Overview
Gross Anatomy
Clinical Anatomy
Supraspinatus
Empty Can Test – arms out in
front with thumbs pointing down, resisting against downward force. Positive
test – Weakness (and pain)
Infraspinatus and Teres Minor
External Rotation examination – Arms by their side,
elbow flexed at 90o, actively externally rotated against resistance Positive test – weakness (and
pain)
Lag Sign - Arms by their side in a neutral position, Supporting the elbow, passively externally rotate the arm, Release the hand. Positive test - Hand/Arm will rotate inwards/back to midline on it’s own
Subscapularis
Lift off Test – arm placed behind
the back with the hand on the lumbar spine region. Ask the patient to lift
their hand off their back against resistance of your hand. Positive test – inability to lift the hand off
the back.
Impingement
Painful Arc –Active/Passive
abduction of the shoulder in the plane of the body. Positive test is where
there is pain on active abduction between 60-120o
Neers Test – full flexion of the
shoulder with a pronated hand and thumb pointing backwards Positive test is
pain at any point. Measure the degree at which pain occurs.
Hawkin’s Kennedy Test – 90o
flexion of glenohumeral joint and elbow. Actively internally rotate the arm. Positive
test is if pain is elicited.
Painful arc testing is most
useful when used in conjunction with the Neer and Hawkins-Kennedy tests and
increases specificity.
Quick Anatomy
Key Facts
Origin |
Insertion |
Arterial
Supply |
Innervation |
Function |
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Supraspinatus |
Medial
two-thirds of the supraspinous fossa of the scapula and the deep fascia that
covers the muscle |
Most
superior facet on the greater tubercle of the humerus |
Suprascapular
Artery and Circumflex Artery |
Suprascapular
N. – C5 (C6) |
Initiation
of abduction of arm to 15o at glenohumeral joint |
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Infraspinatus |
Medial
2/3 of the infraspinous fossa of the scapula and the deep fascia that covers
the muscle |
Middle
facet on posterior surface of the greater tubercle |
Suprascapular
A and Circumflex Scapular Artery |
Suprascapular
Nerve (C5,C6) |
Lateral
rotation of the arm at the glenohumeral joint, hold humeral head in glenoid
cavity of the scapula |
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Teres Minor |
Upper
2/3 of a flattened strip of bone on the posterior surface of the scapula
immediately adjacent to the lateral border of the scapula |
Inferior
facet on greater tuberosity of humerus |
-
Subscapular and circumflex scapular
art |
Axillary
N (C5,C6) |
Lateral
rotation of the arm at the glenohumeral joint |
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Teres Major |
Elongate
oval area on the posterior surface of the inferior angel of the scapula |
Medial lip of the intertubercular
sulcus on the anterior surface of the humerus |
Subscapular
and circumflex scapular arts |
Inferior subscapular N. (c5,c6,c7) |
Medial
rotation and extension of the arm at the glenohumeral joint, adduction |
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Subscapularis |
Subscapular
fossa of the scapula |
Lesser
Tuberorsity of the humerus |
Subscapular
Artery |
Upper
and lower subscapular Nerves (C5, C6, C7) |
Medial
rotation of the arm, adduction of the arm, Holds humeral head in the glenoid
cavity of the scapular. |
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