The Shoulder Complex

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The Shoulder Complex
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Muscles of the AC Joint

• Chapter 4

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Movements of the Scapula

• 1. Elevation
• 2. Depression
• 3. Adduction (retraction)
• 4. Abduction (protraction)

5. Downward rotation 6. Upward rotation
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Anterior Muscles

• Pectoralis Minor
• Serratus Anterior

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Pectoralis Minor

• Origin Anterior surface of 3, 4, and 5 ribs
• Insertion Coracoid process
• Actions
• AC Abduction
• Downward rotation
• Depression

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Serratus Anterior

• Origin Lateral surface of upper 8 ribs
• Insertion Anterior surface of medial border and
  inferior angle of scapula.
• Actions
• AC Abduction
• Upward Rotation

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Posterior Muscles

• Levator Scapluae
• Trapezius
• Rhomboid

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Levator Scapulae

• Origin Transverse processes of the first 4
  cervical vertebrae.
• Insertion Superior angle and medial border of
  the scapula.
• Actions Elevation

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Trapezius

• Origin Occipital bone, ligamentum nuchae,
  spinous process of the C7 and all
  Thorasic vertebrae
• Insertion
• 1. Lateral 1/3 of clavicle.
• 2. Top of Acromion process.
• 3. Upper border of spine of the scapula.
• 4. Medial surface of spine of the scapula.

• Actions
• Upper elevation of the scapula
• Middle elevation, upward rotation, AC
  adduction
• Lower depression, AC adduction and upward
  rotation

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• Upper elevation

• Middle elevation, upward rotation, adduction

• Lower depression, adduction and upward rotation

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Pull of the lower fibers
Movement of scapula
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Rhomboid (major and minor)

• Origin Ligamentum nuchea and spinous process of
  C1-7 and 2-5 T
• Insertion Medial border of the scapula
• Actions
• AC Adduction
• Downward rotation,
• Elevation

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Subclavius

• Origin Superior aspect of first rib
• Insertion Inferior aspect at mid-clavicle
• Action
• Depression
• Stabilization

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Muscles of the Shoulder Joint

• Chapter 5

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Anterior Shoulder (GH Joint) Muscles

• Coracobrachialis
• Pectoralis Major
• Subscapularis

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Coracobrachialis

• O Coracoid process
• I Anteromedial surface of midshaft of humerus
• Actions
• Flexion
• Adduction of the shoulder
• Horizontal Adduction

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Pectoralis Major

• Origin
• Medial two-thirds of clavicle
• Sternum
• Insertion intertubercular groove
• Actions
• Upper fibers (Clavicular)
• Internal rotation
• Horizontal Adduction
• Flexion
• GH Adduction
• Abduction w/ Arm above 90 degrees
• Lower fibers (Sternal)
• Internal Rotation
• Horizontal adduction
• Extension
• GH Adduction

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Subscapularis

• O Subscapular fossa
• I Lesser tubercle and crest of humerus
• Actions
• Internal Rotation
• GH Adduction
• Extension from flexed position
• Stabilization
• Anterior Rotator Cuff Muscle.

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Superior Shoulder Muscles

• Deltoid
• Supraspinatus

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Deltoid

• Origin
• Lateral 1/3 of clavicle (Anterior
  fibers)
• Acromion process (Middle fibers)
• Spine of scapula (Posterior
  fibers)
• Insertion deltoid tuberosity

• Actions
• Anterior GH Abduction, Flexion, Horizontal
  adduction, Internal rotation.
• Middle GH Abduction
• Posterior GH Abduction, Extension, Horizontal
  abduction, External rotation

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Supraspinatus

• O Supraspinous fossa
• I Greater tubercle
• Action
• GH Abduction
• Stabilization
• Superior Rotator Cuff Muscle.

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Inferior Shoulder Muscles

• Latissimus Dorsi
• Teres Major

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Latissimus Dorsi

• O Spinous process of lower 6 thorasic and all
  lumbar and sacral vertebrae iliac crest
• I Intertubercular groove
• Actions
• Extension
• GH Adduction
• Horizontal Abduction

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Teres Major

• O Inferior angle of scapula
• I Intertubercular groove
• Actions
• Extension
• GH Adduction
• Internal rotation
• Lats little helper

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Posterior Shoulder Muscles

• Infraspinatus
• Teres Minor

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Infraspinatus

• O Infraspinous fossa
• I Greater tubercle
• Actions
• External rotation
• Horizontal abduction
• Extension
• Stabilization
• Posterior Rotator Cuff Muscle

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Teres Minor

• O Upper 2/3 of lateral border of scapula
• I Greater tubercle
• Actions
• External rotation
• Horizontal abduction
• Extension
• Stabilization
• Posterior Rotator Cuff Muscle

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Practice

• Name the actions of the shoulder (GH) joint.
• Flexion
• Extension
• Adduction
• Abduction
• Horizontal adduction
• Horizontal abduction
• Medial rotation
• Lateral rotation.

• Name the actions of the scapula (AC joint)
• Elevation
• Depression
• Adduction (retraction)
• Abduction (protraction)
• Upward rotation an
• Downward rotation.

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Scapula
Adduction Abduction Upward Rotation Downward Rotation
Trap (middle) Pect Minor Serratus Ant. Pect Minor
Trap (lower) Serratus Ant. Trap (middle) Rhomboid
Rhomboids Trap (lower)
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Practice

• Name the muscles for Horizontal Adduction
• Pect Major (upper)
• Pect Major (lower)
• Corachobrachialis
• Deltoid (anterior)

• Name the muscles for Horizontal Abduction
• Deltoid (post)
• Infraspinatus
• Teres minor
• Lats

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Practice

• List the muscles the do flexion of the shoulder

• List the muscles the do AC adduction

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Name the muscle.
Coracobrachialis
Name the action
Adduction of the shoulder
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Name the muscle.
Pectoralis Major
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Name the muscle.
Rhomboid
Name the action
Adduction of scapula
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Name the muscle.
Pectoralis minor
Name the action
Depression of the scapula
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Name the muscle.
Subscapularis
Name the action
Internal rotation of the shoulder
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Name the muscle.
Trapezius
Name the action
Adduction of the scapula
Name the action
Upward rotation
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Name the muscle.
Levator scapula
Name the action
Elevation of the scapula
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Name the muscle.
Deltoid
Name the action
Abduction of shoulder
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Name the muscle.
Infraspinatus
Name the action
External rotation
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Name the action
Name the muscle.
Adduction of scapula
Teres Major
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Name the muscle.
Serratus Anterior
Name the action
Abduction of scapula
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Name the muscle.
Teres Minor
Name the action if the humerus move directly to
the posterior
Extension of the shoulder
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Name the muscle.
Supraspinatus
Name the action
Abduction of the shoulder
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Latissimus Dorsi
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Coracobrachialis
Pect. Major
Subscapularis
Deltoid
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Supraspinatus
Teres Major
Infraspinatus
Teres Minor
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Pectoralis Minor
Levator Scapula
Rhomboid
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• Origin Occipital bone, ligamentum nuchae,
  spinous process of the C7 and all Thorasic v.
• Insertion
• 1. Lateral 1/3 of clavicle.
• 2. Top of Acromion process.
• 3. Upper border of spine of the scapula.
• 4. Medial surface of spine of the scapula.
• Actions
• Upper elevation
• Middle retraction and upward rotation
• Lower depression and upward rotation

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• Origin Supraspinatus fossa
• Insertion Greater tubercle of the humerus
• Action Weak abduction stabilization
• Name another muscle that abducts the shoulder.

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• Origin Medial 2/3 of the clavicle medial
  portion of the first 6 ribs the adjoining
  sternum.
• Insertion Outer lip of the intertubercular
  groove.

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• Origin 1) posterior crest of the iliac crest, 2)
  back of the sacrum and spinous processes of the
  lumbar and the lower 6 thorasic vertebrae and 3)
  inferior angle in some
• Insertion Intertubercle groove
• Name a muscle that would have the same actions as
  this one.

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• Origin Ligamentum nuchea and spinous process of
  C1-7 and 2-5 T
• Insertion Medial border of the scapula
• Actions Downward rotation, retraction, and
  elevation

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• Origin Lateral surface of upper 8 ribs
• Insertion Anterior surface of medial border and
  inferior angle of scapula.
• Actions Protraction (upper) and Upward Rotation
  (upper and lower)

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• Origin lateral 1/3 of clavicle, border of
  Acromion, lower edge of the spine of the scapula
• Insertion deltoid tuberosity on the lateral
  side of the humerus
• Actions
• Anterior Flexion, medial rotation and abduction
• Middle Abduction
• Posterior Extension, lateral rotation and
  abduction

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• Origin Transverse processes of the first 4
  cervical vertebrae.
• Insertion Superior angle and medial border of
  the scapula.
• Action Elevation