SHOULDER

SHOULDER

1. Anatomy

   • bones
     • clavicle (collar bone)
       • long bone,has three main functions: Attaches the upper limb to the trunk. Protects the underlying neurovascular Transmits force from the upper limb to the axial skeleton.
       • Sternal (medial) End contains a large facet
       • Shaft acts a point of origin and attachment for several muscles
       • Acromial (lateral) End has a small facet
     • Scapula (shoulder blade)
       • triangular, flat bone,serves as a site for attachment for many (17) muscles
       • Costal Surface( anterior surface):Subscapular fossa+coracoid process
       • Lateral Surface:Glenoid fossa+Infraglenoid tubercle+Supraglenoid tubercle
       • Posterior Surface:Spine+Infraspinous fossa +Supraspinous fossa+Acromion
     • humerus
       • The proximal region articulates with the forming part of the shoulder joint. glenohumeral joint
       • Distally, the humerus articulates with the forearm bones (radius and ulna), to form the elbow joint.
       • The humerus acts as an attachment site for many muscles and ligaments, resulting in various raised roughening on the bony surface.
       • the head, anatomical neck, surgical neck, greater and lesser tubercles and intertubercular sulcus.
   • arteries
     • subclavian artery
       • superior thoracic
     • axilliary
       • thoracodorsal
         • deltoid
         • acromial
         • clavicular
         • pectoral
     • brachial
       • anterior humeral circumflex
       • posterior humeral circumflex
       • subscapular
   • nerves
     • from the ventral rami of C5, 6,7,8, and T1
       • Roots:(C5 dorsal scapular) (C5,C6,C7 long thoracic nerve)
       • Upper Trunk
         • C5&C6 subclevius
         • Subscapular
       • Lateral cord
         • lateral pectoral
         • lateral root of the median nerve
         • musculocutaneous
       • medial cord
         • medial pectoral
         • medial root of the median nerve
         • medial cutaneous nerve of the arm
         • medial cutaneous of the forarm
         • Ulnar
       • Posterior cord
         • upper suprascapular
         • lower suprascapular
         • thoracodorsal
         • axillary
         • radial
   • veins
     • begins at a continuation of the basilic vein at the lower border of the teres major
     • become the subclavian vein in the outer border of the first rib
   • muscles
     • extrinsic
       • Superficial
         • latissimus dorsi
         • trapezius
       • deep
         • Rhomboid minor
         • levator scapulae
         • Rhomboid major
     • intrinsic
       • Deltoid
       • Superaspinatus
       • Infeaspinatus
       • Teres minor
       • Teres major
       • subscapularis
     • pectoral region
       • pectoralis major
       • Pectoralis Minor
       • serratus anteror
       • subclavius
     • upper arm
       • biceps brachii
       • triceps brachii
       • coracobrachialis

2. pain

   • types
     • nocicpetive
       • somatic
       • visceral
     • nueoropathic
     • psychognic
   • assessment scales
     • minor
     • modirate
     • severe

3. Examination

   • inspection:looking for scars,discoloration...
   • palpation:feeling :temperature ,swelling...
   • range of movement: abducton,flextion
   • special tests:conformatory tests such as speed's,hawkin's ...

4. Diseases of shoulder pain

   • tendon infalmmation
   • instability
   • arthritis
   • fracture
   • impingement