Shoulder Flashcards
what is the purpose of the shoulder?
- UE movement
- Interaction with the environment (ADLs)
what bones are involved in the shoulder?
humerus and scapula
identify the landmarks of the humerus
- head
- greater tubercle
- lesser tubercle
- intertubercular groove
- deltoid tuberosity
identify the landmarks of the scapula
- acromion process
- coracoid process
- spine
- fossae
- glenoid
- supraspinous
- infraspinous
- borders
- angles
what joint is the shoulder joint referred to?
glenohumeral joint
what kind of joint is the glenohumeral joint and what ligaments are involved?
- Multiaxial ball and socket
- Glenohumeral ligament and
coracohumeral ligament - Glenoid labrum
what is the glenoid labrum?
the ring of cartilage that lines the shoulder socket
what is the purpose of the glenoid labrum?
- Purpose: enhance stability, deepen fossa concavity
- Buttress to limit humeral head translation
stability vs mobility
- Stability = ability to maintain control and support joints during movement
- Mobility = ability to move freely and easily
As mobility increases, stability decreases
Instability issues include: subluxation, dislocation, labral tears, and rotator cuff impingement
intrinsic vs extrinsic GH muscles
intrinsic: origin = scapula and clavicle
extrinsic: origin = not scapula and clavicle
what are the intrinsic GH muscles?
- Deltoid
- Coracobrachialis
- Teres major
- Rotator cuff
what are the extrinsic GH muscles?
- Latissimus dorsi
- Pectoralis major
what is the deltoid origin, insertion, movement, and innervation?
- Origin:
Lateral clavicle
Acromian
Inferior edge spine of scapula - Insertion:
Deltoid tuberosity - Shoulder movement:
Ant fibers - ABD, horizontal ADD, flexion, IR, diagonal ADD
Post fibers - ABD, horizontal ABD, extension, ER, diagonal ABD
Middle fibers - ABD
- Innervation:
C5-C6
Axillary nerve
what is the pectoralis major origin, insertion, movement, and innervation?
- Origin:
Medial clavicle
Costal cartilages 1-6
Sternum - Insertion:
Lateral lip-intertubercular groove - Shoulder movement:
Upper fibers - horizontal ADD, IR, diagonal ADD
- flexion, ABD (>90 degrees), ADD (<90 degrees)
Lower fibers - horizontal ADD, IR, diagonal ADD
- ext (from flexed position), ADD
- Innervation:
C5-T1
Medial and lateral pectoral nerve
what is the latissimus dorsi origin, insertion, movement, and innervation?
- Origin:
Posterior iiac crest
Sacrum and SP T7-L5
Ribs 10-12 - Insertion:
Medial lip - intertubercular groove - Shoulder movement:
ADD
Ext
IR
Horizontal ABD - Innervation:
C6-C8
Thoracodorsal nerve
what is the teres major origin, insertion, movement, and innervation?
- Origin:
Lateral border of the scapula - Insertion:
Medial lip - intrtubercular groove - Shoulder movement:
Ext
IR
ADD - Innervation:
C5-C6
Lower subscapular nerve
what is the coracobrachialis origin, insertion, movement, and innervation?
- Origin:
coracoid process - Insertion:
Humeral shaft - Shoulder movement:
Flex
ADD
Horizontal ADD
Diagonal ADD - Innervation:
C5-C7
musculocutaneous
what are the rotator cuff muscles?
- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis
what is the supraspinatus origin, insertion, movement, and innervation?
- Origin:
Infraspinous fossa - Insertion:
Greater tubercle posteriorly - Movement:
ER
Horizontal ABD
Ext
Stabilizes humeral head in glenoid fossa - Innervation:
C5-C6
Suprascapular nerve
what is the teres minor origin, insertion, movement, and innervation?
- Origin:
Lateral scapular border - Insertion:
Greater tubercle posteriorly - Shoulder movement:
ER
Horizontal ABD
Ext
Diagonal ABD
Stabilizes humeral head in glenoid fossa - Innervation:
C5-C6
Axillary nerve
what is the subscapularis origin, insertion, movement, and innervation?
- Origin:
Subscapular fossa - Insertion:
Lesser tubercle - Shoulder movement:
IR
ADD
Ext
Stabilizes humeral head in glenoid fossa - Innervation:
C5-C6
Upper and lower subscapular nerves
describe the shoulder movement: Flexion
forward movement - 180 degrees
describe the shoulder movement: Extension
backward movement - 60 degrees
describe the shoulder movement: Abduction
upward lateral movement/away from body - 180 degrees
describe the shoulder movement: Adduction
downward lateral movement/towards midline - 0 degrees
describe the shoulder movement: Horizontal adduction
toward/across midline - 135 degrees
describe the shoulder movement: Horizontal abduction
away from midline - 45 degrees
describe the shoulder movement: Internal rotation
toward midline with elbow flexed 90 degrees - 70 degrees
describe the shoulder movement: External rotation
away from midline with elbow flexed 90 degrees - 90 degrees
what are the agonists and exercises associated with shoulder flexion?
A: ant deltoid, pec major (upper fibers)
E: front arm raise
what are the agonists and exercises associated with shoulder extension?
A: teres major, lat dorsi, subscapularis, pec major (lower fibers)
E: straight arm pull down
what are the agonists and exercises associated with shoulder adduction?
A: lat dorsi, teres major, subscapularis, pec major (upper fibers)
E: lat pull down
what are the agonists and exercises associated with shoulder abduction?
A: deltoid, supraspinatus, pec major (upper fibers)
E: lat raise
what are the agonists and exercises associated with horizontal abduction?
A: teres minor, infraspinatus, deltoid
E: prone T raise, reverse fly
what are the agonists and exercises associated with horizontal adduction
A: anterior deltoid, pec major, coraobrachialis
E: dumbbell or machine fly
what are the agonists and exercises associated with shoulder internal rotation?
A: lat dorsi, teres major, subscapularis, pec major
E: TB IR
what are the agonists and exercises associated with shoulder external rotation?
A: infraspinatus, teres minor
E: TB BUE ER
describe the causes of shoulder dysfunction
- Frequent
injuries/dislocations common - Glenoid fossa=shallow
- Laxity of ligaments
- strength/flexibility
imbalances
what are the different types of RTC dysfunction?
- impingement
- tear
- tendonitis
what are the causes of RTC dysfunction?
- Acute injury
- Repetitive stress (overhead
activities) - Scapulohumeral rhythm
dysfunction
what is GIRD and what is a common cause of it?
glenohumeral IR deficit
- Difference in IR ROM from
dominant to nondominant
UE - Common cause: Often in throwing athletes
what is a SLAP lesion and what are some causes?
superior labrum anterior & posterior
- Can involve biceps tendon
attachment - Causes: acute injury (MVA,
FOOSH) or repetitive injury
(overhead sports)
