Color Atlas of Human Anatomy

Vol. 1: Locomotor System

Bearbeitet vonWerner Platzer

6. durchges. Auflage 2008. Buch. ca. 480 S.ISBN 978 3 13 533306 9

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aus: Platzer, Locomotor System (ISBN 9783135333069), � 2009 Georg Thieme Verlag KG

Upper Limb: Muscles, Fascias, and Special Features

Shoulder MusclesInserted on the Humerus

Dorsal Muscle Group, continued (A–D)

Insertion on the lesser tubercle and its crestsubscapularis, teres major and latissimus dorsi

The subscapularis (1) arises in the sub-scapular fossa (2) and is inserted on thelesser tubercle (3) and the proximal part ofits crest. Near to its attachment betweenthe subscapularis and the joint capsule oc-curs the subtendinous bursa of the sub-scapularis (4), and between it and the baseof the coracoid process lies the subcoracoidbursa (5). Both bursae are connected withthe joint space. It produces medial (inter-nal) rotation of the arm.Nerve supply: subscapular nerve (C5–C8).

Variant: The occurrence of accessorybundles.

Clinical tip: Paralysis of the subscapularis pro-duces maximal lateral (external) rotation ofthe upper limb, which indicates that it is a par-ticularly strong medial rotator of the arm.The term “rotator cuff” is often incorrectly usedfor the subscapularis, supraspinatus (6), in-fraspinatus (7), and teres minor (8) muscles. Itis more correct to use the term “muscle-ten-don cuff” or “tendon hood.”

The teres major (9), which arises from thelateral border (10) of the scapula near theinferior angle, is inserted on the crest of thelesser tubercle (11), near the subtendinousbursa of the teres major. Its main functionis retroversion of the arm toward the mid-line, a movement requiring retroversionand simultaneously a small medial rota-tion. It is particularly prominent if the armhas previously been anteverted andslightly abducted. The muscle also helps inadduction.Nerve supply: thoracodorsal nerve (C6 –C7).

Variant: Fusion with the latissimus dorsi orcomplete absence of the muscle.

The latissimus dorsi (12) is broad and flat,and is the largest muscle in humans. Itarises from the spinous processes of theseventh to twelfth thoracic vertebrae (13) asthe vertebral part, from the thoracolumbarfascia (14) and the posterior third of theiliac crest (15) as the iliac part, from the10th– 12th ribs (16) as the costal part, and, inaddition, very often from the inferior angleof the scapula as the scapular part (17). Thelatissimus dorsi thus usually arises in fourparts which have different functions. Itdevelops embryologically with the teresmajor, with which it is inserted on the crestof the lesser tubercle (18). The subtendinousbursa of the latissimus dorsi lies immedi-ately before the junction of both muscles.The latissimus dorsi provides the muscularbasis of the posterior axillary fold. It lowersthe raised arm and adducts it. When thearm is adducted, it pulls it backward andmedially, and rotates it so far medially thatthe back of the hand can cover the buttock.The latissimus dorsi is often called the“dress coat pocket” muscle. Both latissimican act together to pull the shoulders back-ward and downward. They function, too,during forced expiration and in coughing(coughing muscle).Nerve supply: thoracodorsal nerve (C6–C8).

Variant: The occurrence of aberrant musclefibers that run into the pectoralis major as amuscular arch across the axilla.

19 Long head of triceps muscle20 Long head of biceps muscle21 Coracoacromial ligament22 Glenoid cavity23 Glenoid lip24 Joint capsule25 Bursa of supraspinatus muscle26 External oblique abdominal muscle27 Trapezius muscle (partly resected)

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aus: Platzer, Locomotor System (ISBN 9783135333069), � 2009 Georg Thieme Verlag KG

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Shoulder Muscles Inserted on the Humerus