Name Lab Section

Shoulder Complex Muscles

Purpose: To learn the actions, proximal attachments, and distal attachments of the muscles that act on the clavicle, scapula, and humerus at the glenohumeral, acromioclavicular, and sternoclavicular articulations. Textbook, Flash Anatomy Cards, or other resource for muscle actions & attachments Handout Learning Muscle Attachments (from web page) Handout Rules to Remember (from web page) Articulated skeleton (to be provided by instructor) Disarticulated skeleton (to be provided by instructor)

Equipment:

Background Information As you begin your study of muscle attachments for muscles, know that I will use the terms proximal and distal attachments rather than origins and insertions. The reason for this is that literally defined, origin means the fixed bone and insertion means the moving bone. When a muscle contracts and attempts to shorten, it exerts force on all the bones to which it attaches. The bone that is more stable will not move, and the bone that is freer to move for whatever reason will move. Usually, the distal bone is lighter than the proximal bone and is, therefore, freer to move. Since the distal bone is usually the bone that moves, attachments on the distal bone were called the insertion points. However, you must understand that either bone (proximal or distal) can potentially move. If the distal bone becomes more fixed, or stable, then the proximal bone will move. An example of this would be in a pull-up, where contraction of the biceps brachii, an elbow flexor, cause elbow flexion by pulling the humerus up to the forearm. This is opposite what we usually associate with elbow flexion, where the forearm moves toward the stationary humerus as in a curl motion. In the case of the pull-up, the attachment of the bicep on the forearm would become the origin and the attachment on the scapula would become the insertion in other words, they would be reversed from what we normally consider the origin and insertion. Therefore, to keep things simple, I will use the terms proximal and distal attachment rather than origin and insertion For this lab, you are to learn the actions and attachments for the muscles of the shoulder complex. The shoulder complex consists of two distinct and anatomically independent units: the shoulder girdle and the shoulder (glenohumeral) joint. While they are functionally interdependent in many ways, these two units can also function independently of each other. Therefore, you should learn them and their muscles as individual units at this time. The functional interdependence of these two units will be presented to you later in this course if you are taking the course for 3 credits. We will first discuss the shoulder girdle. The shoulder girdle consists of the scapula and clavicle, and the joints that connect these bones to the thorax [the sternoclavicular (SC) joint and the scapulothoracic (ST) joint] and to each other [the acromioclavicular (AC) joint]. Therefore, movements of the shoulder girdle (the scapula and clavicle) are not a result of motion about a single joint. Instead, movement of the shoulder girdle is the summation of movements that occur at all three joints the AC, SC, and ST. Individually, these joints are classified primarily as nonaxial joints, which means that they do not allow rotation. At this time, we will not learn about these joints individually, but you should understand that the shoulder girdle movements that you learn are a result of motion about 3 joints simultaneously. When we consider the movements of all of these joints together, linear and angular movements of the shoulder girdle can be defined in all 3 planes. In the frontal plane, the linear movements of elevation/depression

occur, and the angular movements of upward and downward rotation occur. In the sagittal plane, the angular movements of upward & downward tilt occur. In the transverse plane, the angular movements of protraction and retraction occur. There are 6 muscles that are devoted to causing and controlling movements of the scapula and/or the clavicle: the subclavius, the serratus anterior, the rhomboids (rhomboid major and rhomboid minor), the trapezius, the pectoralis minor, and the subclavius. While the rhomboid major and rhomboid minor are considered two separate muscles anatomically, you can learn them as one muscle since their functions are identical. On the other hand, while the trapezius muscle is considered one muscle anatomically, you should learn it as three muscles (upper, middle, and lower trapezius) since each portion has a different function from the other portions. As you study the attachment sites for the shoulder girdle muscles, remember that a muscle that causes shoulder girdle movements must attach distally to the scapula or clavicle in order to be able to cause that bone to move. Therefore, proximal attachments (usually origins) must be on the thorax (ribs or vertebrae), and distal attachments (usually insertions) must be on the scapula or clavicle. The shoulder (or glenohumeral) joint is the articulation formed between the head of the humerus and the glenoid fossa of the scapula. It is classified as a triaxial joint, allowing movement in all three planes: flexion, extension, hyperextension in the sagittal plane; abduction, adduction in the frontal plane; and medial rotation, lateral rotation, horizontal adduction, and horizontal abduction in the transverse plane. Because it does permit frontal and sagittal plane motions, it also permits circumduction. Muscles on the front will typically cause flexion, while muscles on the back will typically cause extension and hyperextension. Muscles on the lateral aspect of the shoulder will typically cause abduction while muscles on the medial aspect of the shoulder will typically cause adduction. Transverse plane motions must be understood by examining the line of pull of the muscle relative to the superior-inferior axis of the humerus. As you study the attachment sites for the hip muscles, remember that a muscle that causes shoulder joint movements must cross the shoulder joint. Therefore, proximal attachments (origins) must be on the scapula, clavicle, or thorax, and distal attachments (insertions) must be on the humerus, radius, or ulna. You should not confuse shoulder girdle muscles with shoulder joint muscles if you will remember that shoulder girdle muscles do not cross the shoulder joint and, therefore, cannot have attachments on the humerus or below.

Procedures to be completed prior to lab:

1. Review the bony markings listed below for the scapula, vertebra, sternum, clavicle, radius,
ulna, and humerus. (Resource: BIOL 120 Lab Manual, or Flash Anatomy Cards Bones) Scapula Acromion process Articular facet of acromion process Lateral (axillary) border Coracoid process Glenoid fossa Inferior angle Infraglenoid tubercle Infraspinous fossa Root of the scapular spine Suprascapular notch Spine of scapula Supraspinous fossa Subscapular fossa Superior angle Superior border Supraglenoid tubercle Medial (vertebral) border Sternum Xiphoid process Manubrium Clavicular notch Body Ulna Olecranon process Radius Radial tuberosity Humerus Anatomical neck Body Deltoid tuberosity Head Intertubercular (bicipital) groove Lesser tubercle (or tuberosity) Greater tubercle (or tuberosity) Surgical neck Clavicle Conoid tubercle Sternal end Acromial end Vertebra Atlas (C1) Axis (C2) Coccyx Sacrum Body Lamina Pedicle Spinous process Transverse process Vertebral arch Vertebral foramen

2. Review the joint actions of the shoulder girdle and glenohumeral joint. On a separate sheet of paper,
define the following terms for shoulder girdle (scapular) movements): elevation, depression, abduction (protraction), adduction (retraction), upward tilt, downward tilt, upward rotation, and downward rotation.

3. Use the Handouts Learning Muscle Attachments & Rules to Remember and your Flash Anatomy Cards or other resource to review diagrams, actions, and attachments of the following muscles: Shoulder Girdle (Acromioclavicular, Sternoclavicular, and Scapulothoracic Joints): Upper trapezius (I and II) Middle trapezius (III) Lower trapezius (IV) Shoulder (Glenohumeral Joint): Pectoralis major (sternal) Pectoralis major (clavicular) Latissimus dorsi Teres major Triceps brachii (long head) Supraspinatus Infraspinatus Teres minor Subscapularis Coracobrachialis Anterior deltoid Middle deltoid Posterior deltoid Biceps brachii (short head) Biceps brachii (long head) Levator scapula Rhomboids (major & minor) Subclavius Serratus anterior Pectoralis minor

Procedures to be completed during the lab session: 1. Use the bones, muscle models, and muscle diagrams to help you study these muscles and their attachments and actions. Strive to understand why each muscle has the action(s) that it has by applying concepts previously learned (torque and lines of pull). 2. Attempt to locate and palpate the superficial muscles on your lab partner. This will aid you in learning the location and actions of each of these muscles. Study Questions 1. What are the posterior muscles of the shoulder girdle? 2. Which muscle would be considered the latissimus dorsi's little helper? 3. Which four muscles make up the rotator cuff group? What is their primary function at the shoulder joint as a group? 4. On what aspect of the arm would you expect to find muscles that flex the humerus?

Summary of Muscle Actions: Shoulder Girdle Elevation Upper trapezius Rhomboids Levator scapula Depression Lower trapezius Pectoralis minor Pectoralis major Latissimus dorsi Subclavius Upward rotation Serratus anterior Upper trapezius Lower trapezius Abduction/Protraction Serratus anterior Pectoralis minor Pectoralis major Latissimus dorsi Downward rotation Rhomboids Pectoralis minor Levator scapulae

Adduction/Retraction Middle trapezius Rhomboids Lower trapezius Levator scapula Upper trapezius Upward tilt Pectoralis minor Shoulder Flexion Anterior deltoid Pectoralis major (C) Biceps brachii Coracobrachialis Adduction Latissimus dorsi Pectoralis major Teres major Triceps brachii (L) Coracobrachialis Medial rotation Subscapularis Posterior deltoid Latissimus dorsi Pectoralis major Anterior deltoid Teres major

Extension Pectoralis major (S) Latissimus dorsi Teres major Posterior deltoid Triceps brachii (L) Abduction Deltoid (all parts) Supraspinatus

Hyperextension Posterior deltoid Latissimus dorsi Triceps brachii (L)

Lateral rotation Infraspinatus Teres minor Posterior deltoid

Horizontal adduction Anterior deltoid

Horzontal abduction Pectoralis major Infraspinatus Teres minor