Human scapula: anatomy and structure. Human scapula

Pain under the scapula is not a sensation that occurs too often. Naturally, when such a symptom appears, a person begins to be especially worried about his state of health.

Even after going to a doctor with such pain, you can suffer a lot before all the necessary research is carried out and an accurate diagnosis is made. Indeed, not in all cases, pain in this area is associated with abnormalities in the work of the spine.

Possible disorders in the body

Unpleasant sensations in the area of \u200b\u200bthe shoulder blades indicate disorders in the body, which may be:

osteochondrosis and other pathologies of the spine;
ulcers of the stomach and other organs of the digestive system;
intercostal neuralgia;
hepatic or biliary colic;
irregularities in the respiratory system;
subphrenic abscess;
angina pectoris, myocardial infarction and other disorders of the heart;
nephritis or pyelonephritis;
hypertensive crisis;
cholelithiasis;
various problems of an emotional and psychological nature.

Back pain under the shoulder blades and a feeling of numbness in this area indicates that a person should undergo an examination and make sure that there are no spinal diseases such as scoliosis, neuralgia, kyphosis, herniated disc of the thoracic region, angina pectoris, cholecystitis, hepatitis, pneumonia, ischemia , pleurisy.

A pulling or aching pain under the scapula is a kind of signal from the body that some organs are not working properly and should be checked.

At the same time, the intensity of the pain syndrome often has nothing to do with the level of severity of the problem.

So, among the reasons for such unpleasant sensations can be both very serious disturbances in the functioning of the body, for example, internal bleeding, or a heart attack, and ordinary muscle injuries that do not threaten the future life of a person.

One of the reasons for the appearance of such a symptom may be the so-called subscapularis injury.

As you know, the rotator cuff is composed of four muscles. As the name implies, the subscapularis muscle is located directly under the scapula. Constant strain or injury to this area can spasm or even rupture the muscle.

In such a situation, the traumatic injury is further complicated by the fact that the location of the injured muscle significantly complicates the possibility of its independent massage.

Other causes of back pain under the shoulder blades include some neurological disorders.

Many internal organs do not have their own nerve fibers that would work as pain receptors. Sometimes internal organs share part of the nerve fibers with the part of the body closest to them, so the reaction to traumatic injury or external irritation of a particular organ can be felt in another.

For example, abnormalities in any part of the abdomen can cause pain in the right or left shoulder, or in the middle between the shoulder blades.

If pain occurs simultaneously in the abdomen and between the shoulder blades, you should immediately consult a doctor, as this is a very alarming symptom. Indeed, often such pain occurs precisely with a heart attack - a condition that requires immediate treatment.

Very often, pain under the scapula when inhaling is combined with a similar sensation in the chest area.

Any situation in which soreness in the chest radiates to the left shoulder, arm or jaw may indicate that a person has a heart attack. Moreover, a heart attack may often not be accompanied by any external signs. However, if soreness under the left shoulder blade, or in the middle between the shoulder blades, is combined with a feeling of tightness in the chest or difficulty in breathing, a doctor should be urgently called.

Pain under the scapula during movement can develop for various reasons, one of which is myofascial pain syndrome.

This disorder is a type of chronic muscle pain associated with overly tender points in the muscles. These muscle points are called trigger points, because when you press on them, the soreness immediately spreads throughout the muscle.

Common signs of myofascial pain syndrome include a feeling of deep soreness in the muscle, constant or progressive muscle pain, stiffness in the joints. Often in such a situation there is a decrease in the quality of sleep, which becomes the cause of constant patient fatigue.

Pain in this part of the body can be caused by herpes zoster, which is often called herpes zoster. This disease manifests itself in the form of blisters, or a rash on the surface of the skin.

The general symptoms and signs indicating the presence of herpes zoster in the patient include burning, tingling or numbness in the affected area, red rashes that occur a couple of days after the onset of pain.

Also, this disease may be indicated by the appearance of itchy bubbles filled with liquid, appearing a couple of days after the onset of pain.

Injuries and fractures of the scapula

Among the less common causes of pain in the area under the left scapula is damage to the scapula. Fortunately, this kind of injury is very rare.

According to modern medical statistics, fractures in this part of the body account for less than one percent of the total number of fractures diagnosed annually. It is logical that the statistics show such results, since given the location of this bone, it is very strange how anyone can break it at all.

Most often, fractures of the scapula can occur when this part of the body is directly exposed to great force - for example, when falling from a motorcycle, or in a car accident.

If a fracture of this type has occurred, severe pain will be felt in the back of the shoulder, directly under the left shoulder blade, or slightly above it. In the absence of the necessary and timely treatment, trauma to this area can cause chronic pain.

Traditional methods and pain management

To get rid of pain under the scapula, it is first necessary to accurately determine the reasons for the unpleasant sensations.

A qualified and experienced specialist can provide invaluable assistance in this matter. The patient himself, for his part, can significantly speed up the healing process, using some simple tips.

With such an unpleasant sensation as a dull pain under the scapula, a localized advantage in the muscle, a little physical exertion on the affected area helps well.

Exercises that involve additional stress on the shoulders, flexion help strengthen the joints and muscles of the shoulder girdle. In addition, they are very effective in reducing the intensity of pain syndrome under the shoulder blades.

Another traditional method to relieve pain is massage. For example, a cold type of shoulder massage using regular ice can reduce the intensity of unpleasant pain sensations that were caused by inflammation or damage to the soft tissues of the body in this area.

When performing such a massage, you must make sure that the ice does not directly touch the skin anywhere. So, you can use a towel or a piece of soft cloth, and only after carefully wrapping ice in it, begin massage of the sore spot.

If the soreness under the shoulder blades is of high intensity, such a massage should be performed at least three times a day. In such a situation, the duration of each session should be at least 10-15 minutes to achieve relief.

In conclusion, it is worth recalling that any treatment should be carried out under the supervision of the attending physician, after a thorough examination. This examination is performed after establishing the primary symptoms and causes of pain.

In case of serious illnesses, self-medication will not help in any way, but will only aggravate the situation due to the delay in obtaining qualified assistance.

Shoulder injuries: treatment of the shoulder joint, injury symptoms

To learn more…

Most often, shoulder injuries are manifested in the form of intense pain, often local swelling occurs and the functionality of the entire arm is lost - from hand to shoulder. What caused this condition? The fact is that the shoulder joint is considered the most mobile in the human musculoskeletal system.

Only due to the multifunctionality of the shoulder joint, the upper limbs are able to perform so many different actions, which are indispensable in everyday life.

The shoulder provides the arm with movement in all planes, but when the load on it is increased, damage and even degenerative change can occur.

The structure of the shoulder joint

With regular high loads on the shoulder joint, it loses stability and functionality. The human shoulder has a specific structure. It consists of:

muscles (infraspinatus, supraspinatus, deltoid) and tendons;
bone and connective tissue;
rotator cuff.

These are the main components of the shoulder joint, each of which is responsible for a specific function. The combination of these elements is the shoulder. The subscapularis muscle, for example, provides the hand with rotational movements inward, and the supraspinatus muscle is responsible for lifting the limb up and fixing it in this position.

If the supraspinatus muscle is the guide, then the deltoid determines the force with which the shoulder is abducted.

The function of the infraspinatus muscle, which is part of the rotator cuff, is to provide outward movement.

The same task is performed by another muscle - the small round. But she is also responsible for the movement of the hand to the body.

Thanks to the well-coordinated work of all these muscles, the shoulder joint has high functionality.

Causes of injury and its symptoms

Damage to the shoulder joint can occur from a fall or impact, which compromises the integrity of the bone tissue. Three bones affect hand performance:

collarbone;
glenoid cavity of the scapula;
humeral head bone.

Finding bones in the correct and strong position is ensured by the presence of connective tissue. Each muscle of the cuff also has its own purpose.

Injury to the shoulder joint is always accompanied by intense pain. Its nature directly depends on the degree of destruction of the rotator cuff. The pain can be sharp or aching. Ligament rupture is a type of injury in the shoulder joint, it can be complete or partial.

This damage always has vivid symptoms: weakening of the arm, pain, sometimes complete loss of limb performance.

Another symptom typical of a shoulder injury is the victim's inability to lie on the affected side.

Causes of Rotator Cuff Damage

Any injury to the shoulder can be triggered by injury or bruising. But these factors are not the only ones. There are many other causes of shoulder problems.

The structure of the rotator cuff includes muscle tendons, which are deficient in blood supply. Thus, insufficient blood circulation causes tenopathy (degenerative changes in the shoulder joint).

However, some doctors deny this fact. In their opinion, the blood supply cannot influence the condition of the shoulder structure.

These doctors put forward another hypothesis, from which it follows that the main problems in the rotator cuff arise at the genetic level. In other words, if a patient has hereditary connective tissue abnormalities, they are likely to have problems with the rotator cuff.

Connective tissue contains a special type of protein. In general, protein (collagen) is of four types. If the percentage of proteins of the third and fourth types is increased, the development of tenopathy approaches rapidly.

As can be seen from practice, the disease can manifest itself in any tendon of the cuff. In this case, the patient, when he begins to move, feels severe pain. With the development of supraspinatus tenopathy, pain occurs when the arm is moved to the side.

If the rotator cuff is injured in the subscapularis tendon, pain occurs when the cutlery is brought to the mouth or when the hair is combed. Doctors often call this pathology of the shoulder joint periarthritis of the shoulder scapula - this is fundamentally wrong.

Periarthritis of the shoulder is a completely different disease, moreover, its symptoms and treatment are different. Long-term treatment with antibiotics of another pathology can provoke tenopathy. This reason is the most common. Other risk factors for tenopathy include multiple trauma, which can occur in two ways:

Monotonous repetitive motion that tightens the rotator cuff tendons. The risk group includes people whose professional activities involve such movements (teachers, dancers, athletes, painters, plasterers). Moreover, people in these professions may experience a bruised shoulder, which will entail serious consequences, in particular, damage to the bankart (dislocated shoulder). Such injuries in these people are quite common. This is because the tendons and muscles of the rotator cuff are weakened and easily damaged.
Anatomical features of the structure of the shoulder. It turns out that the rotator cuff of a person at birth can be deformed or have an irregular structure. Such a pathology, in the end, will necessarily lead to numerous fractures and other injuries.

Diagnosis and symptoms of rotator cuff injury

When a patient visits a medical institution for the first time, the doctor will first conduct an oral survey, during which the patient will explain his complaints and possible causes of injury. After that, the doctor will offer the patient a test that requires some specific movements.

Partial rupture symptoms are pain, but movement is possible. With a complete rupture of the ligaments, the limb is not able to produce certain movements. Tendons and muscles are damaged and have lost their functionality.

In this situation, the doctor directs the patient to an x-ray, which will clarify the location of the injury, its degree and, based on the diagnosis, prescribe the correct treatment.

To make a diagnosis, sometimes it is necessary to determine the size of the lesion, so the patient is prescribed an ultrasound examination or an MRI of the shoulder joint.

After all the necessary diagnostic measures have been taken, the doctor can prescribe adequate treatment.

Shoulder injury treatment

In the acute stage of the pathology, anesthetic drugs are required, since pain is often intense and debilitating. In case of incomplete rupture of the ligaments, the arm must be completely immobilized.

For this, there are special fixing braces on the shoulder joint and orthoses, although you can make such a fixator yourself by using an elastic bandage.

When the pain has decreased, you can begin to strengthen the muscles with the help of a special exercise therapy complex.

Treatment with folk methods involves the preparation of healing infusions and decoctions used to apply compresses and lotions. Coniferous baths have a good soothing effect.

The operation is necessary only in the following cases:

Treatment with conservative methods was unsuccessful (symptoms persisted).
A complete rupture of the ligaments renders the arm non-functional.
The rupture of the ligaments is partial, but accompanied by severe pain.

Relieves pain and swelling in the joints with arthritis and arthrosis
Restores joints and tissues, is effective in osteochondrosis

To learn more…

The structure and function of joints and bones: a detailed classification with photos and videos

Perfect sliding for thoughtless movement

When you see in "Minute of Glory" another "snake woman" twisting her body almost in pigtails, you understand that the structure of joints and bones, which is standard for other people, is not about her. What dense fabrics can we talk about - they simply are not here!

Nevertheless, even her hard tissues have a place to be - many joints, bones, as well as structures for their connections, according to the classification, divided into several categories.

Bone classification

There are several types of bones, depending on their shape.

Bones of a tubular shape with a marrow cavity inside and formed from compact and spongy substances, performing a supporting, protective and motor role. Subdivided into:

long (bones of the shoulders, forearms, hips, legs), having a biepiphyseal ossification;
short (bones of both wrists, metatarsus, digital phalanges) with monoepiphyseal type of ossification.

The bones are spongy structure, with a predominance of spongy substance in the mass with a small thickness of the covering layer of the compact substance. Also divided into:

long (including costal and sternal);
short (vertebral, carpal, tarsal bones).

Sesamoid bone formations, located near the joints, participating in their strengthening and contributing to their activity, have no close connection with the skeleton, belongs to the same category.

Flat bones, including categories:

flat cranial (frontal and parietal), playing the role of protection and formed from two outer plates of a compact substance with a layer of spongy substance located between them, having a connective tissue genesis;
flat bones of both girdles of the extremities (scapular and pelvic) with a predominance of spongy substance in the structure, playing the role of support and protection, with genesis from cartilage tissue.

Bones of mixed (endesmal and endochondral) genesis with different structures and tasks:

forming the base of the skull;
clavicular.

Only bones do not live on their own - they are connected by joints in the most ingenious ways: two, three, at different angles, with varying degrees of sliding over each other. Thanks to this, our body is provided with incredible freedom of static and dynamic postures.

Synarthrosis VS diarthrosis

But not all bone joints should be considered diarthrosis.

According to the classification of bone joints, the following types of joints do not belong to such:

continuous (also called adhesions, or synarthrosis);
semi-movable.

The first gradation is:

synostosis - fusion of the boundaries of the bones between themselves to complete immobility, zigzag "lightning" of the seams in the cranial vault;
synchondrosis - fusion by means of a cartilaginous layer, for example, an intervertebral disc;
syndesmosis - strong "stitching" of the connective tissue structure, the interosseous sacroiliac ligament, for example;
syncosis - when the bones are connected with the help of the muscle layer.

Tendon membranes stretched between paired formations of the forearms and lower legs, holding them deadly near each other, are also not joints.

As well as semi-movable joints (hemiarthrosis) in the face of the pubic symphysis with a small (defective) cavity-gap in the thickness of the fibro-cartilaginous suture, or in the form of sacroiliac amphiarthrosis with real articular surfaces, but with an extremely limited range of motion in the semi-joints.

Structure and function

A joint (discontinuous or synovial connection) can only be considered a movable joint of bones that has all the necessary attributes.

In order for all dysarthrosis to move, there are special formations and auxiliary elements in strictly defined places.

If on one bone it is a head with a pronounced roundness in the form of a thickening - the epiphysis of the end section, then on the other adjacent to it it is a depression exactly corresponding to it in size and shape, sometimes significant (such in the pelvic bone is called "vinegar" for its vastness). But there can also be an articulation of one bone head with a structure on the body-diaphysis of the other, as is the case in the radioulnar joint.

In addition to the perfect match of the shapes that form the joint, their surfaces are covered with a thick layer of hyaline cartilage with a literally mirror-smooth surface for flawless sliding over each other.

But smoothness alone is not enough - the joint should not crumble into its component parts. Therefore, it is surrounded by a dense elastic connective tissue cuff - a bag-capsule, similar to a lady's sleeve for warming hands in winter. In addition, the ligamentous apparatus and muscle tone, which provide biodynamic balance in the system, serve as its fastening.

A sign of true dysarthrosis is the presence of a full articular cavity filled with synovial fluid produced by cartilage cells.

The classic and simplest structure is the shoulder. This is the gap of the joint between its bursa and two bony endings that have surfaces: the round head of the humerus and the congruent glenoid cavity on the scapula, filled with synovial fluid, plus the ligaments that hold the entire structure together.

Other dysarthrosis have a more complex structure - in the wrist, each bone is in contact with several adjacent ones at once.

The spine as a special case

But the relationship between the vertebrae - short-columnar bones with a complex surface relief and many structures for varying degrees of mobile adhesion with neighboring formations - is particularly complex.

The spine has a structure that resembles a rosary, only its "beads" are the bodies of each of the adjacent bones, which are connected to each other through hemiarthrosis (synchondrosis) based on the cartilaginous disc. Their spinous processes, overlapping each other like shingles, and the arches that form a receptacle for the spinal cord, are fastened with the help of rigid ligaments.

The joints between the transverse processes of the vertebrae with flat surfaces (as well as the costal-vertebrates, formed through the costal heads and articular cavities on the laterally located vertebral bodies) are quite real, having all the necessary attributes: working surfaces, cracks, capsules and ligaments.

In addition to joining with each other and with the ribs, the vertebrae form a fusion in the sacrum area, turning this group into a monolith, to which a "tail" -coccyx is attached through real joints - the formation is quite mobile, especially during childbirth.

Sacroiliac dysarthrosis is the beginning of the pelvic girdle, formed by the bones of the same name, the pubic symphysis closed in the front in the center into a ring.

In addition to the intervertebrates, there are other joints in the support column system: a combination that forms one unpaired and two paired components of the atlanto-axial connection (between vertebra I and II) and paired atlanto-occipital (between vertebra I and the occipital bone).

Due to this very structure, the spine is an incredibly flexible formation, having a large degree of freedom of movement and, at the same time, extremely strong, bearing the entire weight of the body. In addition to the supporting function, it also plays a protective role, serving as a channel through which the spinal cord passes, and is involved in hematopoiesis.

The spectrum of damage to the joints of the vertebrae is diverse: from injuries (with a different category of fractures and displacements) to metabolic-dystrophic processes leading to varying degrees of stiffness of the spine (osteochondrosis and similar conditions), as well as infectious lesions (in the form of their tuberculosis, lues, brucellosis).

Detailed classification

The above classification of bone joints does not include joint taxonomy, which has several variants.

In accordance with the number of articular surfaces, the following categories are distinguished:

simple, with two surfaces, as in the joint between the phalanges of the first finger;
complex in the presence of more than two surfaces, for example, in the elbow;
complex with the presence of internal cartilaginous structures dividing the cavity into non-insulated chambers, as in the knee;
combined in the form of a combination of joints isolated from each other: in the temporomandibular junction, the intra-articular disc divides the working cavity into two separate chambers.

According to the functions performed, joints with one, two and many axes of rotation (one-, two- and multiaxial) are distinguished, depending on the shape, having the form:

Examples of uniaxial joints are:

cylindrical - atlanto-axial median;
blocky - interphalangeal;
helical - shoulder-ulnar.

Complex shaped structures:

elliptical, like the radial-carpal lateral;
condyle-like, knee-like;
saddle, like the metacarpal-carpal joint of the first finger.

Multiaxials are represented by varieties:

spherical, like the shoulder;
cup-shaped - a deeper variation of the spherical (like the hip);
flat (like intervertebrates).

There is also a separate category of tight joints (amphiarthrosis), which differ in the shape of their surfaces, but are similar in another - they are extremely stiff due to the strong tension of the capsules and a very powerful ligamentous apparatus, therefore, their sliding displacement relative to each other is almost imperceptible.

Characteristics, design and function of major joints

With all the abundance of joints in the human skeleton, it is most logical to consider them as separate groups - categories of joints:

skull;
spine;
limb belts (upper and lower).

Cranial joints

In accordance with this position, two diarthrosis enter the skeleton of the skull:

temporomandibular;
atlanto-occipital.

The first of these paired joints is created with the participation of the heads of the lower jaw bone and the working cavities on the temporal bones.

The joint consists of two structures functioning synchronously, although spaced apart on different sides of the skull. According to its configuration, it is condylar, it belongs to the category of combined ones due to the presence of a cartilaginous disc dividing its volume into two chambers isolated from each other.

Due to the existence of this diarthrosis, freedom of movement of the lower jaw in three planes is possible and its participation both in the process of primary processing of food and in swallowing, breathing and the formation of speech sounds. The jaw also serves as a means of protecting the oral cavity organs from damage and is involved in the creation of facial relief. It can be subject to both injury and infection during the development of acute (parotitis) and exacerbation of chronic (tuberculosis, gout) diseases.

The configuration of the paired atlanto-occipital region is also condylar. It serves to connect the skull (its occipital bone with convex working surfaces) with the spine by means of the first two cervical vertebrae, acting as a whole, on the first of which - the atlas - there are working pits. Each half of this formation acting simultaneously has its own capsule.

Being a biaxial atlas, it allows the head to move both according to the frontal and sagittal axes - both nodding and tilting left and right, providing freedom of orientation and the fulfillment of a social role by a person.

The main pathology of atlanto-occipital diarthrosis is injuries as a result of a sharp throwing back of the head and the development of osteochondrosis and other metabolic-dystrophic conditions due to the long preservation of the forced posture.

Shoulder girdle

Given the above description of the spine, moving on to diarthrosis of the shoulder girdle, it should be understood that the joints clavicle with sternum and scapula with clavicle are synarthrosis. The real joints are:

brachial;
elbow;
ray-carpal;
carpometacarpal;
metacarpophalangeal;
interphalangeal.

The spherical shape of the head of the humerus is a guarantee of almost complete circular freedom of rotation of the upper limb, therefore, the shoulder refers to multiaxial joints. The second component of the mechanism is the scapular cavity. All other attributes of diarthrosis are also present here. The shoulder joint is most susceptible to injury (due to the high degree of freedom), and to a much lesser extent to infections.

The complex structure of the elbow is due to the articulation of three bones at once: the humerus, radius and ulna, having a common capsule.

The shoulder-elbow joint is block-shaped: the shoulder block enters the notch on the ulna, the shoulder-radius is the result of the entry of the head of the condyle of the shoulder into the fossa of the head of the bone-ray with the formation of a spherical working area.

The movements in the system are carried out according to two axes: flexion-extension, and also due to the participation of the proximal radial-ulnar connection, rotation (pronation and supination) is possible, because the head of the ray rolls along the groove on the ulna.

The problems of the elbow joint are injuries, as well as inflammatory conditions (with acute and exacerbation of chronic infections), dystrophy due to professional sports.

The distal radial-ulnar joint is a cylindrical joint that provides vertical rotation of the forearm. In the working cavity there is a disc that separates the designated connection from the cavity of the carpal connection.

Diseases of the elbow region:

arthrosis:
instability;
stiffness.

An ellipsoidal configuration of the wrist joint is formed by means of a capsule covering the lower epiphysis of the ray and the first row of carpal bones. This is a complex articulation with the sagittal and frontal axes of rotation, allowing both adduction-abduction of the hand with its circular rotation, and extension-flexion.

The most common diseases:

damage (in the form of bruises, fractures, sprains, dislocations);
tendovaginitis;
synovitis;
styloiditis;
varying degrees of severity of the tunnel syndrome;
arthritis and arthrosis;
osteoarthritis.

The joints of the small bones of the upper limb are combinations of flat and saddle joints (carpometacarpal) with spherical (metacarpophalangeal) and block-shaped joints (interphalangeal joints). This design provides strength to the base of the hand, and mobility and flexibility to the fingers.

Pelvic girdle

Diarthrosis of the pelvic girdle includes:

hip;
knee;
ankle;
tarsometatarsal;
metatarsophalangeal;
interphalangeal.

The shape of the polyaxial hip joint is cup-shaped, with the participation of the femoral head and the ischial cavity, providing adduction-abduction of the thigh forward-backward and medial-lateral, as well as its rotation.

TBI is susceptible to damage (due to the high degree of freedom) and lesions by the microbial flora, which is brought here most often hematogenously (tuberculosis, brucellosis, gonorrhea).

The most common diseases of the hip region:

coxarthrosis;
bursitis;
tendinitis;
femoral-acetabular impingement syndrome;
perthes disease.

The knee joint (blocky) is formed by the participation of the femoral condyles and the concave surface of the tibia. In addition to the powerful ligamentous apparatus, a sesamoid formation - the patella - creates support in front.

The inner surface is supplemented to fully match the articular surfaces with menisci and ligaments. The available movements are flexion-extension and, in part, rotation.

Pathologies that affect the knee:

trauma (especially dislocation of the patella);
arthritis;
arthrosis;
bursitis;
knee "mouse".

The head-block of the talus and the notch formed by the “fork” of both tibia bones take part in the creation of the ankle (classic block) connection.

The structure of diarthrosis allows you to:

extension-flexion;
small vertical abduction-adduction (in the flexion position).

The most common functional disorder is fractures of the ankles (external or internal), as well as a violation of metabolic processes in the body and blood circulation in the lower extremities.

The tarsal area is formed by a "mosaic" of joints:

subtalar;
talocalcaneonavicular;
calcaneal-cuboid;
wedge-navicular.

These are compounds of a combined or flat configuration (the first two are cylindrical and spherical).

Tarsal-metatarsal diarthrosis is represented by various (mostly flat) joints that form a support for the arches of the foot, made by metatarsophalangeal (block-shaped) joints.

Also, the block-shaped interphalangeal joints of the feet give the toes a sufficient level of mobility and flexibility (patients who have lost both hands draw and even sew with their feet) not at the expense of strength.

Small joints of the feet are characterized by damage due to metabolic-dystrophic processes in the body, with disorders of local and general blood supply and due to chronic injuries in the form of wearing shoes with high heels or elementary tight ones.

The existence of various ways of connecting bones, as well as the variety of the articular surfaces themselves, understanding their structure and the function performed allows a person not only to live and act, but also to treat the musculoskeletal system (and, if necessary, even replace the worn out structures with artificial ones).

Photo from the site yeni.mobi

The unique structure of the scapula provides full functions of the upper limb. This bone acts as a block, it improves mobility and mobility during difficult movements.

Structure

Where are the shoulder blades? Topographically, they are located on the posterior surface of the chest, the upper corner is projected at the level of 2 ribs, the lower - 7 ribs. This position corresponds to the initial position when the arm is lowered; when it changes, the bones can turn or slide along the muscles of the chest.

The structure of the human scapula is complex, we will note the most important anatomical structures:

anterior surface that faces the ribs - thanks to its smooth contour, the scapula can slide over the muscles of the chest;
glenoid cavity - the head of the humerus is connected to it, it forms a joint;
spine - located on the back surface, separates the muscles and is their support;
acromion - the spine continues into it, this process connects to the clavicle and performs a supporting function;
coracoid process - directed forward, the pectoralis minor muscle is attached to it.

In the structure of the scapula, edges, corners, pits and other formations are distinguished - this is a consequence of the attachment of muscles, ligaments, the passage of blood vessels and nerves. The detailed anatomy is studied by doctors to treat diseases and perform surgeries.

Muscle

When studying a human scapula, attention should be paid to the anatomy of the muscles - it is surrounded by five muscles, most of which connect to the humerus and set it in motion. They provide full motor activity and perform a protective function.

Scapula muscles:

deltoid - located on the lateral surface, has great strength;
supraspinatus - located on the back surface at the top;
infraspinatus - located behind the spine;
large and small round - localized behind in the lower part, they pull the humerus down;
subscapularis - located between the scapula and the ribs, prevents injury to hard tissues.

Also, several shoulder muscles are attached to the scapula; they belong to the muscles of another group. This structure provides complex movements - abduction, flexion, rotation.

There is only one ligament in the movable shoulder joint of the scapula; a powerful muscular frame protects it from dislocation. That is why it is imperative to warm up before training.

Functions

The unique anatomy of the scapula was designed by nature to provide multiple functions. It is an element of the musculoskeletal system, creates channels for blood vessels and nerves. The soft tissues surrounding the bone play an important role.

The main functions of the scapula:

is the base of the bones of the upper limbs;
participates in movement - increases the amplitude when raising the arm up and leaning back;
prevents dislocation of the shoulder joint - thanks to powerful muscles and ligaments that limit movement;
is an anatomical block - the muscles of the shoulder begin from it;
protects blood vessels and nerves - thanks to notches and pits, as well as adjacent muscles.

Thanks to the scapula, the capabilities of the upper limbs are significantly expanded. Tendons, ligaments, blood vessels and nerves are located nearby, damage to which leads to limitation of movement and pain.

Most common diseases

All pathologies can be divided into injuries, congenital and acquired diseases. The most common are fractures, dislocations, inflammatory reactions, and developmental abnormalities. Each condition is accompanied by certain symptoms.

Scapula fracture

The scapula is a bone in which damage can be in the form of cracks or fractures. The most common injuries are:

acromion;
coracoid process;
awn;
neck near the glenoid cavity.

With fractures or cracks, there is swelling and severe pain in the upper third of the back on the affected side. When you try to move your hand, the symptoms intensify and can lead to loss of consciousness.

Dislocation of the scapula

Dislocation in the shoulder joint is most often noted, a person has pain in the scapula, radiating to the arm. With this injury, the head comes out of the cavity, so the patient cannot move his arm, sometimes the upper limb freezes in a forced position. Outwardly, the shoulder swells, the slightest movements cause pain. Urgent medical attention is required to reposition the bones and rehabilitation.

Bursitis of the scapula

This is an inflammation of the bursa located under the left or right scapula that covers the subscapularis muscle. The cause is a soft tissue infection. Pathology is accompanied by:

pain;
impaired mobility, especially with a shrug or static load;
local fever or fever.

Bursitis is treated with antibiotics and pain relieving ointments. Mild forms of pathology heal on their own.

Developmental defects of the scapula

Usually, abnormalities of the scapula in humans are found with malformations of the upper limb or ribs. The following deviations are most common:

aplasia (absence) or hypoplasia (underdevelopment);
sprengel's disease - high standing of the scapula with a turn of the lower angle to the spine;
pterygoid form.

With congenital anomalies, the functioning of the upper limb worsens, sometimes there is discomfort during movement. If the position or shape is violated, the hand is shortened on the affected side.

The scapula is a bone that has a supporting function. For the attachment of muscles and ligaments, the passage of blood vessels and nerves, there are processes and pits on its surface. With its pathologies, the movements of the upper limb are disrupted.

List of sources:

Sapin M.R. Human anatomy. - M .: Medicine, 2001-2002 in 2 volumes
Sinelnikov R.D. Atlas of human anatomy. - M .: Medicine, 1996 in 4 volumes
Gaivoronsky I.V. Norm. Human Anatomy: In 2v: Textbook. - SPb .: Special. liter., 2003-2004.

10.02.2017

two surfaces, three edges and three corners.

Anatomy

The scapula is a flat triangular bone located in the back muscles. It distinguishes
two surfaces, three edges and three corners. The costal surface, facies costalis, is concave and called
subscapular fossa, fossa subscapularis. It is made by the subscapularis muscle, i.e. subscapularis.

The dorsal surface, facies dorsalis, is divided by the spine of the scapula, spina scapulae, into two unequal
depressions: supraspinatus fossa, fossa supraspinata, and infraspinatus fossa, fossa infraspinata, in which
supraspinatus originate, m. supraspinatus, and infraspinatus, m. infraspinatus, muscles.

OST of the scapula goes from the medial edge of the scapula to the lateral, gradually increasing in height, and ends with a wide and flattened humeral process, acromion. The area where the spine of the scapula passes into the humeral process is called the angle of the humeral process, angulus acromialis. The anterior edge of the brachial process bears the smooth articular surface of the brachial process, facies rticularis acromii, its posterior surface is rough and serves as the starting point for the deltoid muscle, m. deltoideus.

The upper edge of the scapula, margo superior, thin and short, serves as the site of muscle attachment,
lifting the scapula, m. levator scapulae. In the outer part of the upper edge at the base of the coracoid process, there is a notch of the scapula, incisura scapulae, where the suprascapular nerve passes. The coracoid process, processus coracoideus, begins with a wide base from the lateral part of the upper edge of the scapula and goes up, and then turns at an angle forward and outward. From it originates the beak-brachial muscle, m. coracobrachialis; here also the coracoclavicular, coracochlear ligaments and the pectoralis minor are attached, m. pectoralis minor.

The medial edge of the scapula, margo medialis, is thinned and facing the spine. Attached to it are the anterior dentate, large and small rhomboid muscles, m. serratus anterior, i.e.
rhomboideus minor et major.

The lateral edge, margo lateralis, is thickened and serves as the beginning of the round muscle, m. m. teres major et minor.

On the border of the upper and medial edges of the scapula is the upper corner, angulus superior, the apex of which is rounded.

The lower angle, angulus inferior, is thickened, rough, since the anterior dentate and rhomboid muscles are attached to it.

On the border of the upper and lateral edges there is a lateral angle, angulus lateralis, which
represented by the neck of the scapula, collum scapulae, and the glenoid cavity, cavitas glenoidalis. The latter has a sphere
richesky surface. Above the glenoid cavity and below it are located, respectively, the supra-articular,
tuberculum supraglenoidale, and subarticular, tuberculum infraglenoidale, tubercles.

From the supra-articular tubercle begins the long head of the biceps brachii, caput longum m. biceps
brachii, the long head of the triceps muscle of the shoulder, caput longum m, originates from the sub-articular tubercle.
triceps brachii.

X-ray of the scapula is performed in a direct posterior and lateral projections.

Frontal rear projection. Laying of the scapula in a direct posterior projection when performing an X-ray
performed in the position of the patient on the back. The upper limbs are extended along the body. In order to
the scapula under study was located parallel to the plane of the cassette, the opposite shoulder was slightly raised. The cassette is positioned under the scapula.

The central bundle of rays is directed perpendicularly to the center of the cassette to the subclavian fossa region.

A similar radiograph can be obtained with the patient upright.

Side projection. Laying when performing an X-ray of the scapula in the lateral projection is performed in the position of the patient on the examined side. The chin is as close to the chest as possible. The upper limb of the corresponding side is placed under the head or brought forward. The patient's torso is slightly tilted anteriorly. The cassette is positioned parallel to the table plane under the scapula. Top edge
the cassette should be above the top corner of the scapula. The central beam of rays is directed perpendicularly to the cassette at the protruding upper corner of the blade.

The acromial and coracoid processes are examined in the axial projection of the shoulder joint.

X-ray anatomical analysis

Frontal rear projection. On the radiograph in a direct posterior projection, the scapula is represented by a triangular formation with clear contours (Fig. 129).

Figure: 129. Radiograph of the scapula in a direct posterior projection.

1 - the upper surface of the body of the clavicle; 2 - the lower surface of the body of the clavicle; 4 - conical tubercle and trapezoidal line; 5 - cerebral cavity; 6 - the shoulder end of the clavicle; 10 - upper angle of the scapula; 11- upper edge of the scapula; 12 - coracoid process; 12a - the base of the coracoid process; 13-medial edge of the scapula; 14 - lower corner; 15 - lateral edge; 16 - glenoid cavity of the scapula; 17- posterior edge of the glenoid cavity; 18 - the front edge of the glenoid cavity; 19 - the neck of the scapula; 20 -
sub-articular tubercle; 21 - the base of the spine of the scapula; 22 - shoulder blade; 23 - brachial process; 23a - X-ray joint space of the acromioclavicular joint; 24 - the head of the humerus; 25- anatomical neck of the humerus; 26 - large tubercle; 27- small eel; 28- surgical neck of the humerus; 29 - X-ray joint space of the shoulder joint.

The upper angle of the scapula (10) with a rounded apex is usually projected above the body of the clavicle and smoothly
goes to the top edge)