Shoulder

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Shoulder
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A.A.A. Contest
Answer the Animated AnimaLS

• Throughout the slide show there will be slides
  with written questions.
• When you see a question, think of the answer,
  dont answer it out loud --- this way, everyone
  gets a chance to think.
• Some slides with a question will have
  animations of animals cross the screen. When
  this happens, write down the answer on a post it
  note and quickly WALK it up to post on the board
  at the front of the class.
• The first person to post the correct answer on
  the board is the winner! You get to put a
  sticker on the AAA Contest board.
• The contest will continue throughout the
  quarter at the end of the quarter, the person
  with the most stickers wins!

The winner gets a sur-Prize
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Bones of Shoulder

• Humerus
• The shoulder girdle
• Scapula
• Clavicle

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• The shoulder girdle
• attachment of the upper extremity to the trunk
• It consists of two bones
• the scapula (shoulder blade)
• clavicle (collarbone)

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Shoulder GirdleScapula Clavicle

• Link to Axial skeleton via sternoclavicular joint
  
• Lack of posterior attachment to the axial
  skeleton allows for a wide ROM
• Functions to allow attachment areas for numerous
  muscles that move the shoulder and elbow

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What is the only true synovial joint where there
is an articulation between the humerus and the
axial skeleton?
Sternoclavicular joint
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Landmarks of Scapula

• Borders
• superior, medial (vertebral), lateral (axillary)
• Angles
• inferior, superior
• Acromion process
• Spine of scapula
• Glenoid fossa
• Coracoid process
• Supraspinatus fossa, Infraspinatus fossa,
  Subscapular fossa
• Supraglenoid tubercle Infraglenoid Tubercle

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Posterior View of Scapula
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Anterior View of Shoulder Complex With Scapula,
Humerus and Clavicle
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Lateral View of Scapula (Sagittal Cross Section)
Anterior
Posterior
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• Learning Activity
• Label the landmarks of the scapula
• 1st try from memory
• (in a couple of minutes Zefire will put up a
  labeled picture so you can double check your
  answers, make corrections and additions)

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Joints of theShoulder Girdle

• Sternoclavicular joint
• 2. Acromioclavicular Joint
• Glenohumeral Joint
• (4) Scapulothoracic Joint
• - NOT really a synovial joint
• supported by muscles, not ligaments

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Joints of theShoulder Girdle

• 1. Sternoclavicular
• Sternum and clavicle
• gliding joint
• ligaments
• anterior sternoclavicular ligament
• posterior sternoclavicular ligament
• costoclavicular ligament
• interclavicular ligament

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Joints of theShoulder Girdle

• 2. Acromioclavicular
• Acromion Process of scapula and clavicle
• gliding joint
• ligaments
• coracoclavicular ligaments
• trapezoid ligament
• conoid ligament
• superior inferior acromioclavicular ligaments

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Acromioclavicular Joint
The joint is surrounded by a weak capsule that is
reinforced by strong inferior and superior
acromioclavicular ligaments. Further
strengthening occurs through the coracoclavicular
ligament formed of two strong fibre bundles, the
lateral trapezoid and medial conoid ligaments.
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Joints of theShoulder Girdle

• 3. Glenohumeral
• Glenoid fossa and head of the humerus
• Ball and socket
• Joint that allows most movement of entire body
• Allows movement in 3 planes

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Shoulder Joint Glenohumeral Joint
Process
Fossa
Fossa
Labrum a ring of fibrous cartilage
surrounding the glenoid stabilizes the
joint (makes a deeper socket)
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Shoulder Joint Glenohumeral Joint
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Glenohumeral Joint
What is the bony landmark on the scapula that
articulates with the humerus?
Glenoid Fossa
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Movements allowed by the Shoulder Glenohumeral
Joint Flexion Extension ADduction
Abduction Circumduction Flexion
Extension Adduction
Abduction Medial Rotation Lateral
Rotation Horizontal ABduction Horizontal
ADduction
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Movements allowed bythe Scapulothoracic joint

• Abduction (Protraction)
• Adduction (Retraction)
• Depression inferior movement
• Elevation superior movement
• Downward (inward) rotation inferior angle moves
  medially
• Upward (outward) rotation

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Movements allowed bythe Scapulothoracic joint

• Abduction (Protraction) scapula move away from
  spine
• Adduction (Retraction) scapula move closer to
  spine

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Protraction
Retraction
Bring shoulder blades closer together. A widening
across front of collarbone will occur. Try to
keep space between the hands constant.
Reach fingers forward. A widening between
shoulder blades will occur. Try to keep space
between the hands constant.
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Movements allowed bythe Scapulothoracic joint

• Depression inferior movement
• Elevation superior movement

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Movements allowed bythe Scapulothoracic joint

• Downward (inward) rotation inferior angle moves
  medially, and acromion moves downward
• Upward (outward) rotation inferior angle moves
  laterally, and acromion moves upward

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Scapular Movements in Action
What is the movement at the scapula as this man
contracts his muscles?
Elevation Superior movement of the shoulder
girdle moving the scapula up.
http//www.exrx.net/Articulations/Scapula.htmlanc
hor73267
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Scapular Movements in Action
Besides some depression of the scapula, what
other primary motion is occurring at the scapula
during the pull up?
Downward Rotation Rotary movement of the scapula
Moving inferior angle of scapula medially and
downward.
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Scapular Movements in Action
Upward Rotation
Rotary movement of the scapula Moving inferior
angle of scapula laterally and upward.
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Scapular Movements in Action
During the push-up phase of the movement, what is
the scapular action?
Abduction (Protraction) Forward movement away the
midline of the body moving the scapula away from
the spine.
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Scapular Movements in Action
What scapular movement is occurring during
contraction?
Adduction (Retraction) Backward movement toward
the midline of the body moving the scapula back
toward the spine.
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The scapula moves normally on the thorax only if
the two joints by which it attaches to the axial
skeleton are also free to move
Sternoclavicular joint Acromioclavicular joint
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Sternoclavicular (SC) joint movements
CLAVICULAR ELEVATION AND DEPRESSION
Clavicular protraction and Retraction
BACKWARD AND FORWARD ROTATION OF CLAVICLE OCCUR
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Acromioclavicular joint
Mobility at the AC joint allows the scapula to
move in three dimensions so that it follows the
contours of the ribcage.
Scapular WINGING TIPPING
UPWARD and DOWNWARD
ROTATION
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During shoulder elevation, the scapula and
clavicle must rotate upwardly
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Humeral Flexion and Extension
http//www.biomech.jhu.edu/Projects/shoulder/Defau
lt.htm
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Theres nothing like a good shoulder
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• Learning Activity
• Individually, without your notes
• Take 10 minutes to write an outline of the
  movements possible at the
• Glenohumeral joint
• Scapulothoracic joint
  
• Then, answer these questions Which of these
  joints allows more movement AC -
  acromioclavicular joint or sternoclavicular
  joint? In how many planes does this more
  moveable joint allow movement?
• Try drawing diagrams to see if that helps

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Learning Activity 2) In small groups, your
answers make sure everyone understands. 3) With
a scapula model, take turns, with each person
showing the scapulothoracic movements on a group
members back (while other group member(s) watch
and help).