OTA 125 - UE Goni & Shoulder

Shoulder flexion - position

supine

Shoulder flexion - stationary arm

mid axillary line

Shoulder flexion - axis

head of humerus

Shoulder flexion - moveable arm

middle line of humerus

Shoulder flexion - normal range

0-180

Shoulder horizontal adduction - position

supine

Shoulder horizontal adduction - stationary arm

parallel to floor

Shoulder horizontal adduction - axis

acromium (superior aspect)

Shoulder horizontal adduction - moveable arm

middle line of humerus

Shoulder horizontal adduction - normal range

0-130

Shoulder internal rotation - position

supine

Shoulder internal rotation - stationary arm

perpendicular to floor

Shoulder internal rotation - axis

olecranon process of ulna

Shoulder internal rotation - moveable arm

middle line of Ulna in line with Ulna Styloid Process

Shoulder internal rotation - normal range

0-70

Shoulder external rotation - position

supine

Shoulder external rotation - stationary arm

perpendicular to floor

Shoulder external rotation - axis

olecranon process of Ulna

Shoulder external rotation - moveable arm

middle line of Ulna in line with Ulna Styloid Process

Shoulder external rotation - normal range

0-90

Shoulder extension - position

prone

Shoulder extension - stationary arm

mid axillary line

Shoulder extension - axis

acromion process

Shoulder extension - moveable arm

lateral epicondyle

Shoulder extension - normal range

0-60

Shoulder Horizontal abduction - position

prone

Shoulder Horizontal abduction - stationary arm

parallel to floor

Shoulder Horizontal abduction - axis

acromium (superior aspect)

Shoulder Horizontal abduction - moveable arm

middle line of humerus

Shoulder Horizontal abduction - normal range

0-40

Shoulder abduction - position

standing or seated (depending on height)

Shoulder abduction - stationary arm

parallel to spine/sternum

Shoulder abduction - axis

head of humerus

Shoulder abduction - moveable arm

middle line of humerus

Shoulder abduction - normal range

0-180

Upper Trapezius - O

• external occipital protuberance

• superior nuchal line

• spinous processes of cervical vertebrae via nuchal ligament

Upper Trapezius - Insertion

• lateral third of clavicle

• acromion process

Upper Trapezius - Action

• scapular elevation

• upward rotation

• retraction capital and cervical extension and lateral flexion when scapula is stabilized

Upper Trapezius - Nerves

• spinal accessory (cranial nerve XI)

• C3 and C4 sensory component

middle trapezius - Origin

spinous process of C7 through T3 via supraspinal ligament

middle trapezius - Insertion

medial aspect of acromion and spine of scapula

middle trapezius - Action

• scapular retraction

• upward rotation

middle trapezius - Nerve

• spinal accessory (cranial nerve XI)

• C3 and C4 sensory component

Lower Trapezius - Origin

spinous processes of T4 through T12 via supraspinal ligament

Lower Trapezius - Insertion

base of spine of the scapula

Lower Trapezius - Action

• scapular depression

• upward rotation

• retraction

Lower Trapezius - Nerves

• spinal accessory (cranial nerve XI)

• C3 and C4 sensory component

levator scpaula - Origin

transverse processes C1 through C4

levator scpaula - I

vertebral border of scapula between superior angle and spine of scapula

levator scpaula - Action

• scapular elevation

• downward rotation

• lateral flexion of cervical spine when scapula is stabilized

levator scpaula - Nerve

• third and fourth cervical nerves

• dorsal scapular nerve (C5)

rhomboid muscle - Origin

spinous processes of C7 through T5 via nuchal and supraspinal ligaments

rhomboid muscle - I

vertebral border of scapula between inferior angle and base of spine of scapula

rhomboid muscle - Action

• scapular retraction

• elevation

• downward rotation

rhomboid muscle - Nerve

dorsal scapular nerve

serratus anterior muscle - Origin

lateral surface of 1st through 8th ribs

serratus anterior muscle - Insertion

vertebral border of the scapula, anterior surface

serratus anterior muscle - Action

• scapular protraction and upward rotation

• elevation of thoracic cage when shoulder girdle is stabilized

• accessory muscle of respiration (inhalation)

serratus anterior muscle - Nerve

long thoracic nerve (C5,C6,C7)

pectoralis minor - Origin

anterior surface. 3rd through 5th ribs

pectoralis minor - I

coracoid process of scapula

pectoralis minor - Action

• scapular depression

• protraction

• downward rotation

• tilt

• elevation of thoracic cage when shoulder girdle is stabilized

• accessory muscle of respiration (inhalation)

pectoralis minor - Nerves

medial pectoral nerve (C8, T1)

muscles of the posterior shoulder girdle

• trapezius

• levator scapula

• rhomboids

• serratus anterior

muscles of the anterior shoulder girdle

• pectoralis minor

• serratus anterior

muscles of the lateral shoulder girdle

serratus anterior

motions - flexion/extension

in the sagittal plane and about the frontal axis

motions - abduction/adduction

in the frontal plane and about the sagittal axis

motions - medial/lateral rotation

in the horizontal plane and about the vertical axis

motions - horizontal abduction/adduction

in the horizontal plane and about the vertical axis

circumduction

a combination of shoulder motions

motions of the shoulder joint

shoulder joint osteokinematic ROM

• shoulder

  • flexion:

    • 0-180

  • extension:

    • 0-60

  • abduction:

    • 0-180

  • medial rotation:

    • 0-70

  • lateral rotation:

    • 0-90

• shoulder horizontal

  • abduction:

    • 0-30

  • adduction:

    • 0-120

what ligaments go onto the greater tubercle

• supraspinatus

• infraspinatus

• teres minor

all except what ligament goes onto the greater tubercle

subscapular (lesser tubercle)

anterior deltoid muscle - Origin

lateral third of the clavicle

anterior deltoid muscle - Insertion

deltoid tuberosity

anterior deltoid muscle - A

• shoulder abduction

• flexion

• medial rotation

• horizontal adduction

• depression of the shoulder girdle when humerus is stabilized

  • flexes the shoulder through its entire range

anterior deltoid muscle - N

axillary nerve (C5,C6)

middle deltoid - Origin

acromion process

middle deltoid - Insertion

deltoid tuberosity

middle deltoid - Action

• shoulder abduction

• depression of the shoulder girdle when humerus is stabilized

middle deltoid - Nerves

axillary nerve (C5,C6)

posterior deltoid muscle - Origin

spine of scapula

posterior deltoid muscle - Insertion

deltoid tuberosity

posterior deltoid muscle - Action

• shoulder abduction

• extension

• lateral rotation

• horizontal abduction

• depression of the shoulder girdle when humerus is stabilized

posterior deltoid muscle - Nerves

axillary nerve (C5, C6)

Biceps Brachii muscle - Origin

• long head: supraglenoid tubercle of scapula

• short head: coracoid process of scapula

Biceps Brachii muscle - Insertion

radial tuberosity of radius

Biceps Brachii muscle - Action

• shoulder flexion

• elbow flexion

• forarm supination

Biceps Brachii muscle - Nerve

musculocutaneous nerve (C5,C6)

Coracobrachialis muscle - Origin

coracoid process of the scapula

Coracobrachialis muscle - Insertion

medial surface of the humerus near the midpoint

Coracobrachialis muscle - Action

• shoulder flexion

• adduction

• stabilizes shoulder

Coracobrachialis muscle - Nerve

musculocutaneous nerve (C5,C6,C7)

pectoralis major (clavicular portion) - Origin

medial third of clavicle

pectoralis major (clavicular portion) - Insertion

lateral lip of bicipital groove of humerus (inferior to the sternal portion)

pectoralis major (clavicular portion) - Action

• shoulder flexion - first 60 degrees, medial rotation, adduction

• horizontal adduction

pectoralis major (clavicular portion) - Nerve

lateral and medial pectoral nerves (C5,C6,C7,C8.T1)

pectoralis major (sternal portion) - Origin

sternum, costal cartilage of first six ribs