Anatomy Of The Rotator Cuff Muscles - Everything You Need To Know - Dr. Nabil Ebraheim
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- เผยแพร่เมื่อ 3 มิ.ย. 2024
- Dr. Ebraheim’s educational animated video illustrates the shoulder rotator cuff muscles and associated tears .Dr. Ebraheim animated video illustrates the shoulder rotator cuff muscles and types of imaging for these injuries.it is a shoulder animation video that explains the rotator cuff anatomy , the rotator cuff MRI , ROTATOR CUFF INJURY ,TEAR IS explained .rotator cuff surgery is also explained .rotator cuff rehab is important .The video explains the anatomy of the rotator cuff in relation to rotator cuff nerve supply ,rotator cuff function and rotator cuff action.
Rotator cuff is a group of four muscles that lifts and rotates the arm at the shoulder area.
The rotator cuff muscles originate at the scapula and insert into the head of the humerus.
Rotator cuff tears are a common source of shoulder pain.
When the rotator cuff is torn, the patient will complain of a painful, weak shoulder.
The patient will not be able to lift or rotate the arm with the same range of motion or strength as before the injury.
The patient will have a significant pain associated with motion of the shoulder and the pain is common at night, radiating to the arm.
Rotator cuff tear is usually diagnosed by clinical examination and confirmed by getting an MRI.
Treatment:
- NSAIDS.
- Physical therapy.
- Injection.
- Surgery:
• Surgery is done when the tear is traumatic and when there is failure of conservative treatment.
Complete tear of the rotator cuff will not heal without surgery.
The tendon will need to be repaired by suturing the tendon back to the humerus.
Utilize sutures or bone anchors.
The operation can be done arthroscopically, open, or also done by a combination of both with a small incision.
Some tears are greater than 5cm in size and involve multiple tendons.
These massive tears usually occur in elderly patients.
Sometimes the rotator cuff muscles will have atrophy and fatty infiltration.
These are the patients who will have a poor outcome.
With smaller tears, surgical repair is more successful.
In traumatic tears, the sooner the repair the better the outcome.
The rotator cuff is a dynamic stabilizer by tensioning, contracting, and holding the humeral head tightly within the glenoid cavity as the shoulder moves.
There are four muscles of the rotator cuff:
1- Subscapularis.
2- Supraspinatus.
3- Infraspinatus.
4- Teres minor.
The supraspinatus and the infraspinatus receive innervation from the suprascapular nerve which is the only nerve that arises from the upper trunk.
The subscapularis will get innervation from the upper and lower subscapular nerve from the posterior cord of the brachial plexus.
The teres minor will get innervation from the axillary nerve which comes from the posterior cord of the brachial plexus.
• Supraspinatus:
- Origin is located on the superior aspect of the scapula above the scapular spine and inserts into the greater tubercle of the humerus.
- Function: If you want to know the function of all the rotator cuff muscles, then take a look at their insertion.
- So according to its insertion, the function of the supraspinatus muscle is to initiate the abduction of the arm, so when you test this muscle you will find that when it is torn, you will have weak abduction and drop arm test.
• Infraspinatus:
- Origin: below the spine of the scapula and inserts posteriorly into the greater tuberosity of the humerus.
- This muscle is the primary external rotator of the humerus.
- If this muscle is torn, the patient will have weak external rotation with the arm to the side.
• Teres Minor:
- Origin: from the middle half of the lateral border of the scapula and it inderts into the humeral head inferior to the infraspinatus muscle.
- Function: external rotation of the humerus.
- It is tested by weak Horn Blowers Sign, which is weakness of external rotation at 90° of abduction.
• Subscapularis:
- If the subscapularis rupture, it goes medially and the biceps tendon will be dislocated or subluxed and goes medially also.
- Originates from the subscapularis fossa and inserts on the lesser tuberosity of the humerus.
- Function: internal rotation of the humerus.
- When this muscle ruptures it usually happen acutely similar to an avulsion in young oatients with hyperabduction and external rotation.
- It can also happen post operatively from failure of the repair after surgical procedure on the anterior shoulder area.
- Sometimes it is a tough diagnosis that could be missed, and if the condition becomes a chronic tear, you will probably need to do pectoralis major muscle transfer.
- Subscapularis tear is diagnosed via these two tests:
- Lift- Off Test: it test the upper subscapularis muscle (impotant part).
The patient will be unable to hold the hand behind the back.
- Belly Press Test: it tests the lower subscapularis.
- The third test with the subscapularis test is excessive passive external rotation of the shoulder compared to the other shoulder.
Best illustration possible for rotator cuff anatomy brilliant!
Thank you for all your hard work on these videos.
Innervation:
Supraspinatus & Infraspinatus- Supraspinatus nerve
Subscapularis- upper and lower Subscapularis nerve
Teres minor- Axillary nerve
Action
1. Supraspinatus- Abducts
2. Infraspinatus- Greater tubercle, ER humerus.
Test for ER weakness
3. Teres minor- Greater tubercle, ER
4. Subscapularis- Lesser tubercle, IR
See Hyperabduction and ER
Lift off and belly press
I am having a rotator cuff repair and this video was extremely helpful showing and explaining the mechanics of the shoulder. Thank you so much for this video. Better educated understanding the MRI findings and up coming surgical procedure.
Thank you, Dr. Ebraheim, for all the orthopedic videos.
Very informative and clear as always. Thank you for your work.
Thanks again for your support and prayers
you make understanding easy. thank you for your great work.
Stacy Lynne Doty Thank you for your explanations
best video for understanding rotator cuff
matching the anatomical insertion points with the direction and tests is really what helps impart a holistic understanding.
Just exercises, or just names, or just insertion points is disjointed information.
thank you! you are the best orthopedic doctor on the planet
Thank you so much sir. From now i am a student of you. These leasions are really helpfull for me and all of the medical students.
Excellent explanation sir..
Thank you Doctor .Outstanding job
Thank you so much for this video. 💐💐💐💐💐💐💐💐💐💐
I was falling to the ground and hurt my shoulder so bad, a month ago. 😢The two of the four muscles was torn completely over. 😢
It hurts so much. 😢😢😢
I will not be operated.
Sorry for my bad English.
Greetings from Denmark 🇩🇰
💐💐💐💐💐💐💐💐💐💐
May God bless you in the name of Jesus Christ ❤❤❤. THANK YOU SO MUCH!
very clear and understandable sir..i always watch Your videos for every othro and neuro conditions..
So easy to follow this. Thanks!
Very informative
you are great...... God bless u plz keep it up
thank you,you were indeed helpful.
EXCELLENT-many Thanks
Thanks for integrating the brachial plexus!!!
nice pics....i have been looking for certain views.....of the shoulder nice to see them on your video
Thank you , very helpful
Thank you..im about to have surgery...this was very informative
thanks Dr Ebraheim. as a nurse - i learn so much from your videos.
i would like to see your thoughts/expertise on an a tenotomy bicep tendon cut for impingement. i would like to understand the behaviour over time of the remaining bicep tendon in the bicipital groove. Thanku.
Shukriya.....
It really works😊
that is a good work indeed!
Thank you
Thanks. Can u pls do a video on the knees and feet next, for us all. Great work !
brilliant
Thank you it very helpful
Very good
Very nice 👍👍👍
thanks for this vid ...
Thank you
Thanks...
hello, if I have an AC joint problem and my clavicle on the right shoulder is a bit upper then on my normal left hand. Can u please advice an exercises to bring it to the normal position. Also I have a weak subscapularis on that right side. If I'll stand with my back to the wall , I can hardly push my self with my hand behind my back.
I am 44 years old, this is the disease and I will be operated on 2023 6.15. I didn't do sports but I don't know why this happened. Maybe when I lift heavy things. I was in the hospital for 2 weeks and after 2 weeks I was in the hospital more, the doctor said. 3 to 4 months of therapy is needed. I can only use one hand in the meantime. 🥲can't go back to work yet. and now I'm still in the hospital and still recovering.😢
I don't have the money for surgery, what should I do if it's not completely torn? How would I tell the difference if my muscle is torn beyond healing or if it will heal itself over time?
Dr I don't want surgery on my tear what's is second opinion
❤
I have this issue and keep getting denied medicaid!
Sister age 72; tear 2.30cm on shoulder cup ,kindly suggest type of operation
May God bless you in the name of Jesus Christ!! Greetings from Denmark 🇩🇰
I think my rotator cuff help
hello, if I have an AC joint problem and my clavicle on the right shoulder is a bit upper then on my normal left hand. Can u please advice an exercises to bring it to the normal position. Also I have a weak subscapularis on that right side. If I'll stand with my back to the wall , I can hardly push my self with my hand behind my back.