upper extremity (KIN 361)

what are the bones of the shoulder 

humerus, clavicle, and scapula 

what are the important bony landmarks

lesser and greater tuberosity (humerus)

bicipital groove

acromion and coracoid process (scapula)

what are the joints of the shoulder

scapulothoracic articulation

glenohumeral joint

superhumeral articulation

acromioclavicular joint

sternoclavicular joint 

what is the anatomy of the glenohumeral joint 

glenoid cavity 

labrum

long head of biceps brachii

what is the anatomy of the acromioclavicular joint

acromion, acrocoracoid ligament, clavicle, coracoclavicular ligament

what is the anatomy of the sternoclavicular joint

it is a gliding joint that relies heavily on ligaments for stability since there is not a lot of bony stability (also relies on muscles)

what is the anatomy of the scapulothoracic articulation

scapular, humerus, glenohumeral joint, AC joint, clavicle, and the 13 muscles that are attached to the scapula

what are the ligaments of the shoulder complex

coracohumeral ligament, coracoacromial ligament, coracoclavicular ligament, and glenohumeral ligament 

what are the movements of the glenohumeral joint

flexion/extension

abduction/adduction

outward/inward rotation

horizontal adduction/abduction

what are the movements of the scapula

lots of translation since the scapula doesn’t have bony attachment

elevation and depression (sliding up and down)

abduction/protraction and adduction/retraction (moving outward from midline and then back toward spinal column)

upward rotation and downward rotation

anterior and posterior tilt

what is scapulohumeral rhythm 

0-30 degrees abduction is all glenohumeral motion and after 30 degrees there is a 2:1 ratio of glenohumeral to upward scapular rotation 

what are the muscles of the rotator cuff

infraspinatus, supraspinatus, subscapularis, teres minor

where is the subscapularis origin and insertion

subscapular fossa of the scapula

lesser tuberosity of the humerus

what is the movement of the subscapularis 

internal medial rotation, adduction, and stabilization of the glenoid cavity 

what is the origin and insertion of the infraspinatus

infraspinous fossa of the scapula

greater tuberosity of the humerus

what is the movement of the infraspinatus

external rotation of the arm, stabilization of glenoid cavity

what is origin and insertion of the supraspinatus 

supraspinous fossa of the scapula 

greater tuberosity of the humerus 

what is the movement of the supraspinatus 

initiation of abduction of the arm (first 30 degrees)

stabilizes humeral head in glenoid cavity during shoulder movements 

what is the origin and insertion of the teres minor

lateral border of the scapula

greater tuberosity of the humerus

what is the movement of the teres minor

external rotation, adduction and extension, stabilizes humeral head of the glenoid cavity

what are the origin and insertion of upper trapezius 

occipital bone and upper c spine spinous process 

outer third of clavicle, acromion 

what are the origin and insertion of the mid trapezius

spinous process (c7-t3)

spine of scapula

what are the origin and insertion of the lower trapezius

spinous processes mid lower thoracic

base of scapular spine

what are the origin and insertion of the rhomboid major and minor 

C7-T5 (C7-T1 and then T1-T5 for major and minor )

medial border of the scapula

what are the motions of the rhomboid major and minor

retraction and downward rotation (important for posture and sitting up strength)

what are the origins of the deltoid 

anterior: lateral 3rd of clavicle 

mid: acromion process

posterior: spine of scapula 

what is the insertion of the deltoid

deltoid tuberosity

what is the motion of the deltoid

abduction and flexion/extension, horizontal abduction/adduction

what is the origin and insertion of the levator scapulae 

transverse processes of C1-4

medial border at superior angle 

what is the motion of the levator scapulae

elevates scapula causing acromion to drop

what is the origin and insertion of the serratus anterior

lateral surface of upper 8 ribs (proximal to trunk)

medial scapular border, anterior (underneath on anterior side)

what is the motion of the serratus anterior

protraction that pulls medial border down (how scap moves on trunk) 

what is the origin and insertion of the latissimus dorsi

spinous process T7-L5, posterior sacrum, iliac crest and lower 3 ribs

inferior angle of scapula and medial floor of bicipital groove

what is the motion of the latissimus dorsi

adductor and internal rotator

what is the origin and insertion of the pectoralis minor 

anterior ribs 3-5

coracoid process 

what is the origin and insertion of the pectoralis major

medial 3rd of clavicle, sternum, and cartilage of ribs 1-6

lateral edge of bicipital groove

what is the motion of the pectorals minor

scapular depression and downward rotation

what is the motion of the pectorals major

internal rotation of the glenohumeral joint, horizontal adduction, flexor

what is the origin and insertion of the teres major 

lateral border, inferior angle of scapula

below lesser tubercle 

what is the motion of the teres major

some adduction, internal rotation, some extension (if arm is already flexed)

what is the origin and insertion of the coracobrachialis

coracoid process

medial surface of mid humerus

what is the motion of the coracobrachialis 

flexion, some internal rotation, some adduction 

what are the common injuries of the shoulder girdle

rotator cuff tear (strain)

shoulder impingement

labrum tears (SLAP)

what are causes of the rotator cuff tears

overuse, FOOSH (fall on outstretched hand)

what happens during a shoulder impingement 

tissue is impinged between the humerus and acromion due to overuse and inflammation 

what happens during a labrum tear

the biceps brachii tendon pulls on the glenoid labrum causing it to tear away from the humerus (SLAP - superior labrum anterior posterior tear)