"능형근"

[문형철]

1. 능형근은 견갑골을 사이에 두고 전거근과 장력싸움을 하는 근육. 

2. 현대인의 상부교차증후군때 흔히 lengthening lock이 일어나 통증, 기능부전이 일어나는 근육. 

3. 전거근은 견갑골을 protract시키는데, interiorly and laterallly로 당김

4. 능형근은 견갑골을 retract시키는데, superiorly and medially로 당김. 

5. 대능형근(T2-T5-견갑골)과 소능형근(C7-T1-견갑골)

6. 능형근의 길항근은 전거근과 하부승모근. 만약 하부승모근이 약화되면 전거근과 상부승모근이 견갑골을 상방, 전인방향으로 당김

대능형근

The rhomboid major is a skeletal muscle on the back that connects the scapula with the vertebrae of the spinal column. In human anatomy, it acts together with the rhomboid minor to keep the scapula pressed against thoracic wall and to retract the scapula toward the vertebral column.^[1]

대능형근의 기시-종지

The rhomboid major arises from the spinous processes of the thoracic vertebrae T2 to T5 as well as the supraspinous ligament. It inserts on the medial border of the scapula, from about the level of the scapular spine to the scapula's inferior angle. ^[2]

The rhomboid major is considered a superficial back muscle. It is deep to the trapezius, and is located directly inferior to the rhomboid minor. As the word rhomboid suggests, the rhomboid major is diamond-shaped. The major in its name indicates that it is the larger of the two rhomboids.

대능형근 기능

The rhomboid major helps to hold the scapula (and thus the upper limb) onto the ribcage. Other muscles that perform this function include the serratus anterior and pectoralis minor.

Both rhomboids (major and minor) also act to retract the scapula, pulling it towards the vertebral column.

The rhomboids work collectively with the levator scapulae muscles to elevate the medial border of the scapula, downwardly rotating the scapula with respect to the glenohumeral joint. Antagonists to this function (upward rotators of the scapulae) are the serratus anterior and upper and lower fibers of the trapezius. If the lower fibers are inactive, the serratus anterior and upper trapezii work in tandem with rhomboids and levators to elevate the entire scapula.

대능형근 신경지배 C5

The rhomboid major, like the rhomboid minor, is innervated by the ventral primary ramus via the dorsal scapular nerve (C5).^[2]

Both rhomboid muscles also derive their arterial blood supply from the dorsal scapular artery.

대능형근의 기능부전

If the rhomboid major is torn, wasted, or unable to contract, scapular instability may result. The implications of scapular instability caused by the rhomboid major include scapular winging during scapular protraction, excessive lateral rotation and depression of the scapula, as the antagonistic action of the rhomboid major is absent. With scapular instability, movement in the upper extremity is limited as the scapula cannot guide the desired movement of the arm and shoulders. Pain, discomfort, and limited range of motion of the shoulder are possible implications of scapular instability.

Treatment for scapular instability may include surgery followed by physical therapy. Physical therapy may consist of stretching and endurance exercises of the shoulder. Pilates and yoga have been also suggested as potential treatment and prevention of scapular instability.

소능형근

In human anatomy, the rhomboid minor is a small skeletal muscle on the back that connects the scapula with the vertebrae of the spinal column.

Located inferior to levator scapulae and superior to rhomboid major, it acts together with the latter to keep the scapula pressed against the thoracic wall. It lies deep to trapezius but superficial to the long spinal muscles.^[1]

The rhomboid minor arises from the inferior border of the nuchal ligament, from the spinous processes of the seventh cervical and first thoracic vertebrae, and from the intervening supraspinous ligaments. ^[1]

It is inserted into a small area of the medial border of the scapula at the level of the scapular spine. ^[2]

소능형근 기능

Together with the rhomboid major, the rhomboid minor retracts the scapula when trapezius is contracted. Acting as an antagonist to the trapezius, the rhomboid major and minor elevate the medial border of the scapula medially and upward, working in tandem with the levator scapulae muscle to rotate the scapulae downward. While other shoulder muscles are active, the rhomboid major and minor stabilize the scapula. ^[3]

소능형근 신경지배

The nerve supply comes from the dorsal scapular nerve, with most of its fibers derived from the C5 nerve root and only minor contribution from C4 or C6. ^[4]

The rhomboid minor gets its arterial blood supply from the dorsal scapular artery.

능형근의 Trp탐구

능형근 운동법

1. 아령 운동

2. pulley운동

[heoss]

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[김종현]

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