OTD 512 Midterm Shoulder

Elbow Joint

Hinge Joint

Wrist Joint

Ellipsoid Joint

Origin of Trapezius

External occipital protuberance, medial portion of superior nuchal line of the occiput, ligamentum nuchae, and spinous processes of C-7 through T12

Insertion of Trapezius

Lateral one-third of clavicle, acromion, and spine of the scapula T

Nerve Innervation of Trapezius

Spinal portion of cranial nerve XI (accessory) and ventral ramus C2 to C4

Movement of Trapezius

Bilaterally: Extend Head and neck

Unilaterally: Laterally Flex the head and neck to the same side

Rotate neck to opposite side

Elevate the Scapula

Origin of Levator Scapulae

 Transverse processes of C1-C4

Insertion of Levator Scapulae

Medial border of scapula between superior angle and superior portion of spine of scapula

Nerve Innervation of Levator Scapulae

Cervical C3 and C4, and dorsal scapular C4 and C5

Movement of Levator Scapulae

Elevate the Scapula

Downwardly rotate Scapula

Laterally Flex Head and Neck

Rotate head and Neck to same side

Origin of Rhomboid Major

 Spinous Processes of T2 - T5

Insertion of Rhomboid Major

Medial border of the scapula between the spine of the scapula and inferior angle

Nerve Innervation of Rhomboid Major

Dorsal Scapular C4 and C5

Movement of Rhomboid Major and Minor

Adduct the Scapula

Elevate the Scapula

Downwardly rotate the scapula

Origin of Rhomboid Minor

Spinous processes of C-7 and T-1

Insertion of Rhomboid Minor

Upper portion of medial border of the scapula, across from spine of the scapula

Nerve Innervation of Rhomboid Minor

Dorsal Scapular C4 and C5

Origin of Serratus Anterior

 External surfaces of upper eight or nine ribs

Insertion of Serratus Anterior

Anterior surface of medial border of the scapula

Nerve Innervation of Serratus Anterior

 Long thoracic C5 to C8

Movement of Serratus Anterior

Adduct the Scapula

Upwardly rotate the scapula

Depress the Scapula

Holds medial border against rib cage

Origin of Infraspinatus

 Infraspinous fossa of the scapula

Insertion of Infraspinatus

Greater tubercle of the humerus

Nerve Innervation of Infraspinatus

Suprascapular C4 - C6

Movements of Infraspinatus

Externally rotate the shoulder

Shoulder Adduction

Stabilize the head of humerus in glenoid cavity

Origin of Supraspinatus

Supraspinous fossa of the scapula

Insertion of Supraspinatus

Greater tubercle of the humerus

Nerve Innervation of Supraspinatus 1

Suprascapular C4-C6 1

Movement of Supraspinatus

Shoulder Abduction

Stabilize the head of humerus in glenoid cavity

Origin of Subscapularis

Subscapular Fossa of the Scapula

Insertion of Subscapularis

 Lesser tubercle to the humerus

Nerve Innervation of Subscapularis

 Upper and Lower subscapular C5 - C7

Movement of Subscapularis

Internally rotate the shoulder

Stabilize head of humerus in glenoid cavity

Origin of Teres Major

Inferior angle and lower one-third of lateral border of the scapula

Insertion of Teres Major

Crest of the lesser tubercle of the humerus

Nerve Innervation of Teres Major

Lower subscapular C5 - C7

Movement of Teres Major

Shoulder Extension

Shoulder Adduction

Internally rotate the shoulder 

Origin of Teres Minor

Upper two-thirds of lateral border of the scapula

Insertion of Teres Minor

 Greater tubercle of the humerus

Nerve Innervation of Teres Minor

 Axillary C5 - C6

Movement of Teres Minor

Externally rotate the shoulder

Adduct the shoulder

Stabilize the head of humerus

Origin of Deltoid

Lateral one-third of clavicle, acromion, and spine of scapula D

Insertion of Deltoid

Deltoid Tuberosity

Nerve Innervation of Deltoid

Axillary C5 - C6

Movements of Deltoid

Shoulder Abduction

Shoulder Flexion/Extension

Internal/External Rotation

Horizontal Abduction

Movements around Scapulothoracic Joint

• Elevation/Depression

• Protraction/Retraction

• External/Internal Rotation

Movements around GlenoHumeral Joint

• Flexion/Extension

• Abduction/Adduction

• External/Internal Rotation

• Horizontal Abduction/Adduction

Subacromial Impingement

Compression of the soft tissues between acromion and humeral head

Thoracic Outlet Syndrome

Compression of structures in shoulder

Glenohumeral Sublaxation

Humeral Head partially dislocates inferiorly

Rotator Cuff Tear

Injury usually due to forceful loading of shoulder while elevated

Glenohumeral Joint Dislocation

• Involves damage to the labrum

• Most common dislocated joint in body

Osteoarthritis

• Can significantly limit function

• Requires activity modification or adaptive equipment

Crank and Relocation Test

Anterior Shoulder Instability

Jerk Test

Posterior Shoulder Instability

Rowe’s Test and Sulcus Sign

Inferior and Multidirectional Shoulder Instability

Hawkins-Kennedy Test

Impingement

Champagne Toast Test

Injury to supraspinatus

Drop Arm Codman’s Test

Tear in Rotator Cuff complex

Lift Off Sign

Lesion to Subscapularis

Empty Can or Jobe Test 

Tear to Supraspinatus