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Anatomy

Upper Limb

Question 28 of 239

You are asked to review a 27 year old woman who presents to the ED after she was stabbed in the posterior shoulder during an altercation. There is no immediate life threatening injury. You note that medial rotation and extension of the shoulder is weak, you suspect an injury to the nerve supplying the teres major. The teres major muscle is innervated by which of the following nerves:

Answer:

The teres major is innervated by the lower subscapular nerve.

Teres Major Muscle

Anatomy / Upper Limb / Axilla

Last Updated: 8th April 2019

The teres major muscle passes from the inferior angle of the scapula to the upper humerus and contributes to the posterior axillary skin fold laterally.

Table: Function and Innervation of the Teres Major Muscle

Muscle Teres Major
Origin Posterior surface of inferior angle of scapula
Distal Attachment Medial lip of intertubercular sulcus on humerus
Function Medial rotation and extension of arm at glenohumeral joint
Innervation Lower subscapular nerve

Origin

The teres major muscle originates from a large oval region on the posterior surface of the inferior angle of the scapula.

Insertion

The broad cord-like muscle passes superiorly and laterally and ends as a flat tendon that inserts onto the medial lip of the intertubercular sulcus on the anterior surface of the humerus.

Function

The teres major medially rotates and extends the humerus at the glenohumeral joint.

Innervation

The teres major muscle is innervated by the lower subscapular nerve.

Modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons

Teres Major Muscle. (Image modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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