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35 Cards in this Set

  • Front
  • Back

Shoulder joint motions (glenohumeral)

flexion/extension/hyperextension


abduction and adduction


medial and lateral rotation


horizontal abduction and adduction


circumduction


scaption- 30 degrees forward of frontal plane

What movement occurs in the sagittal plane around frontal axis

flexion-0-180 degrees


extension- return to anatomical position


hyperextension- 45 degrees

What movements occur in the frontal plane around the sagittal axis

abduction and adduction with 180 degrees

Transverse plane around vertical axis

medial/lateral rotation- 90 degrees in each direction


horizontal abduction/adduction

Soft tissue stretch

normal end feel for all shoulder joint motions

Shoulder Joint structures

Joint capsule


coracohumeral ligament


glenoid labrum


rotator cuff (sits muscles)


thoracolumbar fascia

Joint capsule

thin walled spacious container that attaches around the rim of the glenoid fossa of the scapula and the anatomical neck of the humerus. glenoidhumeral ligaments reinforce the anterior portion

Coracohumeral ligament

attaches from the lateral side of the coracoid process and spans the joint anteriorly to the medial side of the greater tubercle. strengthens the upper part of joint capsule

Glenoid labrum

fibrous ring that surrounds the rim of the glenoid fossa. deepens the articular cavity

Rotator cuff (sits muscles)

subcapularis


supraspinatus


infraspinatus


teres minor




keeps the head of the humerus rotating against the glenoid fossa during joint motion



Thoracolumbar fascia

superficial fibrous sheet that attaches to the spinous processes of the lower thoracic and lumbar vertebrae, suprspinal ligament, and the posterior part of the iliac crest, covering the sacrospinalis muscle. provides broad attachment for the latissimus dorsi muscle.

Muscles of the Shoulder Joint

deltoid- anterior, middle, posterior


pectoralis major- clavicular & sternal portion


latissimus dorsi


teres major


supraspinatus


infraspinatus


teres minor


subscapularis


coracobrachialis


biceps brachii


triceps brachii

Anterior Deltoid

origin- lateral third of clavicle


insertion- deltoid tuberosity


action- shoulder abduction, flexion,internal rotation, horizontal adduction


nerve- axillary (C5-C6)

Middle Deltoid

origin- acromion process


insertion- deltoid tuberosity


action- shoulder abduction


nerve- axillary (C5-C6)

Posterior Deltoid

origin- spine of scapula


insertion- deltoid tuberosity


action- should abduction, extension/hyperextension, external rotation, horizontal abduction


nerve- axillary (C5-C6)

Inchworm Effect

concept that describes the action of the should girdle and the deltoid muscles especially the middle during shoulder abduction. origin of deltoid moves away from the insertion on the humerus. this motion lengthens the muscle restoring its contractile potential and allows it to continue to effectively contract throughtout its entire range.

Pectoralis Major

origin- clavicular portion- medial 3rd of clavicle sternal portion- costal cartilage of ribs 1-6


insertion- lateral lip of bicipital groove


action- clavicular portion- 1st 60 degrees of shoulder flexion. sternal portion- 1st 60 degrees of shoulder extension


shoulder adduction, internal rotation, horizontal adduction


nerve- lateral and medial pectoral nerve (C5-T1)

Latissimus Dorsi

origin- spinous process T7-L5, posterior surface of sacrum, iliac crest, lower 3 ribs


insertion- medial floor of bicipital groove on anterior humerus


action- shoulder extension, internal rotation, adduction, hyperextension


nerve- thoracodorsal nerve (C6-C8)

Coracobrachialis

origin- coracoid process of scapula


insertion- medial surface of humerus mid shaft


action- stabilize the shoulder joint


nerve- musculocutaneous nerve (C6-C7)

Teres Major

origin- axillary border of scapula near inferior angle


insertion- anteriorly on humerus at crest below lesser tubercle


action-shoulder extension, internal rotation,adduction


nerve- lower subscapula nerve (C5-C7)




latissimus dorsi's "little helper"

Supraspinatus

origin- supraspinatus fossa


insertion- greater tubercle


action- abduction


nerve- suprascapular nerve (C5-C6)

Infraspinatus

origin-infraspinatous fossa


insertion- greater tubercle


action- horizontal abduction, external rotation


nerve- suprascapular nerve (C5-C6)

Teres Minor

origin- axillary border near inferior angle


insertion- greater tubercle


action- horizontal abduction, external rotation


nerve- axillary nerve (C5-C6)

Subscapularis

origin- subscapular fossa


insertion- lesser tubercle of humerus


action- internal rotation


nerve- upper and lower subscapular nerve (C5-C6)

Anatomical relationship between shoulder girdle and joint

Girdle- muscles attach to the scapula and trunk to move or stabilize the scapula


Joint- muscles attach to the scapula and humerus to move the arm. superficial to girdle


This arrangement allows both sets of muscles to function without getting in each other's way.

Muscle innervation

injury below C6 will keep shoulder joint movements intact but yield weak shoulder extension


injury below C5 will weaken all shoulder joint movement and weaken shoulder extension

Major nerves of the upper limb

musculocutaneous


ulnar


radial


median


axillary

Common shoulder pathologies

acromioclavicular seperation


clavicular fracture


shoulder dislocation


impingement syndrome


adhesive capsulitis(frozen shoulder)


calcific tendonitis


rotator cuff tear

acromioclavicular separation

1st degree- stretched ligaments


2nd degree- stretched/torn ligaments


3rd degree- ruptured ligaments



Clavicular fracture

from fall on outstretched hand, most common in children

shoulder dislocation

extreme abduction and external rotation causes humeral head to slide anteriorly out of glenoid fossa

Impingement Syndrome

overuse where there is compression between acromial arch, humeral head, and soft tissues.


swimmer's shoulder

adhesive capsullitis

inflammation and fibrosis of joint capsule, leads to pain and loss of motion.


frozen shoulder

Calcific tendonitis

chronis inflammation that causes accumulation of mineral deposits, may be symptomatic or asymptomatic, common in supraspinatus tendon

Rotator cuff tear

tear of insertion tendons of SITS muscles from greater/lesser tubercle of humerus. may be chronic or acute