Rotator cuff injuries represent a common cause of shoulder pain. Rotator cuff syndrome (RCS) describes a spectrum of clinical pathology ranging from minor injuries such as acute rotator cuff tendinitis to advanced/chronic rotator cuff tendinopathy and degenerative conditions. On the Bear hug test, the patient places the ipsilateral palm on the opposite deltoid and tries to resist the examiner pulling it away anteriorly. The test is positive if the patient is unable to lift the hands away from the back. In the lift-off test, the patient brings the hands around the back to the lumbar region with the palms facing outward. Subscapularis muscle: Evaluating this muscle uses the 'lift-off' and the 'bear hug' test. It enters the posterior scapular region through the quadrangular space (accompanied by the axillary nerve) and supplies the teres minor muscle.Īll lymphatics from the upper limb drain into lymph nodes in the axilla. The posterior circumflex humeral artery originates from the third part of the axillary artery in the axilla. It gives vascular supply to the subscapularis muscle. It originates from the third part of the axillary artery, follows the inferior margin of the subscapularis muscle, and then divides into the circumflex scapular artery and the thoracodorsal artery. The subscapular artery is the largest branch of the axillary artery. It enters the posterior scapular region superior to the suprascapular foramen (the nerve passes through the foramen) and supplies the supraspinatus and infraspinatus muscles. The suprascapular artery is a branch of the thyrocervical trunk (a major branch of the subclavian artery) and originates at the base of the neck. The vascular supply to the rotator cuff muscles is mainly via the suprascapular artery, the subscapular artery, and the posterior circumflex humeral artery.

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