Part 79

Insertion.—The posterior triangular area on the costal surface of the scapula and the adjacent part of the cartilage.

Action.—The two muscles form a sort of sling in which the trunk is suspended. Contracting together, they raise the thorax; contracting singly, the weight is shifted to the limb on the side of the muscle acting. The two parts can contract separately and are antagonistic in their action on the scapula. The cervical part draws the base of the scapula toward the neck, while the thoracic part has the opposite action; these effects concur in the backward and forward swing of the limb respectively. With the limb fixed, the cervical part extends (raises) the neck or inclines it laterally. The thoracic part may act as a muscle of forced inspiration.

Structure.—In the domesticated animals there is no such clear division of the muscle as is found in man and the apes. On account of the difference in action, however, it seems desirable to distinguish the two portions. The cervical part is thick and almost entirely fleshy. The thoracic part has on its superficial face a thick, tendinous layer which may sustain the weight of the trunk when the muscle substance relaxes. The ventral edge presents distinct digitations, the last four of which alternate with those of the obliquus externus abdominis, and are covered by the abdominal tunic. The fourth, fifth, and sixth digitations extend nearly to the distal ends of the ribs. The last digitation is small and may be absent. Exceptionally additional digitations may be attached to the tenth or eleventh rib or to the fascia over the intercostal muscles. The fibers converge to the insertion, which is thick and is intersected by elastic lamellæ derived from the dorso-scapular ligament.

Relations.—Superficially, the mastoido-humeralis, trapezius, deep pectoral, subscapularis, teres major, latissimus dorsi, panniculus carnosus, the abdominal tunic, the brachial vessels, and the long thoracic nerve; deeply, the splenius, complexus, longissimus, transversalis costarum, the ribs and external intercostal muscles, and branches of the superior cervical and dorsal arteries.

Blood-supply.—Superior cervical, dorsal, vertebral, and intercostal arteries.

Nerve-supply.—Brachial plexus.

II. THE MUSCLES OF THE SHOULDER

Under this head will be described those muscles which arise on the scapula and end on the arm; they may be divided into two groups—one covering the dorsum, the other the venter of the scapula.

The =superficial fascia= of the shoulder and arm contains the panniculus carnosus of this region, and may be considered to be continued on the inner side of the limb by the subscapular fascia.

The =thoracic= or =scapulo-humeral portion= of the =panniculus= (M. cutaneus scapulæ et humeri) arises by a thin aponeurosis from the ligamentum nuchæ at the withers. The fleshy portion begins over the upper part of the scapula and extends to the elbow. Its fibers have in general a dorso-ventral direction. It is continuous behind with the abdominal portion.

The =deep fascia= of the shoulder and arm (Fascia omobrachialis) is much more developed and important. It is strong and tendinous, and is intimately adherent to the muscles on the outer surface of the scapula, between which it detaches =intermuscular septa=, which are attached to the spine and borders of the scapula. The brachial portion is, for the most part, only loosely attached to the underlying muscles, for which it forms sheaths; it is attached to the humerus, especially to the lips of the bicipital groove and the deltoid tuberosity. It blends distally with the tendon of insertion of the biceps, and is continued by the antibrachial fascia.

A. EXTERNAL GROUP (Figs. 178, 179)

1. =Deltoid= (M. deltoideus; long abductor of the arm; scapular portion of the deltoid of man).—This lies partly on the triceps in the angle between the scapula and humerus, partly on the infraspinatus and teres minor.

Origin.—(1) The upper part of the posterior border of the scapula; (2) the spine of the scapula, by means of the strong aponeurosis which covers the infraspinatus.

Insertion.—The deltoid tuberosity of the humerus.

Action.—To flex the shoulder joint and abduct the arm.

Structure.—The origin of the muscle is partly aponeurotic, partly fleshy. The aponeurosis fuses with that of the infraspinatus; the posterior part is attached to the scapula immediately in front of the origin of the long head of the triceps. The belly of the muscle lies for the most part in a cavity formed in the triceps. It is widest about its middle.

Relations.—Superficially, the skin, fascia, panniculus, and mastoido-humeralis; deeply, the infraspinatus, teres minor, triceps, and brachialis muscles, and branches of the posterior circumflex artery and axillary nerve.

Blood-supply.—Subscapular artery (chiefly through the posterior circumflex).

Nerve-supply.—Suprascapular and axillary nerves.

2. =Supraspinatus.=—This muscle occupies the supraspinous fossa, which it fills, and beyond which it extends, thus coming in contact with the subscapularis.

Origin.—The supraspinous fossa, the spine, and the lower part of the cartilage of the scapula.

Insertion.—The inner and outer lips of the bicipital groove.

Action.—To extend the shoulder joint. It also assists in preventing dislocation.

Structure.—The surface of the muscle is covered by a strong aponeurosis, from the deep face of which many fibers arise. The muscle is thin at its origin from the cartilage, but becomes considerably thicker below. At the neck of the scapula it divides into two branches, between which the tendon of origin of the biceps emerges. These branches, fleshy superficially, tendinous deeply, are inserted into the lips of the bicipital groove. They are united by a fibrous membrane already mentioned in connection with the deep pectoral muscle; some fibers are attached to this membrane and the capsule of the shoulder joint.

Relations.—Superficially, the skin, fascia, panniculus, trapezius, and mastoido-humeralis; deeply, the scapula and its cartilage, the subscapularis muscle, and the suprascapular vessels and nerve; in front, the anterior deep pectoral muscle; behind, the spine of the scapula and infraspinatus muscle.

Blood-supply.—Suprascapular and posterior circumflex arteries.

Nerve-supply.—Suprascapular nerve.