Scapula (Bone)

Authors
Affiliations

Doctor of Physical Therapy

B.S. in Kinesiology

Doctor of Physical Therapy

B.A. in Neuroscience

Figure 1: Left Scapula (Anterior view)
Figure 2: Left Scapula (Lateral view)
Figure 3: Plan of Ossification of the Scapula from 7 centers

Osteologic features

Superior angle

Lateral angle

Inferior angle

Superior border

One of the borders of the thoracic outlet

Medial (vertebral) border

Lateral (axillary) border

Supraspinous fossa

Infraspinous fossa

Spine of Scapula

“The spine of the scapula provides a continuous line of attachments for the supporting trapezius muscle along its upper border, whereas the deltoid muscle, which suspends the humerus, gains origin from its lower border.”

Root of the Spine of the Scapula

Acromion

“A prominent feature of the scapula is the large overhanging acromion (see Fig. 16-3), which, along with the coracoacromial ligament and the previously mentioned labrum, functionally enlarges the G-H socket. The position of the acromion also places the deltoid muscle in a dominant position to provide muscular support during elevation of the arm. The morphology of the acromion is variable with three types having been described—(1) a relatively flat undersurface (Type I), (2) a slightly convex undersurface (Type II), and (3) a hooked shape (Type III), with a 2018 study finding that individuals with a type III acromion had almost three times greater odds for an RTC tear as compared to those with a type I or II, concluding that a larger acromial index is associated with a greater likelihood of an RTC tear.9 This despite an earlier study in 2011 that concluded that the type of acromion was not found to have an important role in the etiology of chronic impingement syndrome.10”

Clavicular facet

Glenoid fossa

Supraglenoid tubercle

Infraglenoid tubercle

Coracoid process

Figure 4: Muscles that position the Pectoral Girdle

“The coracoid process (see Fig. 16-3) projects forward like a crow’s beak, for which it is named. This forward position provides an efficient lever whereby the small pectoralis muscle can help to stabilize the scapula. In addition, the process serves as a point of origin for the coracobrachialis and the short head of the biceps muscle”

Myofascial considerations

The coracobrachialis and pectoralis minor both have insertions on the coracoid process, which creates a myofascial line. When the arm is relaxed by one’s side since the pec minor and coracobrachialis fascial lines run in two different directions, thus the line is inactive. However, when shoulder is brought into overhead flexion (i.e. tennis serve or hanging from a bar).

Subscapular fossa of scapula

1.
Gray H. Anatomy of the Human Body. 20th ed. (Lewis WH, ed.). Lea & Febiger; 1918. https://www.bartleby.com/107/
2.
Dutton M. Dutton’s Orthopaedic Examination, Evaluation, and Intervention. 5th ed. McGraw Hill Education; 2020.
3.
Betts JG, Blaker W. Anatomy and Physiology. 2nd ed. OpenStax; 2022. https://openstax.org/details/books/anatomy-and-physiology-2e/?Book%20details
4.
Neumann DA, Kelly ER, Kiefer CL, Martens K, Grosz CM. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation. 3rd ed. Elsevier; 2017.
5.
Myers TW. Anatomy Trains. 4th ed. Elsevier; 2021.

Citation

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