Ch10 shoulder joint (test3)

What provides stability for the shoulder? (5)

-Position of the glenoid fossa -Joint capsule -Ligaments -Rotator cuff muscles -Shoulder girdle muscles

Muscles of the shoulder joint

1. Deltoid (3) 2. Supraspinatus 3. Pectoralis major (2) 4. Latissimus dorsi 5. teres major 6. Infraspinatus 7. Teres minor 8. Subscapularis 9. Coracobrachialis 10. Biceps brachii- assistive muscle 11. Triceps brachii- assistive muscle

4 groups of motions possible at the shoulder joint

1. Flexion/ extension/ hyperextension 2. Abduction/ adduction 3. Medial/ lateral rotation 4. Horizontal Abduction/ adduction

The sternal portion of the pectoralis major is a prime mover in:

180-120 degrees of extension. Needs assistance 120-90 180-150 degrees is most effective zone Pg136 in book

The clavicle portion of the pectoralis major is a prime mover (agonist) in :

60 degrees of flexion &once it reaches 90 degrees it needs to be assisted Pg136 in book

Shoulder joint

A ball and socket joint worth movement in all three plasma and apps all three axes; has the degrees of freedom

Glenoid labrum

A fibrous ring that surrounds the rim of the glenoid fossa; it's function is to deepen the articular cavity

Glenoid fossa

A shallow, somewhat egg shaped socket on the superior end of the scapula,lateral side; articulates with the humerus

Joint capsule

A thin walled, spacious container that attaches around the rim of the glenoid fossa of the scapula and the anatomical neck of the scapula

10. Regarding the pectoralis major: A. Which portion of it is effective in shoulder flexion? B. What part of the range is more effective? C. Why?

A. The clavicular Portion B. First part of range- to approximately 60 degrees C. Its vertical line of pull makes is more effective in the early part of the range and less so as it approaches a more horizontal line of pull

1. There are four sets of motions that occur at he shoulder joint. Which motions occur: A. in the frontal plane around the sagittal axis? B. in the transverse plane around the vertical axis? C. in the sagittal plane around the frontal axis?

A. shoulder abduction/adduction B. shoulder medial/lateral rotation, horizontal abd./add. C. shoulder flex./ext.

Deltod: action Superficial, three sides, triangular shape, gives shoulder rounded shape

A: anterior: flexion, medial rotation, horizontal adduction Middle: abduction Posterior: extension, lateral rotation, horizontal Abduction All 3 working together to abduct

Supraspinatus: action

A: shoulder abduction

What do all 3 of the deltoid muscles work together to do?

Abduction

What are of the movements of the frontal plane & sagittal axis?

Abduction and adduction

Supraspinous fossa

Above the spine of the scapula, providing attachment for the supraspinatus muscle

Clavicular fractures

Account for the most frequently broken bone in children. They usually result from a fall on the lateral aspect of the shoulder or on the out-stretched hand. The clavicle usually breaks in mid portion.

Bicipital groove

Also called the intertubercular groove; the longitudinal groove between the tubercles, containing the tendon of the long head of the biceps

Bicipital ridges

Also called the lateral and medial lip of the bicipital groove, or the crests of the greater and lesser tubercles respectively. The lateral lip (crest of the greater tubercle) provides attachment for the pectoralis major, and the medial lip (crest of the less tubercle) provides attachment for the latissimus dorsi and teres major

This landmark is circumferential groove separating the head from the tubercle

Anatomical neck

Name the muscle located superficially and anterior to the shoulder joint. It is a prime mover for flexion and medial rotation

Anterior Deltoid

Which of the followoing GH joint muscles do not attach to the scapula

Anterior Deltoid

Table 10-1 which muscles perform: flexion

Anterior deltoid, pectoralis major (clavicular- to approx. 60 degrees)

shoulder joint muscle divided into 3 parts:

Anterior, middle, and posterior deltoid muscles

What is the subscapularis named for?

Attachment

What is the supraspinatus named for?

Attachment on the supraspinous fossa

Infraspinous fossa

Below the spine of the scapula, providing attachment for the infraspinatus muscle

Third degree sprain

Both the acromioclavicular and coracoclavicular ligaments are ruptured

Acromion process

Broad, flat area on the superior lateral aspect of the scapula, providing attachment for the middle deltoid muscle

Humeral neck fracture

Caused by a fall onthe outstretched hand. It is common in the elderly and is usually am impacted fracture.

Anatomical neck

Circumferential groove separating the head from the tubercle

Glenohumeral subluxation

Commonly seen in individuals who have hemiplegia, usually from a cerebrovascular accident (stroke). Paralysis of the shoulder muscles leaves them no lino able to hold the head of the humerus in the glenoid fossa. This paralysis along with the pull off gravity and the weight of the arm over time causes partial dislocation.

Name the GH muscle located deep to the anterior deltoid and the pectoralis major, and anterior to the shoulder joint

Coracobrachialis

Name the muscles of the shoulder joint: (9)

Deltoid (3 divisions), Pectoralis Major (2 divisions), Latissimus Dorsi, Teres Major, Supraspinatus, Infraspinatus, Teres Minor, Subscapularis, Coracobrachialis

Table 10-1 which muscles perform: Abduction

Deltoid, supraspinatus

What are the movements of transverse plane & vertical axis?

External rotation, internal rotation, horizontal abduction, and horizontal adduction

True or False: GH joint horizontal adduction requires scapular upward rotation

False

True or False: Problem with winging scapula are due to supraspinatus weakness

False

Glenoid labrum

Fibrocartilaginous roof attached to the rim of the glenoid fossa, which deepens the articular cavity

What are the movements of the sagittal plane & frontal axis?

Flexion, extension, and hyperextension

The landmark where three rotator cuff muscles insert

Greater tubercle of humerus ( Teres minor, infraspinatus, supraspinatus)

What does the rotator cuff and joint capsule do?

Help keep the shoulder in place

Which muscle does the supraspinatus help and what does it help do?

Helps the middle deltoid abduct

Deltod: insertion Superficial, three sides, triangular shape, gives shoulder rounded shape

I: deltoid tuberosity

Supraspinatus: insertion

I: greater tuberosity of humerus

Subscapular fossa

Includes most of the area on the anterior (costal) surface, providing attachment for the subscapularis muscle

Dislocation of the shoulder is usually _______ & ________ because of less muscle

Inferior & anterior

Table 10-1 which muscles perform: Lateral Rotation

Infraspinatus, Teres Minor, Posterior Deltoid

Which landmark of the scapula deepens the socket to hold the head of the humerus?

Labrum

Greater tubercle

Large projection lateral to head and lesser tubercle; provides attachment for the supraspinatus, infraspinatus, and teres minor muscles

Name the muscle that is located superficially on the posterior thorax attached to the spinous processes by way of an aponeurosis

Latissimus Dorsi

Table 10-1 which muscles perform: Medial Rotation

Latissimus Dorsi, Teres Major, Subscapularis, Pectoralis Major, Anterior Deltoid

Test Q: what muscle is the strongest adductor that you have (use to perform a sliding board transfer)

Latissimus dorsi

Table 10-1 which muscles perform: hyperextension

Latissimus dorsi, posterior deltoid

Humerus

Longest and largest bone of the upper extremity

Deltod: innervation Superficial, three sides, triangular shape, gives shoulder rounded shape

N: axillary

What is the infraspinatus named for?

Named for its attachment

Deltod: origin Superficial, three sides, triangular shape, gives shoulder rounded shape

O: anterior- lateral 1/3 of clavicle Middle: acromion process Posterior: spine of scapula

Supraspinatus: origin

O: supraspinous fossa of scapula

Deltoid tuberosity

On the lateral side near the midpoint; not usually a well defined landmark

Anterior shoulder dislocation

One of the most common joint dislocations; this is a forced shoulder abduction and lateral rotation tends to be the dislocating motion causing the humeral head to slide anteriorly out of the glenoid fossa

Shaft

Or "body"; the area between the surgical neck proximally and the epicondyles distally

Table 10-1 which muscles perform: Horizontal Adduction

Pectoralis Major, Anterior Deltoid

Table 10-1 which muscles perform: Adduction

Pectoralis Major, Teres Major. Latissimus Dorsi

This muscle that moves the s. joint has the same "first name" as the s. girdle muscle.

Pectoralis major

Table 10-1 which muscles perform: Horizontal Abduction

Posterior Deltoid, infraspinatus, teres minor

Table 10-1 which muscles perform: extension

Posterior deltoid, Latissimus Dorsi, teres major, pectoralis major (sternal-to approximately 120 degrees)

Axillary border

Providing attachment for the teres major and teres minor muscles

This keeps the humeral head rotating in contact with the glenoid fossa

Rotator Cuff

Name the shoulder joint motions and accompanying shoulder girdle motions: 4. Placing a book on the upper bookshelf

S. Joint: Shoulder Flexion S. Girdle: Scapular upward rotation and protraction

Name the shoulder joint motions and accompanying shoulder girdle motions: 2. reaching up to get hold of your seat belt (drivers side with left hand)

S. Joint: Shoulder abduction and lateral rotation S. Girdle: Scapular upward rotation and retraction

Name the shoulder joint motions and accompanying shoulder girdle motions: 5. Tucking and holding a book under your arm

S. Joint: Shoulder adduction S. Girdle: scapular downward rotation

Name the shoulder joint motions and accompanying shoulder girdle motions: 3. fastening seatbelt with your left hand

S. Joint: Shoulder adduction and medial rotation S. Girdle: scapular downward rotation and protraction

Name the shoulder joint motions and accompanying shoulder girdle motions: 1. Putting your billfold in your left back pocket with your left hand:

S. Joint: Shoulder hyperextension and medial rotation S. Girdle: scapular tilt and protraction

Head of the humerus

Semi rounded proximal end; articulates with the scapula

What are the teres minor and teres major named for?

Shape and size

Surgical neck

Slightly constricted area just below tubercles where the head meet the body

Lesser tubercle

Smaller projection on the anterior surface, medial to the greater tubercle; provides attachment for the subscapularis muscle

The joint formed by the clavicle and the sternum is called the __________________ joint.

Sternoclavicular

This landmark includes most of the area on the anterior surface of the scapula

Subscapular

The fossa on the anterior scapula

Subscapular fossa

Linda fell and injured a rotator cuff muscle. which muscle could it be?

Subscapularis

Glenohumeral ligaments

Superior, middle, and inferior; reinforce the anterior portion of the joint capsule; not well- defined ligaments but actually pleated folds of the capsule

What are the SITS muscles?

Supraspinatus Infraspinatus Teres Minor Subscapularis

6. What are the SITS muscles, and why are they called "rotator cuff muscles"?

The *S*upraspinatus, *I*nfraspinatus, *t*eres minor, and *S*ubscapularis muscles; they hold the head of the humerus in toward the glenoid fossa as it moves within the socket.

Second degree sprain

The acromioclavicular ligament is ruptured and the coracoclavicular ligament is stretched

First degree sprain

The acromioclavicular ligament is stretched

9. Which shoulder joint muscles do NOT attach on the scapula?

The anterior deltoid, pectoralis major, and latissimus dorsi muscles

2. Describe circumduction and the shoulder joint motions involved.

The circular arc of the upper extremity formed by a combination of the shoulder motions - flexion, abd., extension, and add.

Shoulder joint

The head of the humerus articulating with the glenoid fossa of the scapula; one of the most movable joints in the body and one of the least stable

What is the rotator cuff and what does it do?

The rotator cuff is the tendinous band formed by the blending together of the tendinous insertions of the subscapularis, supraspinatus, infraspinatus, and teres minor muscles. These muscles help keep the head of the humerus rotating against the glenoid fossa during joint motion.

7. Name the shoulder joint muscles attaching on the anterior surface of the scapula.

The subscapularis and coracobrachialis muscles

Rotator cuff

The tendinous band formed by the blending together of the tendinous insertions of the subscapularis, supraspinatus, infraspinatus, and teres minor.

8. Name the shoulder joint muscles attaching on the posterior surface of the scapula.

The teres major, teres minor, infraspinatus, supraspinatus, and posterior deltoid muscles

Acromioclavicular separation

The term commonly used to describe the various amounts of ligament injury at the acromioclavicular joint; first, second, and third degree sprains

Rotator cuff *test question!!*

These muscles help to keep the head of the humerus "rotating"against the glenoid fossa during joint motion

this landmark is located on the medial side of the distal end of the humerus and articulates with the ulna

Trochlea

True or False: Ahesive capsulitis is also referred to as frozen shoulder.

True

5. What landmarks can be used to determine if a model of an unattached bone is a right or left humerus?

With the humerus in the vertical position, the bicipital groove facing anteriorly, and the head facing medially, the right humeral head faces toward the left.

The close-packed position is _______________

abduction and lateral rotation

joints that make up the shoulder girdle

acromioclavicular, coacoclavicular, sternoclavicular, scapulothoracic articulation

The shoulder joint muscles that do not attach to the scapula

ant. deltoid, pectoralis major, lat. dorsi

The shoulder joint is classifies as a _____________ joint

ball and socket

____________________ move in the same direction as the joint motion

concave joint surfaces

__________________ move in the opposite direction as the joint motion

convex joint surfaces

The shoulder joint m. that attaches to the coracoid process

coracobrachialis

The _____________ muscle is divided into 3 parts and moves the shoulder joint

deltoid

The deltoid muscle has insertion on the _____________

deltoid tuberosity

This landmark is on the lateral side near the midpoint of the humerus; not usually a well-defined landmark

deltoid tuberosity

The companion movement of the shoulder joint when the scapula protracts and upwardly rotates is

flexion

A _______________ has muscles pulling in different directions to achieve the same motion

force couple

Three of the shoulder joint muscles are attached to this landmark of the humerus

greater tubercle

The ______________ of the humerus articulates with the _______________ of the scapula to form the shoulder joint

head; glenoid fossa

Adhesive Capsulitis

inflammation and fibrosis of the shoulder joint capsule, which leads to pain and loss of shoulder range of motion. AKA frozen shoulder

The s. joint muscle that is inferior to the supraspinatus muscle, superior to the teres minor, and, in part, deep to the trapezius and deltoid muscles

infraspinatus

The infraspinous muscle has an origin on the _________ fossa

infraspinous

torn rotator cuff

involves the distal tendinous insertion of the supraspinatus, infraspinatus, teres minor, and subscapularis

This muscle's proximal attachment is by way of an aponeurosis _________________

lat. dorsi

This landmark is a "bump" located on the lateral side of the distal end of the humerus above the capitulum

lateral epicondyle

The largest muscle of the shoulder joint

latissimus dorsi

This depression is located on the posterior surface of the distal end of the humerus

olecranon fossa

The shoulder joint muscles attached to the bicipital groove

pectoralis major, Lat. Dorsi

The shoulder girdle m. that attaches to the coracoid process

pectoralis minor

The shoulder girdle m. that attaches to the ribs

pectoralis minor, serratus anterior

3. Which fossa is located on the anterior surface of the scapula?

subscapular fossa

the shoulder joint muscles that passes inferior to the acromion process

supraspinatus, infraspinatus

4. The spine of the scapula divides the posterior surface into which two fossas?

the supraspinous and infraspinous fossas

The shoulder is a ___________ ball-and-socket joint

triaxial