Presentation on theme: "Shoulder (Glenohumeral) Joint"— Presentation transcript:
1 Shoulder (Glenohumeral) Joint Heather, Riley, Tonia, and Jo
2 Surface AnatomyAnterior axillary fold - The inferior border of the pectoralis major muscle forms the anterior axillary foldClavicular head of pectoralis major - The clavicular head is the smaller top section of the bare-chested upper-torsoClavipectoral triangle - The clavipectoral triangle (deltopectoral triangle) is the depressed area just inferior to the lateral part of the clavicle, bounded by the clavicle superiorly, the deltoid laterally, and the clavicular head of the pectoralis major medially.Sternocostal head of pectoralis major - The sternal-costal head consists of more muscle mass. It originates at the sternum and six sternum costal cartilages
3 Surface AnatomyClavicle - can be felt from end to end (subcutaneous) since they produce horizontal ridges visible at the junction of the neck to the thoraxManubrium – the upper segment of the sternum in which the clavicles and upper two ribs articulate
4 Surface Anatomy Parts of the Deltoid : •clavicular part ( or anterior): originates on the lateral third of the clavicle•acromial part (or middle): originates on the acromion process•spinal part (or posterior): originates on the scapular spine
5 Surface AnatomyPosterior Axillary Fold – formed by the latissimus dorsi winding around the lateral border of the teres major muscleTriangle of auscultation - The space bounded by the lower border of the trapezius, the latissimus dorsi, and the medial margin of the scapula, used to listen to (auscultate) the lungs because the stethoscope can be placed close to the thoracic wall at this locationThree areas of the Trapezius Muscle :Descending Part of Trapezius (the superior region or Upper fibers) - which functions to support the weight of the armAscending Part of Trapezius (the inferior region or Lower Fibers) - which function to rotate and or lower the scapulae.Middle Part of the Trapezius (the intermediate region or middle fibers) - which function to draw or pull the scapulae inwards closer to the spine
6 BONES OF THE SHOULDER JOINT Made up of three bones:ClavicleHumerusScapula
11 ShoulderBursaeA bursa is a sac between two moving surfaces that contains a small amount of lubricating fluid, and they reduce friction where two body parts are moving against one another and there is no joint.
12 CARTILAGELabrum: is a type of cartilage found in the shoulder, found only around the socket where it is attached. This cartilage is more fibrous and rigidArticulating Cartilage: white cartilage found on the ends of bones, which allows the bones to glide and move on each other. When this type of cartilage starts to wear out you get arthritis.
13 Articular Capsule Synovial Membrane: Layer of connective tissue that lines the joints, tendon sheaths, and bursae and makes synovial fluid, which has a lubricating function.
14 THE ROTATOR CUFF:Group of muscles and tendons that surround the shoulder jointKeep the head of your upper arm bone firmly within the shallow socket of the shoulder.
16 CLINICAL CONCERNS ROTATOR CUFF INJURY SYMPTOMS: Dull ache deep in the shoulderDisturb sleep, particularly if you lie on the affected sideDifficult to comb your hair or reach behind your backArm weakness
17 ROTATOR CUFF INJURY TYPES: CAUSE: Partial tear: damages the soft tissues but does not completely sever itFull thickness tear or a complete tear: splits the soft tissue into two pieces.CAUSE:Injury: Falling on an outstretched hand or lifting something too heavy are two common injuries associated with rotator cuff tears.Degeneration: Repetitive stress, lack of blood supply, and bone spurs are factors that contribute to degeneration.
18 OTHER COMMON INJURIES TO THE SHOULDER Labrum TearInstability- One shoulder joint moves or is forced out of its normal position. This condition can result in a dislocation of one of the joints in the shoulder.Impingement-Caused by excessive rubbing of the shoulder muscles against the top part of the shoulder blade (acromion)OTHERCOMMONINJURIESTO THESHOULDERCLINICAL CONCERNS
27 Upper TrapeziusOrigin: Superior line of the occipital bone, ligamentum nuchae, and cervical vertebraeInsertion: Lateral 1/3 of clavicle and acromion processAction: Scapular elevation and upward rotationInnervation: Spinal Accessory nerveRoots C3 and C4Synergists:-Elevation : Levator Scapulae-Upward Rotation: Upper and Lower TrapeziusAntagonists:-Adduction: Rhomboids Major and Minor, Middle Trapezius-Downward Rotation: Levator Scapula, Rhomboids Major and Minor.
28 Middle Trapezius Origin: Spinous Processes of C7 to T3 Insertion: Scapular SpineAction: Scapular Adduction (retraction)Innervation: Spinal Accessory NerveRoots C3 and C4Synergists: Adduction: Rhomboids Major and MinorAntagonists: Serratus Anterior, Pectoralis Minor
29 Lower TrapeziusOrigin: Spinous Processes of Middle and Lower Thoracic VertebraeInsertion: Base of the scapular SpineAction: Scapular depression and upward rotationInnervation: Spinal Accessory NerveRoots C3 and C4Synergists:-Depression: Pectoralis Minor-Upward Rotation: Upper Trapezius, Serratus AnteriorAntagonists:-Elevation: Levator Scapulae, Upper Trapezius, Rhomboids Major and Minor-Downward Rotation: Rhomboids Major and Minor, Levator Scapulae
30 Levator Scapulae:Origin: Transverse process of first four cervical vertebraeInsertion: Vertebral border of scapula between the superior angle and the spineAction: Scapular elevation and downward rotation (Inferior rotation of Glenoid Cavity)Innervation: Dorsal Scapular and Cervical nerves and Dorsal scapular arteryRoots: Dorsal Scapular C5-Cervical C3 and C4Synergists:-Elevation: Upper Trapezius, Rhomboids Major and Minor-Inferior Rotation: Rhomboid Major and Minor, Pectoralis MajorAntagonists:-Depression: Lower Trapezius, Pectoralis Minor-Superior Rotation: Upper and Lower Trapezius, Serratus Anterior
31 Pectoralis Minor Origin: Anterior Surface, third through fifth Ribs Insertion: Coracoid process of the scapulaAction: Ribs Fixed: Draws scapula forward (abducts) and rotates scapula downward against the thoracic wallScapula fixed: Elevates the rib cage.Innervation: Medial pectoral nerve, Axillary arterySynergists: Abduction: Serratus AnteriorRespiration: Sternocleidomastoid, ScalenesAntagonists: Adduction: Rhomboids major and minor, Middle TrapeziusRespiration: Rectus Abdominus
32 Serratus Anterior: Origin: Lateral Surface of the Upper eight ribs Insertion: Anterior surface of the vertebral border of the scapulaAction: Scapular protraction and Upward Rotation, holds scapula against thoracic wallInnervation: Long thoracic nerve, Lateral thoracic arteryRoots C5-C7Synergists:-Abduction: Pectoralis Minor-Upward Rotation: Upper and lower TrapeziusAntagonists:-Adduction: Rhomboids Major and Minor, Middle Trapezius-Downward Rotation: Levator Scapulae, Rhomboids Major and Minor
33 Rhomboid Major: Origin: Spinous processes of T2 - T5 Insertion: Vertebral border of the scapula between the spine and inferior angleAction: Adducts (retracts) Scapula, Depresses Glenoid Cavity, Stabilizes scapulaInnervation: Dorsal Scapular Nerve and Dorsal Scapular ArterySynergists:-Adduction: Middle Trapezius-Downward Rotation: Levator Scapulae, Pectoralis MinorAntagonists:-Abduction: Serratus anterior, Pectoralis Minor-Upward Rotation: Upper and lower Trapezius, Serratus Anterior
34 Rhomboid Minor:Origin: Nuchal Ligament and spinous process of C7 and T1Insertion: Vertebral border of scapula superior to spineAction: Adducts (retracts) Scapula, Depresses Glenoid Cavity, Stabilizes scapulaInnervation: Dorsal Scapular Nerve and Dorsal Scapular ArterySynergists:-Adduction: Middle Trapezius-Downward Rotation: Levator Scapulae, Pectoralis MinorAntagonists:-Abduction: Serratus anterior, Pectoralis Minor-Upward Rotation: Upper and lower Trapezius, Serratus Anterior
35 Deltoids Anterior (Clavicular) Origin: Lateral 1/3 of Clavicle Action: Shoulder Abduction, Flexion, Medial rotation, Horizontal AdductionMiddle (Acromial)Origin: Acromion processAction: Shoulder AbductionPosterior (Spinal)Origin: Scapular SpineAction: Shoulder Abduction, Extension, Hyperextension, Lateral Rotation, Horizontal AdductionAll 3 Deltoids Insert on the Deltoid Tuberosity and are Innervatedby the Axillary Nerve with Roots C5-C6All 3 Deltoids have the Supraspinatus as a Synergist whenperforming Abduction
36 Pectoralis MajorOrigin: (clavicular head) Medial third of the clavicle, (sternal head) sternum, costal cartilage of first six ribs and the aponeurosis of the External ObliqueInsertion: Lateral lip of bicipital groove of humerusAction: Shoulder Adduction, Medial Rotation, Draws Scapula anteriorly and inferiorly, Clavicular Head Flexes Humerus, Sternal Head Extends HumerusInnervation: Lateral and Medial Pectoral NerveRoots: Clavicular C5-C6, Sternocostal C7-C8Synergists:-Adduction: Latisumus Dorsi, Teres Major-Medial Rotation: Latissumus Dorsi, Anterior Deltoid, Teres Major-Extension: Posterior Deltoid, Latissimus Dorsi, Teres MajorAntagonists:-Abduction: Deltoids, Supraspinatus-Lateral Rotation: Infraspinatus, Teres Minor, Posterior Deltoid-Flexion: Anterior Deltoid
38 Supraspinatus: Origin: Supraspinous fossa of the scapula Insertion: Greater Tubercle of the humerusAction: Initiates and Assists the Deltoid Abduct the armInnervation: Suprascapular nerveRoot: C5 and C6Synergist-Abduction: DeltoidsAntagonist-Adduction: Pectoralis Major, Teres Major and Latissimus Dorsi
39 Teres Major Origin: Dorsal surface of inferior angle of the scapula Insertion: Medial lip of intertubercular groove of humerusAction: Adducts and medially rotatesInnervation: Lower subscapular nerveRoot: C6 and C7Synergist-Adduction: Pectoralis Major, Teres Major, Latissimus Dorsi-Medial Rotation: Latissimus Dorsi, Teres Major, Subscapularis, and Pectoralis MajorAntagonist:-Abduction: Deltoids and Supraspinatus-Lateral Rotation: Infranspinatus, Teres Minor, and Posterior Deltoid
40 Subscapularis Origin: Subscapular fossa of the scapula Insertion: Lesser tubercle of the humerusAction: Shoulder Medial Rotation and adduction, also helps hold Humeral Head in Glenoid CavityInnervation: Subscapular nerve and Subscapular ArteryRoots: C5-C7Synergists:-Adduction: Pectoralis Major, Teres Major, Latissumus dorsi-Medial Rotation: Latissimus dorsi, Teres Major, Pectoralis Major, Anterior DeltoidAntagonists:-Abduction: Deltoid, Supraspinatus-Lateral Rotation: Teres Minor, Posterior Deltoid
41 Coracobrachialis Origin: Coracoid process of the scapula Insertion: Medial 1/3 of the humerusAction: Helps adduct the shoulder jointInnervation: Musculocutaneus nerveRoots: C6-C7Synergists:-Arm Flexion: Biceps Brachii, Anterior Deltoid-Adduction: Subscapularis, Teres major, Pecotalis MajorAntagonists:-Forearm extension: Triceps Brachii, Posterior Deltoid-Abduction: Deltoids, Supraspinatus
42 Infraspinatus Origin: Infraspinous fossa of the scapula Insertion: Greater tubercle of the humerusAction: External (lateral) Rotation Innervation: Suprascapular nerveRoot: c5 and c6Synergist:-Lateral Rotation: Teres Minor and Posterior DeltoidAntagonist:-Medial Rotation: Latissimus Dorsi, Teres Major, Subscapularis, Pectoralis Major and Anterior Deltoid
43 Teres Minor Origin: Superior lateral border of the scapula Insertion: Greater tubercle of the humerusAction: External Rotation, weak rotationInnervation: Axillary nerveRoot: c5 and c6Synergist-Lateral Rotation: Infraspinatus andthe Posterior DeltoidAntagonist:-Medial Rotation: Latissimus Dorsi,Teres Major, Subscapularis,Pectoralis Major,and Anterior Deltoid
44 Overview of the Muscles of the SHOULDER/GLENOHUMERAL region
45 Referencesanterior-and-posterior-axillary-folds/https://web.duke.edu/anatomy/Lab10/Lab11_preLab.htmlhttps://web.duke.edu/anatomy/Lab10/images/Grant's%20Atlas%206.30%20(1).jpgClemente, Carmine D. Atlas, A regional Atlas of the Human Body. 6th edition. 2011 https://www.google.com/search?q=levator+scapulae&biw=1301&bih=641&source=lnms&tbm=i sch&sa=X&ei=kD9hVJy7JsTuoASNp4CoBg&sqi=2&ved=0CAYQ_AUoAQ#tbm=isch&q=pectoralis+ major+images&imgdii=_BLEVINS, GARY THE OFFICIAL MUSCLE SHEET