The Shoulder & Shoulder Girdle

What is the purpose of the upper extremity?

to position the hand in various points in space for maximal function

What is the most mobile joint in the body?

glenohumeral joint

Is the shoulder more flexible or stable?

flexible

What makes up the shoulder complex?

-scapula

-clavicle

-sternum

-humerus

-ribcage

What are the joints of the shoulder complex?

-glenohumeral

-sternoclavicular

-acromioclavicular

-scapulothoracic

What makes up the shoulder girdle?

-scapula

-clavicle

-sternum

Where is the superior angle of the scapula (picture)?

Where is the inferior angle of the scapula (picture)?

Where is the vertebral border of the scapula (picture)?

towards the vertebrae

Where is the axillary border of the scapula (picture)?

towards the armpit

Where is the spine of the scapula (picture)?

Where is the coracoid process of the scapula (picture)?

Where is the acromion process of the scapula (picture)?

Where is the glenoid fossa (picture)?

Where is the sternal end of the clavicle (picture)?

medial

Where is the acromial end of the clavicle (picture)?

lateral

Where is the manubrium of the sternum (picture)?

Where is the xiphoid process of the sternum (picture)?

What type of joint is the sternoclavicular joint?

synovial

What is the sternoclavicular joint?

where the clavicle meets the sternum

What is the only direct attachment of the axial skeleton to the appendicular skeleton of the UE?

sternoclavicular joint

How much movement is in the sternoclavicular joint?

relatively little

How many degrees of freedom does the sternoclavicular joint?

3

During shoulder elevation, the clavicle moves in which direction?

superior

During shoulder depression, the clavicle moves in which direction?

inferior

What type of joint is the acromioclavicular joint?

synovial

What is the acromioclavicular joint?

where the acromion process meets the end of the scapula

Movement at the acromioclavicular joint occurs to accompany what?

movement of the sternoclavicular joint during scapular upward rotation

What type of joint is the scapulothoracic articulation?

not a true joint

What structure comes together to form the scapulothoracic articulation?

none

What is the scapulothoracic articulation?

where the scapula articulates with the posterior thoracic rib cage

What are the ligaments of the sternoclavicular joint?

-sternoclavicular ligament

-costoclavicular ligament

-interclavicular ligament

What is the sternoclavicular ligament?

reinforces the joint capsule; limits anterior and posterior movement of the clavicle's medial end

What is the costoclavicular ligament?

limits clavicular elevation

What is the interclavicular ligament?

limits clavicular depression

What are the ligaments of the acromioclavicular joint?

-coracoclavicular ligament (2)

-coracoacromial ligament

What is the coracoclavicular ligament?

prevents backward motion and rotation of scapula

What is the coracoacromial ligament?

protective arch over head of humerus

Which ligament is goes across the same bone?

coracoacromial ligament

What are the joint motions of the scapula?

-elevation

-depression

-protraction (scapular abduction

-retraction (scapular adduction)

-upward rotation (scapular lateral rotation)

-downward rotation (scapular medial rotation)

-scapular tilt

What is another name for scapular retraction?

scapular adduction

What is another name for scapular protraction?

scapular abduction

What is another name for scapular upward rotation?

scapular lateral rotation

What is another name for scapular downward rotation?

scapular medial rotaiton

What is scapulohumeral rhythm?

beyond the first 30 degrees, for every 2 degrees of shoulder flexion/abduction, there is 1 degree of scapular movement

If a shoulder is flexed at 90 degrees what is the degree of the GH joint and the degree of scapular upward rotation?

GH joint: 60 degrees

Scapular Upward Rotation: 30 degrees

What happens without proper scapulohumeral rhythm?

the joint will lack mobility; it will create tearing/fraying of the supraspinatus

What are the muscles of the shoulder girdle?

-trapezius

-levator scapula

-rhomboids

-serratus anterior

-pectoralis minor

What is the glenohumeral joint?

where the humeral head and the glenoid fossa meet

What type of joint is the glenohumeral joint?

synovial; ball and socket

What is one of the most unstable joints of the body?

glenohumeral joint

What is a scaption?

abduction in the scapular plane

What is the scapular plane?

movement 30 degrees forward of the frontal plane

Does flexion/extension of the shoulder spin or glide?

spin

Does abduction/adduction of the shoulder spin or glide?

glide

Does medial/lateral rotation of the shoulder spin or glide?

glide

Does horizontal abduction/adduction spin or glide?

glide

Does scaption of the shoulder spin or glide?

glide

What is circumduction of the shoulder?

combination of movements

Where is the glenoid fossa of the scapula (picture)?

Where is the glenoid labrum of the scapula (picture)?

Where is the subscapular fossa of the scapula (picture)?

Where is the infraspinous fossa of the scapula (picture)?

Where is the supraspinous fossa of the scapula (picture)?

Where is the surgical neck of the humerus (picture)?

Where is the anatomical neck of the humerus (picture)?

Where is the greater tubercle of the humerus (picture)?

Where is the lesser tubercle of the humerus (picture)?

Where is the deltoid tuberosity (picture)?

Where is the bicipital groove of the humerus?

What is the glenohumeral ligament?

connects humerus to the glenoid cavity

What is the coracohumeral ligament?

strengthens the upper part of the joint capsule

What is the rotator cuff?

tendons and muscles in the shoulder, connecting the humerus to the scapula

What is the glenoid labrum?

fibrocartilage that deepens the articular cavity

What is the thoracolumbar fascia?

broad attachment for latissimus dorsi

What are the muscles of the shoulder?

-deltoids

-supraspinatus

-pectoralis major

-latissimus dorsi

-teres major

-infraspinatus

-teres minor

-subscapularis

-coracobrachialis

What muscles make up the rotator cuff?

-supraspinatus

-infraspinatus

-teres minor

-subscapularis

What does the glenoid labrum do?

provides stability and improves congruency

What is the shoulder joint capsule?

thin-walled capsule surrounds the glenohumeral joint; creates partial vacuum to maintain humeral head on the glenoid fossa

What does the shoulder joint capsule attach to?

rim of glenoid fossa and neck of humerus

Once the vacuum of the shoulder joint capsule has been removed what happens?

it can not be repaired so the probability of reoccurrence is increased

What is the normal ROM for shoulder flexion?

180 degrees

What is the normal ROM for shoulder extension?

60 degrees

What is the normal ROM for shoulder abduction?

180 degrees

What is the normal ROM for shoulder adduction?

no norms

What is the normal ROM for shoulder lateral rotation?

90 degrees

What is the normal ROM for shoulder medial rotation?

70 degrees

What is a torn rotator cuff?

tearing of one or more of the rotator cuff tendons

What can cause a torn rotator cuff?

acute, traumatic instance, repetitive overuse, gradual degradation

Which rotator cuff muscle is most commonly torn?

supraspinatus

What is often a contributor to rotator cuff tears that happen over time?

poor scapulohumeral rhythm

What is impingement syndrome?

compression of the tissue structures between the acromial arch and the humerus

What is biceps tendonitis?

inflammation of the tendon of the long head of the biceps

What is adhesive capsulitis?

inflammation of the joint capsule that surrounds the glenohumeral joint

What is another adhesive capsulitis?

frozen shoulder

What is a shoulder dislocation?

total loss of joint congruency

What is an anterior shoulder dislocation?

combining excessive horizontal abduction and lateral rotation

What is a posterior shoulder dislocation?

combining excessive horizontal adduction and medial rotation

What is one of the most common joint dislocations?

anterior dislocation of the glenohumeral joint