ABSTRACT

We view the topography of the upper limb as having four separate regions. These are the chest wall (pectoral region) in the anterior, shoulder (scapular region) in the posterior, arm (brachium) and forearm (antebrachium) dropping down laterally, and wrist (carpus) and hand (manus) at the distal end of the limb. The pectoral region is covered by two muscles, the pectoralis major and the pectoralis minor. The shoulder is bound by two bones, the clavicle and the scapula, and the muscles connecting these two bones, which are the deltoid and the trapezius. Besides the deltoid and trapezius, only a few other muscles attached to the scapula need to be remembered for our purposes. They are the levator scapulae and the rhomboideus minor and major, all of which insert along the medial border of the scapula. The supraspinatus and infraspinatus muscles lodge separately in the supraspinous and infraspinous fossa. Their tendons attach to the humeral head and conjoin with tendons of the subscapularis and teres minor muscles to build up the rotator cuff. Clinically, the rotator cuff is almost always blamed as the culprit for shoulder joint pain. More will be said about pain in the shoulder joint in a later chapter. Here, it is useful to keep in mind that such pain is invariably initiated at one acupoint, which sits right on the top of tendon of the long head of the biceps brachii muscle.