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The scapula may also be misplaced if a rib deep to it is not moving correctly. Often in the case of Shoulder impingement syndrome, the scapula may be anteverted such that the shoulder on the affected side appears protracted. The ribs that may cause such an anteversion of the scapula include ribs 2–8.
The original technique was first described by Eden [4] in 1924 and verified by Lange in the 1950s. [5] [6] The rhomboid major and rhomboid minor were transferred laterally from the medial border of the scapula to the infraspinatous fossa, and the levator scapulae was transferred laterally to the spine of the scapula, near the acromion.
Dorsal scapular nerve syndrome can be caused by nerve compression syndrome. A winged scapula is the most common symptom. [7] Shoulder pain may occur. [7] It causes weakness in rhomboid major muscle, rhomboid minor muscle, and levator scapulae muscle. [7] The range of motion of the shoulder may be limited. [7] Treatment is usually conservative. [7]
Laterocollis is the tilting of the head from side to side. This is the "ear-to-shoulder" version. This involves many more muscles: ipsilateral sternocleidomastoid, ipsilateral splenius, ipsilateral scalene complex, ipsilateral levator scapulae, and ipsilateral posterior paravertebrals. The flexion of the neck (head tilts forwards) is anterocollis.
Levator scapulae forms part of the latter group together with rhomboid major, rhomboid minor, serratus anterior, and trapezius. The trapezius evolved separately, but the other three muscles in this group evolved from the first eight or ten ribs and the transverse processes of the cervical vertebrae (homologous to the ribs).
There are several options of treatment when iatrogenic (i.e., caused by the surgeon) spinal accessory nerve damage is noted during surgery. For example, during a functional neck dissection that injures the spinal accessory nerve, injury prompts the surgeon to cautiously preserve branches of C2, C3, and C4 spinal nerves that provide supplemental innervation to the trapezius muscle. [3]
levator scapulae, the upper fibers of the trapezius Scapular depression [12] The scapula is lowered from elevation. The scapulae may be depressed so that the angle formed by the neck and shoulders is obtuse, giving the appearance of "slumped" shoulders. [citation needed] pectoralis minor, lower fibers of the trapezius, subclavius, latissimus dorsi
The accessory nerve (CN XI) is particularly vulnerable to damage during lymph node biopsy. Damage results in an inability to shrug the shoulders or raise the arm above the head, particularly due to compromised trapezius muscle innervation.