Whilst examining the shoulder of a 27 year old woman you note she has weakness of certain movements. You suspect this is due to weakness of the latissimus dorsi. The latissimus dorsi muscle acts to produce which of the following movements:
The latissimus dorsi muscle forms much of the muscle mass underlying the posterior axillary skin fold extending obliquely upwards from the trunk to the arm.
Muscle | Latissimus Dorsi |
---|---|
Origin | Spinous processes of lower 6 thoracic vertebrae and related interspinous ligaments; via the thoracolumbar fascia to the spinous processes of the lumbar vertebrae, related interspinous ligaments and iliac crest; lower 3 – 4 ribs |
Insertion | Floor of intertubercular sulcus |
Function | Adduction, medial rotation and extension of arm at glenohumeral joint |
Innervation | Thoracodorsal nerve |
The latissimus dorsi originates from the spinous processes of the lower six thoracic vertebrae and related interspinous ligaments, via the thoracolumbar fascia to the spinous processes of the lumbar vertebrae, related interspinous ligaments and iliac crest and from the inferior 3 or 4 ribs.
The muscle inserts onto the floor of the intertubercular sulcus of the humerus.
The latissimus dorsi produces adduction, medial rotation and extension of the humerus at the glenohumeral joint.
The latissimus dorsi is innervated by the thoracodorsal nerve.
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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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