"소원근 - 작은원근, teres minor

[문형철]

1. 어깨 내회전 : 어깨 외회전 힘 = 100 : 63. 어깨 생체역학적 짝힘의 균형

2. 소원근과 극하근은 어깨외회전의 주동근

3. 어깨질환 환자는 흔히 소원근 근위축이 발생

ak에 의하면 놀랍게도 갑상선질환과 연관된 근육, 요오드와 티로신 영양제가 필요함...

panic bird...

임상에서 소원근이 중요한 이유

카페회원들의 안전을 위해 iframe 태그를 제한 하였습니다. 관련공지보기▶

)

The teres minor (Latin teres meaning 'rounded') is a narrow, elongated muscle of the rotator cuff.

소원근의 기시와 종지

It arises from the dorsal surface of the axillary border of the scapula for the upper two-thirds of its extent, and from two aponeurotic laminæ, one of which separates it from the infraspinatus muscle, the other from the teres major muscle.

Its fibers run obliquely upward and laterally; the upper ones end in a tendon which is inserted into the lowest of the three impressions on the greater tubercle of the humerus; the lowest fibers are inserted directly into the humerus immediately below this impression.

The tendon of this muscle passes across, and is united with, the posterior part of the capsule of the shoulder-joint.

소원근의 신경지배

- 액와신경

The muscle is innervated by the posterior branch of axillary nerve where it forms pseudoganglion. Pseudoganglion has no nerve cells but only nerve fibres are present. Damage to the fibers innervating the teres minor is clinically significant.

소원근의 기능

The infraspinatus and teres minor attach to head of the humerus; as part of the rotator cuff they help hold the humeral head in the glenoid cavity of the scapula. They work in tandem with the posterior deltoid to externally (laterally) rotate the humerus, as well as perform transverse abduction, extension and transverse extension.

Sometimes a group of muscle fibres from teres minor may be fused with infraspinatus.

소원근, 극하근 근위축 영상

Atrophy of the teres minor muscle is often a consequence of a rotator cuff tear. But also uncommon isolated teres minor atrophies have been found. A so-called quadrilateral / quadrangular space syndrome causes excessive and or chronically compression of the structures which pass through this anatomical tunnel. The axillary nerve and the PHCA posterior humeral circumflex artery pass posteriorly through the space. The concerned patients note shoulder pain and paresthesia down the arm first and foremost in abduction, extension, external rotation and overhead activity. Selective atrophy of the musculus teres minor has been seen and pulled together directly with compression of the corresponding axillary nerve branch or PHCA. Fibrous bands, inferior paralabral cysts, lipoma or dilated veins can occupy the quadrilateral space pathologically. Similar symptoms are common with anterior shoulder dislocation, humeral neck fracture, brachial plexus injury and thoracic outlet and inlet syndrome. It is important to include those pathologies for a complete as possible differential diagnosis.

Ultrasonography is a wide spread, low cost, harmless and useful tool to detect a fatty degenerative atrophy of the teres minor and shows in affected muscles increased echogenicity and betimes a slight reduction in muscle bulk. MR imaging helps to consolidate the diagnosis of neurogenic muscle atrophy. Extracellular edema after traumatic events causing neural damage show an increased signal intensity on T2-weighted MRI sequences and normal intensity on T1-weighted sequences. PHCA compression and reduced blood flow in stressful arm positions and or maneuvers can easily be diagnosed by a dynamic ultrasonographic Color Doppler blood flow examination. The nerve should be detected adjacent to the vessel. In an elevated arm position the axillary neurovascular bundle can be seen at the posterior axillary fold just before it perforates the deltoideus. While the posterior course is well visible in the neutral position. As all but always, the imaging assessment has to be bilateral comparative and there are asymptomatic arterial occlusions. For a detailed assessment of the artery, a MR angiography is required. The major task of an ultrasonographic examination is to rule out any space occupying mass. Additional electromyography is helpful to reveal any decelerated nerve conduction velocity, and thus denervation of the concerned muscle.
First to identify via ultrasonography is the characteristic shape of the infraspinatus muscle tendon unit. On the longitudinal view it reveals itself due to the central tendon and triangular shape. Subsequently the transducer has to be slided inferiorly, maintaining the same orientation in order to reach the teres minor muscle tendon unit. Following the unit leads to the broad insertion on the humerus. Rotating the transducer 90° allows the transversal view, on which the musculus teres minor insertion has a characteristic elongated shape.^[3]

소원근 Trp 탐구! 

에반스의 소원은 isolated stretching

[홍삼]

좋은 자료들이네요~

[윤발]

감사합니다!

[tommyjung]

T. minor 는 위축이 되는 경우는 매우 적습니다. 위에도 나와 있듯이. Infraspinatus 가 주로 힘을 같이 사용하기 때문에 설령 위축이 되어 있다고 해도 알 길을 매우 어렵습니다. 대게 개인적인 경험상 Infraspinatus 근육이 위축이 되는 경우는 왕왕 있지요.

대개는 환자분들 옷을 입고 이학적 검사를 하기 때문에 위축이 된 여부를 알지 못하고 지나가는 경우가 많습니다. 이미 힘이 없다고 한 경우는 매우 심하거나, 거의 다 말랐겠지요! 해당 근육들이...