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subscapularis muscle wikipedia jump to content main menu main menu move to sidebar hide navigation main page contents current events random article about wikipedia contact us contribute help learn to edit community portal recent changes upload file special pages search search appearance donate create account log in personal tools donate create account log in contents move to sidebar hide top 1 structure toggle structure subsection 1 1 origin 1 2 insertion 1 3 innervation 1 4 actions movements 2 function 3 clinical significance toggle clinical significance subsection 3 1 examination 3 2 imaging 3 3 ultrasonography 3 3 1 longitudinal plane of the musculus subscapularis and its tendon 3 3 2 tissue harmonic imaging 4 additional images 5 references 6 external links toggle the table of contents subscapularis muscle 27 languages العربية azərbaycanca català čeština dansk deutsch español eesti فارسی français galego עברית hrvatski magyar bahasa indonesia italiano 日本語 한국어 latina nederlands polski português română русский slovenščina svenska українська edit links article talk english read edit view history tools tools move to sidebar hide actions read edit view history general what links here related changes upload file permanent link page information cite this page get shortened url switch to legacy parser print export download as pdf printable version in other projects wikimedia commons wikidata item appearance move to sidebar hide from wikipedia the free encyclopedia large triangle muscle of the shoulder this article needs more citations please help improve this article by adding citations to reliable sources unsourced material may be challenged and removed find sources subscapularis muscle news newspapers books scholar jstor april 2021 learn how and when to remove this message subscapularis muscle subscapularis muscle in red ribs are shown as semi transparent anterior view the subscapularis is difficult to see from the front labeled middle right details origin subscapular fossa insertion lesser tubercle of humerus artery subscapular artery nerve upper subscapular nerve lower subscapular nerve c5 c6 actions internally rotates and adducts humerus stabilizes shoulder identifiers latin musculus subscapularis ta98 a04 6 02 012 ta2 2460 fma 13413 anatomical terms of muscle edit on wikidata the subscapularis is a large triangular muscle which fills the subscapular fossa and inserts into the lesser tubercle of the humerus and the front of the capsule of the shoulder joint structure edit the subscapularis is covered by a dense fascia which attaches to the scapula at the margins of the subscapularis attachment origin on the scapula 1 the muscle s fibers pass laterally from its origin before coalescing into a tendon of insertion citation needed the tendon intermingles with the glenohumeral shoulder joint capsule 1 a bursa which communicates with the cavity of the shoulder joint 1 2 via an aperture in the joint capsule 2 intervenes between the tendon and a bare area at the lateral angle of the scapula 1 the neck of the scapula 2 the subscapularis supraserratus bursa separates the subscapularis is from the serratus anterior 2 origin edit it arises from its medial two thirds of the costal surface of the scapula the intermuscular septa which create ridges upon the scapula 1 and the lower two thirds of the groove on the axillary border subscapular fossa of the scapula citation needed some fibers arise from tendinous laminae which intersect the muscle and are attached to ridges on the bone others from an aponeurosis which separates the muscle from the teres major and the long head of the triceps brachii citation needed insertion edit it inserts onto the lesser tubercle of the humerus 1 and the anterior part of the shoulder joint capsule tendinous fibers extend to the greater tubercle with insertions into the bicipital groove citation needed innervation edit the subscapularis is supplied by the upper and lower subscapular nerves c5 c6 branches of the posterior cord of the brachial plexus 1 actions movements edit the subscapularis medially internally rotates the humerus acting here as a prime mover 1 and adducts it when the arm is raised it draws the humerus forward and downward citation needed function edit the subscapularis stabilises the shoulder joint by contributing to the fixation of the proximal humerus during movements of the elbow wrist and hand 1 it is a powerful defense to the front of the shoulder joint preventing displacement of the head of the humerus citation needed clinical significance edit examination edit it is difficult to isolate the action of the subscapularis from other medial rotators of the shoulder joint there is no satisfactory test for this muscle 1 the gerber lift off test is the established clinical test for examination of the subscapularis 3 the bear hug test internal rotation while palm is held on opposite shoulder and elbow is held in a position of maximal anterior translation for subscapularis muscle tears has high sensitivity positive bear hug and belly press tests indicate significant tearing of subscapularis 4 imaging edit mri partial rupture of the cranial subscapularis tendon at the insertion site there is no singularly imaging device or technique for a satisfying and complete subscapularis examination but rather the combination of the sagittal oblique mri short axis us and axial mri long axis us planes seems to generate useful results additionally lesser tuberosity bony changes have been associated with subscapularis tendon tears findings with cysts seem to be more specific and combined findings with cortical irregularities more sensitive 5 another fact typically for the subscapularis muscle is the fatty infiltration of the superior portions while sparing the inferior portions since the long biceps tendon absents itself from the shoulder joint through the rotator cuff interval it is easily possible to distinguish between the supraspinatus and the subscapularis tendon those two tendons build the interval sling ultrasonography edit mack et al developed an ultrasonographic procedure with which it is possible to explore almost the complete rotator cuff within six steps it unveils clearly the whole area from the subedge of the subscapularis tendon until the intersection between the infraspinatus tendon and musculus teres minor one of six steps does focus on the subscapularis tendon in the first instance the examinator guides the applicator to the proximal humerus as perpendicularly as possible to the sulcus intertubercularis gliding now medially shows the insertion of the subscapularis tendon 6 longitudinal plane of the musculus subscapularis and its tendon edit the subscapularis tendon lies approximately 3 to 5 cm under the surface quite deep for ultrasonography and therefore displaying through a highly penetrative 5 mhz linear applicator is worth a try and it really turned out to ease a detailed examination of the muscle which just abuts to the scapula however the tendon of primary interest does not get mapped as closely as desired as anatomical analysis showed it is only by external rotation possible to see the ventral part of the joint socket and its labrum while at the neutral position the tuberculum minus occludes the view summing up it is through an external arm rotation and a medially applied 5 mhz sector sonic head possible to display the ventral part of the joint socket and its labrum with notedly lower echogenicity 7 the following sectional planes are defined for the sonographic examination of the different shoulder joint structures 8 ventral transversal ventral sagittal medial ventral sagittal lateral lateral coronal lateral transversal sagittal dorsal transversal dorsal sagittal subscapularis muscle longitudinal subscapularis muscle transversal intertub sulcus with long head of biceps brachii longitudinal supraspinatus muscle longitudinal supraspinatus muscle transversal infraspinatus muscle longitudinal supraspinatus muscle transversal intertubercular sulcus with long head of biceps brachii transversal hill sachs lesio tissue harmonic imaging edit primarily in abdominal imaging tissue harmonic imaging thi gets more and more valued and used additionally to conventional ultrasonography thi involves the use of harmonic frequencies that originate within the tissue as a result of nonlinear wave front propagation and are not present in the incident beam these harmonic signals may arise differently at anatomic sites with similar impedances and thus lead to higher contrast resolution along with higher contrast resolution it has an elevated signal to noise ratio and significantly reduced inter and intraobserver variability compared with conventional us additionally it is possible to nearly eliminate ordinary us artifacts i e side lobe near field artifacts reverberation artifacts as aforementioned thi has already led to enhanced abdominal breast vascular and cardiac sonography for musculo skeletal aspects thi has not been used that much although this method features some useful potential for example for the still tricky discrimination between the presence of a hypoechoic defect and or loss of the outer tendon convexity non visualization of the tendon that is between partial and full thickness rotator cuff tears in comparison to a checking mr arthrography strobel k et al has arrived at the conclusion that through thi it is possible to achieve a generally improved visibility of joint and tendon surfaces especially superior for subscapularis tendon abnormalities 9 additional images edit wikimedia commons has media related to subscapularis muscles subscapularis muscle shown in red animation same as the left but the bones around the muscle are shown as semi transparent transverse section of thorax featuring subscapularis muscle diagram of the human shoulder joint references edit this article incorporates text in the public domain from page 440 of the 20th edition of gray s anatomy 1918 1 2 3 4 5 6 7 8 9 10 sinnatamby chummy 2011 last s anatomy 12th ed pp 44 45 isbn 978 0 7295 3752 0 1 2 3 4 milano giuseppe and grasso andrea shoulder arthroscopy principles and practice archived 27 april 2021 at the wayback machine springer science business media dec 16 2013 isbn 9781447154273 accessed 2016 11 07 simons stephen dixon j bryan 3 april 2017 physical examination of the shoulder uptodate archived from the original on 20 april 2017 retrieved 19 april 2017 barth johannes r h burkhart stephen s de beer joe f october 2006 the bear hug test a new and sensitive test for diagnosing a subscapularis tear arthroscopy the journal of arthroscopic and related surgery 22 10 1076 1084 doi 10 1016 j arthro 2006 05 005 pmid 17027405 morag yoav jamadar david a miller bruce dong qian jacobson jon a 2009 the subscapularis anatomy injury and imaging skeletal radiology 40 3 255 69 doi 10 1007 s00256 009 0845 0 pmid 20033149 s2cid 13833846 mack l a matsen f a kilcoyne r f davies p k sickler m e 1985 us evaluation of the rotator cuff radiology 157 1 205 9 doi 10 1148 radiology 157 1 3898216 pmid 3898216 katthagen bd et al schultersonographie stuttgart isbn 3 13 719401 6 page needed thelen m et al radiologische diagnostik der verletzungen von knochen und gelenken stuttgart etc georg thieme 1993 isbn 3 13 778701 7 page needed strobel klaus zanetti marco nagy ladislav hodler juerg 2004 suspected rotator cuff lesions tissue harmonic imaging versus conventional us of the shoulder1 radiology 230 1 243 9 doi 10 1148 radiol 2301021517 pmid 14631052 external links edit v t e muscles of the arm shoulder deltoid rotator cuff supraspinatus infraspinatus teres minor subscapularis teres major fascia deltoid fascia supraspinous fascia infraspinous fascia arm compartments anterior coracobrachialis biceps brachialis posterior triceps brachii anconeus articularis cubiti fascia axillary sheath axillary fascia brachial fascia intermuscular septa lateral medial other spaces quadrangular space triangular space triangular interval forearm compartments anterior superficial pronator teres palmaris longus flexor carpi radialis flexor carpi ulnaris flexor digitorum superficialis deep pronator quadratus flexor digitorum profundus flexor pollicis longus posterior superficial mobile wad brachioradialis extensor carpi radialis longus and brevis extensor digitorum extensor digiti minimi extensor carpi ulnaris deep supinator anatomical snuffbox abductor pollicis longus extensor pollicis brevis extensor pollicis longus extensor indicis fascia bicipital aponeurosis common tendons extensor flexor antebrachial fascia other cubital tunnel osborne s ligament hand lateral volar thenar opponens pollicis flexor pollicis brevis abductor pollicis brevis adductor pollicis medial volar hypothenar opponens digiti minimi flexor digiti minimi brevis abductor digiti minimi palmaris brevis intermediate lumbrical interossei dorsal palmar fascia posterior extensor retinaculum extensor expansion anterior flexor retinaculum palmar aponeurosis portal anatomy authority control databases terminologia anatomica retrieved from https en wikipedia org w index php title subscapularis_muscle oldid 1278131164 categories muscles of the upper limb rotator cuff shoulder medial rotators hidden categories articles with short description short description is different from wikidata use dmy dates from january 2019 use american english from january 2019 all wikipedia articles written in american english articles needing additional references from april 2021 all articles needing additional references all articles with unsourced statements articles with unsourced statements from may 2023 webarchive template wayback links wikipedia articles needing page number citations from may 2015 commons category link is on wikidata wikipedia articles incorporating text from the 20th edition of gray s anatomy 1918 this page was last edited on 28 february 2025 at 17 12 utc page was rendered with 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