Shoulder Complex Flashcards
Four Joints that make up the shoulder?
SC, AC, GH, ST
Sternoclavicular Joint ROM
~45 degrees of elevation
~10 degrees of depression
~15 degrees of pro/retraction
~20-35 degrees of rotation (posterior only)
Superior and Inferior acromioclavicular ligaments action
Prevents horizontal distraction
Coracoclavicular ligaments (trapezoid & conoid)
limits upward scap rotation, transfers medially directed forces from glenoid, prevents medial scap displacement, produces longitudinal clavicle rotation during UE elevation
Scapulothoracic Joint
ST motion helps maintain good GH contact, 3 degrees of freedom, movements are coupled with AC and SC motion.
ROM at AC joint during scapular upward rotation, AP tilting, and IR/ER
Upward rotation ~ 30 degrees
AP tilting ~ 5-30 degrees
IR/ER ~ 5-30 degrees
Glenohumeral joint close and open packed position
Close Packed: 90 abduction with full ER
Open packed: 50 abduction with 30 horizontal adduction
Glenohumeral Joint ROM
120 degrees of flexion, 120 degrees of abduction, 65 degrees of extension
Principle #1
Active shoulder abduction of 180 degrees occurs as a result of simultaneous 120 degrees of glenohumeral joint abduction and 60 degrees of scapulothoracic upward rotation
Principle #2
the 60 degrees of upward rotation of the scapula during full shoulder abduction is the result of a simultaneous elevation at the sternoclavicular joint combined with upward rotation at the acromioclavicular joint
Principle #3
Clavicular retraction, the clavicle retracts 15 degrees at the SC joint during shoulder abduction
Principle #4
Scapular Tilt and Rotation, the upwardly rotating scapula posterior tilts and, less, consistently, externally rotates slightly during full shoulder abduction
Principle #5
Clavicular rotation, the clavicle posteriorly rotates 15-20 degrees around its own axis during shoulder abduction
Principle #6
Humeral ER, the GH joint externally rotates during shoulder abduction
The shoulder during gait
at initial contact, the contralateral shoulder is in 25 degrees of flexion
at toe off, the contralateral shoulder is in 10 degrees of extension
Force couple (or triple) during upward scapular rotation
Lower trap, upper trap, serratus anterior
what joint links to axial skeleton
Sternoclavicular joint
Sternoclavicular ligament
limits anterior and posterior movement of clavicle
costoclavicular ligament
limits elevation of proximal clavicle
interclavicular ligament
protects brachial plexus and prevents downward motion
Superior glenohumeral ligament
Limits external rotation and inferior translation of the humeral head.
Middle glenohumeral ligament
Limits external rotation and anterior translation of the humeral head.
Inferior glenohumeral ligament
Limits external rotation and superior and anterior translation of the humeral head (anterior portion)
Limits internal rotation and anterior translation (posterior portion)
Transverse humeral ligament
This ligament serves to keep the tendon of the long head of the biceps in the bicipital groove.
Coracohumeral ligament
Anterior portion limits extension while the posterior portion limits flexion.
Both divisions limit inferior and posterior translation of the humeral head.