The deltoid muscle (m. Deltoideus) (Fig. 111, 112, 113, 114) takes the shoulder of the duck to the horizontal plane, while the front muscle bundles pull the hand forward, and the rear - back. This is the thick muscle of the triangular shape, covering the shoulder joint and partly the muscles of the shoulder. Its large bundles fanually converge towards the top of the triangle, pointing down. The muscle begins on the axis of the blades, the acromion and the lateral part of the clavicle, and is attached to the deltoid perturbation of the shoulder bone. Under the bottom surface of the muscles there is a fake-shaped bag (bursa subdeltoidea).
Supported muscle (m. Supraspinatus) (Fig. 114) has a triangular shape and loses the blades in a supervoloral fossa, located directly under the trapezoidal muscle. The oversight muscle raises his shoulder and pulls the shoulder joint capsule, not allowing her pinching. The point of commencement of the muscle is on the surface of the tight hole, and the place of attachment is on the top platform of a large tubercle of the shoulder bone and on the back surface of the shoulder joint capsule.
Safety muscle (m. Infraspinatus) (Fig. 114) turns the shoulder of the duck, the hand raised turns back and pulls the shoulder joint capsule. This is the flat muscles of the triangular shape that fills the entire sirebo. Its the upper part is covered by the trapezoidal and deltoid muscles, and the bottom - the widest muscle of the back and the big circular muscle. The suitable muscle begins on the wall of the suitable fifth and the rear surface of the blade, and it is attached to the middle platform of a large tubercle of the shoulder bone and the shoulder joint capsule. At the place of its attachment to the shoulder bone there is a docking bag of the siretteel muscle (Bursa Subtendinea MM. Infraspinati).
| Fig. 111. Shoulder muscles and shoulder belts (front view): 1 - muscle lifting a blade; |
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 | Fig. 112. Shoulder muscles and shoulder belts (front view): 1 - Double-headed shoulder muscle: a) short head, b) long head; |
 | Fig. 113. Shoulder muscles and shoulder belts (side view): 1 - supervoloral fascia; |
 | Fig. 114. Shoulder muscles and shoulder belts (rear view): 1 - supervoloral fascia; |
Small round muscle (m. Teres Minor) (Fig. 114) turns the shoulder of the shower, at the same time slightly pulling it back, and pulls the shoulder joint capsule.
An oblong, rounded muscle form, the upper part of which is adjacent to the suitable muscle, the front part is covered with a deltoid muscle, and the back part is a large round muscle. The start point is located on the rear surface of the blade below the siretteel muscle, and the place of the attachment is on the lower seat of the large mole of the shoulder bone and the rear surface of the shoulder joint capsule.
A large round muscle (m. Teres Major) (Fig. 112, 113, 114) turns the shoulder inside and pulls it back, leading his hand to the body. The oblong flat muscle adjacent to the widest muscle of the back and partially covered with it in the backyard. In the outdoor department, a large round muscle is covered with a deltoid muscle. The start point is the rear surface of the blade at its lower angle, the place of attachment is the comb of a small tubercle of the shoulder bone. Near the fastening site there is a trunk bag of a large round muscle (Bursa Subtendinea Mm. Teretis Majoris).
The sublock muscle (m. Subscapularis) (Fig. 111, 112) rotates the shoulder inside and takes part in its delivering to the body. Flat wide muscle of triangular shape, filling the entire subupathy hole. It begins on the surface of the subband pits, and ends on a small tubercle of the shoulder bone and on the front surface of the shoulder joint capsule.
At the fastening site there is a small docking bag of the subband muscle (Bursa Subtendinea Mm. Subscapularis).
All the muscles of the upper limb are made to divide into 2 groups: on the muscles of the shoulder belt and the free upper limb, which in turn consist of 3 topographic sites - shoulder muscles, muscles of forearm and brushes. Many mistakenly think that the muscles of the shoulder belt include the shoulder muscles, but according to the adopted anatomical classification it is not. Shoulder is part of the free upper limb, ranging from the shoulder joint and ending with the elbow articulation.
All the muscles of the shoulder anatomical area can be divided into the rear and front groups.
Front muscle group shoulder
These include:
- blood muscle shoulder,
- kryvoid-shoulder muscle,
- shoulder muscle.
Double-headed
He has two heads, from where and received its characteristic name. The long head originates with the help of a tendon from the overall tuberculk blades. The tendon passes through the articular cavity of the shoulder articulation, falls into the cross-bone passing groove and goes into muscle tissue. In the Mercuorbar Barroke, the tendon is surrounded by a synovial shell, which is connected to the cavity of the shoulder joint.
A short head originates from the top of the beak blade of the blades. Both heads merge together and switch to the muscle fabric of the belief-shaped form. A little higher than the elbow moss muscle narrows and passes again into the tendon, which is attached to the beagrousity of the ray bone of the forearm.
Functions:
- flexion of the upper limb in the shoulder and elbow joints;
- supposition of the forearm.
Kryvoid-Shoulder
Muscular fiber begins with a beak-like blasting bone effect, attached to the shoulder bone around the middle of the inside.
Functions:
- begging the shoulder in the shoulder articulation;
- bringing shoulder to the body;
- takes part in the turn of the shoulder outward;
- pulls the scaling bone down and the kleon.
Shoulder
This is a wide muscle that lies directly under the double-headed. It begins from the front surface of the top of the shoulder bone and from the intertensive partitions of the shoulder. Fastened to the junction of the elbow bone. The function is the bending of the forearm in the cords of the elbow.
Rear muscular group
This group includes:
- three-headed shoulder muscles,
- elbow
- muscle elbow joint.
Three-headed
This anatomical education has three heads, from where the name. The long head originates from the instrument of the humerus of the shoulder bone and below the middle of the shoulder bone goes into the total tendon heads.
The side head begins on the rear surface of the shoulder bone and the side intermissile septum.
The middle head begins on the rear surface of the shoulder bone and both intertensive shafts of the shoulder. Fucked with powerful tendons to the elbow bone elbow process.
Functions:
- extending forearm in the elbow joint;
- bringing the shoulder and extension due to the long head.
Elbow
It is a continuation of the middle head of the three-headed shoulder muscles. It takes its beginning from the side brace of the shoulder bone, and is attached to the rear surface of the elbow efficiency of the elbow bone and to its body (proximal part).
Function is the extension of the forearm in the elbow joint.
Muscle elbow Sustav
This is a non-permanent anatomical education. Some experts consider it as part of the fibers of the median head of the three-headed muscles, which are attached to the cable of elbow articulation.
Function - pulls the casing of the elbow joint, which prevents it from pinching.
Muscles of the shoulder belt
It is worth named and the muscles of the belt of the upper limb, which are often ranked with muscular shoulder formations:
- delta Muscle Shoulder,
- over- and sibwise muscle,
- small and big round,
- sublock.
Both arm muscle groups are separated from each other by two connective tissue intermuscular partitions, which stretch from the shared shoulder fascia (enveloping the entire muscular skeleton of the shoulder) to the side and median edges of the shoulder bone.
Muscle pain shoulder
The pain in the shoulder and shoulder belt is a frequent complaint of people of various age groups. Such a symptom may be associated with the pathology of the skeleton, joints, ligaments, but most often the reason is hidden in damage to muscle tissue.
The reasons
Consider the most common causes of pain syndrome in the shoulder area:
- overvoltage and stretching of ligaments, tendons, muscles;
- diseases or traumatic damage to the shoulder joint;
- inflammation of ligaments and muscle tendons (tendinite);
- rupture tendons and muscles;
- capsuitis joint (inflammation of the articular capsule);
- the inflammation of the occasional bags - bursitis;
- syndrome "Frozen Shoulder";
- plecelopath periarthrosis;
- miofascial pain syndrome;
- vertebrogenic causes of pain syndrome (associated with the damage to the cervical and thoracic spine);
- impeller syndrome;
- rheumatic polymalgia;
- the myosites of infectious (specific and non-specific) and non-infectious nature (with autoimmune, allergic diseases, besifying my opinion).
The pain in the shoulder area can be associated both with the damage to bones, joints, a binder, and with damage to the muscular fabric
Differential diagnosis
The following criteria will help to distinguish the pain in the shoulder area due to the damage to the muscles from the articular diseases.
| Sign | Articular diseases | Muscular lesions |
| Character of pain syndrome | The pain constant does not disappear in the state of rest, slightly increases when driving | Pain occurs or significantly enhances with a certain form of motor activity (depending on the damaged muscle) |
| Localization of pain | Not limited, diffuse character, spilled | It has clear localization and certain boundaries, which depends on the localization of damaged muscle fiber |
| Dependence on passive and active movements | All types of movements are limited due to the development of pain syndrome | Due to pain, the amplitude of active movements is reduced, but all passive persists in full |
| Additional diagnostic signs | Change shape, contours and joint size, its swelling, hyperemia | The joint area is not changed, but a swelling may be observed in the area of \u200b\u200bsoft tissues, a slight diffuse redness and an increase in local temperature under inflammatory causes of pain |
What to do?
If you suffer from pain in your shoulder, which is associated with the damage to muscle tissue, the first thing to be done in order to get rid of such an unpleasant symptom is to identify the provocation factor and eliminate it.
If after that the pain is still returning, it is necessary to visit the doctor, perhaps the cause of the painful syndrome is completely different. The following recommendations will help to get rid of pain:
- in case of acute pain, it is necessary to immobilize the sore hand and provide it with full peace;
- it is possible to take 1-2 tablets of the non-pressed painkillers nesteroidal anti-inflammatory tool or apply it to the affected area in the form of ointments or gel;
- massage can be used only after the elimination of acute pain syndrome, as well as physiotocreders;
- after sinking pain, it is important to regularly engage in therapeutic physical education for the development and strengthening of the shoulder muscles;
- if a person on duty is forced to perform daily monotonous movements with hands, it is important to take care of the protection of the muscles and the prevention of their defeat (wearing special bandages, protective and supporting orthoses, perform gymnastics for relaxation and strengthening, regular treatment and preventive massage courses, etc.).
As a rule, the treatment of muscle pain due to overvoltage or easy injury lasts no more than 3-5 days and requires only rest, minimum load on hand, recreation of recreation and labor, massage, sometimes taking non-steroidal anti-inflammatory funds. If the pain does not pass or it initially has a high intensity, accompanied by other anxious signs, it is mandatory to visit the doctor to examine and correlate treatment.
60. Muscles, discharge and leading shoulder.
Shop shoulder: Deltaid muscle, supervolor muscle.
Deltoid
Tight muscle It begins with a supervoloral fossa of the blade and covering its fascia, and attaching to the large tuberculus of the shoulder bone and partly to the shoulder joint capsule. The muscle feature is to lead the shoulder and pull the articular capsule of the shoulder joint.
Lead shoulder: Big breast muscles, wide back muscle, sublock muscle, suitable muscle.
Big thoracic muscle
Shorty muscle back
Podlopean muscle
Safety muscle
61. Muscles that supine and penetrate shoulder.
Turn the shoulder of the dudder:deltaid muscle (rear bundles), big round muscle, suitable muscle.
Deltoid It starts from the clavicle (the front of the muscle), the acromion (middle part) and the ush of the blades (rear part), and is attached to the deltoid peerness of the shoulder bone. If an alternately works alternately, then its back part, then there is a movement of the upper limb forward and backward, i.e. Flexion and extension. If the muscle is tightened with everything entirely, then its front and rear parts form a relay, on the board of which coincides with the direction of the fibers of the middle part of the muscle, contributing to the shoulder lead to the horizontal level.
Big round muscle It starts from the lower angle of the blade and is attached to the ridge of a small tubercle of the shoulder bone often with one tendon with the widest muscles of the back. Reducing, a large round muscle performs in the form of elevation of a rounded form when the enclosed shoulder is brought. The function of the muscle is to bring, pronation and extension of the shoulder bone.
Safety muscle It starts from the suitable fifth blade. In addition, the site of the beginning of this muscle is the share of fascia. It is attached to the large tubercle of the shoulder bone. The function of the suitable muscle lies in bringing, supination and extension of the shoulder in the shoulder joint.
Turn the shoulder inside: Deltaid muscle (front beams), big thoracic muscle, wide back muscle, big round muscle, sublock muscle.
Deltoid
Big thoracic muscle It begins from the medial half of the clavicle (crooking part), the front surface of the sternum and cartilage parts of the upper five or six ribs (sternum-rib), the front wall of the vagina's direct abdominal muscle (abdominal part) and attached to the crest of a large tubercle of the shoulder bone. It belongs to the muscles that go from the body to the free upper limb. This muscle pulls forward the blade and takes it from the spinal column. But this feature is side. Basically it participates in the movements of the shoulder bone. If the torso is fixed, then this muscle leads, penetrates and begins the shoulder bone.
Shorty muscle back It begins on the spawn processes of the lower five-six breast vertebrae, all lumbar, upper sacrats, and from the back of the ileum, four teeth of four lower edges, is attached to the ridge of the small tubercle of the shoulder bone. Leading and penetrating the shoulder bone, it causes lowering the belt of the upper limb and bringing the blades to the spinal pole; The part of the muscle that starts from the ribs can lift them and have some effect on an increase in the amount of the chest when inhaling.
Big round muscle
Podlopean muscle Located on the front surface of the blade, filling the sublocking hole, from which it begins. Muscle is attached to a small tuberculk bone. It makes the shoulder; Acting is isolated, it is his pronator.
a - front view; b, in - rear view;
1 - supervolor muscle; 2-speed muscle; 3 - Small round muscle; 4 - Big Round Muscle; 5 - the long head of the shoulder double muscle; 6 - lateral head of the three-headed muscles of the shoulder; 7 - the medial head of the three-headed muscles of the shoulder; 8 - radial nerve in the playry non-canal; 9 - the sublock muscle; 10 - Kryvumoid-Shoulder Muscle; 11 is a triangular hole; 12 - four-sided hole.
Big round muscle (T. TERES MAJOR)starts from the dorsal surface of the lower corner of the blade; It is attached to the crest of a small tubercal tube.
Function:reducing, the muscle performs in the form of elevation of a rounded form when the enclosed shoulder is given, pulls the shoulder back, participates in bringing, the pronation and extension of the shoulder bone, rotates inside and leads to the body.
Innervation:
Podlopean muscle(t. subscapularis)it is located on the front surface of the blade, filling the subband pamph. Starts from the rib surface of the blade and the subband fascia; It is attached to the small tubercle of the shoulder bone and the articular capsule.
Function: Reducing together with the previous muscles, it produces shoulder lead; Acting insulated, is his Pronator, rotates the shoulder inside, penetrates, leads his shoulder to the body and pulls the capsule.
Since this muscle is multiple, it has a significant lifting force.
Innervation: Podleopartic nerve, C V -C VI.
Muscles that produce movements of the shoulder belt.Schematically movement of the shoulder belt (blades and clavicle) are divided into:
1. Movement forward and backward with the brave of the spawood from the spinal column and bringing it to it.
2. Raising and lowering the blade and clavicle.
3. Movement of the blade around the sagittal axis by the bottom angle in the medial and lateral side.
4. Circular motion by the lateral end of the clavicle and at the same time the blade.
Six functional muscle groups participate in these movements.
Movement forward shoulder belt Muscles produce, which crosses the vertical axis of the breast and clearable joint and are located in front of it. These include breast muscles:
1) the big breast, acting on the belt of the upper limb through the shoulder bone;
2) Small breast;
3) Front gear.
Big thoracic muscle (t. Pectoralis Major) It has a significant thickness and width. It covers the top ribs in front and is involved in the formation of the anterior wall of the armpit. And refers to the muscles that go from the body to the free upper limb.
Muscles of the chest and shoulder, carrying out the movement of the shoulder belt.
1 - deltoid muscle; 2 - big breast muscle; 3 - double-headed arm arm; 4 - small breast muscle; 5 - plug-in muscle; 6 - Kryvoid-Shoulder Muscle; 7 - Shoulder muscle.
The big breast muscle pulls forward the blade and removes it from the spinal column. This feature is side.
Basically it participates in the movements of the shoulder bone. If the torso is fixed, then this muscle leads, penetrates and begins the shoulder bone. The lower muscle department can also help rabbing ribs by participating in breathing mechanism.
From the shape of a large breast muscle, the external form of the front surface of the upper body of the body depends largely.
With good development of this muscle and thin skin during the reduction of the muscles, not only its upper and lower boundaries are clearly visible, but also the direction of its separate beams.
Big Big Muscle Building
One of the features of the building of the big breast muscle is that its lower bundles go to the middle and the upper not only from the bottom, but also behind. On the shoulder bone, the lower beams are attached higher than the top moving from the clavicle. Thanks to such a feature of the structure, the upper and lower beams when the shoulder lead is evenly stretched and somewhat unchecked, which is especially well expressed when rising hands up.
Small thoracic muscle Located under the big chest and moves the shoulder belt forward and down, and also participates in the rotation of the blade by the lower angle in the medial side (to the spinal pole). If the blade is fixed, then this muscle raises the ribs and contributes to the expansion of the chest when inhaling.
Front gear muscle Located on the lateral surface of the chest and covered with large and small breast muscles. This is the main muscle, moving the blade of the Kepened and laterally. The lower teeth of this muscle lower the shovel and pull its lower corner not only down, but also ahead. In addition, the upper and lower teeth can produce opposite actions, rotating the shovel that the upper, then the lower angle of the shock. The front, the toothed muscle is especially clear when the hand raised. Covering the side surface of the chest, this muscle is the medial wall of the axillary fifth.
Traffic back of the shoulder beltmuscles crossing the vertical axis of the breast and clearable joint and behind it. This muscle group includes:
1) trapezoidal muscle;
2) diamond muscle, big and small;
3) The widest muscles of the back.
Movement up shoulder beltmuscles are carried out that intersect the sagittal axis of the breast-clearable joint and lie with the lateral side from it. They go to the shovel and the clavicle from top to bottom.
Rising shoulder belts are produced by the following muscles:
1) the upper beams of the trapezoidal muscle, which pulls up the lateral end of the clavicle and the acromion of the blade;
2) muscle racoping;
3) diamond muscles, with decomposition of which there is some component, directed upwards;
4) Breast-curable-cottage muscle, which, attaching one of his head to the clavicle, pulls it, and, therefore, the shovel is up.
The muscles of the upper and lower limb are divided into groups based on the regional affiliation (topography) and the functions performed by them. Muscles of the upper limb (Fig. No. 87, 88, 89, 90, 91, 92) It is customary to divide on the muscles of the shoulder belt and the muscles of the free upper limb: shoulder, forearm and brushes. Muscles of the lower limb (Fig. No. 85, 86, 93, 94, 95, 96, 97, 98, 99, 100, 101,102,103) - on the muscles of the pelvic belt (pelvis) and the free lower limb: hips, legs and feet. At the same time, between the muscles of the upper limb and the lower, it is impossible to carry out a complete analogy due to the difference in the structure and functions of the belts and the free parts of the limbs. Due to the specifics of the bone function, the shoulder belt are connected to the skeleton of the body moving and have special muscles acting on the collar and especially on the blade. Due to this, the blade and the clavicle have great freedom of movements. On the lower limb, the pelvic belt is firmly, almost motionless, connects to the spine in the sacratling joint.
For better assimilation of a wide variety of extremities muscles, we consider their graultial structure on topography and the function executable (see schema 1).
Muscles of the shoulder belt(Fig. No. 83, 87, 88) are located around the shoulder joint and provide him with a full amount of movements (with the participation of some breast and back muscles). All 6 muscles of this group begin on the bones of the shoulder belt and are attached to the shoulder bone.
1) The deltoid muscle begins from the lateral third of the clavicle, the acromion and the uks of the blades. It is attached to the deltoid pugishness of the shoulder bone. The front of the muscle flexions shoulder, the average - assigns, the rear - extension of the shoulder.
2) The oversight muscle begins on the venge of the spawth of the same name, attached to the large tubercle of the shoulder bone. Takes the shoulder, being a synergist of the middle beams of the deltoid muscle.
3) The sibid muscle begins on the venge of the blade of the same name, attached to the large tuberculk bark. Rotates the shoulder dust.
4) A small round muscle begins from the lateral edge of the blade, attached to a large tuberculus of the shoulder bone. Synergist of the Salt Muscle, i.e. Rotates the shoulder dust.
5) A large round muscle begins from the lateral edge and the lower corner of the blade, attached to the crest of a small tubercle of the shoulder bone. Pulls the shoulder of the book and the Zada, at the same time rotating it inside.
6) The sublock muscle begins from the Snacks of the same name and is attached to the small tubercle of the shoulder bone and its crest. Synergist of a big round muscle and wide back muscles: raised hand lowers, lowered his hand rotates inside.