7Bursa of Shoulder Joint Contain thin layer of synovial fluidLocated where tendons rub against bone, ligaments, or tendons and when skin moves over bone directly beneathSubscapular bursaSubacromial (subdeltoid) bursa
8Subacromial (subdeltoid) bursa Subscapular bursaBetween tendon of subscapularis muscle and neck of scapulaCommunicates with cavity of shoulder jointSubacromial (subdeltoid) bursaBetween deltoid, supraspinatus tendon and glenohumeral capsuleDoes not communicate with cavity of shoulderFacilitates movement of deltoid over joint capsule and supraspinatus tendon under coracoacromial arch
9Movements: Mobile but unstable joint - The head of the humerus doesn’t fit perfectly with the glenoid fossa and Glenoid labrum
12Stability Depends mainly on Rotator cuff muscle, deltiod & biceps musclesThe weakest part isthe inferior aspect of the capsule( no muscles)
13ANTERIOR DISLOCATIONShoulder joint is the most commonly dislocated large jointCommon type is anterior dislocation (post. Dislocation is very rare)Young adult(athletes)Excessive extension and lateral rotation of the humerusHead of the humerus comes to lie inferior to the glenoid fossaHead is pulled (by flexors and adductors of the shoulder joint) forward And upward into the subcoracoid position
15Elbow Joint TYPE: Hinge type of synovial joint ARTICULATIONS : Trochlea and spheroidal capitulum of the humerus articulate with the trochlear notch of the ulna and the slightly concave superior aspect of the head of the radius
16CAPSULE :The fibrous layer of the joint capsule surrounds the elbow joint.The synovial membrane lines the internal surface of the fibrous layer of the capsule and the intracapsular non- articular parts of the humerus.
17Ligaments of the Elbow Joint Lateral: Radial collateral ligament extends from the lateral epicondyle of the humerus and blends distally with the anular ligament of the radius.Medial: Ulnar collateral ligament extends from the medial epicondyle of the humerus to the coronoid process and olecranon of the ulna.
18Movements of the Elbow Joint Flexion and extension occur at the elbow joint.Chief flexors of the elbow joint are the brachialis and biceps brachii.Chief extensor of the elbow joint is the triceps brachii.
19Bursae around the Elbow Joint 1. Intratendinous olecranon bursa2. Subtendinous olecranon bursa3. Subcutaneous olecranon bursa
20Bursitis of the ElbowStudent's elbow: Subcutaneous olecranon bursa is exposed to injury during falls on the elbow and to infection from abrasions of the skin covering the olecranon.
21Tennis elbow(Lateral epicondylitis) It occurs at the common extensor tendon that originates from the lateral epicondyle.The acute pain that a person might feel occurs as one fully extends the arm.
22Golfer's elbow(medial epicondylitis) Is an inflammatory condition of the medial epicondyle of the elbow.
23Proximal radioulnar joint Type: Pivot type of synovial jointArticulation: Head of the radius articulates with the radial notch of the ulnaLigaments: The strong anular ligament, attached to the ulna anterior and posterior to its radial notch.
24Movements Pronation and supination. Pronation: Pronator quadratus (primarily) and pronator teresSupination: Supinator and biceps brachii.
25Subluxation and Dislocation of Radial Head Pulled elbow or Nursemaid's elbowThe sudden pulling of the upper limb tears the distal attachment of the anular ligament, where it is loosely attached to the neck of the radius.
26Wrist Joint (radiocarpal) Type: Condyloid (ellipsoid) type of synovial jointArticulation: The ulna does not participate in the wrist joint.The distal end of the radius articulate with the proximal row of carpal bones, except for the pisiform.
27Movements of the Wrist Joint Flexion, extension, abduction and adduction (radial deviation and ulnar deviation).
29Tendon ReflexesDeep Tendon Reflexes will not work if either the sensory or motor component of the nerve to the muscle being tested are injured, or if the spinal cord segment where the reflex is integrated is injured.
30Biceps jerkTechnique :Patient sitting and relaxed.Therapist places her thumb over biceps tendon and applies a brisk tap (to her thumb nail) with reflex hammerHypo reflex – problem in Nerves or RootsHyper Reflex – Problem in Spinal cord or Brain
31Triceps Jerk nerve root ( C7) It is initiated by the Cervical spinal nerve 7nerve root ( C7)