DIAG 2730 The Shoulder Complex

DIAG 2730 The Shoulder Complex - The Shoulder Complex The...

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The Shoulder Complex The primary function of the shoulder is to: i) Position the hand in space, allowing the upper extremity to perform fine motor function – an inability to position the hand results in impairment of the entire upper extremity ( Cyriax) ii) Suspend the upper extremity iii) Provide some point for fixation so motion of the upper extremity can occur iv) To serve as a fulcrum for arm elevation = scaption
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Anatomy of the Shoulder n The shoulder complex functions as an integrated unit, it is anatomically easier to describe each joint separately. The shoulder joint complex consists of: n Three bones (the humerus, the clavicle, and the scapula) n Three joints (the sternoclavicular (S-C), the acromioclavicular (A- C), and the glenohumeral (G-H) joints)
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Anatomy of the Shoulder n One “pseudojoint” – ST articulation n One physiological area – suprahumeral or subacromial space
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Glenohumeral Joint The G-H joint is a true synovial- lined diathrodial joint it connects the upper extremity to the trunk, as part of a kinetic chain The GH joint = the humeral head and the glenoid fossa of the scapula
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Anatomy of the Shoulder n Glenoid fossa n The glenoid fossa is flat, but is made approximately 50% deeper and more concave by a ring of fibrocartilage = labrum n The labrum, forms part of the articular surface, is attached to the margin of the glenoid cavity and the joint capsule, and contributes to joint stability
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Anatomy of the Shoulder The humeral head and glenoid fossa contact = 2 primary functions i) spreads the joint loading over a broad area ii) permits movement with minimal friction and wear
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Anatomy of the Shoulder n Scapula n The scapula = base of the G-H joint n It is a flat blade of bone that lies along the thoracic cage at 30 ° to the frontal plane, 3 ° superiorly relative to the transverse plane, and 20 ° forward in the sagittal plane n The scapula’s wide and thin configuration allows for its smooth gliding along the thoracic wall, and provides a large surface area for muscle attachments both distally and proximally
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Anatomy of the Shoulder n 16 muscles attach to the scapula – of these only six support and move the scapula n 1) trapezius 2) rhomboids 3) levator scapulae 4) serratus anterior 5) Latissimus Dorsi 6) Pectoralis Minor n The other 10 either stabilize the humerus or move the G/H joint ( see table 14-2) page 409 in Dutton
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Anatomy of the Shoulder n Three types of acromion morphology has been described – 1) flat undersurface n 2) slightly convex n 3) hooked, which can predispose the shoulder to rotator cuff pathology
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n Coracoid process projects forward like a crow’s beak (why it is named this) – the forward projection = a lever for the pectoralis major muscle to help stabilize the scapula. n
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DIAG 2730 The Shoulder Complex - The Shoulder Complex The...

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