Kine305: Ch. 13 Shoulder Joint

Exam 2

What movements are associated with the shoulder joint?

Flexion/Extension

Abduction/Adduction

Medial/Lateral rotation

Horizontal Abduction/Horizontal Adduction

Circumduction (moving through all planes)

Scaption (inbetween abduction and flexion)

Shoulder joint flexion ROM

0-180

Shoulder joint extension ROM

0-60

Shoulder joint abduction ROM

0-180

Shoulder joint adduction ROM

0, anatomical position

Shoulder joint medial rotation ROM

0-70

Shoulder joint lateral rotation ROM

0-90

Shoulder joint horizontal abduction ROM

0-30

Shoulder joint horizontal adduction ROM

0-120

What is the concave/convex relationship in a glenohumeral joint?

Convex on concave (think about how the humerus head is bigger than the glenoid fossa) also this means distal and proximal segments are moving opposite to each other

As you abduct the arm, you arm moves ___ and glides ___

superior and inferior

What is the primary arthrokinematic motion with flexion/extension?

spin

What is the labrum?

Fibrocartilage ring attached to the rim of the glenoid fossa, it deepens the fossa in a way to get more stability and encircles that glenoid fossa to provide more stability, also decreases friction on the joint surfaces and helps with shock absorption

Bones and landmarks of the scapula

Acromion process

Infraglenoid tubercle

Supraglenoid fossa

Coracoid process

Glenoid fossa

Glenoid labrum

Supraspinous fossa

Infrasinous fossa

Axillary border

Subscapular fossa

Bones and landmarks of the humerus

Head

Surgical neck (common surgical site)

Anatomical neck

Shaft

Greater tubercle (bigger, more posterior, where rotator cuff insertion points will be)

Lesser tubercle (more anterior, where rotator cuff insertion points will be)

Bicipital groove

Bicipital rides

What are the other ligaments and structures of the shoulder joint?

Joint capsule

Glenohumeral ligaments (superior, middle, inferior)

Coracohumeral ligament

Transverse humeral ligament

Coracohumeral ligament

Spans anteriorly from the corocoid process, medially to the humerus and reinforces the superior portion of the joint so is important for supporting the joint capsule

Transverse humeral ligament

Attaches to the tubercles and lip of bicipital groove and closes bicipital groove anteriorly, can click if there is a tear in the ligament which means tendon with a lot of force coming through it thats not staying in place, bumping all around so overtime wear and tear

Why do we need all of this in our GH joint?

Bc there is so much stuff that goes on in our GH joint, a lot of motion and force so you need all these structures to provide that secondary layer for stability

Bursa

Little sacs filled with fluid, shock absorbing and reduce friction based on where they are, the shoulder has a lot of them because there is a lot going on

Subdeltoid bursa and subacromial bursa

Serve the purpose of calming friction down and protecting the tendon from rubbing on the joint, better shelf life for those muscles

What is the close-pack for sternoclavicular and shoulder joint?

Full abduction and external rotation

What is close-pack?

When joint surfaces are closest together

What is the end feel for sternoclavicular and shoulder joint?

Firm

What muscles are innervated by the axillary nerve?

Deltoids and teres minor

What muscles are innervated by the musculocutaneous nerve?

corachobrachialis, biceps brachii, and brachialis

What are the muscles of the shoulder joint?

Deltoid (anterior, middle, and posterior portion)

Latissiumus Dorsi

Teres major

Pec major (clavicular and sternal portion)

Coracobrachialis

Rotator Cuff (SITS- supraspinatus, infraspinatus, teres minor, and subscapularis)

Where does the deltoid insert?

Deltoid tuberosity

Subscapulohumeral rhythm

Scapula has minimal movement through first 30 degrees of SJ abduction

Deltoid and rotator cuff

Force couple, deltoid is strong abductor and as we activate the deltoid, they will provide a superior force to the proximal end of the humerus. so without the rotator cuff, that humeral head would end up jammed in acromion process. rotator cuff is a big stabilizing force in GH joint.

Shoulder subluxation

common pathology, when head of humerus moves but not completely out of glenoid fossa

Shoulder dislocation

common pathology, when you have full seperation of bone out of socket, often need to put back in (primarily anterior bc of extension so falling on an outstretched arm)

Fractures

common pathology, neck, mid humeral (mostly twisting), and pathological (cancer, osteoporosis)

Impingement syndrome

common pathology, most common area is supraspinatus muscle and greater tuberosity (slumping and reaching forward, rotator cuff is being compressed under the acromion) so it will get irritated or inflamed

Adhesive capsulitis

frozen shoulder, not too known why it happens, restricted ROM, story about PT sister who saw patient in thawing phase and had him in flexion and it popped and made loud sound

Torn rotator cuff

tear as one or more tendons of the rotator cuff muscles (most commonly supraspinatus)

Labral tear

Tear of the glenoid labrum (fibrocartilaginous rim attached to the glenoid cavity), leads to shoudler pain, instability or mechanical symptoms, risk factors: athletes (baseball, volleyball), history of shoulder instability, causes: trauma, heavy lifting, sudden traction injury, overhead activity

Calcific tendinitis

like an overuse of the muscle, deposition of calcium hydroxyapatite crystals within a tendon, most commonly affects supraspinatus tendon of the rotator cuff, causes acute or chronic shoulder pain

Biceps brachii tendonitis

Inflammation (acute) of the long head of the biceps tendon, most commonly occur in the bicipital groove of the humerus, often associated with rotator cuff pathology