0:06 Alright so let's get into the muscles now, and I want you guys to try to think 0:15 through this process. I know the answers are on the board, I'm not taking them 0:20 away from you, but let's try to think through this. So the first muscle up 0:34 there is your serratus anterior, yeah, your serratus anterior if i remember 0:49 correctly 1:01 inserts into the vertebral or medial border of your scapula, which is which 1:06 side? Which side of my scapula is my vertebral or medial border? Touch it, 1:16 palpate it, this side right the inside. Now it courses underneath my scapula 1:26 wraps around and it originates on the top eight ribs, you guys cool with that. 1:33 You guys know this muscle, you guys ever seen bodybuilders and they do this thing, 1:37 they're like dude I'm so huge my lats got teeth. You guys know what I'm talking 1:44 about. No you have no idea. You guys know what I'm talking about those little 1:48 little teeth that come out right here, that's not your lat that's your serratus 1:52 anterior poking out, in fact the name serratus comes from what, it looks like a 1:58 serrated knife right, it's that shape. Well if it attaches from ribs to scapula 2:05 what joint is it going to move, not my shoulder, my scapula right. We kind of 2:13 said that these two joints, we say we can kind of combine them, and we call it 2:18 movement of the scapulae right. So we're talking about the scapula. So that's the 2:28 joint, what are my joint actions for my scapula, let's make a little word bank. 2:37 Good. 2:49 Protraction, retraction, who are we missing? Good. 3:16 So we know that the serratus anterior is going to move my scapula, and these are 3:21 my scapular joint actions. Now we just have to figure out which joint actions 3:24 my serratus anterior is going to cause. Well is my serratus anterior 3:29 going to move my ribs? Probably not much. Ribs don't like to move all that much. 3:34 It's definitely going to pull my scapula then towards my origin, which is going to 3:40 look like what? What is this muscle going to do when it contracts? Right so is it 3:52 going to do this? Show me, if you can't tell me show me. So what joint action is 3:58 that? Protraction, right protraction. Now the other joint action the serratus 4:11 anterior does is a little complicated too, well it's not complicated it's just 4:16 not as easy to visualize. So what ends up happening is, if, what would happen to my 4:29 scapula if my seratus anterior pulled the bottom of my scapula in this 4:40 direction? What joint action would I have? 4:45 Upward rotation. 4:52 That's it, we're done with serratus anterior. Was that terrible? Yep that was 4:58 terrible, okay on to the next muscle. Should we do PEC minor, sure why not, why 5:09 not do the PEC minor. So my PEC minor 5:18 originates from ribs three four and five, and inserts into my coracoid process. So 5:26 it's a muscle on the front here right. So 5:36 draw the front of my scapula, my little coracoid process here. Put some ribs in 5:53 little PEC minor. 6:01 You guys want to feel your PEC minor. I'm going to show you how to palpate your 6:05 PEC minor, which direction are those fibers? More or less vertical right. Which 6:12 way does your PEC major run across? So your PEC major is on top of your PEC 6:19 minor, so we need to feel through your PEC major. So what you're going to do is 6:24 you're going to kind of relax your PEC major. On the outside of your PEC major 6:29 here you're going to strum this way, and what you'll start to feel if you kind of 6:35 dig in there, is you'll start to feel like some vertical guitar strings that 6:40 you can kind of strum over, that are probably pretty tender. Some 6:45 of you guys a little tender? These guys tend to get pretty tight, yeah, no. Is 6:51 anybody having a problem feeling their PEC minor? I can come over and help you 6:56 palpate. I don't have a problem with this. Who can't feel their PEC 7:01 minor, everybody's going to feel their PEC minor. Alright so your PEC minor is right, 7:08 right and those fibers right there. So you guys are probably just not pressing 7:12 hard enough, or your pressing too far over, those guys right there, those guys 7:16 right there. Everybody everybody I touch just like oh god yes these muscles have a 7:20 tendency to get tight, sore. Everybody got it, you got it? Press deep, it's right here. 7:26 Alright so what do these fibers do? What do these this muscle do? What joint 7:31 actions? Well what joint does it cross? 7:43 What joint? Not shoulder joint, shoulder would be the combination of my humerus 7:50 and my scapula, this goes from ribcage to scapula, which means who is it going to 7:54 remove? Scapula alright. So what joint actions do you think this muscle can do? 8:04 Protraction it's on the front, that's a good guess. 8:16 What else? Depression right, yeah it has that vertical arrangement, it's going to 8:27 want to kind of pull this way, right. If it pulls on the outside corner that way, 8:33 what happens? And a little downward rotation, nice job. That's PEC minor. Yes 8:46 ma'am great question. So traditionally origins and insertions have been based 8:54 on, origin is the more stable of the two attachments of the muscle, but that 9:02 doesn't always work out. You will see some textbooks where it's written 9:06 proximal and distal attachment right. Generally origins are more proximal, 9:10 that's not always the case. Let me tell you how much I care about which one's 9:14 the origin and which ones the insertion. 9:20 Initially guys you don't even have to memorize the origins and insertions. If 9:24 you can memorize the bones and visualize roughly where they're at on the bone, 9:27 you're in good shape. Later origins and insertions will mean a lot more to you 9:32 as you get more into like pathology and problems that happen, and injuries that 9:37 happen, then you have to start understanding origins and insertions a 9:40 little bit better right. Now your big thing today, what bone does it attach to? 9:45 What joint does It move? What direction is it going to move that joint in? That's 9:49 it right, slowly but surely. You can add origins and insertions later, and 9:53 honestly whether you flip them it doesn't matter. I mix up origins and 9:57 insertions all the time. As far as which ones which, guess how much it affects my 10:02 practice, oh my god did you see what he did he touched the insertion and he 10:11 thought it was the origin, haven't been fired yet for that one. You're okay, all 10:21 right. Trapezius, you guys know where your traps 10:24 are? Do you know why your trapezius is called your trapezius? It's shaped like a 10:31 trapezoid. What's the trapezoid shape, 10:35 it's a kite shape right. You guys know that? So you guys are doing good in 10:42 kinesiology and you did great in geometry, is what you're telling me, um. So 10:47 yeah trapezoid is a kite shaped, and that's how your traps are shaped. That's 10:54 a trapezoid, there's a lopsided trapezoid, let's change this chest a little bit. 11:03 Everybody's cool with that all right let's, the funny thing about the trap is 11:09 it's actually kind of like three muscles. 11:20 Too big, that's not going to work all right. Head, spine everybody's good with that? 11:33 Scapula. 11:42 Scapula. 11:48 All right now let's draw the trap. So we have upper trap that goes from the 11:55 acromion process and spine of the scapula to external occipital 11:59 protuberance. down your ligamentus nuchi, which is looking at in your spine, 12:05 and into maybe the top thoracic vertebrae. Then you have more middle 12:13 trapezius, it connects to kind of this midsection of the spine in your scapula, 12:17 and then some more of those middle thoracic vertebrae. You guys still cool? 12:24 Maybe this one actually comes off more like this, and then you have your lower 12:33 trapezius which goes from spine of scapula all the way down to t12. So you 12:42 got upper, middle and lower. 12:59 So the trapezius goes from spine to scapula. What's it going to move? Your 13:08 scapula for the most part. All right now let's start with the upper, that's that's 13:14 this fiber direction right here. What joint actions do you think the upper 13:22 trap is going to cause? Maybe some elevation, you guys think that's a good 13:29 that's a good call, that's a good call. So we got a little bit elevation, what else? 13:39 Yeah pulls on this outside edge here right, so if it pulls up on the outside 13:46 edge isn't my scapula going to want to do that? Yeah so it'll contribute to some 13:51 upward rotation. What is the middle one's going to do? These guys. Which one? A 14:00 muscle can't do two opposing joint actions. Yeah if it contracts it's 14:06 going to retract. 14:12 What about my lower traps, what are they going to do? Depression, that's good call. 14:21 I think they'll pull this way. 14:30 What else, and that picture started out looking so clean and now it's beginning 14:34 to look like a mess, sorry about that. Start over. 14:50 Just do one scapular again, 15:07 and the purple marker is dying all right. So I had my upper guys pulling this way, 15:20 i have my middles pulling this wa,y and my lowers pull in this way. So my lower 15:28 will do depression, what else will it do? 15:32 Whew we have, we have a debate going? I heard one upward rotation and one 15:38 downward rotation, which one is it going to do mmm. You guys remember my pinwheel 15:47 analogy? You guys want to change your answer, can you guys see this, if I pull 16:00 down on this inside corner what happens to my glenoid fossa, it goes up right. Did 16:11 you guys see that if I pull down here, this goes up. Upper trap pulls from the 16:18 outside, which is why it also goes up. 16:25 Does that make sense? Cool you guys are cruising through the scapulae muscles, 16:34 cruising. Levator scapulae with a name like levator scapula, what do you think 16:48 is a joint action this muscle might contribute to? Elevation, thank you thank 16:54 you. Sometimes we get to give me in the PT or in the anatomy world, you got to take 16:59 them when they come alright. So let's do levator scapulae. 17:29 Levator scapula, what joint are we moving again? Yeah i'm going to guess with 17:36 levator scapulae is the name, we're also going to be moving the scapula. Given 17:44 that it has an origin on the superior angle of the scapula, and then an 17:52 insertion into the transverse processes of C1 through 4. Alright so up on 18:04 the top of the cervical spine, it kind of looks like this. What joint actions do we 18:09 got? Elevation, but you're not done. So i agree with you its elevation, it will 18:22 definitely do some of this. but if it pulls on this corner what happens to 18:28 this? Yeah it's a downward rotator. So by pulling up on this corne,r that causes 18:39 this guy to go down that way. So it makes sense? Cool. 18:50 You guys ready for rhomboids. 19:06 Rhomboids there's a major and a minor, but for we can think about them as one 19:15 muscle for the most part. They go from C7 to T5 alright, C7 to T5 on the spine to 19:27 the medial border of the scapula. Why are they why are they called rhomboids, 19:34 because they're shaped like a rhombus. 19:39 Alright if they go from spine to scapula what are they probably going to 19:45 move? Scapula, based on the direction of their fibers what joint action is it going 19:53 to be good at? I like that, what joint action is that? Retraction. So you have a 20:07 muscle its shape like this, yeah it's going to pull this way, anybody want to 20:18 take a guess on what rotation it does? 20:22 Everybody's cooled down word, but you guys got that pretty quick huh. So yeah 20:27 you can kind of see how in this direction it would pull a scapula here 20:39 right, or another way to look at it is if I upwardly rotated my scapula what would 20:47 happen to my rhomboids? They get stretched out right, which means when 20:51 they contract they pull me back down into downward rotation. Does that make 20:57 sense? Alright you guys are killing it, killing it. So I think we're ready for 21:06 our first graph, go to page 11. So I'm going to make you kind of flip stuff, all 21:17 the answers you need we've already gone over, but I'm just kind of flipping how 21:20 you look at this. So what I want you to do is how many boxes do you guys got? One 21:26 two three four five six seven eight so they can, in that graph I 21:31 included anterior and posterior tipping as the last two boxes, you can skip those 21:37 if you want. I want one joint action per box for the six joint actions we have up 21:44 here. You're then going to tell me what plane each one of those joint actions is, 21:51 what muscles are responsible for each joint action, and a sample exercise for 21:59 each joint action, you guys good with this? I'll give you a big hint on the 22:04 muscles, there's at least two muscles per joint action. In fact for most of the 22:11 joint actions there's only two muscles. There is a couple where a third muscle 22:15 could be added. You guys got, how much time you need, five minutes. You guys can 22:23 confer with each other, and then we'll throw it up on the board. 22:34 Alright so what are my joint actions guys? 22:40 So I got protraction, retraction, what else? Upward rotation, downward rotation, 23:07 elevation and depression. What plane is protraction in? Transverse. What plane is 23:27 retraction in then? Transverse. Upward and downward rotation? Frontal. 23:46 What about elevation and depression? Frontal. 24:00 Alright we already knew that from earlier today. So now let's add the the 24:05 muscles to this. Who will protract the scapula? Serratus anterior is actually 24:12 your primary protractor so you guys can put a star by that one. Who else? 24:23 Pectoralis minor. 24:34 Who wants to pick an exercise, what's an exercise that includes protraction? Maybe 24:47 not pull ups. Bench, bench, anything anything, we in fact we could generalize 24:53 a little bit and just call it pushing. Anytime you push something you want to 25:01 protract your scapula. What about retraction ,what are the muscles that 25:06 retracts? Middle trapezius and rhomboids. 25:23 What's an exercise that would include retraction? Reverse fly sure. If 25:35 pushing includes protraction, what probably includes retraction? Pulling. 25:46 Upward rotators? Serratus anterior, thank you big important one. This is one of the 26:00 ones that has three muscles, upper and lower traps. 26:12 What's an example of an exercise with upward rotation? Lateral raise sure. 26:31 Downward rotation? Pectoralis minor 26:44 and levator scapula and rhomboids, nice job. What's an exercise? Pull up sure. 27:20 Elevation, who's going to elevate? Upper trap and levator scapulae. 27:41 Exercise? Shrugs. 27:55 Depressors? PEC minor and lower trap. 28:12 Exercise, that one's a tough one right, we don't really do a lot of exercises with 28:22 just depression. No dip would pull you into depression. maybe the top of a dip 28:36 right like if you really try to push through the top, I could see that top of 28:41 a dip. There's a physical therapy thing, 28:46 something called a functional pushup. 28:52 I'll show you guys what this is so people for example who have lost some of 29:03 their lower extremity function right, they don't, they're not able to use their 29:07 legs real well, and you got to teach them how to get around to bed, and if you can 29:13 get them sitting how could I have them scoot side to side on a bed with limited 29:19 lower body function? 29:26 Right so that's scapular depression right and then they shift over. Cool 29:35 little movement pattern. Alright so you guys could write that down as an example. 29:38 How'd you guys do on that graph? At the very least you have a nice little 29:43 study guide for the scapular muscles right, and that's all the scapular 29:46 muscles, that's it from us, you guys nailed it. 29:58
