table with the client’s forearm between the knees.

Place palpating hand inferior to the spine of the scapula in the infraspinous fossa.

Ask client to laterally rotate the arm at the shoulder joint against resistance of your knee. Feel for contraction of infraspinatus.

Move hand to the superior lateral border of the scapula and have the client laterally rotate the arm against resistance of your knee. Feel for contraction of the teres minor.

Palpate the distal tendon at its attachment to the greater tubercle of the humerus.

Client prone with arm resting on the table and forearm off the table resting between the therapists knees.

Place palpating hand just lateral to the lower aspect of the lateral border of the scapula.

Ask the client to medially rotate the arm at the shoulder joint against resistance of your knee.

Feel for contraction of the teres major at the inferior aspect of the lateral border of the scapula.

Locate the bicipital groove and move anterior to the medial lip. Have client again medial rotate arm against resistance and feel for the distal attachment.

Have the client alternate between medial and lateral rotation and try to distinguish the teres major from the teres minor.

Client supine with the arm resting on the trunk and the other side hand gently holding the elbow of the side being palpated.

Place palpating finger pads against the anterior surface of the scapula.

Support hand reaching under the client’s body to grip the medial border of the scapula.

Passively protract (pull laterally) the scapula with your support hand.

Ask client to take a deep breath in and as the client exhales, slowly but firmly press our finger pads in against the anterior surface of the scapula.

Ask the client to medial rotate the arm at the shoulder joint to palpate the subscapularis.

Client seated with arm abducted to 90 degrees and laterally rotated at the shoulder joint, and the forearm flexed at the elbow joint 90 degrees.

Stand in front of client and palpate medial aspect of the proximal half of the client’s arm.

Support hand placed on the distal end of the client’s arm, just proximal to the elbow joint.

Resist the client’s horizontal flexion of the arm at the shoulder joint and feel for contraction of the coracobrachialis .

Palpate attachment to attachment with perpendicular strumming over the muscle.

Client seated with the arm relaxed and the forearm fully supinated and resting on the client’s thigh.

Place palpating hand on the middle of the anterior arm.

Support hand placed on the anterior distal forearm just proximal to the wrist joint,

With mild to moderate force, resist the client from flexing the forearm at the elbow joint and feel for contraction of the biceps brachii.

Try to palpate attachment to attachment.

Client seated with the arm relaxed and the forearm fully pronated and resting on the client’s thigh.

Palpating hand on the anterolateral arm, immediately posterior to the biceps brachii.

Supporting hand placed on the client’s anterior distal forearm, just proximal to the wrist joint.

With gentle force, resist the client from flexing the forearm at the elbow joint and feel for contraction of the brachialis.

Strum perpendicular to the fibers and palpate attachment to attachment.