Name, locate, & describe the structure & ligamentous reinforcements of the joints. 2. Name & demonstrate movements possible. 3. Name & locate muscles & muscle groups, and name their primary actions. 4. Analyze the fundamental movements with respect to joint & muscle actions. 5. Describe common injuries.
5-3 Articulation of acromion & distal end of clavicle. Acromioclavicular ligament strengthens joint superiorly. Aponeurosis of trapezius & deltoid strengthen joint posteriorly. Coracoclavicular ligament further stabilizes joint. Fig 5.1
5-4 Proximal clavicle articulates with sternum and cartilage of 1 st rib. Capsule thickened by anterior & posterior sternoclavicular ligaments. The only bony connection between the humerus and axial skeleton. Permits limited motion of the clavicle. Partially responsible for movements of the scapula. Clavicular movements at the SC joint: elevation & depression, protraction & retraction, forward & backward rotation. Fig 5.2
5-5 Fig 5.3 a & b Abduction (Protraction) Adduction (Retraction) Elevation Depression
5-6 Fig 5.3 c & d Upward rotation Downward rotation Anterior tilt Posterior tilt
5-8 Function: Movements of scapula: downward rotation, anterior tilt, depression. Lifting effect on ribs in forced inspiration and posture. Fig 5.4
5-9 Function: Abduct (protract) scapula. With trapezius, upward rotation of scapula. Active in reaching and pushing. Fig 5.4
5-10 Function: Protect and stabilize sternoclavicular joint. Depress scapula. Fig 5.4
5-11 Function: Elevation and downward rotation of scapula. Fig 5.5
5-12 Function: Downward rotation, adduction (retraction), & elevation of scapula. Works with trapezius for maintenance of good posture. Fig 5.5
5-13 Function: I. Elevation II. Elevation, upward rotation, adduction III. Adduction IV. Upward rotation, depression, adduction Fig 5.6
5-14 Articulation of spherical head of humerus with small, shallow glenoid fossa of scapula. Glenoid labrum deepens the fossa and cushions impact of humeral head in forceful movements. Fig 5.7 Fig 5.8
5-27 Function: Internal rotation, extension, & adduction of the arm. Fig 5.15
5-28 Function: Long head assists in adduction, extension, and hyperextension of the humerus. Fig 5.15
5-29 Movements of the arm on the trunk involve the cooperative action of the shoulder girdle Acromioclavicular joints Sternoclavicular joints and the shoulder (glenohumeral) joint.
5-30 Shoulder Joint: Abduction Deltoid & supraspinaus Shoulder Girdle: Upward rotation of scapula Serratus anterior; trapezius II & IV Fig 5.16 Fig 5.17 Shoulder Joint: Adduction Latissimus dorsi, teres major, pectoralis major (sternal), & post. deltoid. Shoulder Girdle: reduction of upward rotation Rhomboids & pectoralis minor.
5-31 Shoulder Joint: Flexion Anterior deltoid & pectoralis major (clavicular). Shoulder Girdle: Upward rotation of scapula Serratus anterior & trapezius II & IV. Fig 5.18
5-32 Shoulder Joint: Extension Pectoralis major (sternal), teres major, latissimus dorsi, post. deltoid. Shoulder Girdle: Reduction of upward rotation of scapula Relaxation of agonists Against resistance - trapezius IV, rhomboids, pect. minor. Fig 5.19 Fig 5.20 Shoulder Joint: Hyperextension Teres major, latissimus dorsi, post. Deltoid. Shoulder Girdle: Anterior tilt of scapula Pectoralis minor.
5-33 Shoulder Joint: External Rotation Infraspinatus & teres minor Shoulder Girdle: Adduction of scapula Rhomboids & trapezius III. Fig 5.22a
5-34 Shoulder Joint: Internal Rotation Subscapularis, teres major, latissimus dorsi, ant. deltoid, pectoralis major. Shoulder Girdle: Abduction of scapula Serratus anterior & pectoralis minor. Shoulder Joint: Horizontal Adduction Pectoralis major, ant. deltoid, & coracobrachialis. Fig 5.22b Shoulder Girdle: Abduction of scapula Serratus anterior & pectoralis minor Shoulder Joint: Horizontal Abduction Post. deltoid, post middle deltoid, infraspinatus, teres minor, long head of biceps. Shoulder Girdle: Adduction of scapula Rhomboids & trapezius III.
5-35 Diagonal forward-downward and slightly inward movement of the arm. Fig 5.23 Fig 5.10
5-36 AC joint forced beyond normal ROM. Downward blow to outer end of shoulder. Fall on outstretched hand. Damage consists of tearing or severe stretching of AC ligaments.
5-37 Clavicle fractures have causes similar to AC sprain: Downward blow to outer end of shoulder. Fall on outstretched hand. May indicate injury by supporting injured arm. Head may be tilted toward injured side with face turned to opposite side.
5-38 May be forward, downward, or posterior. Most likely when arm is forcefully abducted and laterally rotated. May occur by a blow to top of shoulder. Head of humerus is forced out of the glenoid fossa. Arm held out from side in a position of slight abduction and lateral rotation. Loss of normal rounded contour of deltoid muscle.
5-39 Supraspinatus (supraspinatus tendon) most often injured. Nature of injury depends on arm kinematics. Caused by overuse, falls, or violent, fast arm motion.
5-40 Soft tissue superior to humeral head pressed against acromion process. Due to overuse, inflammation, trapped bursa, degeneration with aging. Will cause pain and inflammation in shoulder.