Shoulder Complex

Shoulder Complex

1. Shoulder Joint

   • ROM
     • Flexion
       • 180
       • Scapular Upward Rotation and Protraction
     • Extension
       • 45-60
       • Scapular downward rotation and Retraction
     • Abduction
       • 150-180
       • Scapular Retraction
       • Ho. Abduction
         • 30-45
     • Ho. Adduction
       • 135
     • Internal Rotation
       • 70-80
     • External Rotation
       • 80-90
   • Special Tests
     • Rotator Cuff
       • Empty Can
         • Supraspinatus
       • Hawkins-kennedy
       • Neer
         • LHBT pathology
       • Drop Arm
     • AC joint
       • AC Traction
         • Sprain of AC or CC ligaments
       • AC Compression
         • AC Sprain
     • STA
       • Scapular Assistance
         • Poor scapular motion
       • Scapular Retraction
         • Empty can, then + scap stabilizer
     • Glenohumeral Joint
       • Anterior Instability
         • Apprehension Test
         • Relocation + Anterior Release
       • Posterior Instability
         • Posterior Apprehension Test
         • Jerk Test
       • Inferior Instability
         • Sulcus Sign
     • Bicep Tendon Pathology
       • Yergason's
       • Speed's Test
     • SLAP Lesion
       • O'Brien's
       • Anterior Slide
         • Hands on hips
       • Compression-Rotation Test

2. Scapulothoracic Articulation

   • Scapular Kinematics
     • Protraction
       • Serratus Anterior
     • Retraction
       • Rhomboids
       • Trapezius
         • Middle
         • Lower
     • Elevation
       • Levator Scapula
       • Rhomboids
       • Upper Serratus Anterior
       • Trapezius
         • Upper
     • Depression
       • Serratus Anterior
         • Lower
       • Trapezius
         • Lower
       • Pactoralis Major
         • Clavicular
     • Upward Rotation
       • Serratus Anterior
       • Trapezius
     • Downward Rotation
       • Rhomboids
       • Levator Scapula
   • MOVES ONLY IN RESPONSE TO AC AND SC JOINT MOVEMENT

3. Glenohumeral joint

   • UNSTABLE BECAUSE OF
     • Different sizes of articulating surfaces
     • Loose joint capsule
     • Weak ligamentous support
   • Glenoid Labrum
     • Deepens socket
     • Increases articular surface
   • Joint Capsule
     • Volume 2x size of humeral head
     • Laxity allows humeral head to be distracted 2 cm or more
     • Reinforced by GH and CH ligaments
     • Taut when humerus is abducted to 90 and ext. rotated
   • Ligaments
     • GH Ligaments
       • Inferior
         • Inferior pouch connects anterior and posterior band
       • Middle
       • Superior
         • Foramen of Weitbrecht
           • Between sup. and mid., weak site torn in GH dislocation
     • Coracohumeral ligament
       • Connects with sup. capsule and supraspinatus to limit inferior translation of humerus in neutral
     • Coracoacromial ligament
       • Forms coracoacromial arch

4. Sternoclavicular Joint

   • Sternoclavicular disc
     • Upper attaches to clavicle
     • Lower Attaches to Manubrium and First Costal Cartilage
   • Ligaments
     • Anterior and posterior sternoclavicular ligaments
       • Reinforce synovial membrane
     • Interclavicular Ligament
       • Attach SC joints
     • Costoclavicular ligament
       • AKA Rhomboid ligament
       • Limit elevation and medial movement of clavicle

5. Acromioclavicular Joint

   • Ligaments
     • Coracoclavicular Ligament
       • Suspend Scapula from clavicle
       • Trapezoid ligament
         • Lateral
         • Limits lateral movement of clavicle
       • Conoid ligament
         • Medial
         • Limits superior movement of clavicle
     • AC ligaments
       • Superior and inferior
         • Maintain continuity between acromion and clavicle
   • Synovial disc
     • Between clavicle and acromion
       • Lasts until age 40