DOCSLIB.ORG

Muscles of the Thorax

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Muscles of the Thorax MUSCLES OF THE THORAX PROF. RAMIREZ 1 Thorax • Thorax refers to the entire chest • Functions: – Protect organs in chest and upper abdomen – Provides support for bones of upper limbs • Bony cage flattened from front to back • Formed by: – Sternum – Ribs – Costal cartilages – Bodies of thoracic vertebrae. 2 Pectoralis Major O: Clavicular Head: Medial clavicle Sternal Head: Sternum and the upper costal cartilages I: Lateral lip of the bicipital groove A: Adduction, medial rotation, and horizontal adduction of the arm. The clavicular head also causes flexion of the arm. Secondarily depresses and protracts the scapula. **Reversed muscle action causes elevation of the trunk, lateral deviation, and ipsilateral rotation. N: Medial and Lateral Pectoral nerves 3 Pectoralis Minor • When contracting it pulls on the coracoid process and pulls scapula in such a manner that the lateral border is pulled in toward the lateral body wall and the medial border moves away from posterior body wall. – This movement is called lateral tilt. • Rounded shoulders is a common postural condition in which the scapulae are protracted and depressed and the humeri are medially rotated. – Given the pec minor’s action of both protraction and depression, when pec minor muscles are tight, they can contribute to this condition. • By elevating ribs 3-5, this muscle can expand the ribcage during inspiration (accessory muscle of inspiration) 4 Pectoralis Minor O: Anterior borders of ribs # 3 through 5 I: Coracoid process of the scapula A: Protracts, Depresses, and downwardly rotates the scapula **Reversed muscle action rd includes elevation of the 3 th through 5 ribs N: Medial pectoral nerve 5 Subclavius • If clavicle is fixed to the scapula, then subclavius can also depress the scapula at the scapulocostal joint • Many believe main function is to act as a fixator of the clavicle during arm/shoulder movements. • Common entrapment site for nerves of brachial plexus and subclavian artery called costoclavicular syndrome 6 Subclavius muscle is “under” the clavicle O: 1st rib I: Inferior surface of the clavicle A: Depression of the clavicle and Elevation of the 1st rib N: Nerve to the subclavius from the brachial plexus 7 Serratus anterior (ventralis) • O-Ribs 1-9 • I- Scapula • A- Protract, Rotate scapula • N-Long Thoracic 8 External Intercostals • Oriented in the same direction as the external oblique abdominal muscles. – Appear to be extensions of external obliques • Involved in respiration (inspiration) • These muscles should be addressed in any client who has a respiratory condition. • This is the meat which is eaten when one eats spare ribs. 9 O: Inferior borders of ribs 1-12 I: Superior border of the rib below A: Elevation of ribs 2-12 N: Intercostal nerves 10 Internal Intercostals • Oriented in the same direction as fibers of the internal abdominal obliques. • Generally thinner then external intercostals. • Involved in respiration (expiration) • There is another layer of muscles called the innermost intercostals which are located deep to the internal intercostals. 11 Internal Intercostals located between the ribs and internal to external intercostals O: Superior border of the rib below I: Inferior border of the rib above A: Depresses ribs 1-11 N: Intercostal nerves 12 Transversus Thoracis • Superior fibers run primarily vertically but inferior fibers run horizontally • Located internally i.e. located within thoracic cavity • Primary role is as a respiratory muscle. 13 Transversus Thoracis Runs transversely across the thoracic region O: Internal surfaces of the sternum, xiphoid and adjacent costal cartilages I: Internal surfaces of costal cartilages 2-6 A: Depression of ribs 2-6 N: Intercostal nerves 14 Diaphragm • Separates the thoracic and abdominal cavities. • Number of openings to allow passage of structures between thoracic and abdominal cavities. – Largest openings for esophagus, aorta and inferior vena cava • Only muscle that must contract for quiet, relaxed inspiration. • Usually under both conscious and unconscious control. • Innervation is phrenic nerve composed of spinal nerves C3, 4, 5. – “C3, 4, 5 keeps the diaphragm alive!” • Clinically a Hiatal hernia is when part of the stomach herniates through the diaphragm into the thoracic cavity. 15 Diaphragm O: Internal surfaces of ribcage, sternum and spine I: Central tendon of diaphragm A: Increases volume of thoracic cavity during inspiration N: Phrenic nerve 16 Diaphragm openings • The diaphragm has three major openings. • The esophageal opening in the right crus transmits the esophagus and vagus nerves. • The aortic opening lies posterior to the crura and transmits the aorta, the thoracic duct and greater splanchnic nerves, and occasionally the azygos vein. • The foramen for the inferior vena cava, in the right half of the central tendon, transmits the vena cava, right phrenic nerve, and lymphatic 17 vessels. Neurovascular Bundle of Intercostal Muscles • VAN (vein, artery, nerve) – Intercostal vein – Intercostal artery – Intercostal nerve • Sit in Subcostal Groove • Between Internal Intercostal and Innermost intercostal layer Nerves of the Thoracic Wall • The 12 pairs of thoracic spinal nerves supply the thoracic wall. • They divide into anterior and posterior primary rami • The anterior rami of nerves T1 to T11 form the intercostal nerves that run along the extent of the intercostal spaces. • The anterior ramus of nerve T12, coursing inferior to the 12th rib, is the subcostal nerve • The posterior rami of thoracic spinal nerves 19 pass posteriorly supplys the joints, muscles, and skin of the back in the thoracic region dermatomes 20 CLINICAL • vertebrocostal trigone • a triangular area in the diaphragm near the lateral arcuate ligament that is devoid of muscle fibers; it is covered by pleura superiorly and by peritoneum inferiorly. • congenital diaphragmatic hernia • absence of the pleuroperitoneal membrane (usually on the left) or an enlarged Morgagni's foramen which allows protrusion of abdominal viscera into the chest. 21 Intercostal Nerve Block • Local anesthesia of an intercostal space is produced by injecting a local anesthetic agent around the intercostal nerves between the paravertebral line and the area of required anesthesia. • In this procedure, an intercostal nerve block, involves infiltration of the anesthetic around the intercostal nerve trunk and its collateral branches. 22 Dyspnea: Difficult Breathing • When people with respiratory problems (e.g., asthma) or with heart failure struggle to breathe, they use their accessory respiratory muscles to assist the expansion of their thoracic cavity. • They lean on their knees or on the arms of a chair to fix their pectoral girdle so these muscles are able to act on their rib attachments and expand the thorax. 23 Needle thoracocentesis • Performed in patients in whom a life threatening tension pneumothorax is suspected. • A needle is inserted into the second intercostal space in the midclavicular line on the the side of the tension pneumothorax, with the patient in an upright position. • A sudden escape of air is heard when the needle enters the pariental pleura. A chest tube is inserted after this procedure. 24 25 Subclavian vein cannulation • Is performed with the patient supine, the head turned slightly to the opposite side, and the arms placed by the side. • The central venous needle is then inserted from the inferior edge of the clavicle towards the suprasternal notch. • The needle is directed so that it passes just below the posterior border of the clavicle; care must be taken to avoid downward direction of the needle, which may cause a 26 pneumothorax. Gentle aspiration of the syringe is performed whilst the needle is being advanced until the subclavian vein is punctured END 27 .
Load more

Recommended publications
  • Thoracic Outlet and Pectoralis Minor Syndromes
    S EMINARS IN V ASCULAR S URGERY 27 (2014) 86– 117 Available online at www.sciencedirect.com www.elsevier.com/locate/semvascsurg Thoracic outlet and pectoralis minor syndromes n Richard J. Sanders, MD , and Stephen J. Annest, MD Presbyterian/St. Luke's Medical Center, 1719 Gilpin, Denver, CO 80218 article info abstract Compression of the neurovascular bundle to the upper extremity can occur above or below the clavicle; thoracic outlet syndrome (TOS) is above the clavicle and pectoralis minor syndrome is below. More than 90% of cases involve the brachial plexus, 5% involve venous obstruction, and 1% are associate with arterial obstruction. The clinical presentation, including symptoms, physical examination, pathology, etiology, and treatment differences among neurogenic, venous, and arterial TOS syndromes. This review details the diagnostic testing required to differentiate among the associated conditions and recommends appropriate medical or surgical treatment for each compression syndrome. The long- term outcomes of patients with TOS and pectoralis minor syndrome also vary and depend on duration of symptoms before initiation of physical therapy and surgical intervention. Overall, it can be expected that 480% of patients with these compression syndromes can experience functional improvement of their upper extremity; higher for arterial and venous TOS than for neurogenic compression. & 2015 Published by Elsevier Inc. 1. Introduction compression giving rise to neurogenic TOS (NTOS) and/or neurogenic PMS (NPMS). Much less common is subclavian Compression of the neurovascular bundle of the upper and axillary vein obstruction giving rise to venous TOS (VTOS) extremity can occur above or below the clavicle. Above the or venous PMS (VPMS).
    [Show full text]
  • Using Neutrality to Increase Shoulder Strength
    Using Neutrality To Increase Shoulder Strength SUSAN M. T. McKAY, OTR/L [email protected] GOAL Look at shoulder rehab in a different way. Strength can come from increasing flexibility and placing a joint in proper alignment. Conversely, strengthening a shoulder in improper alignment can cause injury. WHY PICK ON THE SHOULDER? . Impairs function/limits ADL’s . Pain in shoulder . Compensatory patterns can lead to back pain . Elderly rely on upper body to move/ambulate . The sooner issues are treated, the less physiological damage there is SHOULDER ANATOMY . Muscles and how they move . A basic review and more . Important to know… SHOULDER ANATOMY . Supraspinatus . Initiates and assists deltoid in abduction of arm and acts with other rotator cuff muscles. SHOULDER ANATOMY . Infraspinatus . Laterally rotate arm; helps to hold humeral head in glenoid cavity of scapula SHOULDER ANATOMY . Subscapularis . Medially rotates arm and adducts it; helps to hold humeral head in glenoid cavity of scapula SHOULDER ANATOMY . Teres Minor . Laterally rotate arm; helps to hold humeral head in glenoid cavity of scapula SHOULDER ANATOMY . Deltoid . Anterior part: flexes and medially rotates arm; Middle part: abducts arm; Posterior part: extends and laterally rotates arm SHOULDER ANATOMY . Latissimus dorsi . Extends, adducts, and medially rotates humerus; raises body toward arms during climbing SHOULDER ANATOMY . Teres Major . Adducts and medially rotates arm SHOULDER ANATOMY . Pectoralis major . Adducts and medially rotates humerus; draws scapula anteriorly and inferiorly; Acting alone: clavicular head flexes humerus and sternocostal head extends it SHOULDER ANATOMY . Pectoralis Minor . Stabilizes scapula by drawing it inferiorly and anteriorly against thoracic wall SHOULDER ANATOMY .
    [Show full text]
  • Parts of the Body 1) Head – Caput, Capitus 2) Skull- Cranium Cephalic- Toward the Skull Caudal- Toward the Tail Rostral- Toward the Nose 3) Collum (Pl
    BIO 3330 Advanced Human Cadaver Anatomy Instructor: Dr. Jeff Simpson Department of Biology Metropolitan State College of Denver 1 PARTS OF THE BODY 1) HEAD – CAPUT, CAPITUS 2) SKULL- CRANIUM CEPHALIC- TOWARD THE SKULL CAUDAL- TOWARD THE TAIL ROSTRAL- TOWARD THE NOSE 3) COLLUM (PL. COLLI), CERVIX 4) TRUNK- THORAX, CHEST 5) ABDOMEN- AREA BETWEEN THE DIAPHRAGM AND THE HIP BONES 6) PELVIS- AREA BETWEEN OS COXAS EXTREMITIES -UPPER 1) SHOULDER GIRDLE - SCAPULA, CLAVICLE 2) BRACHIUM - ARM 3) ANTEBRACHIUM -FOREARM 4) CUBITAL FOSSA 6) METACARPALS 7) PHALANGES 2 Lower Extremities Pelvis Os Coxae (2) Inominant Bones Sacrum Coccyx Terms of Position and Direction Anatomical Position Body Erect, head, eyes and toes facing forward. Limbs at side, palms facing forward Anterior-ventral Posterior-dorsal Superficial Deep Internal/external Vertical & horizontal- refer to the body in the standing position Lateral/ medial Superior/inferior Ipsilateral Contralateral Planes of the Body Median-cuts the body into left and right halves Sagittal- parallel to median Frontal (Coronal)- divides the body into front and back halves 3 Horizontal(transverse)- cuts the body into upper and lower portions Positions of the Body Proximal Distal Limbs Radial Ulnar Tibial Fibular Foot Dorsum Plantar Hallicus HAND Dorsum- back of hand Palmar (volar)- palm side Pollicus Index finger Middle finger Ring finger Pinky finger TERMS OF MOVEMENT 1) FLEXION: DECREASE ANGLE BETWEEN TWO BONES OF A JOINT 2) EXTENSION: INCREASE ANGLE BETWEEN TWO BONES OF A JOINT 3) ADDUCTION: TOWARDS MIDLINE
    [Show full text]
  • Pectoral Region and Axilla Doctors Notes Notes/Extra Explanation Editing File Objectives
    Color Code Important Pectoral Region and Axilla Doctors Notes Notes/Extra explanation Editing File Objectives By the end of the lecture the students should be able to : Identify and describe the muscles of the pectoral region. I. Pectoralis major. II. Pectoralis minor. III. Subclavius. IV. Serratus anterior. Describe and demonstrate the boundaries and contents of the axilla. Describe the formation of the brachial plexus and its branches. The movements of the upper limb Note: differentiate between the different regions Flexion & extension of Flexion & extension of Flexion & extension of wrist = hand elbow = forearm shoulder = arm = humerus I. Pectoralis Major Origin 2 heads Clavicular head: From Medial ½ of the front of the clavicle. Sternocostal head: From; Sternum. Upper 6 costal cartilages. Aponeurosis of the external oblique muscle. Insertion Lateral lip of bicipital groove (humerus)* Costal cartilage (hyaline Nerve Supply Medial & lateral pectoral nerves. cartilage that connects the ribs to the sternum) Action Adduction and medial rotation of the arm. Recall what we took in foundation: Only the clavicular head helps in flexion of arm Muscles are attached to bones / (shoulder). ligaments / cartilage by 1) tendons * 3 muscles are attached at the bicipital groove: 2) aponeurosis Latissimus dorsi, pectoral major, teres major 3) raphe Extra Extra picture for understanding II. Pectoralis Minor Origin From 3rd ,4th, & 5th ribs close to their costal cartilages. Insertion Coracoid process (scapula)* 3 Nerve Supply Medial pectoral nerve. 4 Action 1. Depression of the shoulder. 5 2. Draw the ribs upward and outwards during deep inspiration. *Don’t confuse the coracoid process on the scapula with the coronoid process on the ulna Extra III.
    [Show full text]
  • Lateral Pectoral Nerve Transfer for Spinal Accessory Nerve Injury
    TECHNICAL NOTE J Neurosurg Spine 26:112–115, 2017 Lateral pectoral nerve transfer for spinal accessory nerve injury Andrés A. Maldonado, MD, PhD, and Robert J. Spinner, MD Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota Spinal accessory nerve (SAN) injury results in loss of motor function of the trapezius muscle and leads to severe shoul- der problems. Primary end-to-end or graft repair is usually the standard treatment. The authors present 2 patients who presented late (8 and 10 months) after their SAN injuries, in whom a lateral pectoral nerve transfer to the SAN was per- formed successfully using a supraclavicular approach. http://thejns.org/doi/abs/10.3171/2016.5.SPINE151458 KEY WORds spinal accessory nerve; cranial nerve XI; lateral pectoral nerve; nerve injury; nerve transfer; neurotization; technique PINAL accessory nerve (SAN) injury results in loss prior resection, chemotherapy, and radiation therapy. The of motor function of the trapezius muscle and leads left SAN was intentionally transected due to the proximity to weakness of the shoulder in abduction, winging of the cancer to it. The right SAN was identified, mobi- Sof the scapula, drooping of the shoulder, and pain and lized, and preserved as part of the lymph node dissection. stiffness in the shoulder girdle. The majority of the cases Postoperatively, the patient experienced severely impaired of SAN injury occur in the posterior triangle of the neck. active shoulder motion bilaterally, with shoulder pain. On When the SAN is transected or a nonrecovering neuro ma- physical examination, the patient showed bilateral trape- in-continuity is observed, the standard treatment would zius muscle atrophy and moderate left scapula winging.
    [Show full text]
  • Anatomical Basis of Pedicles in Breast Reduction
    Review Article Anatomical basis of pedicles in breast reduction Marcelo Irigo1, Leonardo Coscarelli1, Alberto Rancati2 1Department of Surgery, University of La Plata, La Plata, Argentina; 2Department of Surgery, University of Buenos Aires, Buenos Aires, Argentina Contributions: (I) Conception and design: All authors; (II) Administrative support: All authors; (III) Provision of study materials or patients: All authors; (IV) Collection and assembly of data: All authors; (V) Data analysis and interpretation: All authors; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Marcelo Irigo, MD. Department of Surgery, University of La Plata, La Plata, Argentina. Email: [email protected]. Abstract: The mammary gland is composed of multiple tubules acinar pockets in which the secretory layer, connective tissue stroma, and fatty tissue all respond to hormonal and systemic influences. These structures are irrigated by three vascular pedicle branches, from the axillary artery, internal mammary artery, and intercostal artery. This vascular anastomotic arrangement forms the anatomical basis of the flaps used in breast reduction techniques. The veins form a strong subdermal network, latticed with the arterial network. The lymph vessels have three well-defined pedicles, skin, glandular and milk ducts that drain into internal, external, and posterior ducts. The understanding of these anatomical structures determines the selection of different pedicles in breast volume reduction and preservation
    [Show full text]
  • The Spinal Cord and Spinal Nerves
    14 The Nervous System: The Spinal Cord and Spinal Nerves PowerPoint® Lecture Presentations prepared by Steven Bassett Southeast Community College Lincoln, Nebraska © 2012 Pearson Education, Inc. Introduction • The Central Nervous System (CNS) consists of: • The spinal cord • Integrates and processes information • Can function with the brain • Can function independently of the brain • The brain • Integrates and processes information • Can function with the spinal cord • Can function independently of the spinal cord © 2012 Pearson Education, Inc. Gross Anatomy of the Spinal Cord • Features of the Spinal Cord • 45 cm in length • Passes through the foramen magnum • Extends from the brain to L1 • Consists of: • Cervical region • Thoracic region • Lumbar region • Sacral region • Coccygeal region © 2012 Pearson Education, Inc. Gross Anatomy of the Spinal Cord • Features of the Spinal Cord • Consists of (continued): • Cervical enlargement • Lumbosacral enlargement • Conus medullaris • Cauda equina • Filum terminale: becomes a component of the coccygeal ligament • Posterior and anterior median sulci © 2012 Pearson Education, Inc. Figure 14.1a Gross Anatomy of the Spinal Cord C1 C2 Cervical spinal C3 nerves C4 C5 C 6 Cervical C 7 enlargement C8 T1 T2 T3 T4 T5 T6 T7 Thoracic T8 spinal Posterior nerves T9 median sulcus T10 Lumbosacral T11 enlargement T12 L Conus 1 medullaris L2 Lumbar L3 Inferior spinal tip of nerves spinal cord L4 Cauda equina L5 S1 Sacral spinal S nerves 2 S3 S4 S5 Coccygeal Filum terminale nerve (Co1) (in coccygeal ligament) Superficial anatomy and orientation of the adult spinal cord. The numbers to the left identify the spinal nerves and indicate where the nerve roots leave the vertebral canal.
    [Show full text]
  • 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.
    [Show full text]
  • The Supraclavius Muscle Is a Novel Muscular Anomaly Observed in Two Cases of Thoracic Outlet Syndrome
    From the Midwestern Vascular Surgical Society The supraclavius muscle is a novel muscular anomaly observed in two cases of thoracic outlet syndrome Payam Salehi, MD, PhD, Wande B. Pratt, MD, Michael F. Joseph, BS, Lauren N. McLaughlin, ACNP, and Robert W. Thompson, MD, St. Louis, Mo Various anomalous muscles and fibrofascial structures have been described in relation to the anatomy of thoracic outlet syndrome. We describe two patients with a previously undescribed muscle anomaly, which originated laterally near the trapezius muscle, coursed across the supraclavicular space deep to the scalene fat pad, and attached obliquely to the superior undersurface of the medial clavicle, which we have termed the “supraclavius” muscle. The significance of the supraclavius muscle is unknown, but its occurrence in patients with thoracic outlet syndrome indicates that it can be associated with narrowing of the anatomic space adjacent to the neurovascular structures. (J Vasc Surg Cases 2015;1:84-6.) Thoracic outlet syndrome (TOS) refers to a group of by right paraclavicular thoracic outlet decompression for venous uncommon disorders arising from extrinsic compression of TOS. During the operation, after initial mobilization of the scalene the neurovascular structures that serve the upper extremity fat pad, a supraclavius muscle was discovered, with its medial as they pass through the spaces of the thoracic outlet. attachment to the deep superior aspect of the clavicle, separate from Various anomalous muscles and fibrofascial structures have and lateral to the clavicular head of the sternocleidomastoid muscle. been described in relation to the anatomy of TOS.1-8 We The lateral extent of this muscle was joined to the trapezius muscle, describe here two patients in whom a previously unde- yielding a distinct muscle w7cmlongand2cmwide(Fig), which scribed anomalous muscle was observed.
    [Show full text]
  • Chapter 4 the Shoulder Girdle
    Bones • Key bony landmarks – Manubrium – Clavicle Chapter 4 – Coracoid process The Shoulder Girdle – Acromion process – Glenoid fossa – Lateral border – Inferior angle – Medial border © McGraw-Hill Higher Education. All rights reserved. 4-1 © McGraw-Hill Higher Education. All rights reserved. 4-2 Bones Joints • Key bony landmarks • Shoulder girdle (scapulothoracic) – Acromion process – scapula moves on the rib cage – Glenoid fossa – joint motion occurs at sternoclavicular joint – Lateral border & to a lesser amount at the – Inferior angle acromioclavicular joint – Medial border – Superior angle – Spine of the scapula From Seeley RR, Stephens TD, Tate P; anatomy and physiology , ed 7, New York, 2006, McGraw-Hill © McGraw-Hill Higher Education. All rights reserved. 4-3 © McGraw-Hill Higher Education. All rights reserved. 4-4 Joints Joints • Sternoclavicular (SC) • Sternoclavicular (SC) – (multiaxial) arthrodial classification – Ligamentous support – Movements • anteriorly by the anterior SC ligament • anteriorly 15 degrees with protraction • posteriorly by the posterior SC ligament • posteriorly 15 degrees with retraction • costoclavicular & interclavicular • superiorly 45 degrees with elevation ligaments provide stability against • inferiorly 5 degrees with depression superior displacement © McGraw-Hill Higher Education. All rights reserved. 4-5 © McGraw-Hill Higher Education. All rights reserved. 4-6 1 Joints Joints • Acromioclavicular (AC) • Scapulothoracic – arthrodial classification – not a true synovial joint – 20- to 30-degree total
    [Show full text]
  • The Chondrocoracoideus Muscle: a Rare Anatomical Variant of the Pectoral Area
    Case report Acta Medica Academica 2017;46(2):155-161 DOI: 10.5644/ama2006-124.200 The chondrocoracoideus muscle: A rare anatomical variant of the pectoral area Dionysios Venieratos1, Alexandros Samolis1, Maria Piagkou1, Stergios Douvetzemis1, Alexandrina Kourotzoglou1, Kontantinos Natsis2 1Department of Anatomy, School of Objective. The study adds important information regarding the de- Medicine, Faculty of Health Sciences, scriptive anatomy of a very rarely reported unilateral chondrocora- National and Kapodistrian University of coideus muscle (of Wood). Additionally it highlights the concomitant Athens, Greece, 2Department of Anatomy muscular and neural alterations. Case report. The current case pres- and Surgical Anatomy, School of Medicine ents the occurrence of a chondrocoracoideus muscle situated left-sid- Faculty of Health Sciences, Aristotle ed, as an extension of the abdominal portion of the pectoralis major University of Thessaloniki, Greece muscle (PM). The chondrocoracoideus coexisted with a contralateral atypical PM, partially blended with the clavicular fibers of the deltoid Correspondence: muscle. There was an accessory head of the biceps brachii while the [email protected] palmaris longus was absent on the right side of a 78-year-old Greek Tel.: + 302 10 746 2427 male cadaver. Conclusion. The above mentioned muscular abnor- Fax.: + 302 10 746 2398 malities are shown as disturbances of embryological pectoral muscle Received: 16 April 2017 development, and their documentation is essential in order to increase Accepted: 12
    [Show full text]
  • Clinical Study the Relationship of the Subclavius Muscle with Relevance to Venous Cannulation Below the Clavicle
    Hindawi Publishing Corporation Anesthesiology Research and Practice Volume 2016, Article ID 6249483, 4 pages http://dx.doi.org/10.1155/2016/6249483 Clinical Study The Relationship of the Subclavius Muscle with Relevance to Venous Cannulation below the Clavicle Kyutaro Kawagishi,1 Joho Tokumine,2 and Alan Kawarai Lefor3 1 DepartmentofAnatomy,ShinshuUniversitySchoolofMedicine,3-1-1Asahi,Matsumoto-shi,Nagano-ken390-8621,Japan 2Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan 3Department of Surgery, Jichi Medical University, Tochigi 329-0498, Japan Correspondence should be addressed to Joho Tokumine; [email protected] Received 6 December 2015; Accepted 18 January 2016 Academic Editor: Yukio Hayashi Copyright © 2016 Kyutaro Kawagishi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. The catheter “pinch-off syndrome” has been described to be secondary to crimping of the catheter between the clavicle and the first rib, as well as entrapment of the catheter at the site of penetration of the subclavius muscle. The lateral insertion technique has been recommended to prevent catheter pinch-off, but it is unknown if this technique can prevent entrapment by the subclavius muscle. We undertook this study to evaluate the anatomical relationship of the subclavius muscle and the subclavian vein. Methods. Twenty-eight adult cadavers were studied on both right and left sides. The adherence between the subclavian vein and subclavius muscle was subjectively assessed and the distance between the two structures was measured in mm.
    [Show full text]