THE FORE LIMB 



CHAPTER I 



SUPERFICIAL EXAMINATION 



The student should first examine the outer aspect of the region of the 

 shoulder, and endeavour as near as possible to locate the outHne of the 

 scapula. Having done this, it will be observed that running obliquely 

 downw^ards and forwards over the area enclosed by the imaginary outline 

 drawn, there are four elevations, which are formed by the following 

 inuscles : 

 'l-^ The most superior or anterior elevation indicates the position of the 

 supraspinatus muscle, which lies in the supraspinous fossa and is attached 

 inferiorly to the anterior divisions of both tuberosities at the proximal 

 end of the humerus. Between the two tendons of insertion of this muscle 

 the tendon of origin of the biceps emerges. The second elevation is 

 formed by the infraspinatus muscle. This muscle has two tendons of 

 insertion also, one of which is attached to the inner side of the 

 convexity {i.e., the more posterior of the two divisions of the external 

 tuberosity), whilst the other tendon plays over the outer aspect of the 

 convexity and is inserted into the upper extremity of the deltoid ridge. 

 A small synovial bursa is placed between this tendon and the outer 

 surface of the convexity. Between the two muscles named, the tubercle 

 of the spine of the scapula may be easily located. It is important to 

 note that the tendons of the supraspinatus and infraspinatus muscles by 

 their disposition materially assist in keeping the head of the humerus in 



