| Teres minor muscle | |
|---|---|
 Teres minor muscle (shown in red), seen from behind. | |
 Muscles on the dorsum of the leftscapula, and theTriceps brachii muscle: #3 isLatissimus dorsi muscle #5 isTeres major muscle #6 is Teres minor muscle #7 isSupraspinatus muscle #8 isInfraspinatus muscle #13 is long head ofTriceps brachii muscle | |
| Details | |
| Origin | Lateral border of thescapula |
| Insertion | Inferior facet ofgreater tubercle of thehumerus |
| Artery | Posterior circumflex humeral artery and thecircumflex scapular artery |
| Nerve | Axillary nerve (C5-C6) |
| Actions | Laterally rotates the arm, stabilizes humerus |
| Identifiers | |
| Latin | musculus teres minor |
| TA98 | A04.6.02.010 |
| TA2 | 2459 |
| FMA | 32550 |
| Anatomical terms of muscle | |
Theteres minor (Latinteres meaning 'rounded') is a narrow, elongated muscle of therotator cuff. The muscle originates from the lateral border and adjacent posterior surface of the corresponding right or left scapula and inserts at both the greater tubercle of thehumerus and the posterior surface of the joint capsule.[1]
The primary function of the teres minor is to modulate the action of thedeltoid, preventing the humeral head from sliding upward as the arm is abducted. It also functions to rotate the humerus laterally. The teres minor is innervated by theaxillary nerve.[2]
It arises from the dorsal surface of the axillary border of thescapula for the upper two-thirds of its extent, and from twoaponeurotic laminae, one of which separates it from theinfraspinatus muscle, the other from theteres major muscle.
Its fibers run obliquely upwards and laterally; the upper ones end in a tendon which is inserted into the lowest of the three impressions on thegreater tubercle of thehumerus; the lowest fibers are inserted directly into the humerus immediately below this impression.
A normal anatomical variant of this is a much smaller appearing muscle with an intact tendon. This is referred to as the teres minimis; some literature refer to it as teres micro.
The teres minor originates at the lateral border and adjacent posterior surface of thescapula. It inserts at the greater tubercle of the humerus. The tendon of this muscle passes across, and is united with, the posterior part of the capsule of theshoulder-joint.
The muscle is innervated by the posterior branch ofaxillary nerve where it forms apseudoganglion.[3] A pseudoganglion has no nerve cells but nerve fibres are present. Damage to the fibers innervating the teres minor is clinically significant.
Sometimes a group of muscle fibres from teres minor may be fused withinfraspinatus.
Theinfraspinatus and teres minor attach tohead of the humerus; as part of therotator cuff they help hold the humeral head in the glenoid cavity of the scapula. They work in tandem with theposterior deltoid to externally (laterally) rotate the humerus, as well as adduction.Teres Minor can produce only very small scapular plane adduction during maximal contraction (Hughes RE, An KN 1996) with adductor moment arm of approximately 0.2 cm at 45° of shoulder internal rotation and approximately 0.1 cm at 45° of shoulder external rotation.
There are two types ofrotator cuff injuries: acute tears and chronic tears.
Acute tears occur as a result of a sudden movement. This might include throwing a powerful pitch, holding a fast moving rope during water sports, falling over onto an outstretched hand at speed, or making a sudden thrust with the paddle in kayaking.
A chronic tear develops over a period of time. They usually occur at or near the tendon, as a result of the tendon rubbing against the underlying bone.[4] The teres minor is typically normal following a rotator cuff tear.[5]
Atrophy of the teres minor muscle is often a consequence of arotator cuff tear, but common isolated teres minor atrophies have also been found. Aquadrangular space syndrome causes excessive and or chronically compression of the structures which pass through this anatomical tunnel. Theaxillary nerve and theposterior humeral circumflex artery pass through the space. People affected note shoulder pain andparesthesia down the arm first and foremost in abduction, extension, external rotation and overhead activity. Selective atrophy of the teres minor muscle has been seen and pulled together directly with compression of the corresponding axillary nerve branch or posterior humeral circumflex artery. Fibrous bands,cysts of theglenoid labrum,lipoma or dilated veins can occupy the quadrilateral space pathologically. Similar symptoms are common with anteriorshoulder 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 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. Extracellularedema after traumatic events causing neural damage show an increased signal intensity on T2-weighted MRI sequences and normal intensity on T1-weighted sequences. Posterior humeral circumflex artery compression and reduced blood flow in stressful arm positions and or maneuvers can be diagnosed by aDoppler ultrasonography. 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. For a detailed assessment of the artery, aMR angiography is required. The major task of an ultrasonographic examination is to rule out any space occupying mass. Additionalelectromyography is helpful to reveal any decelerated nerve conduction velocity, and thus denervation of the concerned muscle.[6]
This article incorporates text in thepublic domain frompage 441 of the 20th edition ofGray's Anatomy(1918)
