Unit 3; Upper Extremity

Bones, Muscles, Joints, Joint Function, Joint Actions, Insertions, Origins

Shoulder Complex

Shoulder Joint + Shoulder Girdle

Shoulder Joint

Ball and Socket Joint (aka glenohumeral joint) that focuses on the movement of the humerus

Shoulder Girdle

False joint (scapulothoracic joint) that puts the glenoid fossa in a favorable position to allow diverse movements of humerus

Shoulder Girdle Bones

Clavicle and Scapula

Shoulder Joint Bones

Scapula and Humerus

Shoulder Girdle Joints

Acromioclavicular, Sternoclavicular, and Scapulothoracic

Shoulder Joint Joint

Glenohumeral Joint

Sternoclavicular Joint

Connects upper extremity to the trunk; Plane joint

Acromioclavicular Joint

Maintains relationship between the clavicle & scapula in early stages of shoulder elevation

Allows scapula extra ROM about thorax in latter stages of elevation

Plane joint

Scapulothoracic Joint

A false joint with no ligamentous support

Shoulder Girdle Movements

Elevation, Depression, Upward Rotation, Downward Rotation, Adduction (retraction), Abduction (protraction)

Glenohumeral Joint Actions

Flexion, Extension, Abduction, Adduction, External Rotation, Internal Rotation, horizontal shoulder abduction, horizontal shoulder adduction, diagonal abduction, diagonal adduction

Shoulder Girdle Muscles

Pectoralis Minor, Serratus Anterior, Trapezius, Rhomboids, and Levator Scapulae

Pectoralis Minor Origin and Insertion

Originates in the anterior surfaces of 3rd-5th ribs, inserts into the coracoid process

Pectoralis Minor actions and integrated function(s)

Protraction, downward rotation, and depression. Stabilizes the shoulder girdle as well and works synergistically with the pec major and decelerates the opposing actions.

Serratus Anterior actions and integrated functions

Scapular protraction and upward rotation. Provides dynamic stabilization to the S.T. joint and decelerates the opposing actions.

Lower trapezius action and integrated functions

Scapular depression, retraction, and upward rotation. Works with upper trap and serratus anterior to protract scapula during elevation, helps maintain appropriate length tension relationship of the RC mm., and isometric stabilization of scapula.

Middle trapezius action and integrated functions

Scapular elevation, retraction, and upward rotation. Stabilizes medial border of the scapula and gives a stable base for the prime movers during abduction and upward rotation. Works with lower trap and serratus anterior for abduction and UR during humeral elevation.

Upper trapezius action and integrated functions

Scapular elevation, upward rotation (and cervical extension and rotation). Creates a force couple with other muscles and provides stabilization to the cervical spine.

Rhomboids origin and insertion

Originates in the spinous processes of the last cervical and 1st 5 thoracic vertebrae. Inserts into the medial border of the scapula below the scapula spine.

Rhomboids actions and integrated functions

Scapular retraction, downward rotation, and elevation. Helps decelerates the opposite actions and isometric stabilization of the scapula.

Levator Scapulae actions and integrated functions

Scapular elevation (primarily), downward rotation, and adduction. Helps decelerates opposing actions and isometrically stabilizes the cervical spine and scapula.

Pectoralis Major (upper) origin and insertion

Originates in the medial half of anterior surface of clavicle. Inserts into the flat tendon 2-3” wide to lateral lip of intertubercular groove of humerus.

Pectoralis Major (lower) origin and insertion

Originates in the anterior surface of costal cartilages of 1st 6 ribs and adjoining portion of the sternum. Inserts into the flat tendon 2-3” wide to lateral lip of intertubercular groove of humerus.

Pectoralis Major (upper) actions and integrated functions

Shoulder internal rotation, horizontal shoulder adduction, diagonal adduction, flexion, and abduction. Isometrically stabilizes the shoulder girdle.

Pectoralis Major (lower) actions and integrated functions

Shoulder internal rotation, horizontal shoulder adduction, diagonal adduction, extension, and adduction. Isometrically stabilizes the shoulder girdle.

Coracobrachialis action

Shoulder flexion, adduction, and horizontal shoulder adduction

Anterior Deltoid action and integrated function

Shoulder abduction, flexion, horizontal shoulder adduction, internal rotation, diagonal adduction. Works synergistically with pecs.

Medial Deltoid action and integrated function

Shoulder abduction, horizontal abduction. Works as a force-couple with the supraspinatus during abduction.

Posterior Deltoid action and integrated function

Shoulder abduction, extension, horizontal shoulder abduction, external rotation, and diagonal abduction. Assists in deceleration of shoulder following throwing/hitting.

Latissimus Dorsi action

Shoulder extension, adduction, and internal rotation

Teres Major action

Shoulder extension and internal rotation

Supraspinatus action and integrated function

Shoulder abduction. Works w/ other RC mm. to dynamically stabilize the humeral head in the glenoid fossa and initiates abduction and dynamic caudal glide when the deltoid acts as the prime mover during shoulder abduction.

Infraspinatus action and integrated function

Shoulder external rotation, horizontal shoulder abduction, extension, diagonal abduction. Works synergistically w/ other RC mm. to dynamically stabilize the humeral head in the glenoid fossa during functional movements and produce dynamic caudal glide of the humeral head in the glenoid fossa during elevation.

Teres Minor action and integrated function

Shoulder external rotation, horizontal shoulder abduction, extension, diagonal abduction. Works w/ other RC mm. to dynamically stabilize the humeral head in the glenoid fossa during dynamic activity and works synergistically to produce a dynamic caudal glide of the humeral head in the glenoid fossa during elevation to prevent impingement.

Subscapularis action and integrated function

Shoulder internal rotation, adduction, and extension. Works synergistically w/ the other RC mm. to stabilize the humeral head in the glenoid fossa during functional activities and decelerates shoulder opposing actions during dynamic activities.

Elbow Joints

Humeroulnar and radioulnar joint

Biceps Brachii Long Head Origin and Insertion

Originates in the supraglenoid tubercle above the superior lip of the glenoid fossa. Inserts into the radial tuberosity and bicipital aponeurosis.

Bicep Brachii Short Head Origin and Insertion

Originates in the coracoid process and upper lip of glenoid fossa, inserts into the radial tuberosity and bicipital aponeurosis.

Bicep Brachii long/short head action and integrated function

Radioulnar supination, elbow flexion, weak glenohumeral flexion and abduction. Isometrically stabilizes elbow and shoulder girdle.

Brachialis Origin and Insertion

Originates in the distal ½ of anterior humerus, inserts into the coranoid process of the ulna.

Brachialis action

Elbow flexion with more isolation in pronation.

Brachioradialis Origin and Insertion

Originates in the distal 2/3 of lateral supracondylar ridge of humerus and inserts into the lateral surface of distal end of radius at styloid process.

Brachioradialis action and integrated function

Elbow flexion and radioulnar pronation and supination to neutral. Isometrically stabilizes the elbow.

Pronator Teres action and integrated function

Radioulnar pronation and weak elbow flexion. Isometrically stabilizes proximal radioulnar joint and elbow.

Pronator Quadratus action and integrated function

Radioulnar pronation. Isometrically stabilizes the radioulnar joint.

Triceps Brachii Long Head Origin and Insertion

Originates in the infraglenoid tubercle below inferior lip of glenoid fossa, inserts into the olecranon process of ulna.

Triceps Brachii Medial Head Origin and Insertion

Originates in the distal 2/3 posterior humerus. Inserts into the olecranon process of ulna.

Triceps Brachii Lateral Head Origin and Insertion

Originates in the upper ½ posterior humerus. Inserts into the olecranon process of ulna.

Triceps Brachii action and integrated function

Elbow extension, (long head) glenohumeral extension and adduction. Isometrically stabilizes shoulder girdle (long head) and elbow.

Supinator action and integrated function

Radioulnar supination. Isometrically stabilizes radioulnar joint and elbow.

Anconeus Origin and Insertion

Originates in the posterior surface of lateral condyle of humerus. Inserts into posterior surface of lateral surface of olecranon and proximal ¼ of ulna.

Anconeus action and integrated function

Elbow extension. Isometrically stabilizes elbow.

Biceps brachii long head origin and insertion

Originates from the supraglenoid tubercle of the scapula, inserts into the radial tuberosity and bicipital aponeurosis