SHOULDER SCAPULAR REGION 89 



vessels, the suprascapular nerve, and the circumflex scapular 

 vessels which lie between it and the bone. Occasionally there 

 is a small bursa between it and the posterior surface of the 

 capsule of the shoulder- joint which communicates with the 

 cavity of the joint. 



Divide the teres minor where the circumflex scapular artery 

 passes between it and the posterior surface of the axillary border 

 of the scapula, and verify its origin from the scapula and its 

 insertion into the inferior facet on the greater tubercle of the 

 humerus, and to the ridge which descends from the tubercle. 



When the infraspinatus and teres minor have been reflected, 

 look for the inferior transverse ligament of the scapula. It is 

 a band of fascia which passes from the lateral border of the 

 spine of the scapula to the posterior border of the glenoid fossa, 

 arching across the great scapular notch. It protects the infra- 

 spinous branch of the transverse scapular artery and the supra- 

 scapular nerve as they pass behind the neck of the scapula from 

 the supra- to the infraspinous fossa. 



Now clean the transverse scapular vessels, and the supra- 

 scapular nerve and the circumflex scapulae branch of the sub- 

 scapular artery. Commence with the transverse scapular 

 artery as it lies medial to the coracoid process, and the supra- 

 scapular nerve which accompanies it. The artery lies on the 

 superior transverse ligament of the scapula, immediately medial 

 to the coracoid process. The nerve passes through the notch 

 on the superior border of the scapula beneath the ligament. 

 Follow the artery and nerve behind the neck of the scapula into 

 the infraspinous fossa, and note that both pass between the neck 

 of the scapula and the inferior transverse ligament. Then 

 clean the circumflex scapular artery, and study the transverse 

 ligaments of the scapula and the arterial anastomosis round the 

 scapula. 



Ligamenta Transversa Scapulae. There are two transverse 

 scapular ligaments (i) a superior, tigamcntum transversum 

 scapula superius', (2) an inferior, Ugamentum transversum scapulce 

 inferius (O.T. spino-glenoid). Both the transverse ligaments 

 are associated with the transverse scapular vessels and the 

 suprascapular nerve. The superior transverse ligament 

 bridges across the notch in the superior border of the scapula 

 and converts it into a foramen. It lies between the transverse 

 scapular artery, which passes above it, and the suprascapular 

 nerve, which lies in the notch below it. In not a few cases it 

 is ossified. The inferior transverse ligament is a weaker band 

 which bridges across the great scapular notch at the back of 

 the neck of the scapula, passing from the lateral border of the 

 spine of the scapula to the posterior margin of the glenoid 

 cavity. The infraspinous branch of the transverse scapular 

 artery and the suprascapular nerve lie in the notch, deep to 

 the ligament. 



