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Shoulder Complex
Shoulder Complex
28
Health Care
Graduate
02/27/2012

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Term
Introduction to Shoulder
Definition
shoulder region is complex of:
- 20 muscles
- 3 bony articulations
-3 soft tissue moving surfaces

-Maximizes mobility at the sake of stability

-primary purpose: position the hand for function
Term
Stability sacrificed for mobility
Definition
- evolutionary changes
-freed human UE
- prehension and functional use
- shoulder complex evolved to position the hand in space
- instability= prone to injury, strain and diseases
Term
Shoulder Girdle
Definition
- only 1 bony attachment of the UE to the trunk= sternoclavicular joint
- support/ stabilization relies on muscles and ligaments
- prime movers w/lots of synergists to stabilize that girdle (due to 1 bony connection)
Term
Manubrium
Definition
-superior aspect contains shallow depression for medial clavicular attachments
- sitting b/w the 2 clavicles in sternal or jugular notch
Term
Clavicle
Definition
- "S" shaped similar to crank
- tubular at sternal end; flatter at acromial end
Term
Clavicle
Definition
-holds scapula and humerus away from body
- provides for muscle attachment
- protects blood vessels and nerves
- assists in maintaining the position of the shoulder complex
- enables increased ROM of the GH joint
Term
Scapula
Definition
- flat triangular bone
- vertebral border positioned b/w T2 & T7
- provides location for GH muscles to originate and provide stable base from which GH joint can operate
Term
Scapula
Definition
- works in concert with clavicle to enhance total shoulder ROM
- many unique bony prominences:
-Superior & Inferior angles, spine, borders
-glenoid fossa, acromion, coracoid process
-supraspinatus/infraspinatus/subscapular fossa
-supra & infraglenoid tubercle
Term
Humerus
Definition
-convex head, approx half of a sphere
-positioned medially and superiorly in frontal plane; rotated posteriorly in transverse plane
-frontal plane angle of inclination= 135 deg.
-transverse plane- retroverted 30 deg.
Term
Humerus Anatomy
Definition
- head of humerus
- greater tubercle
- lesser tubercle
- intertubular groove or bicipital groove
Term
Joints of Shoulder Complex
Definition
- sternoclavicular joint (SC)
- Acromialclavicular joint (AC)
- Glenohumeral joint (GH)
- scapulo-thoracic joint
- not a true articulation
- rather where the scapula moves over the thorax
Term
Sternoclavicular joint
Definition
Ligaments
-anterior/posterior
- interclavicular
- costoclavicular- clavicle to 1st rib
Term
Sternoclavicular Joint

'Osteokinematics'
Definition
- connects UE to axial skeleton
- saddle joint with 3 degrees of freedom
- elevation/depression
-protraction/retraction
-rotation
Term
Sternoclavicular

'osteokinematics'
Definition
- elevation/depression
-frontal plane; Anterior/posterior axis
-30-45 degrees of elevation
-costoclavicular; subclavius
-5-10 degrees of depression
-interclavicular; 1st rib
Term
Sternoclavicular

'osteokinematics'
Definition
protraction/retraction
-transverse plane- superior/inferior axis
- 15-30 degrees protraction
-posterior sternoclavicular
-15-30 degrees retraction
-anterior sternoclavicular
Term
sternoclavicular

'osteokinematics'
Definition
rotation
- long axis of clavicle; M/L axis
- posterior direction with shoulder elevation
- occurs after elevation at sternoclavicular joint is completed (2nd 90 degrees of shoulder elevation)
Term
sternoclavicular

'arthrokinematics'
Definition
elevation/depression
-convex on concave
protraction/retraction
-concave on convex
rotation
-spin of clavicular head on disc
Term
acromioclavicular joint
Definition
- synovial joint
- 3 degrees of freedom
- variable presence of articular disc (likely due to degeneration)
- ligaments
-superior/inferior AC; coracoclavicular
Term
Acromioclavicular

'osteokinematics'
Definition
- 25-30 degrees of upward rotation; A/P axis
- small amounts of tilting
-medial/lateral tilt about a superior/inferior axis
- A/P tilt about a M/L axis
Term
shoulder girdle movements
Definition
- elevation/depression
- protraction/retraction
- upward rotation/downward rotation
Term
scapulothoracic Joint
Definition
- involves subscapular bursae/serratus anterior
- functions include:
- maintain length- tension relationship of RC/deltoid
-position glenoid to receive humeral head
- shock absorption
-permit elevation of body
- enhance shoulder ROM
Term
Scapulothoracic Kinematics
Definition
- 60 degrees of upward rotation
-30 degrees from SC joint; 30 degrees from AC joint
- elevation/depression
- 10 cm/2 cm
- protraction/retraction
-10 cm/5 cm
Term
Glenohumeral Joint
Definition
- ball and socket 3 degrees of freedom
- inherently unstable
- humeral head more than twice the size of glenoid fossa
- labrum deepens socket
- large capsule
Term
Glenohumeral joint
Definition
-capsular reinforcements
-superior/middle/inferior GH ligaments
- coracohumeral ligament
- long head of biceps/triceps
- rotator cuff tendons blend with capsule
Term
Glenohumeral joint
Definition
Coracoacromial arch
-forms "roof" of GH joint
-subacromial space b/w humeral head and acromion
-coracoacromial ligament
Term
Glenohumeral Osteokinematics
Definition
Abduction/adduction
-frontal- A/P axis
Flexion/Extension
-sagittal- M/L axis
M/L rotation
-transverse- Superior/inferior axis
Term
Glenohumeral Arthrokinematics
Definition
-flexion/extension- spin
- abduction- superior roll; inferior glide
- lateral rotation- posterior roll
- medial rotation- anterior roll, posterior glide
Term
Scapulohumeral Rhythm
Definition
-after 30 degrees abduction, 2:1 ratio is evident
-120 degrees from GH; 60 from scapula (AC + SC)
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