shoulder

shoulder

1. muscles

   • serratus anterior
     • protraction, upward rotation, depression of scapula
     • long thoracic, C5,C6,C7 roots
   • deltoid
     • anterior
       • forward flexion, H. adduction, IR
     • middle
       • abduction
     • posterior
       • extension, H.abduction, ER
     • axillary nerve C5-C6 posterior cord
   • trapezius
     • upper traps
       • elevation and upward rotation of scapula
     • middle
       • retraction of scapula
     • lower
       • depression and upward rotation of scapula
     • spinal accessory nerve(cranial nerve XI)
   • coracobrachialis
     • forward flexion
     • musculocutaneous C5-C6 lateral cord
   • triceps brachii
     • extension of shoulder (long head)
     • radial nerve C7,C8,T1 posterior cord
   • latissimus dorsi
     • Ext, IR of Shoulder, Depression, protraction of scapula
     • Thoracodorsal C6-C8 posterior cord
   • rotator cuff muscles
     • supraspinatus
       • abduction of the shoulder
       • suprascapular C5-C6 uppel trunk
       • palpation: Sitting, adduction, IR, Extension
       • US: sitting abduct 90 with int. rotation
       • test: empty can
     • infraspinatus
       • ER, abduction of shoulder
       • suprascapular C5-C6 upper trunk
     • teres minor
       • horizontal abduction,abduction, ER
       • axillary C5-C6 posterior cord
     • subscapularis
       • internal rotation, abduction
       • subscapular nerve C5-C6 posterior cord
     • palpation: passive extension of humerus
   • Biceps brachii (long head)
     • flexion(when strong contraction), abduction (if arm ER first)
     • musculocutaneus nerve C5-C6 lateral cord
     • US: Lateral rotation and extension
   • pectoralis major
     • sternocostal
       • extension, adduction, and IR
     • clavicular
       • forward flexion
     • lateral and medial pectoral nerves C5-C6 lateral cord
   • pectoralis minor
     • medial pectoral nerves C8-T1 medial cord
     • depression and protraction of scapula
   • rhomboids major
     • retraction, downward rotation, elevation of scapula
     • dorsal scapular nerve C5
   • rhomboids minor
     • retraction, downward rotation & elevation of scapula
     • dorsal scapular nerve C5
   • levator scapulae
     • elevation of scapula, downward rotation of scapula
     • dorsal scapular n. C3-C4 nerve roots
   • teres major
     • IR, adduction, extension, H.abduction
     • subscapular nerve C5-C6 posterior cord

2. joints

   • glenohumeral joint
     • open pack: 55 abduction, 30 horizontal adduction
     • closed pack: full abduction, lateral rotation
     • capsular pattern: lateral rotation, abduction, medial rotation
     • painful arc: 60-120
   • sternoclavicular joint
     • open pack:arm at side
     • close pack: full elevation
     • capsular: pain at extremes, especially at horizontal adduction and full elevation
   • acromioclavicular joint
     • open pack: arm at side
     • close pack: 90 abduction
     • capsular: pain at extremes of ROM: especially horizontal adduction and full elevation
     • painful arc: 170-180