Supraspinatus muscle | |
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Details | |
Origin | Supraspinous fossa of scapula |
Insertion | Superior facet of greater tubercle of humerus |
Artery | Suprascapular artery |
Nerve | Suprascapular nerve |
Actions | Abduction of arm and stabilizes humerus |
Identifiers | |
Latin | musculus supraspinatus |
TA98 | A04.6.02.006 |
TA2 | 2457 |
FMA | 9629 |
Anatomical terms of muscle |
The supraspinatus (pl.: supraspinati) is a relatively small muscle of the upper back that runs from the supraspinous fossa superior portion of the scapula (shoulder blade) to the greater tubercle of the humerus. It is one of the four rotator cuff muscles and also abducts the arm at the shoulder. The spine of the scapula separates the supraspinatus muscle from the infraspinatus muscle, which originates below the spine.
The supraspinatus muscle arises from the medial two-thirds supraspinous fossa of the scapula. [1]
The supraspinatus tendon inserts onto the superior facet of the greater tubercle of the humerus. [2]
The supraspinatus muscle tendon passes laterally beneath the cover of the acromion. [3] [4] The tendon blends with the shoulder joint capsule. [1]
The supraspinatus muscle is innervated by suprascapular nerve (C5-6) [1] of the upper trunk of the brachial plexus.
The supraspinatus muscle performs abduction of the arm, and pulls the head of the humerus medially towards the glenoid cavity. [5] It independently prevents the head of the humerus from slipping inferiorly. [5] The supraspinatus works in cooperation with the deltoid muscle to perform abduction, including when the arm is in an adducted position. [5] Beyond 15 degrees, the deltoid muscle becomes increasingly more effective at abducting the arm and becomes the main propagator of this action. [6]
The supraspinatus forms part of the rotator cuff and is one of its most frequently damaged components, whether from acute injury or gradual degeneration. [7] Bad posture and age are leading risk factors, with a high prevalence of asymptomatic partial and full tears, as well as symptomatic syndromes with chronic pain. Associated pathologies include acromial impingement, frozen shoulder, and poor sleep, especially on the affected side. Both ultrasound and MRI are useful methods of diagnosis.
Antero-posterior projectional radiography of the shoulder may demonstrate a high-riding humeral head, with an acromiohumeral distance of less than 7 millimetres (0.28 in). [8]
One study has indicated that arthroscopic surgery for full-thickness supraspinatus tears is effective for improving shoulder functionality. [9]
A comparative effectiveness review of nonoperative and operative treatments for rotator cuff tears was performed at the University of Alberta Evidence-based Practice Center in 2010. The review identified one study which reported that, "Patients receiving early surgery had superior function compared with the delayed surgical group". The review noted that the level of significance of the study was not reported, and the review chose not to include it as one of their conclusions. Instead it concluded that "The paucity of evidence related to early versus delayed surgery is of particular concern, as patients and providers must decide whether to attempt initial nonoperative management or proceed immediately with surgical repair". In terms of operative techniques, differences in neither cuff integrity nor shoulder function were reported in studies comparing single-row versus double-row suture anchor fixation and mattress locking versus absorbable sutures. Postoperatively, a slight advantage was evident in patients who performed continuous passive motion alongside physical therapy, as opposed to those who solely performed physical therapy. There is insufficient evidence to adequately compare the effects of operative against nonoperative interventions. Complications were reported very seldom, or were not determined to be clinically significant. [10]
A 2016 study evaluating the effectiveness of arthroscopic treatment of rotator cuff calcification firmly supported surgical intervention. Calcification of the supraspinatus tendon is a major contributor to shoulder pain in the general population and is often worsened following a supraspinatus tear. The results of the study included the return to sports and original functionality of 95.8% of the patients after a mean of 5.3 post-operative months. A significant decrease in pain was observed over time following removal of the calcification. The study showed the overall effectiveness of arthroscopic procedures on shoulder repair, and the lack of risk experienced. [11] Before surgery, supraspinatus tendonitis should be ruled out as the cause of pain.
The suprascapular nerve which innervates the supraspinatus can be damaged along its course in fractures of the overlying clavicle, which can reduce the person's ability to initiate the abduction.[ citation needed ]
The scapula, also known as the shoulder blade, is the bone that connects the humerus with the clavicle. Like their connected bones, the scapulae are paired, with each scapula on either side of the body being roughly a mirror image of the other. The name derives from the Classical Latin word for trowel or small shovel, which it was thought to resemble.
The humerus is a long bone in the arm that runs from the shoulder to the elbow. It connects the scapula and the two bones of the lower arm, the radius and ulna, and consists of three sections. The humeral upper extremity consists of a rounded head, a narrow neck, and two short processes. The body is cylindrical in its upper portion, and more prismatic below. The lower extremity consists of 2 epicondyles, 2 processes, and 3 fossae. As well as its true anatomical neck, the constriction below the greater and lesser tubercles of the humerus is referred to as its surgical neck due to its tendency to fracture, thus often becoming the focus of surgeons.
The rotator cuff (SITS muscles) is a group of muscles and their tendons that act to stabilize the human shoulder and allow for its extensive range of motion. Of the seven scapulohumeral muscles, four make up the rotator cuff. The four muscles are:
Shoulder problems including pain, are one of the more common reasons for physician visits for musculoskeletal symptoms. The shoulder is the most movable joint in the body. However, it is an unstable joint because of the range of motion allowed. This instability increases the likelihood of joint injury, often leading to a degenerative process in which tissues break down and no longer function well.
The human shoulder is made up of three bones: the clavicle (collarbone), the scapula, and the humerus as well as associated muscles, ligaments and tendons.
The deltoid muscle is the muscle forming the rounded contour of the human shoulder. It is also known as the 'common shoulder muscle', particularly in other animals such as the domestic cat. Anatomically, the deltoid muscle is made up of three distinct sets of muscle fibers, namely the
Rotator cuff tendinopathy is a process of senescence. The pathophysiology is mucoid degeneration. Most people develop rotator cuff tendinopathy within their lifetime.
The teres minor is a narrow, elongated muscle of the rotator cuff. The muscle originates from the lateral border and adjacent posterior surface of the corresponding right or left scapula and inserts at both the greater tubercle of the humerus and the posterior surface of the joint capsule.
The suprascapular nerve is a mixed nerve that branches from the upper trunk of the brachial plexus. It is derived from the ventral rami of cervical nerves C5-C6. It provides motor innervation to the supraspinatus muscle, and the infraspinatus muscle.
In human anatomy, the infraspinatus muscle is a thick triangular muscle, which occupies the chief part of the infraspinatous fossa. As one of the four muscles of the rotator cuff, the main function of the infraspinatus is to externally rotate the humerus and stabilize the shoulder joint.
The shoulder joint is structurally classified as a synovial ball-and-socket joint and functionally as a diarthrosis and multiaxial joint. It involves an articulation between the glenoid fossa of the scapula and the head of the humerus. Due to the very loose joint capsule, it gives a limited interface of the humerus and scapula, it is the most mobile joint of the human body.
The teres major muscle is a muscle of the upper limb. It attaches to the scapula and the humerus and is one of the seven scapulohumeral muscles. It is a thick but somewhat flattened muscle.
The shoulder girdle or pectoral girdle is the set of bones in the appendicular skeleton which connects to the arm on each side. In humans, it consists of the clavicle and scapula; in those species with three bones in the shoulder, it consists of the clavicle, scapula, and coracoid. Some mammalian species have only the scapula.
The supraspinous fossa of the posterior aspect of the scapula is smaller than the infraspinous fossa, concave, smooth, and broader at its vertebral than at its humeral end. Its medial two-thirds give origin to the Supraspinatus.
The coracoacromial ligament is a strong triangular ligament between the coracoid process and the acromion. It protects the head of the humerus. Its acromial attachment may be repositioned to the clavicle during reconstructive surgery of the acromioclavicular joint.
Subacromial bursitis is a condition caused by inflammation of the bursa that separates the superior surface of the supraspinatus tendon from the overlying coraco-acromial ligament, acromion, and coracoid and from the deep surface of the deltoid muscle. The subacromial bursa helps the motion of the supraspinatus tendon of the rotator cuff in activities such as overhead work.
Calcific tendinitis is a common condition where deposits of calcium phosphate form in a tendon, sometimes causing pain at the affected site. Deposits can occur in several places in the body, but are by far most common in the rotator cuff of the shoulder. Around 80% of those with deposits experience symptoms, typically chronic pain during certain shoulder movements, or sharp acute pain that worsens at night. Calcific tendinitis is typically diagnosed by physical exam and X-ray imaging. The disease often resolves completely on its own, but is typically treated with non-steroidal anti-inflammatory drugs to relieve pain, rest and physical therapy to promote healing, and in some cases various procedures to breakdown and/or remove the calcium deposits.
Shoulder surgery is a means of treating injured shoulders. Many surgeries have been developed to repair the muscles, connective tissue, or damaged joints that can arise from traumatic or overuse injuries to the shoulder.
Shoulder replacement is a surgical procedure in which all or part of the glenohumeral joint is replaced by a prosthetic implant. Such joint replacement surgery generally is conducted to relieve arthritis pain or fix severe physical joint damage.
Shoulder impingement syndrome is a syndrome involving tendonitis of the rotator cuff muscles as they pass through the subacromial space, the passage beneath the acromion. It is particularly associated with tendonitis of the supraspinatus muscle. This can result in pain, weakness, and loss of movement at the shoulder.