DOCSLIB.ORG

Sbohunicky Thesis 06.21.21

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

i Myofascial Release of the Pectoral Fascia: Effect on Shoulder Posture, Pectoral Length, Muscle Activity, and Movement Performance by: Sarah Bohunicky A Thesis submitted to the Faculty of Graduate Studies of The University of Manitoba in partial fulfillment of the requirements of the degree of MASTER OF SCIENCE Faculty of Kinesiology and Recreation Management University of Manitoba Winnipeg June 23rd, 2021 Copyright © 2021 by Sarah Bohunicky ii Abstract Context: Neck-shoulder pain is among the most common health care problems, especially in office workers and females. Forward shoulder posture (FSP) is a common postural deviation and known risk factor for the development of neck-shoulder pain and pathology. Common approaches for reducing FSP include stretching and performing manual techniques to increase the length and extensibility of the scapular protractors and strengthening the scapular retractors. Myofascial release (MFR) is a group of manual techniques that elongate and soften restricted fascia, however, the effects of myofascial release to the pectorals on FSP are currently unknown. Objective: To determine the impact of 4-minutes of MFR on: 1) FSP, 2) pectoral length, 3) muscle activity of the upper, middle, and lower trapezius and pectoralis major, 4) scapular retractor to protractor ratio of activity, and 4) movement performance compared to a soft-touch control. Participants: Eighteen females (27 years ± 10) with FSP but otherwise healthy shoulders. Interventions: One 4-minute MFR treatment and one 4-minute soft-touch control (CON) treatment. Main Outcome Measures: FSP, pectoral length, muscle activity of upper, middle, and lower trapezius (UT, MT, LT) and pectoralis major (PEC), scapular retractor-protractor ratio of activity (R/P), and movement performance (reaction time [RT], movement time [MvT], end-point accuracy [constant and variable error]). Statistical Analysis: Two-way (treatment [MFR or CON] by time [PRE and POST]) repeated measures analysis of variance (ANOVA) was conducted on all dependent variables. Results: There was a statistically significant decrease in FSP, F(1, 17) = 6.66, p = .019, partial η2= .282. The means (millimetres) and standard deviations were as follows: PRE-MFR 124 (15), POST-MFR 118 (14), PRE-CON 124 (15), POST-CON 122 (15). There were no statistically significant changes in pectoral length, muscle activity, or movement performance. Conclusion: A 4-minute MFR to the pectoral fascia is effective at reducing FSP, but does not impact pectoral length, muscle activity, or movement performance. However, the study sample was well underpowered, thus possibly impacting the results of the other outcome variables. It is unclear if this reduction in FSP is considered clinically significant in reducing the risk for development of neck-shoulder pain or pathology. iii Acknowledgements When I made the decision to return to school to complete my Master of Science degree, I do not think I ever could have anticipated the road that lied ahead. The ebbs and flows of graduate studies are more challenging, frustrating, and exhausting than I ever imagined, yet rewarding, exciting, and fulfilling all at once. The tremendous support I have received from family, friends, lab mates, colleagues, professors, and supervisors is truly humbling and overwhelming and has helped get me through this seemingly endless degree (thanks to COVID-19). I am proud of my work thus far in graduate studies and cannot wait to see where my academic pursuits take me. I have overcome many barriers, some of which were unprescendented, and for that, I thank you all for pushing me when I didn’t want to push myself. First and foremost, I want to thank my supervisor, Dr. Trisha Scribbans. In January 2018, when we first discussed me pusuing graduate studies under your supervision, I never would have imagined our working relationship to be as seamless and enjoyable as it now is. I have never had another person outside my family wanting to see me as wildly successful as you do. Your personal, academic, and professional support, mentorship, and guidance is truly astounding and words cannot express my gratitude for you enough. I am very much looking forward to the many years we have left working together. Secondly, I would like to thank my other committee members Dr. Cheryl Glazebrook and Dr. Joanne Parsons for their valuable support, input, and expertise on the project. In particular, I would like to thank Dr. Glazebrook for the numerous hours she spent advising and guiding me through the use of E-Prime and scripting letters of reference. Thirdly, I would like to thank my lab mates in the Integrative Musculoskeletal Research Lab for their knowledge, patience, and support throughout my degree. I could not have asked for a better group of grad students-turned-friends to go through this experience with. Thank you for your help with piloting, listening to my 3MT about 50 times, and fueling me with coffee, high- fives, and laughs, even on the darkest of grad school days. I would especially like to thank Zach for his non-judgemental help with research, ethics, analysis, and all things stats related. I thoroughly enjoyed learning from you and participating in “tea-time.” Lastly, but certainly not least, I would like to thank my parents, Bernie and Diane. “Thank-you” doesn’t seem like enough for your endless emotional, personal, and yes, financial support. You two have and will always be my rock, and I am forever grateful to have such supportive, loving, and compassionate parents. Thank-you for always supporting my endeavors and encouraging me in ways I would not be able to do for myself. Thank-you for being my shoulders to cry on, my personal bartenders and chefs, the ones who make me laugh (even when I don’t want to), the ones to jump up and down in celebration with, and my persistent force to do the absolute best I can. Without you, I would not be where I am or who I am today. “This is an investment in your future”- my Dad This project was supported by the Massage Therapy Research Foundation, College of Massage Therapists of Ontario, and Massage Therapy Association of Manitoba iv Table of Contents Abstract ........................................................................................................................................... ii Acknowledgements ........................................................................................................................ iii List of Tables ................................................................................................................................ vii List of Figures .............................................................................................................................. viii 1. Introduction ........................................................................................................................... 10 2. Review of the Literature ........................................................................................................... 13 2.1 Shoulder Complex Applied Anatomy Review ............................................................. 13 2.1.1 Sternoclavicular, Glenohumeral, and Acromioclavicular Joints ................................. 13 2.1.2 Scapulothoracic Joint ................................................................................................... 14 2.1.3 Scapular Protractors ..................................................................................................... 15 2.1.4 Scapular Retractors ...................................................................................................... 16 2.1.5 Fascia ........................................................................................................................... 17 2.1.6 Pectoral Fascia ............................................................................................................. 17 2.1.7 Fascial Adhesions and Trigger Points .......................................................................... 18 2.1.8 Implications of Fascial Adhesions and Trigger Points ................................................ 19 2.2 Posture ................................................................................................................................. 20 2.3 Reciprocal Inhibition .......................................................................................................... 22 2.4 Movement Performance ...................................................................................................... 23 2.4.1 Speed-Accuracy Trade Off (aka Fitts’ Law) ............................................................... 23 2.4.2 Schema Theory ............................................................................................................ 24 2.4.3 Applicability to Whole-Limb Real Movements .......................................................... 25 2.5 MSK Disorders ................................................................................................................... 26 2.5.1 Work-Related Musculoskeletal Disorders ................................................................... 27 2.5.2 MSK Disorders in Office Jobs ..................................................................................... 28 2.5.3 Changes in Muscle Activity Due to MSK Disorders ................................................... 29 2.5.4 MSK Disorder Risk Factors ......................................................................................... 30 2.5.4a Sex Differences .....................................................................................................
Recommended publications
  • Bilateral Sternalis Muscles Were Observed During Dissection of the Thoraco-Abdominal Region of a Male Cadaver

    Bilateral Sternalis Muscles Were Observed During Dissection of the Thoraco-Abdominal Region of a Male Cadaver

    Case Reports Ahmed F. Ibrahim, MSc, MD, Saeed A. Makarem, MSc. PhD, Hassem H. Darwish, MBBCh. ABSTRACT Bilateral sternalis muscles were observed during dissection of the thoraco-abdominal region of a male cadaver. A full description of the muscles, as well as their attachments and innervations were reported. A brief review of the existing literature, regarding the nomenclature, incidence, attachments, innervations and clinical relevance of the sternalis muscle, is also presented. Neurosciences 2005; Vol. 10 (2): 171-173 he importance of continuing to record and Case Report. A well defined sternalis muscle Tdiscuss anatomical anomalies was addressed (Figures 1 & 2) was found, bilaterally, during recently1 in light of technical advances and dissection of the thoraco-abdominal region of a interventional methods of diagnosis and treatment. male cadaver in the Department of Anatomy, The sternalis muscle is a small supernumerary College of Medicine, King Saud University, Riyadh, muscle located in the anterior thoracic region, Kingdom of Saudi Arabia. Both muscles were superficial to the sternum and the sternocostal covered by superficial fascia, located superficial to fascicles of the pectoralis major muscle.2 In the the corresponding sternocostal portion of pectoralis literature, sternalis muscle is called "a normal major and separated from it by pectoral fascia. The anatomic variant"3 and "a well-known variation",4 left sternalis was 19 cm long and 3 cm wide at its although in most textbooks of anatomy, it is broadest part. Its upper end formed a tendon insufficiently mentioned. Yet, clinicians are continuous with that of the sternal head of left surprisingly unaware of this common variation.
  • Myofascial Trigger Points of the Shoulder

    Myofascial Trigger Points of the Shoulder

    Johnson McEvoy and Jan Dommerholt Myofascial Trigger Points of the Shoulder Shoulder problems are common, with a 1-year prevalence in developing a more comprehensive approach to shoulder ranging from 4.7% to 46.7% and a lifetime prevalence of rehabilitation. Inclusion of MTrPs in the assessment and 6.7% to 66.7%.1 Many different structures give rise to shoulder management of shoulder pain and dysfunction does not pain, including the structures in the subacromial space, such necessarily replace other techniques and approaches, but it does as the subacromial bursa, the rotator cuff, and the long head of add an important dimension to the management plan. biceps,2,3 and are presented in various lessons. Muscle and spe- cifically myofascial trigger points (MTrPs), have been recog- nized to refer pain to the shoulder region and may be a source TRIGGER POINTS of peripheral nociceptive input that gives rise to sensitization and pain. MTrP referral patterns have been published for the A myofascial trigger point is defined as a hyperirritable spot in shoulder region.4-6 skeletal muscle, which is associated with a hypersensitive Often, little attention is paid to MTrPs as a primary or sec- palpable nodule in a taut band.4 When compressed, a MTrP ondary pain source. Instead, emphasis is placed only on muscle may give rise to characteristic referred pain, tenderness, motor mechanical properties such as length and strength.7,8 dysfunction, and autonomic phenomena.4 MTrPs have been The tendency in manual therapy is to consider muscle pain as described as active or latent. Active MTrPs are associated with secondary to joint or nerve dysfunctions.
  • The Surgical Anatomy of the Mammary Gland. Vascularisation, Innervation, Lymphatic Drainage, the Structure of the Axillary Fossa (Part 2.)

    The Surgical Anatomy of the Mammary Gland. Vascularisation, Innervation, Lymphatic Drainage, the Structure of the Axillary Fossa (Part 2.)

    NOWOTWORY Journal of Oncology 2021, volume 71, number 1, 62–69 DOI: 10.5603/NJO.2021.0011 © Polskie Towarzystwo Onkologiczne ISSN 0029–540X Varia www.nowotwory.edu.pl The surgical anatomy of the mammary gland. Vascularisation, innervation, lymphatic drainage, the structure of the axillary fossa (part 2.) Sławomir Cieśla1, Mateusz Wichtowski1, 2, Róża Poźniak-Balicka3, 4, Dawid Murawa1, 2 1Department of General and Oncological Surgery, K. Marcinkowski University Hospital, Zielona Gora, Poland 2Department of Surgery and Oncology, Collegium Medicum, University of Zielona Gora, Poland 3Department of Radiotherapy, K. Marcinkowski University Hospital, Zielona Gora, Poland 4Department of Urology and Oncological Urology, Collegium Medicum, University of Zielona Gora, Poland Dynamically developing oncoplasty, i.e. the application of plastic surgery methods in oncological breast surgeries, requires excellent knowledge of mammary gland anatomy. This article presents the details of arterial blood supply and venous blood outflow as well as breast innervation with a special focus on the nipple-areolar complex, and the lymphatic system with lymphatic outflow routes. Additionally, it provides an extensive description of the axillary fossa anatomy. Key words: anatomy of the mammary gland The large-scale introduction of oncoplasty to everyday on- axillary artery subclavian artery cological surgery practice of partial mammary gland resec- internal thoracic artery thoracic-acromial artery tions, partial or total breast reconstructions with the use of branches to the mammary gland the patient’s own tissue as well as an artificial material such as implants has significantly changed the paradigm of surgi- cal procedures. A thorough knowledge of mammary gland lateral thoracic artery superficial anatomy has taken on a new meaning.
  • A Detailed Review on the Clinical Anatomy of the Pectoralis Major Muscle

    A Detailed Review on the Clinical Anatomy of the Pectoralis Major Muscle

    SMGr up Review Article SM Journal of A Detailed Review on the Clinical Clinical Anatomy Anatomy of the Pectoralis Major Muscle Alexey Larionov, Peter Yotovski and Luis Filgueira* University of Fribourg, Faculty of Science and Medicine, Switzerland Article Information Abstract Received date: Aug 25, 2018 The pectoralis major is a muscle of the upper limb girdle. This muscle has a unique morphological Accepted date: Sep 07, 2018 architectonic and a high rate of clinical applications. However, there is lack of data regarding the morphological and functional interactions of the pectoralis major with other muscle and fascial compartments. According to the Published date: Sep 12, 2018 applied knowledge, the “Humero-pectoral” morpho-functional concept has been postulated. The purpose of this review was the dissectible investigation of the muscle anatomy and literature review of surgical applications. *Corresponding author Luis Filgueira, University of Fribourg, General Anatomy Faculty of Science and Medicine,1 Albert Gockel, CH-1700 Fribourg, Switzerland, The pectoralis major is a large, flat muscle of the pectoral girdle of the upper limb. It has a fan- Tel: +41 26 300 8441; shaped appearance with three heads or portions: the clavicular, the sternocostal and the abdominal Email: [email protected] head. Distributed under Creative Commons The clavicular head originates from the medial two-thirds of the clavicle (collar bone). The muscle fibers of the clavicular head have a broad origin on the caudal-anterior and caudal-posterior surface CC-BY 4.0 of the clavicle covering approximately half to two-thirds of that surface and converting toward the humerus, resulting in a triangular shape [1].
  • Anatomy Module 3. Muscles. Materials for Colloquium Preparation

    Anatomy Module 3. Muscles. Materials for Colloquium Preparation

    Section 3. Muscles 1 Trapezius muscle functions (m. trapezius): brings the scapula to the vertebral column when the scapulae are stable extends the neck, which is the motion of bending the neck straight back work as auxiliary respiratory muscles extends lumbar spine when unilateral contraction - slightly rotates face in the opposite direction 2 Functions of the latissimus dorsi muscle (m. latissimus dorsi): flexes the shoulder extends the shoulder rotates the shoulder inwards (internal rotation) adducts the arm to the body pulls up the body to the arms 3 Levator scapula functions (m. levator scapulae): takes part in breathing when the spine is fixed, levator scapulae elevates the scapula and rotates its inferior angle medially when the shoulder is fixed, levator scapula flexes to the same side the cervical spine rotates the arm inwards rotates the arm outward 4 Minor and major rhomboid muscles function: (mm. rhomboidei major et minor) take part in breathing retract the scapula, pulling it towards the vertebral column, while moving it upward bend the head to the same side as the acting muscle tilt the head in the opposite direction adducts the arm 5 Serratus posterior superior muscle function (m. serratus posterior superior): brings the ribs closer to the scapula lift the arm depresses the arm tilts the spine column to its' side elevates ribs 6 Serratus posterior inferior muscle function (m. serratus posterior inferior): elevates the ribs depresses the ribs lift the shoulder depresses the shoulder tilts the spine column to its' side 7 Latissimus dorsi muscle functions (m. latissimus dorsi): depresses lifted arm takes part in breathing (auxiliary respiratory muscle) flexes the shoulder rotates the arm outward rotates the arm inwards 8 Sources of muscle development are: sclerotome dermatome truncal myotomes gill arches mesenchyme cephalic myotomes 9 Muscle work can be: addacting overcoming ceding restraining deflecting 10 Intrinsic back muscles (autochthonous) are: minor and major rhomboid muscles (mm.
  • Appleton & Lange Review of Anatomy

    Appleton & Lange Review of Anatomy

    0523-00 FM 07/15/02 15:30 Page i Sixth edition APPLETON & LANGE REVIEW OF ANATOMY Royce Lee Montgomery, PhD Professor Department of Cell and Developmental Biology School of Medicine University of North Carolina Chapel Hill, North Carolina Kurt Ogden Gilliland, PhD Department of Cell and Developmental Biology School of Medicine University of North Carolina Chapel Hill, North Carolina Appleton & Lange Reviews/McGraw-Hill Medical Publishing Division New York Chicago San Francisco Lisbon London Madrid Mexico City Milan New Delhi San Juan Seoul Singapore Sydney Toronto 0523-00 FM 07/15/02 15:30 Page ii Appleton & Lange Review of Anatomy, Sixth Edition Copyright © 2003 by The McGraw-Hill Companies, Inc. All rights reserved. Printed in the United States of America. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a data base or retrieval system, without the prior written permission of the publisher. Previous editions copyright © 1995, 1989, by Appleton & Lange; copyright © 1982, 1978, 1974, by Arco Publishing, Inc. 1 2 3 4 5 6 7 8 9 0 VNH VNH 0 9 8 7 6 5 4 3 2 ISBN: 0-07-137727-1 Notice Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the stan- dards accepted at the time of publication.
  • Prezentace Aplikace Powerpoint

    Prezentace Aplikace Powerpoint

    Mimsa Dissection 2 Session Konstantinos Choulakis Thorax Borders: • Superiorly: jugular fossa – clavicles – acromion – 7th cervical vertebra • Inferiorly: xiphoid process – ribs – spinous process of 12th thoracic vertebra Superior thoracic aperture: 1st thoracic vertebra – first ribs – superior margin of sternum Inferior thoracic aperture: 12th thoracic vertebra – last ribs – distal costal arches 2 Regions: 1 1. Deltoid 3 3 3 4 2. Inflaclavicular ( =clavipectoral= deltopectoral) 5 3. Pectoral 6 6 4. Presternal 5. Axillary 7 7 6. Mammary 7. Inframammary Muscles: M. Pectoralis Major M. Pectoralis M. Subclavius M. Transversus M. Serratus anterior Minor Thoracis O: I: Inn: F: M. Externus Intercostalis M. Internus Intercostalis M. Innermost Intercostal I Origin I Insertion O O Fasciae • Superficial thoracic fascia: Underneath the skin. • Pectoral fascia: The pectoral fascia is a thin lamina, covering the surface of the pectoralis major, and sending numerous prolongations between its fasciculi: it is attached, in the middle line, to the front of the sternum; above, to the clavicle; laterally and below it is continuous with the fascia of the shoulder, axilla • Clavipectoral fascia: It occupies the interval between the pectoralis minor and Subclavius , and protects the axillary vessels and nerves. Traced upward, it splits to enclose the Subclavius , and its two layers are attached to the clavicle, one in front of and the other behind the muscle; the latter layer fuses with the deep cervical fascia and with the sheath of the axillary vessels. Medially, it blends with the fascia covering the first two intercostal spaces, and is attached also to the first rib medial to the origin of the Subclavius .
  • Human Anatomy: Thoracic Wall

    Human Anatomy: Thoracic Wall

    Thoracic wall - structure, blood supply and innervation Ingrid Hodorová UPJŠ LF, Dept. of Anatomy MediTec training for students 1.-15.9.2019, Kosice, Slovakia Thoracic borders external - Upper: jugular notch, clavicule, acromion scapulae, spine of C7 (vertebra prominens) Lower: xiphoid process, costal arches (right and left), Th12 internal - Upper: superior thoracic aperture: jugular notch, 1. pair of ribs, Th1 Lower: inferior thoracic aperture: diaphragm (right side - to 4. ICS left side - to 5. ICS) Lines of orientation Anterior axillary l. Anterior median line (midsternal) Scapular l. Sternal line Middle axillary l. Paravertebral l. Parasternal l. Posterior median line Midclavicular l. Posterior axillary l. Layers of thoracic wall ► Deep layer - osteothorax, muscles of proper thoracic wall + intrinsic muscles of the back, deep structures, endothoracic fascia ► Middle layer - thoracohumeral mm., spinohumeral mm., spinocostal mm., (fascie, vessels, nerves) ► Superficial layer - skin, subcutaneous tissue, superficial structures, mammary gland ►Deep layer Osteothorax - ribs - sternum - thoracic vertebrae Osteothorax Ribs Types of ribs: Sternum - manunbrium of sternum - body of sternum - xiphoid process - manunbriosternal and xiphisternal synchondrosis(synostosis) Movement of the ribs and sternum during breathing Thoracic vertebrae - body - arch (lamina+pedicles) - spinous process - transverse processes - superior and inferior articular processes Joints of the ribs anteriorly ►sternocostal joints (2nd-5th ribs) posteriorly ►costovertebral
  • Fascia: a Morphological Description and Classification System Based on a Literature Review Myroslava Kumka, MD, Phd* Jason Bonar, Bsckin, DC

    Fascia: a Morphological Description and Classification System Based on a Literature Review Myroslava Kumka, MD, Phd* Jason Bonar, Bsckin, DC

    0008-3194/2012/179–191/$2.00/©JCCA 2012 Fascia: a morphological description and classification system based on a literature review Myroslava Kumka, MD, PhD* Jason Bonar, BScKin, DC Fascia is virtually inseparable from all structures in Le fascia est pratiquement inséparable de toutes les the body and acts to create continuity amongst tissues structures du corps, et il sert à créer une continuité to enhance function and support. In the past fascia entre les tissus afin d’en améliorer la fonction et le has been difficult to study leading to ambiguities in soutien. Il a déjà été difficile d’étudier le fascia, ce qui nomenclature, which have only recently been addressed. a donné lieu à des ambiguïtés dans la nomenclature, Through review of the available literature, advances qui n’ont été abordées que récemment. Grâce à un in fascia research were compiled, and issues related examen de la documentation disponible, les avancées to terminology, descriptions, and clinical relevance of dans la recherche sur le fascia ont été compilées, fascia were addressed. Our multimodal search strategy et les problèmes relevant de la terminologie, des was conducted in Medline and PubMed databases, with descriptions et de la pertinence clinique du fascia ont été other targeted searches in Google Scholar and by hand, traités. Nous avons adopté une stratégie de recherche utilizing reference lists and conference proceedings. multimodale pour nos recherches dans les bases de In an effort to organize nomenclature for fascial données Medline et PubMed, avec des recherches ciblées structures provided by the Federative International dans Google Scholar et manuelles, au moyen de listes de Committee on Anatomical Terminology (FICAT), we références et de comptes rendus de congrès.
  • FIPAT-TA2-Part-2.Pdf

    FIPAT-TA2-Part-2.Pdf

    TERMINOLOGIA ANATOMICA Second Edition (2.06) International Anatomical Terminology FIPAT The Federative International Programme for Anatomical Terminology A programme of the International Federation of Associations of Anatomists (IFAA) TA2, PART II Contents: Systemata musculoskeletalia Musculoskeletal systems Caput II: Ossa Chapter 2: Bones Caput III: Juncturae Chapter 3: Joints Caput IV: Systema musculare Chapter 4: Muscular system Bibliographic Reference Citation: FIPAT. Terminologia Anatomica. 2nd ed. FIPAT.library.dal.ca. Federative International Programme for Anatomical Terminology, 2019 Published pending approval by the General Assembly at the next Congress of IFAA (2019) Creative Commons License: The publication of Terminologia Anatomica is under a Creative Commons Attribution-NoDerivatives 4.0 International (CC BY-ND 4.0) license The individual terms in this terminology are within the public domain. Statements about terms being part of this international standard terminology should use the above bibliographic reference to cite this terminology. The unaltered PDF files of this terminology may be freely copied and distributed by users. IFAA member societies are authorized to publish translations of this terminology. Authors of other works that might be considered derivative should write to the Chair of FIPAT for permission to publish a derivative work. Caput II: OSSA Chapter 2: BONES Latin term Latin synonym UK English US English English synonym Other 351 Systemata Musculoskeletal Musculoskeletal musculoskeletalia systems systems
  • The Pericardium Posteriorly

    The Pericardium Posteriorly

    Boundaries: superior –incisura jugularis, clavicle, acromion, spina scapulae and proc. spinosus of C7 inferior – proc. xiphoideus, costal arch, XI and XII rib to proc. spinosus of T12 Posterior axillary line divides it: Pectus, chest Dorsum, back 1 2 3 Regions: 1. Regio infraclavicularis 2. Regio mammalis 3. Regio axillaris The axilla is the region between the pectoral muscles, the scapula, the arm, and the thoracic wall. It is a region of passage for vessels and nerves that course from the root of the neck into the upper limb. Axillary vessels and their branches Lymph nodes – pectoral lateral subscapular central apical Brachial plexus – branches - n. intercostobrachialis Axillary vessels and their branches Lymph nodes – pectoral lateral subscapular central apical Brachial plexus – branches - n. intercostobrachialis Axillary vessels and their branches Lymph nodes – pectoral lateral subscapular central apical Brachial plexus – branches - n. intercostobrachialis Axillary vessels and their branches Lymph nodes – pectoral lateral subscapular central apical Brachial plexus – branches - n. intercostobrachialis Surface Anatomy: Skin Subcutaneous tissue Pectoral fascia Muscles Thoracic cavity Surface Anatomy: Skin Subcutaneous tissue Pectoral fascia Muscles Thoracic cavity Skeleton of the thorax - Sternum - Ribs - Vertebrae The thoracic skeleton forms the thoracic cage, which protects the thoracic viscera and some abdominal organs. The thoracic skeleton includes: Sternum - Ribs - Vertebrae Intercostal Spaces - three layers of muscle fill the intercostal space Intercostal Muscles: external intercostal muscle, internal intercostal muscle, innermost intercostal muscle. m. transversus thoracis subcostal muscles Intercostal Muscles: external intercostal muscle, internal intercostal muscle, innermost intercostal muscle. m. transversus thoracis subcostal muscles Intercostal Muscles: external intercostal muscle, internal intercostal muscle, innermost intercostal muscle. m.

  • Fascial Palpation

    Fascial Palpation Thomas Myers Some form of connective tissue matrix is everywhere within the body except the open lumens of the respiratory and digestive tubing, so we cannot palpate anywhere without contacting at least some corner of this unitary body-wide network. (Myers 2008) The same is true of the neural and circulatory syncitia, and epithelia are everywhere as well. With the caveat that no tissue can be truly isolated or separated, this chapter points to some salient and prominent fascial or connective tissue features within this overall net. We will explore these features within the myofasciae of the locomotor system - as opposed to the organic ligaments or meninges within the dorsal and ventral cavities - in terms of the myofasial meridians known nd as the Anatomy Trains (3rd e​ d. Elsevier, 2014) ​ ​ ​ Before we begin this systematic process, a word about fascial layering: Although the fascial net takes its first form around the end of the second week of embryonic development, as a single three-dimensional cobweb of fine reticular fibers surrounding and investing the entire simple trilaminar embryo, the subsequent origami of embryonic development folds the original fascial net into recognizable layers. (Schultz 1996) ● In the mature phenotype (that would be us), picking up the skin anywhere in the body brings with it the first layer of fascial sheeting, the dermis, a tough but elastic layer that acts as the backing for the carpet of the skin. ● The next layer (although we are at pains to note that each of these layers is incompletely separate from its neighbors as each layer is always connected to the next by variable fuzzy or gluey connections) is known as the areolar or adipose layer.