The upper edges of the shoulder blades of the right and left. Human shoulder blade

The scapula is a bone from the girdle group of the upper limbs. It is adjacent to the chest from the posterolateral part. This happens in the area of the second to seventh ribs. Thanks to the scapula, the clavicle and humerus are united. The scapula is considered a flat bone, which is why it appears as a flat, thinned bone with a triangle shape.

The blade has three angles. These are the top and bottom, as well as the side. In addition, it has three edges. The first one is the middle one. It is turned towards the vertebral column. The second is lateral. This angle is directed towards the outer part and slightly towards the lower part. The third is the top corner. It has a notch of the scapula, which is necessary for the advancement of nerves and blood vessels. The blade is divided into two surfaces. The frontal surface is concave, which is why it is called the subscapular fossa. It is at this point that the subscapularis muscle attaches. The back surface can be felt directly under the skin. It has a convexity and is divided by bony protrusions moving in a horizontal direction, namely the scapular spine.

The spine is similar to a triangle, but only flattened from top to bottom. The apex of the spine moves towards the vertebral edge. It begins in the area of the middle edge of the shoulder blade, after which it goes to the lateral corner. On its way it increases in height. Its end is the acromion, the upper part of which has an articular surface through which it is united with the clavicle. The acromion forms the highest point of the shoulder. This is a large, but at the same time very elongated process. It has a slight flattening in the frontal-posterior direction. In addition, it also goes beyond the limits, first sideways, and then bends forward and upward.

There is a small depression near the base of the acromion. It is the glenoid cavity of the scapula. The head of the humerus bone is attached to this point. The scapula still merges with the collarbone at the acromioclavicular joint. The other hook-shaped projection is the coracoid process. It begins to move from the upper area of the scapula, and ends the movement at the place where a certain number of muscles attach.

The lower angle of the scapula goes in a lower direction, while the rest are attached to the ends of the upper region of the scapula. The lateral angle has a thickening, as well as an almost flat glenoid cavity. Its edge extends from the entire part of the scapula due to the neck. There is a tubercle above the upper edge of the depression. It is to this that the tendons belonging to the long head of the biceps muscle are attached. At the bottom of the cavity there is another tubercle, to which the head is attached by the triceps brachii muscle. The coracoid process is removed from the top of the scapula near the glenoid cavity. The end of this process in its own way acts as a place for muscle attachment. The serratus anterior muscle originates at the two corners of the scapula. It is docked due to large teeth from the first to ninth ribs. This muscle moves the scapula to the side and in the frontal direction, and also secures it to the sternum.

The upper part of the shoulder blade is almost two times smaller than the inner part. In addition, there is a notch on it, which in some cases is attached through a bone bridge. It moves to the base of the coracoid process. The medial part of the scapula is the longest, which is why it was called the base. The lateral part is considered the thickest. It begins in the area of the lower zone of the glenoid cavity, which does not prevent it from slightly tilting to the lower and posterior sides.

In humans, it is a flat bone approximately triangular in shape.

* upper (margo superior),

* lower (angulus inferior),

The blade has three edges:

Anatomy of the Human Scapula - information:

Spatula -

The scapula, scapula, is a flat triangular bone adjacent to the posterior surface of the chest in the space from the II to VII ribs. According to the shape of the bone, three edges are distinguished in it: the medial one, facing the spine, margo medialis, the lateral one, margo lateralis, and the upper one, margo superior, on which the notch of the scapula is located, incisura scapulae. The listed edges converge with each other at three angles, of which one is directed downward (lower angle, angulus inferior), and the other two (upper, angulus superior, and lateral, angulus lateralis) are located at the ends of the upper edge of the scapula.

The lateral angle is significantly thickened and equipped with a slightly deepened, laterally facing glenoid cavity, cavitas glenoidalis. The edge of the glenoid cavity is separated from the rest of the scapula by an interception, or neck, collum scapulae. Above the upper edge of the cavity is a tubercle, tuberculum supraglenoidale, the site of attachment of the tendon of the long head of the biceps muscle. At the lower edge of the glenoid cavity there is a similar tubercle, tuberculum infraglenoidale, from which the long head of the triceps brachii muscle originates. The coracoid process, processus coracoideus - the former coracoid, extends from the upper edge of the scapula near the glenoid cavity.

The anterior surface of the scapula, facing the ribs, facies costalis, is a flat depression called the subscapular fossa, fossa subscapularis, where the so-called subscapularis is attached. On the posterior surface of the scapula, facies dorsalis, there passes the spine of the scapula, spina scapulae, which divides the entire posterior surface into two unequally sized fossae: the supraspinous, fossa supraspinata, and the infraspinatus, fossa infraspinata. The spina scapulae, continuing to the lateral side, ends in the acromion, acromion, hanging behind and above the cavitas glenoidalis. It contains an articular surface for articulation with the clavicle - facies articularis acromii.

The scapula on the posterior radiograph looks like a characteristic triangular formation with three edges, angles and processes. On the margo superior, at the base of the coracoid process, it is sometimes possible to catch a notch, incisura scapulae, which can be mistakenly taken for a focus of bone destruction, especially in cases where, due to senile calcification of the ligamentum transversum scapulae superius, this notch turns into a hole.

Ossification. At birth, only the body and spine of the scapula consists of bone tissue. On radiographs in the 1st year, a point of ossification appears in the coracoid process (synostosis vlet), and at the age of age additional ones appear in the corpus scapulae, in the epiphyses (cavitas glenoidalis, acromion) and apophyses (processus coracoideus, margo medialis, angulus inferior). The lower angle before the onset of synostosis appears to be separated from the body by a line of clearing, which should not be mistaken for a break line. The acromion ossifies from multiple ossification points, one of which can remain for life as an independent bone - os acromiale; it can be mistaken for a fragment. Complete synostosis of all ossification nuclei of the scapula occurs every year.

Ligaments of the scapula. In addition to the ligamentous apparatus connecting the clavicle to the scapula, the latter has three ligaments of its own that are not related to the joints. One of them, lig. coracoacromiale, stretches in the form of an arch over the shoulder joint from the anterior edge of the acromion to the processus coracoideus, the other, lig. transversum scapulae superius, stretches over the notch of the scapula, turning it into an opening and, finally, the third ligament, lig. transversum scapulae inferius, weaker, goes from the base of the acromion through the neck of the scapula to the posterior edge of the cavity; a passes underneath it. suprascapularis.

Spatula

The scapula is a flat, triangular-shaped bone located on the side of the thoracic spine. Together with the collarbone, it forms the shoulder girdle.

In the rear (top) view, there is a noticeable bone that can be felt under the skin. The coracoid process and the subscapular fossa can be observed in the anterior view (left).

Under each shoulder blade they run from the second to the seventh ribs. Having the shape of a triangular plate, the scapula has three boundaries: middle (axillary edge), upper (upper edge) and outer (vertebral edge), forming between themselves new angles.

BLADE SURFACES

The shoulder blade has two surfaces: anterior and posterior. The anterior surface is adjacent to the ribs and has a concave shape with a large depression called the subscapular fossa. Muscles are attached to the anterior surface.

The posterior surface is divided into two by a ridge or scapular spine. Above is a small supraspinatus fossa, and below is a larger infraspinatus fossa. The muscles of the same name are attached to these depressions.

BONE PROCESSES OF THE SCUBA

The spinal ridge of the scapula continues in the form of a bony protrusion called the humeral process. This flat process forms the top of the shoulder. In the area of the lateral angle, the scapula has maximum thickness, and there is a glenoid cavity into which the head of the humerus is inserted, forming the shoulder joint. The coracoid process, which can also be felt in this area, plays an important role in serving to attach muscles and ligaments.

Pterygoid blade

The shoulder blade is not rigidly connected to the ribs and spine, and it is pressed to the chest only by the force of the muscles, primarily by the serratus anterior muscle.

This muscle is innervated by a long thoracic nerve, descending from the armpit to the outer surface of the muscle just under the skin, where it can be easily damaged. If it turns out to be torn, for example due to a penetrating wound, the muscle stops working and stops holding the shoulder blade pressed to the ribs.

In this case, the vertebral edge and the lower angle protrude and move away from the middle stripe, causing the scapula to look like | on the wing of a bird. This is where the name “pterygoid scapula” comes from for a condition that can also be observed when a person rests his outstretched arms against the wall in front of him.

The position of the left shoulder blade in this patient changed as a result of damage to the long thoracic nerve. This nerve innervates the serratus anterior muscle, which holds the scapula pressed against the ribs.

Spatula

The outer angle of the scapula at the point of connection with the upper end of the humerus has a shallow oval glenoid cavity. The depression is separated from the subscapular fossa in front by the neck of the scapula. Along the upper edge of the bony triangle above the neck, the scapula has a curved coracoid process that covers the front of the shoulder joint.

Muscular surroundings of the scapula

Diseases localized in the scapula area

Pain under the shoulder blade as a symptom of internal organ diseases

A burning sensation in the interscapular area or under the left shoulder blade is a symptom of necrosis of an area of the heart muscle - acute myocardial infarction. To clarify the diagnosis, an electrocardiogram is performed ( ECG), which reveals signs of damage to cardiac tissue.

Pain under the shoulder blade can be a symptom of lung diseases - pneumonia, pleurisy, pneumothorax. Pneumonia is an acute infectious inflammation of the lung tissue, which is usually accompanied by fever, chills, general weakness and sweating. Pleurisy is inflammation of the lining of the lung, often accompanies pneumonia. Pneumothorax is a rupture of the membrane of the lung with the release of air into the chest cavity and compression of the lung, until the organ completely collapses. Pneumothorax can be traumatic - due to external influences, as well as spontaneous - a sudden phenomenon. To clarify the cause of pain in the subscapular areas, doctors prescribe x-rays.

If there is pain and aching under the right shoulder blade, the cause of discomfort may be liver or bile duct disease - hepatitis, cholecystitis, cholangitis, cholelithiasis. Diseases of the liver and biliary tract are accompanied by pain in the right hypochondrium, dryness and bitterness in the mouth, episodes of nausea and vomiting. To clarify the diagnosis, the doctor will prescribe an ultrasound, biochemical blood and urine tests.

Burning pain in the subscapular region and intercostal spaces is caused by herpetic inflammation of the paravertebral nerve ganglia - herpetic ganglionitis. In the acute stage of the disease, while there are no rashes of characteristic vesicles along the intercostal nerves, it is very difficult to make a diagnosis. These pains are not relieved by any painkillers. With the appearance of a herpetic rash in the intercostal spaces, the cause of the disease becomes clear, and the patient is prescribed antiviral treatment.

Scapula in the human skeleton: anatomy, main functions, diseases and injuries of this bone

The human scapula is a wide and flat paired bone behind the chest, which is the basis of the shoulder girdle and has the appearance of a bayonet shovel, pointing downwards. The wide part of the shoulder blade is located in the area of the shoulder girdle (which in everyday life is not quite correctly called the shoulder).

Anatomy

The lateral (outer) edge of the scapula is thickened; in its upper corner there is an articular cavity, which with the head of the humerus forms the shoulder joint (the shoulder is the upper part of the arm: from the same shoulder joint to the elbow). The shoulder joint is one of the most mobile joints of the human skeleton.

There, next to the articular cavity, there are two bony protrusions - the acromion directed backwards and the coracoid process protruding forward. Articulated with the acromion at the acromioclavicular joint is the clavicle, the bone that connects the scapula to the sternum.

The coracoid process does not articulate with the bones - muscles are attached to it: the pectoralis minor, which is responsible for moving the scapula down, forward and towards its inner lateral edge, as well as the biceps (with its short head). The long head of the biceps is attached to a tubercle located above the glenoid cavity of the scapula. The biceps (biceps muscle) is responsible for flexing the shoulder at the shoulder joint and the forearm (the lower part of the arm - from the elbow to the wrist) at the elbow. Also attached to the coracoid process is the coracoid brachialis muscle, which is connected to the shoulder and is responsible for its elevation and minor rotational movements.

The anterior plane of the scapula, facing the ribs, is slightly concave; it is called the subscapular fossa. The posterior surface is convex, it is divided into two unequal parts by a bony protrusion running horizontally - the spine (ridge). The ridge originates from the inner edge of the scapula, rises higher and, approaching the outer edge, passes into the acromion.

The deltoid muscle, which has the shape of a triangle, is attached to the crest, the outer part of the acromion and half of the clavicular bone. It completely covers the coracoid process and the shoulder joint, and its tip is attached to the humerus. This muscle forms the upper part of the shoulder and is involved in abduction of the shoulder joint.

The smaller - upper - part of the scapula above the crest is called the supraspinatus fossa, the lower, respectively, the infraspinatus. The muscles of the same name are attached to the subscapularis, supraspinatus and infraspinatus fossa

For the prevention and treatment of diseases of the JOINTS and SPINE, our readers use a new NON-SURGICAL treatment based on natural extracts, which..

The main function of the subscapularis, supraspinatus and infraspinatus muscles is to hold the shoulder joint, which is poor in its own ligamentous apparatus. The same purpose is used for another muscle – the teres minor, attached to the upper part of the outer edge of the scapula.

In general, the scapula is almost completely enveloped on both sides by muscles responsible only for the shoulder - its fixation and mobility. The scapula itself moves only thanks to the dorsal and pectoral muscles.

Functions of the scapula

Main functions of the scapula:

The shoulder blades are the main link between the shoulder girdle and the arms and sternum.

The processes of the shoulder blades - the coracoid and acromion - as well as their ligamentous apparatus protect the shoulder joint from above. In addition, the shoulder blade bones with their muscles and ligaments, along with the ribs and back muscles, protect the lungs and aorta.

Part of the muscles extending from the shoulder blades strengthens and holds the shoulder joint.

The shoulder blades are involved in the movement of the entire shoulder girdle and arms - performing rotational movements in the shoulder joint, raising the arm, abducting and adducting the shoulder. This participation can be either indirect: with the help of the muscles responsible for the movement of the shoulder, attached to the scapula, or direct: for example, abduction of the shoulder, starting from a certain angle, is possible only when the scapula is rotated. If the scapula is damaged, the mobility of the shoulder girdle is sharply limited and the ability to work is lost.

Diseases and injuries of the scapular region

The scapular bones and joints can be subject to injury and inflammatory processes. There are also malformations of the shoulder blades. The shoulder blades may be in an incorrect position due to spinal deformities. In addition, pain in the scapular region does not always indicate disease of the shoulder blades in particular and the shoulder girdle in general.

Fractures

Scapula fractures usually occur as a result of a strong blow from the rear or front. There are intra-articular (involving the glenoid cavity) and extra-articular (any area without damage to the glenoid cavity) fractures.

Scapula fractures may be accompanied by the following symptoms:

too high mobility;
characteristic grinding sound of friction of bone fragments;
pain;
swelling, hematoma;
a sharp decrease in mobility.

Joint problems are a direct path to disability!

Stop putting up with this joint pain! Write down a verified prescription from an experienced doctor.

For intra-articular fractures, surgery is most often required - osteosynthesis, which includes comparison and fixation of bone fragments. Fractures of the body of the scapula usually heal on their own without complications, provided there is complete rest. Depending on the fracture, the patient’s arm, bent at the elbow, is fixed to the chest on the affected side or, conversely, taken to the side using a special splint. Fixation lasts about a month, after which the arm in the shoulder joint is gradually developed.

The scapula is designed in such a way that significant external force is required to fracture it. In addition, vital organs are in close proximity - the heart, lungs, and great vessels. Therefore, if you suspect a fracture of the scapula, you should consult a doctor as soon as possible.

Dislocation

Scapula dislocations are extremely rare. Their cause is a strong tug on the arm, as a result of which the shoulder blade rotates and moves outward, and its lower edge is compressed between the ribs. This causes stretching and tearing of the muscles attached to the shoulder blade and spine.

the scapula is in an abnormal position - its outer lateral edge is sharply protruded;
any movement in the shoulder joint causes severe pain.

The dislocation is reduced by a surgeon under local anesthesia, after which the arm is fixed to the torso for two to three weeks.

Bursitis

Bursitis of the shoulder blade refers to inflammation of the periarticular bursae of the shoulder joint. The cause of the disease can be injury, infection, or an autoimmune reaction.

pain that gets worse with movement;
swelling in the joint area;
limited mobility;
feeling of numbness in the hand and forearm.

Bursitis is treated with conservative methods - antibiotic therapy, painkillers, physical therapy - under the supervision of a doctor.

Developmental defects

Examples of congenital anomalies of the scapula:

aplasia (absence) and hypoplasia (underdevelopment);
pterygoid blade;
Sprengel's disease.

Aplasia is most often combined with the absence of an arm on the same side.

The pterygoid scapula is not only a cosmetic defect - a protruding inner edge, but also a functional disorder - the inability to rotate the arm and raise it. The disease is treated promptly.

Sprengel's disease is characterized by an abnormally high position of the scapula (scapulae), often by impaired development of the muscles of the shoulder girdle, and is also often combined with other anomalies. Complaints: cosmetic defect and difficulty in shoulder abduction. In mild cases, physiotherapy is prescribed; in more severe cases, surgery is prescribed.

Protruding blades

Shoulder blades can “stick out” in both children and adults for various reasons, including:

poor posture;
curvature of the spine (kyphosis, scoliosis);
paralysis or rupture of the muscles supporting the shoulder blades.

Depending on the cause, protrusion of the shoulder blades may not bring suffering other than moral, or be accompanied by disorders that significantly reduce the quality of life.

Poor posture can be corrected quite easily with the help of exercises, massage, and developing the habit of keeping your back straight. In other cases, it is necessary to treat the underlying disease.

Pain in the shoulder blades

Pain in the scapula may indicate damage to the scapula itself, its joints or the musculo-ligamentous apparatus, as well as diseases of the internal organs, in which the pain often “radiates” to the scapular region.

So, pain under the left shoulder blade may be accompanied by:

heart diseases – coronary heart disease (angina, heart attack), myocarditis;
lung diseases;
stomach diseases;
aortic aneurysm dissection;
pancreatic diseases.

Pain in the area of the right shoulder blade is caused by:

diseases of the biliary system and liver parenchyma (sometimes pain can radiate to the left shoulder blade);
malignant breast tumors.

Pain in the area of any shoulder blade can be accompanied by complicated osteochondrosis and neuralgia.

Get the book “17 recipes for delicious and inexpensive dishes for the health of the spine and joints” for free and start recovering effortlessly!

Human scapula: structure and functions. Human Scapula Anatomy

In this article we will look at one of about two hundred bones of the human body - the scapula. Where this bone is located in a person, what functions it performs, what kind of muscles it attaches to itself and what its structure is, we will consider in this article. And also here you will find a photo and description of its components.

Human shoulder blade

This is a bone lying in the girdle of the upper limbs. It is the connecting link in the articulation of the humerus and clavicle. This bone has the shape of a triangle, reminiscent of a tool, a shovel.

On the surface of the shoulder blades there are several sections (costal and dorsal), 3 different edges, among which are the vertebral, superior and axillary, and 3 angles called medial, inferior and lateral.

In the structure of the human scapula, on the front part of the surface, which is slightly concave inward, there is a subscapular fossa, which is necessary for muscle attachment. On the posterior convex surface there is a bone formation called the scapular spine. This protrusion divides the bone area into two sections with the supra- and infraspinatus fossae. The spine originates in the area of the medial edge, and then, succumbing to elevation, goes to the lateral angle and turns into the acromion, at the top of which the surface necessary for articulation with the clavicle is formed.

Near the acromion, on one of its angles, namely the lateral one, there is an articular cavity to which the head of the humerus is attached. The coracoid process, which has the shape of a hook-shaped protrusion, extending from the upper edge, carries an ending necessary for the attachment of certain muscles.

Muscle tissue

The anatomy of the human scapula is designed in such a way that the muscles surrounding this bone only originate on its surface. But they are driven only by the muscles of the back, namely its superficial layers. The chest is also partially involved. In view of all this, the shoulder blade is covered with muscles over almost the entire surface. The acromial processes, ridge and posterior edge remain open.

The following muscles find their place of attachment on the human shoulder blade:

clavicular-brachial;
triceps and biceps brachii;
pectoralis minor;
serratus anterior;
a row of rhomboid, deltoid and trapezius muscles;
supraspinatus and infraspinatus;
small and large round;
latissimus dorsi muscles;
scapular-hyoid;
subscapular.

Blade surfaces

The human shoulder blade has 2 surfaces:

The costal (ventral) is a wide subscapular fossa, two-thirds of which are striated with a small number of ridges, obliquely and laterally upward. They are engaged in ensuring the attachment of the subscapularis muscle, and specifically its tendons. The surface on the lateral part of the fossa is smooth and filled with muscle fibers. Triangular-shaped areas separate the vertebral edge and the fossa, which is observed at two angles, medial and inferior. There you can also see a narrow ridge lying between them. It is these formations that allow the serratus muscle to attach to the scapula. The upper element of the pit bears a transverse impression on its surface. Here the bone bends along a line that passes through the glenoid cavity and maintains a right angle, thereby forming the subscapular angle. This shape of the bone body gives it strength.
The dorsal (posterior) surface is a convex area, which is divided unevenly into two parts by a massive protrusion - the spine. The area located above the spine is called the supraspinatus fossa, and below it is called the infraspinatus fossa. The supraspinatus fossa is smaller than the infraspinatus fossa, smooth and slightly concave inward, widened at the vertebral edge in comparison with the humeral one. 2/3 of the fossa area is necessary for attachment of the supraspinatus muscles. The infraspinatus fossa has a much larger surface, slightly concave in the upper part; the center takes the form of a protrusion, a slight convexity, and the lateral edges have indentations.

In the area of the posterior surface, near the axillary edge, there is a ridge directed downward and backward. It is necessary for articulation with the fibrous septum, which separates the infraspinatus muscles from the teres minor and major.

The ridge and axillary edge begin to narrow together, and they are crossed by a groove of blood vessels that goes around the scapula.

The lower third of the fossa has a wide triangular shape, to the surface of which the teres major muscle is attached, and the latissimus muscle lies on top of it.

Getting to know the spine

The human scapula has a spine, a protruding plate that crosses at an oblique angle and medially one-fourth of the dorsal area. This formation divides it in the upper part into sub- and supraspinatus fossae. The exit point of the spine is located on the vertical edge of a smooth platform, and its end turns into an acromion hanging over the shoulder joint. The spine takes the shape of a triangle and is flattened from top to bottom.

The concept of acromion

In the anatomy of the human scapula, there is a special component - the acromion. The element that forms the highest point of the shoulder. The process of the acromion has an elongated shape, similar to a triangle, and flattens from beginning to end. In the anterior part, it bends upward and is located on top of the glenoid cavity. Bundles of deltoid muscles join it.

The lower part of the process has a smooth surface and is slightly concave. Three or four tubercles form the lateral edge of the process, necessary for articulation with the tendons. The medial part of the edge, in comparison with the lateral, is shorter. It has a concavity and attaches the trapezius muscles to its surface. On the same edge there is an oval-shaped surface necessary for connection with the end of the clavicular acromian.

Bone edges

There are two edges in the structure of the scapula:

Upper. It has a concavity and extends from the angle directed medially to the very base of the coracoid process. The lateral section bears a semicircular notch. It is formed in part by the process base and forms the opening through which the subscapular nerve canal passes. The section adjacent to the lateral part is necessary as a site of attachment for the omohyoid muscles.
Lateral. It originates at the origins of the glenoid cavity. Has a deviation towards the back and down, looks at the lower corner. Below, under the cavity, the triceps tendons are attached to the roughness. The underlying third of the edge in question is pointed and quite thin; the subscapularis and teres major muscles of the human scapula are attached to it.

Shoulder blade: structure, functions and damage

The scapula belongs to the scapulohumeral section of the spine. In the context of the anatomical structure, the human scapula is a paired bone with a triangular shape. It is located on the back with the base up and the sharp end down, on both sides of the spinal column. The bone itself is wide and flat, slightly curved backwards.

Anatomical structure

The scapula has the following structure at the back:

spine (protruding surface that crosses one-fourth of the scapula);
acromion (outer end of the scapula);
coracoid process (named for its resemblance to a bird's beak);
neck;
body;
inner edge;
outer corner.

The blade has two surfaces:

The concave anterior surface is a small depression where the scapular muscle is attached, and the convex posterior surface is the spine of the scapula. The scapular spine is a protruding surface that crosses one-fourth of the scapula.

the upper one, in which there is an opening for the passage of nerve fibers and blood vessels;
vertebral (medial) is called so because it is closest to the spine;
axillary (lateral) - the most massive area, which is formed by tubercles on the brachial muscle.

And also three angles:

upper (medial), slightly rounded and facing upward;
the lower corner, which is thicker in structure than the upper;
lateral opposite to superior medial.

The lateral angle is isolated from the main bone by a small restriction called the neck. But between the neck and the upper edge there is a coracoid process.

Functions of the scapula

Its function is to ensure mobility of the upper limb by connecting the humerus and clavicle into one common movable complex.

The following functions are also distinguished:

The protective function is that vital organs, veins and arteries are in close proximity.

The motor function, together with the muscle groups that are attached to the scapula, are capable of performing various movements of the limb. The range of these movements is quite wide:

rotation by hand;
abduction of the arm to the side, back and forth;
raising your hands up.

If the scapula is damaged, quality of life and loss of performance are reduced.

Injuries, damage and pathologies

Damage to this anatomical segment occurs for the following reasons:

falling from a height onto your back;
blow to the back;
falling on the shoulder and arm;
road traffic accidents;
injuries at work.

In this case, injuries can be of a closed or open type. With closed injuries, there is no violation of the integrity of the skin. Open - occur as a result of skin rupture and the appearance of a wound surface.

Fractures are of the following types:

in the cervical area;
in the area of the glenoid cavity;
in the axis area;
damage to the coracoid process;
injuries of the acromion process;
injuries in the upper and lower corners;
longitudinal and transverse fractures;
comminuted fractures;
damage from a bullet wound or impact with a sharp object (perforated).

Of all the injuries listed, the most common are injuries to the glenoid cavity and acromion. And the most difficult injury is a fracture of the neck of the scapula, which has serious complications and consequences.

Symptoms include severe pain in the shoulder and forearm, which becomes unbearable when trying to move the limb. Swelling is observed and hematomas are formed. Pathological mobility. With a crack, the above symptoms are not observed.

Traumatization of this area has one characteristic symptom - Comolli's triangle. What is the essence of the phenomenon? It appears as a triangular swelling. When you try to touch the area of injury, the pain becomes more pronounced. And with a displaced fracture, an acoustic phenomenon appears - crepitation of fragments.

In some cases, the following symptom is observed: the shoulder and limb rise. This suggests that the pearl occurred in the joint area. In the part of the elevation, blood accumulates in the joint cavity, so the shoulder increases in size. When the neck is fractured, the shoulder, on the contrary, goes down (hangs), when the acromial process is injured, it protrudes forward, and when the coracoid process is damaged, it deepens.

An open fracture, in which bone fragments are visible and an open wound has occurred, can become infected. Also in this case, blood vessels and nerve endings are damaged.

intra-articular, when the joint is involved;
extra-articular, as a rule, there is trauma to any area, but without involving the joint in the pathological process.

Intra-articular injuries require surgical treatment to compare and restore bone fragments. Fractures of the body of the scapula usually heal well provided strict bed rest is observed. To do this, the arm bent at the elbow is fixed to the torso with a special splint. The duration of wearing the splint is approximately a month. After which physiotherapeutic procedures, massage and development of the shoulder joint are prescribed.

Such damage is extremely rare. It develops due to a strong jerk of the arm or shoulder to the side, resulting in displacement of the scapula. In this case, a characteristic manifestation is its protrusion and severe pain, especially when trying to move the arm. The dislocation is reduced by a qualified specialist, only in a medical facility and only under anesthesia. Then immobilization is carried out, fixing the arm to the body for 15 days.

This is an inflammatory disease that manifests itself as damage to the periarticular bursae of the shoulder joint. The cause of the disease is most often an infection of both an endogenous and exogenous nature. It can also occur as a result of injury and an autoimmune process. Manifested by the following symptoms:

pain in the area of the affected joint;
swelling and redness of the skin;
feeling of numbness;
limitation of mobility.

Treatment is carried out conservatively. The following drugs are prescribed:

nonsteroidal drugs (NSAIDs);
steroid hormones;
antibiotics (for infectious etiology of the disease);
analgesics;
chondroprotectors;
vitamin and mineral complexes.

Protruding shoulder blades are considered developmental defects. Most often they are congenital, but can also appear as a result of spinal curvature as a result of incorrect back position for a long time. Such damage includes:

poor posture;
kyphosis and scoliosis;
muscle rupture or paralysis.

Most often, their protrusion does not cause pain, but is considered a cosmetic flaw or defect. After all, it seems that the person has grown a hump. Therefore, this causes him to feel inferior and suffer morally, which significantly affects the quality of a person’s life. Currently, such defects can be corrected with the help of physical therapy and massage.

Spatula

The scapula, scapula, is a flat bone. Located between the back muscles at the level of the II to VIII ribs. The scapula has a triangular shape and, accordingly, there are three edges: superior, medial and lateral, and three angles: superior, inferior and lateral.

The upper edge of the scapula, margo superior scapulae, is thinned, in its outer part there is a notch of the scapula, incisura scapulae: above it, the superior transverse ligament of the scapula, lig, is stretched on the non-macerated bone. transversum scapulae superius, which together with this notch forms an opening through which the suprascapular nerve passes, n. suprascapularis.

The outer sections of the upper edge of the scapula pass into the coracoid process, processus coracoideus. Initially, the process is directed upward, then bends forward and somewhat outward.

Medial edge of the scapula, margo medialis scapulae. It faces the spinal column and can be easily felt through the skin.

The lateral edge of the scapula, margo lateralis scapulae, is thickened, directed towards the axilla.

The upper corner, angulus superior, is rounded, facing upward and medially.

The lower angle, angulus inferior, is rough, thickened and facing downwards.

The lateral angle, angulus lateralis, is thickened. On its outer surface there is a flattened glenoid cavity, cavitas glenoidalis, with which the articular surface of the head of the humerus articulates. The lateral angle is separated from the rest of the scapula by a small narrowing - the neck of the scapula, collum scapulae.

In the area of the neck, above the upper edge of the glenoid cavity, there is a supraglenoid tubercle, tuberculum supraglenoidale, and below the glenoid cavity there is a subarticular tubercle, tuberculum infraglenoidale (traces of the beginning of the muscles).

The costal surface (anterior), facies costalis (anterior), concave, is called the subscapular fossa, fossa subscapularis. It is filled with the subscapularis muscle, m. subscapularis.

The spine of the scapula, spina scapulae, is a well-developed ridge that crosses the posterior surface of the scapula from its medial edge towards the lateral angle.

13-medial border of the scapula.

6-cavitas glenoidalis (angulus lateralis);

The scapula (lat. scapula) is a bone of the upper limb girdle, providing articulation of the humerus with the collarbone. In humans, it is a flat bone approximately triangular in shape.

There are two surfaces in the blade:

* anterior, or costal (facies costalis),

* posterior, or dorsal (facies posterior);

* upper (margo superior),

* medial, or vertebral (margo medialis),

* lateral, or axillary (margo lateralis);

* medial, superior (angulus superior),

* lower (angulus inferior),

* lateral (angulus lateralis).

The anterior surface is slightly concave and represents a subscapular fossa, which serves as the attachment point for the muscle of the same name.

The posterior surface of the scapula is convex, divided horizontally by a passing bony protrusion - the scapular bone (spina scapularis) - into the periosteal and subosseous fossae. The bone starts from the medial edge of the scapula and, gradually rising, follows to the lateral angle, where it ends with the acromion, at the top of which there is an articular surface for connection with the clavicle.

Near the base of the acromion, also on the lateral angle, there is a depression - the articular cavity of the scapula (cavitas glenoidalis). The head of the humerus is attached here. The scapula also articulates with the collarbone through the acromioclavicular joint.

Another hook-shaped protrusion, the coracoid process (processus coracoideus), extends from the upper edge of the scapula; its end serves as an attachment point for several muscles.

The costal, or ventral, surface of the scapula is a wide subscapular fossa.

The medial 2/3 of the fossa is obliquely striated in the superolateral direction with a few ridges, which provide attachment to the surface of the tendons of the subscapularis muscle. The lateral third of the fossa is smooth; it is filled with fibers of this muscle.

The fossa is separated from the vertebral edge by smooth triangular areas at the medial and lower corners, as well as by the often absent narrow ridge, which is located between them. These platforms and the transitional ridge provide attachment for the serratus anterior muscle.

On the surface of the upper part of the fossa there is a transverse depression where the bone bends along a line passing at right angles through the center of the glenoid cavity, forming a significant subscapular angle. The curved shape will give the bone body greater strength, and the load from the spine and acromion falls on the protruding part of the arch.

The posterior surface of the scapula is convex, it is divided into two unequal parts by a massive bony protrusion - the spine. The area above the spine is called the supraspinatus fossa, the area below the spine is called the infraspinatus fossa.

* The infraspinous fossa is the smaller of the two, it is concave, smooth and wider at its vertebral edge than at the humeral one; the medial two-thirds of the fossa serves as the insertion point for the supraspinatus muscle.

* The infraspinatus fossa is significantly larger than the first, in its upper part, closer to the vertebral edge, it is somewhat concave; its center protrudes in the form of a convexity, and a depression runs along the lateral edge. The medial two-thirds of the fossa serves as the attachment point for the infraspinatus muscle, and the lateral third is filled with it.

On the posterior surface, near the axillary margin, a raised ridge is noticeable, running downward and posteriorly from the lower part of the glenoid cavity to the lateral margin, approximately 2.5 cm above the lower angle.

The ridge serves to attach the fibrous septum that separates the infraspinatus muscle from the teres major and minor.

The surface between the crest and the axillary edge, narrowed in its upper two-thirds, is intersected at the center by a vascular groove intended for the vessels circumflexing the scapula; it serves to attach the teres minor muscle.

Its lower third is a wide, somewhat triangular surface that serves as the attachment point for the teres major muscle, over which the latissimus dorsi muscle slides; the latter is often also attached there with some of its fibers.

The wide and narrow parts mentioned above are separated by a line running obliquely from the lateral edge posteriorly and downward towards the ridge. A fibrous septum is attached to it, separating the teres muscles from the others.

The spine (spina scapulæ) is a protruding bony plate that crosses obliquely 1/4 of the dorsal surface of the scapula in its upper part, and separates the supra- and infraspinatus fossae. The spine starts from the vertical edge with a smooth triangular platform and ends with the acromion, which hangs over the shoulder joint. The spine has a triangular shape, flattened from top to bottom, and its apex is directed towards the vertebral edge.

The acromion forms the highest point of the shoulder; This is a large, elongated, approximately triangular process, flattened in the anteroposterior direction, initially protruding laterally, and then curving anteriorly and upward, hanging over the glenoid cavity.

Its upper surface, directed upward, posteriorly and laterally, is convex and rough. It serves as the attachment point for part of the deltoid muscle bundles and is almost entirely located subcutaneously.

The lower surface of the process is concave and smooth. Its lateral margin is thick and irregular, formed by three or four tubercles for the deltoid tendons. The medial edge is shorter than the lateral one, concave, part of the trapezius muscle is attached to it, a small oval surface on it is intended for articulation with the acromial end of the clavicle.

The blade has three edges:

* The upper edge is the shortest and thinnest, concave; it continues from the medial angle to the base of the coracoid process. In the lateral part there is a deep semicircular notch (notch of the scapula), partially formed by the base of the coracoid process. Covered by the superior transverse ligament, which can sometimes become calcified, the notch forms an opening that allows the suprascapular nerve to pass through. The adjacent part of the upper edge serves to attach the omohyoid muscle.

* The lateral margin is the thickest of the three; starting from the lower edge of the glenoid cavity, it deviates downward and posteriorly towards the lower angle. Directly under the glenoid cavity there is a small, about 2.5 cm, rough impression (subarticular tuberosity), which serves as the site of attachment of the tendon as long as the head of the triceps brachii muscle; Anterior to it runs a longitudinal groove, which occupies the lower third of the edge and is the point of attachment of the subscapularis muscle. The lower third of the edge, thin and sharp, serves to attach the fibers of the teres major (back) and subscapularis muscles (front).

Atlas of human anatomy. Akademik.ru. 2011.

Spatula

It distinguishes two surfaces: the anterior one, facing the ribs - the costal one, fades costalis, and the dorsal one, fades dorsalis, facing back, and three edges: the upper one, margo superior, the medial one, margo medialis, and the lateral one, margo lateralis, as well as three angles: medial, angulus medialis, lower, angulus inferior, and lateral, angulus lateralis.

On the upper edge of the scapula there is a notch of the scapula, incisura scapulae, which sometimes turns into an opening through which the suprascapular nerve passes. On the upper edge, between the notch and the lateral angle, there is a beak-shaped process, processus coracoideus, with its apex facing forward. The medial edge faces the spine and is easily palpated through the skin. The lateral edge is thickened and directed towards the axillary region. It contains the glenoid cavity, cavitas glenoidalis, for connection with the head of the humerus. The glenoid cavity is delimited from the scapula by a narrowing - the neck of the scapula, collum scapulae. In the area of the neck, above the upper edge of the glenoid cavity, there is a supraglenoid tubercle, tuberculum supraglenoidale, and below the glenoid cavity there is a subglobal tubercle, tuberculum infraglenoidale.

The anterior costal surface is concave and is called the subscapular fossa, fossa subscapulatis. This is where the subscapularis muscle originates. The dorsal surface, due to the scapular spine, spina scapulae, is divided into two fossae: supraspinous, fossa supraspinata, and infraspinous, fossa infraspinata. The scapular spine is a well-developed ridge, the lateral part of which passes into the supra-humeral process, acromion, which combines the articular surface with the acromial end of the clavicle. The following forms are distinguished: sickle-shaped, triangular, quadrangular and intermediate.

Ossification. The ossification point in the body of the scapula appears at 2-3 months of intrauterine development. A separate point of ossification appears in the first year of life in the coracoid process, which fuses with the scapula. Complete ossification of the cartilaginous parts of the scapula is completed during the last years of life.

Regio scapularis

Borders: above - the line connecting the humeral process of the scapula with the spinous process of the VII cervical vertebra; inferiorly, a horizontal line drawn through the lower angle of the scapula; medial vertebral line; lateral posterior border of the deltoid muscle and the midaxillary line.

The skin is thick, mobile, folded. The subcutaneous tissue contains the subcutaneous venous network and cutaneous arterial branches. Deeper, on top of the proper fascia, lie the lateral cutaneous branches from rr. dorsales of the thoracic nerves.

Rice. 23. Scapular and subscapular areas after removal of skin and subcutaneous tissue to the proper fascia. View from the right, rear.

The fascia proper consists of superficial and deep layers. The superficial layer forms a fascial sheath for the trapezius muscle and the vastus dorsi muscle.
M. trapezius covers only part of its fibers the superomedial region and is attached to the scapular spine and the humeral process of the scapula. M. latissimus dorsi mainly lies in the regio infrasca-pularis and only the upper sections of the muscle cover the lower angle of the scapula. Under the trapezius muscle there is a layer of loose fiber containing fat in some areas. In the same layer in the area of the scapular spine there is often a synovial bursa.

Rice. 24. Superficial muscles of the scapular and subscapular regions. View from the right, rear.
The skin, subcutaneous tissue and superficial layer of the fascia over the vastus dorsi, trapezius and teres major muscles were removed.

Rice. 25. Scapular and subscapular areas after removal of the trapezius muscle and vastus dorsi muscle. Supraspinatus and infraspinatus fascia. View from the right, rear.

Rice. 26. Deep muscles of the scapular and subscapular regions. Supraspinatus and infraspinatus osteofibrous receptacles. View from the right, rear.
The trapezius and deltoid muscles, the latissimus dorsi muscle and the deep plate of the fascia propria were partially removed; The supraspinatus and infraspinatus fascia were opened.

Rice. 27. Supraspinatus and infraspinatus osteo-fibrous containers of the scapular region. View from the right, rear.
Same as in fig. 26. In addition, the teres minor, supraspinatus and infraspinatus muscles were partially removed down to the layer of fiber located under these muscles. The fiber contains blood vessels that lead to nerves.

Rice. 28. Vessels and nerves of the supraspinatus and infraspinatus osteofibrous receptacles of the scapula. Trilateral and quadrilateral foramina and the vessels and nerves passing through them. View from the right, rear.
Same as in fig. 27; in addition, the infraspinatus, supraspinatus and teres minor muscles, as well as the lower part of the levator scapulae muscle, were almost completely removed. The fiber is removed to the periosteum. Vessels and nerves were prepared.

Rice. 29. Subscapularis muscle and its subtendinous bursa. View from the right, rear.
Same as in fig. 28; in addition, the scapula was removed, with the exception of its medial edge and the coracoid process,” and the articular capsule of the shoulder joint and the subtendinous bursa of the subscapularis muscle were opened.

The deep leaf of the fascia proper, attaching to the edges of the scapula and scapular spine, together with the supraspinatus and infraspinatus fossa of the scapula, forms the supraspinatus and infraspinatus osteo-fibrous containers, in which muscles, blood vessels, nerves and fiber are located. In this area, the fascia is strong and may contain tendon fibers. In the supraspinatus and infraspinatus containers, directly under the fascia, there is a thin layer of fiber and muscle. M. supra-spinatus begins in the supraspinatus fossa and, passing below the humeral process of the scapula and around the shoulder joint from above, attaches to the capsule of the shoulder joint and to the upper platform of the greater tuberosity humerus. M. infraspinatus begins in the infraspinatus fossa and, going around shoulder joint posteriorly and superiorly, attached to the middle platform of the greater tuberosity of the humerus. M. teres minor is located below the infraspinatus muscle, lies behind the shoulder joint and is attached to the lower platform of the greater tuberosity of the humerus. Below the teres minor muscle in a separate fascial sheath lies the sh. teres major. It begins at the lower angle of the scapula and, together with the vastus dorsi muscle, is attached to the crest of the lesser tuberosity of the humerus.

Anterior to the muscles in the lateral part of the supraspinatus and infraspinatus fossa there is a layer of fiber in which the suprascapular artery, vein and nerve pass. N. supra-scapularis passes into the supraspinous fossa through the incisura scapulae under the transverse scapular ligament. A. suprascapularis goes above the ligament, but can also accompany the nerve. In the supraspinatus fossa, the artery and nerve are located between the periosteum and the muscle, go down, pass through the fascia, bending around the scapular spine on the lateral side, and penetrate the infraspinatus osteofibrous sheath, where they supply the infraspinatus and teres minor muscles. Through the three-sided foramen, a. passes into the infraspinatus fossa. circumflexa scapulae, branch of the subscapular artery. The arteries are located directly on the periosteum of the scapula and anastomose with each other, as well as with the branches of a. scapularis descendens. The latter is a deep branch of a. transversa colli, descends from top to bottom along the medial edge of the scapula and is located anterior to the rhomboid major and minor muscles and behind the superior serratus posterior muscle.

Spatula forms the bone basis of the region and is located at the level of the II-VII ribs. From the costal surface of the scapula in the fossa subscapularis, the subscapularis muscle begins, which in front of the capsule of the shoulder joint is attached to the lesser tuberosity of the humerus. Between the posterior surface of the muscle tendon and the anterior surface of the capsule of the shoulder joint there is a synovial bursa (bursa m. subscapularis subtendinea), which communicates with the articular cavity of the shoulder joint. In front, the subscapularis muscle is covered with a thin layer of fiber and fascia, which is attached to the edges of the scapula and forms a bone-fibrous sheath for the muscle. The branches of the subscapular and axillary arteries, veins and the subscapular nerve approach the muscle through the fascia.

Anterior to the fascia of the subscapularis muscle and posterior to the fascia of the serratus anterior muscle is the posterior prescapular fissure, filled with fatty tissue, vessels, nerves and lymph nodes. On the inside, it is limited by the attachment of the serratus anterior muscle to the medial edge of the scapula; on the lateral side, the tissue of the space directly passes into the tissue of the axilla.

The serratus anterior muscle begins on the anterolateral surface of the chest with teeth from the 8-9 upper ribs, covers the chest in the direction from front to back and is attached to the medial edge of the scapula. Between the rib cage itself (ribs, intercostal muscles and the fascia covering them) and the serratus anterior muscle there is an anterior prescapular fissure, filled with fiber. The deepest muscle in the region lying directly on the rib cage is the serratus posterior superior. Beneath it lies a thin layer of fiber that separates it from the chest.

Rice. 30. Neurovascular bundle of the axilla from the side of the scapular region. View from the right, rear.
Same as in fig. 29; in addition, the scapula and soft tissues of the scapular region were completely removed, with the exception of the subscapularis muscle, the lateral part of which was retracted medially and downwards. The teres major and latissimus dorsi muscles are retracted to the lateral side.

Lymph flows from the scapular region in several directions. From the medial sections of the region (trapezius, rhomboid muscles and the levator scapulae muscle), lymphatic vessels with 2-3 stems go up along the descending scapular artery and are partially interrupted in 1-2 lymph nodes lying at the upper corner of the scapula. From here, going around the levator scapulae muscle on the medial side, the lymphatic vessels along the transverse artery of the neck are directed to the lower deep cervical nodes. From the contents of the supraspinatus and upper part of the infraspinatus fossa, 2-3 lymphatic vessels run along the suprascapular artery, are interrupted in the lymph node lying at the scapular notch, and from it along the suprascapular artery and nerve are directed to the deep lower cervical nodes. From the inferolateral part of the infraspinatus fossa and from the teres major muscle, lymph flows into the nodes located at the entrance to the trilateral and quadrilateral foramina and into the subscapular and central lymph nodes of the axilla. The lymphatic vessels of the subscapularis muscle drain into the subscapularis nodes, into the apical lymph nodes of the axilla and into the deep lower cervical nodes.

Rice. 31. Cellular spaces of the scapular, axillary and subclavian regions on a horizontal cut. View from above.
The cut was made at the level of the head of the humerus.

Related materials:

Anatomy

In general, the scapula is almost completely enveloped on both sides by muscles responsible only for the shoulder - its fixation and mobility. The scapula itself moves only thanks to the dorsal and pectoral muscles.

Functions of the scapula

Main functions of the scapula:

The shoulder blades are the main link between the shoulder girdle and the arms and sternum.

The processes of the scapula - the coracoid and acromion - as well as their ligamentous apparatus protect the shoulder joint from above. In addition, the shoulder blade bones with their muscles and ligaments, along with the ribs and back muscles, protect the lungs and aorta.

Part of the muscles extending from the shoulder blades strengthens and holds the shoulder joint.

Diseases and injuries of the scapular region

Fractures

Scapula fractures may be accompanied by the following symptoms:

The scapula is designed in such a way that significant external force is required to fracture it. In addition, vital organs are in close proximity - the heart, lungs, and great vessels. Therefore, if you suspect a fracture of the scapula, you should consult a doctor as soon as possible.

Dislocation

Symptoms:

the scapula is in an abnormal position - its outer lateral edge is sharply protruded;
any movement in the shoulder joint causes severe pain.

The dislocation is reduced by a surgeon under local anesthesia, after which the arm is fixed to the torso for two to three weeks.

Bursitis

Bursitis of the shoulder blade refers to inflammation of the periarticular bursae of the shoulder joint. The cause of the disease can be injury, infection, or an autoimmune reaction.

Symptoms:

Bursitis is treated with conservative methods - antibiotic therapy, painkillers, physical therapy - under the supervision of a doctor.

Developmental defects

Examples of congenital anomalies of the scapula:

aplasia (absence) and hypoplasia (underdevelopment);
pterygoid blade;

Aplasia is most often combined with the absence of an arm on the same side.

The pterygoid scapula is not only a cosmetic defect - a protruding inner edge, but also a functional disorder - the inability to rotate the arm and raise it. The disease is treated promptly.

Protruding blades

Shoulder blades can “stick out” in both children and adults for various reasons, including:

Depending on the cause, protrusion of the shoulder blades may not bring suffering other than moral, or be accompanied by disorders that significantly reduce the quality of life.

Poor posture can be corrected quite easily with the help of exercises, massage, and developing the habit of keeping your back straight. In other cases, it is necessary to treat the underlying disease.

Pain in the shoulder blades

So, pain under the left shoulder blade may be accompanied by:

heart diseases – coronary heart disease (angina, heart attack), myocarditis;
lung diseases;
stomach diseases;
aortic aneurysm dissection;
pancreatic diseases.

Pain in the area of the right shoulder blade is caused by:

diseases of the biliary system and liver parenchyma (sometimes pain can radiate to the left shoulder blade);
malignant breast tumors.

Pain in the area of any shoulder blade can be accompanied by complicated osteochondrosis and neuralgia.