HEALTH SCIENCES365

Chapter 5 – Shoulder Joint

Bones of the Shoulder Joint

ClavicleScapula

Humerus
Head
Anatomical Neck
Greater Tubercle
Lesser Tubercle
Intertubercular Groove (bicipital)
Surgical Neck
Deltoid Tuberosity
Radial Groove
Med. & Lat. Supracondylar Ridges
Med. & Lat. Epicondyles
Capitulum
Trochlea
Olecranon Fossa
Coronoid Fossa
Radial Fossa /
Shoulder Joint

Glenohumeral Joint (enarthrodial) (Relationship between stability and mobility)

  • Glenoid Labrum ______
  • Superior, Middle, & Inferior Glenohumeral ligaments ______
  • Coracohumeral ligament ______
  • Transverse Humeral ligament ______
  • Capsule ______
  • Subacromial bursae ______

Shoulder Joint Movements & Range of Motion
Abduction: 90° (180° w/ shoulder girdle)
Adduction: 75°
Flexion: 90° (180° w/ shoulder girdle)
Extension (Hyperextension): 45° - 60° / Internal Rotation: 90°
External Rotation: 90°
Horizontal Abduction: 45°
Horizontal Adduction: 130°
Movements of the Shoulder
Flexion – movement of humerus anteriorly from any point in the saggital plane / Extension – movement of the humerus posteriorly from any point in saggital plane
Abduction – upward lateral movement of humerus in the frontal plane away from body / Adduction – downward medial movement of humerus in frontal plane toward body from abduction
External Rotation – movement of the humerus laterally in the transverse plane around its long axis away from the midline / Internal Rotation – movement of the humerus medially in the transverse plane around its long axis toward the midline
Horizontal Adduction – movement of humerus in a horizontal or transverse plane anteriorly and across the chest / Horizontal Abduction – movement of the humerus in a horizontal or transverse plane posteriorly away from the chest
Myotome & Cutaneous Distribution of Axillary & Musculocutaneous Nerves
Muscles of the Shoulder
Pectoralis Major (upper fibers - claviclar head)
O. Medial half of anterior surface of clavicle
I.Lateral lip of the intertubercular groove of humerus
A. ______
______
N. Lateral Pectoral
Pectoralis Major (lower fibers -sternal head)
O. Anterior surface costal cartilage of first six ribs & adjacent sternum
I. Lateral lip of the intertubercular groove of humerus
A. ______
______
N. Medial Pectoral
Deltoid (anterior)
O. Anterior surface of lateral 1/3 of clavicle
I. Deltoid tuberosity
A. ______
______
N. Axillary
Deltoid (middle)
O. Lateral surface of acromion process
I. Deltoid tuberosity
A. ______
______
N. Axillary
Deltoid (posterior)
O. Lower border of spine of scapula
I. Deltoid tuberosity
A. ______
______
N. Axillary
Latissimus Dorsi
O. Spinous processes of T6-T12 and L1-L5, posterior iliac crest, posterior
sacrum, and lower 3 ribs
I. Medial lip in intertubercular groove
A. ______
______
N. Thoracodorsal
Coracobrachialis
O. Coracoid process of scapula
I. Middle of medial border of humerus
A. ______
______
N. Musculocutaneous
*Subscapularis
O. Subscapular fossa of scapula
I.Lesser tubercle of humerus
A. ______
______
N.Upper and Lower Subscapular
*Supraspinatus
O.Supraspinous fossa of scapula
I.Greater tubercle of humerus (upper facet)
A. ______
______
N.Suprascapular
*Infraspinatus
O. Infraspinous fossa of scapula
I.Greater tubercle of humerus (posterior middle facet)
A. ______
______
N.Suprascapular
*Teres Minor
O. Posteriorly on the upper lateral border of scapula
I. Greater tubercle of humerus (posterior middle facet)
A. ______
______
N.Axillary
Teres Major
O. Lower 1/3 lateral border of scapula & just superior to inferior angle
I.Medial lip of the intertubercular groove of humerus (posterior to lats)
A. ______
______
N.Lower Subscapular

*Rotator Cuff (SITS)

a. Rotation force on the humerus

b. Stabilization of head of humerus in glenoid fossa

c. Deceleration (eccentric) of humerus following forceful concentric motions

  • Injuries: Etiology: Repetitive movement of upper limb above horizontal resulting

in recurrent inflammation (musculotendinous junction tears) of the rotator cuff (supraspinatus impingement on coracoacromial arch)

Pull-up:

  1. Primary mover: ______
  2. Grip Differences
  • Supinated grip - ______
  • Pronated grip - ______

______

  1. Muscle involvementdifferences?

Supinated Grip
(Saggital plane - extension) / Pronated Grip
(Frontal plane - adduction)
Conditions/Deviations

Shoulder Dislocation

  1. Mechanism of Injury (MOI):
  2. Soft tissue damage
  3. Nerve damage
  4. Position/support of injured extremity:

Subacromial Bursitis: Pain occurs during 50° to 130° abduction