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Joint Detail
Last saved by yatesh
4/30/2017
6:32:39 PM
Shoulder joint Specifically known as Glenohumeral Joint
Name: Codie Hilton, Tamara Stacey, Megan Pate, James
Date: 09/01/10
Mecalf
Joint type
Enarthrodial
Joint Stability
Static (ligaments)
Dynamic (muscles)
Close packed position
Extension
Anterior
Coracohumeral, superior
Pectoralis major, pectoralis minor, internal
Loose packed position
Flexion
Glenohumeral, inferior
intercostals, coracobrachialis, subscapularis,
Degrees of freedom
170-180 degrees flexion and abduction
Glenohumeral, middle
deltoid trapezius, stemocleidomastiod
glenohumeral
Bones & specific bony
Humerus
Greater tuberosity, lesser tuberosity
landmarks
Posterior
Levator scapulae, supraspinatus, deltoid,
Scapula
Spine of scapula, acromion, coracoid process
infraspinatus, teres minor, teres, major,
Sternum
Manubrium of sternum
rhomboideus major, latissimus dorsi,
Specific articulating bony
Greater tuberosity, lesser tuberosity, bicipital groove, Spine of scapula,
trapezius, deltoid
surfaces
acromion, coracoid process, clavicle, Manubrium of sternum
Medial
Lateral
Inferior Glenohumeral, middle
Glenohumeral, superior
Glenohumeral, coracohumeral,
Movement
Muscles
Goniometry
Manual Muscle Testing
Agonists
Palpation
Proximal
Distal Attachment Innervation
Recommended Sitting, with thoracic &
Motion or
Muscle
Motion:
Attachment
Testing Position lumbar spine well
specific,
Flexion
supported by the back of
list ↓
Pectoralis major From medial end of
Medial half of
Flat tendon 2 or 3 Lateral pectoral
Range:
the chair. Tongue
upper fibers
clavicle to the
anterior surface of inches wide to nerve (C5, C6,
Muscle(s) Deltoid
90-100
depressor can be held
intertubercular groove of clavicle
lateral lip of
C7
anterior
degrees
between teeth for
the humerus, during
intertubercular
fibers,
Plane:
reference
flexion
and
adduction
groove
of
Pectoralis
Sagittal
from
the
anatomical
humerus
Stabilization
Shoulder
girdle
is
major upper
Axis:
position
stabilized
to
prevent
fibers
Frontal
flexion of thoracic & Recommend Patient is
Deltoid anterior From the clavicle toward Anterior lateral Deltoid tuberosity Axillary nerve
lumbar spine
fibers
the anterior humerus
third of clavicle on the lateral
(C5, C6)
ed Testing short sitting
during resisted flexion or
humerus
Center
Over the external
Position with arms at
horizontal adduction
auditory meatus
sides, elbow
slightly
Proximal Arm Perpendicular or parallel
flexed, and
to ground
forearm
Distal Arm
With base of nares or
supinated
parallel to longitudinal
axis of tongue depressorResistance Examiner
Hand
stands at
Placement test side
with one
hand giving
maximal
resistance
over distal
humerus
and other
hand
1
Joint Detail
Motion:
Extension
Range:
40-60
degrees
Plane:
Sagittal
Axis:
Frontal
Motion:
Abduction
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Agonists
Palpation
Pectoralis major From the lower ribs and
lower fibers
sternum to the
intertubercular groove of
the humerus, during
resisted extension from a
flexed position
Latissimus dorsi The tendon may be
palpated as in passes
under the teres mahor at
the posterior axillary wall,
particularly during
resisted extension and
internal rotation. The
muscle can be palpated
in the upper lumbar/lower
thoracic area during
extension from a flexed
position and throughout
most of its length during
resisted adduction from a
slightly abducted position
Teres major
Just above the latissimus
dorsi and below the teres
minor on the posterior
scapula surface, moving
diagonally upward and
laterally from the inferior
angle of the scapula
during resisted internal
rotation
Agonists
Palpation
4/30/2017
Proximal
Attachment
Anterior surface
of costal
cartilages of first
six ribs, and
adjoining portion
of sternum
Posterior crest of
ilium, back of
sacrum and
spinous
processes of
lumbar and lower
six thoracic
vertebrae, slips
from lower three
ribs
Distal Attachment
Posterirly on
inferior third of
lateral border of
scapula and just
superior to
inferior
Medial lip
Lower
intertubercular subscapular
groove of
nerve (C5, C6)
humerus, just
posterior to the
insertion of the
latissimus dorsi
Proximal
Attachment
Innervation
Flat tendon 2 or 3 Medial pectoral
inches wide to nerve (C8, T1)
lateral lip of
intertubercular
groove of
humerus
Medial side of
Thoracodorsal
intertubercular (C6, C7, C8)
groove of
humerus, just
anterior to the
insertion of the
teres major
Distal Attachment
Innervation
6:32:39 PM
stabilizing
shoulder.
Patient Patient
Instruction raises arm
off table
keeping
elbow
straight.
Special
notes
Recommended Prone, head facing
Motion
Muscle specific, list
Testing Position away from involved
or
↓
shoulder, G-H 00
Muscle( Pectoralis major lower fibers,
abduction & rotation,
s)
Latissimus dorsi, Teres major
elbow slight flex, 00 of Recommended Patient is prone with
pronation-supination Testing Position arms at sides and
Stabilization Scapula to prevent
shoulder internally
elevation, anterior tilting
rotated.
Center
Close to acromion
Resistance Hand Examiner stands at
process
Placement
test side and applies
Proximal Arm Midaxillary line of
maximal resistance
thorax
over posterior arm
just above elbow.
Distal Arm
Lateral midline of
humerus, lateral
Patient Instruction Patient raises arm
epicondyle
off table keeping
elbow straight.
Special notes
Recommended Supine, may be sitting
Testing Position or prone, G-H 00 flex-
Motion
or
Muscle specific, list
↓
2
Joint Detail
Range:
90-100
degrees
Plane:
Frontal
Axis:
Sagittal
Motion:
Adduction
Range:
0 degrees
Plane:
Frontal
Axis:
Sagittal
Last saved by yatesh
Pectoralis major From medial end of
Medial half of
upper fibers
clavicle to the
anterior surface
intertubercular groove of of clavicle
the humerus, during
flexion and adduction
from the anatomical
position
Deltoid anterior From the clavicle toward Anterior lateral
fibers
the anterior humerus
third of clavicle
during resisted flexion or
horizontal adduction
Deltoid middle From the lateral border of Lateral aspect of
fibers
the acromion down
acromion
toward the deltoid
tuberosity during resisted
abduction
Deltoid posterior From the lower lip of the Lateral aspect of
fibers
spine of the scapula
acromion
toward the posterior
humerus during resisted
extension or horizontal
abduction
Supra spinatus Above the spine of the Medial 2/3 of
scapula in supraspinatus supraspinatus
fossa during initial
fossa
abduction in the scapula
plane, tendon may be
palpated just off acromion
on greater tubercle
Agonists
Palpation
Proximal
Attachment
Pectoralis major From the lower ribs and Anterior surface
lower fibers
sternum to the
of costal
intertubercular groove of cartilages of first
the humerus, during
six ribs, and
resisted extension from a adjoining portion
flexed position
of sternum
Lattissimus
The tendon may be
Posterior crest of
dorsi
palpated as in passes
ilium, back of
under the teres mahor at sacrum and
the posterior axillary wall, spinous
particularly during
processes of
resisted extension and lumbar and lower
internal rotation. The
six thoracic
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Flat tendon 2 or 3 Lateral pectoral
inches wide to nerve (C5, C6,
lateral lip of
C7
intertubercular
groove of
humerus
Deltoid tuberosity Axillary nerve
on the lateral
(C5, C6)
humerus
Deltoid tuberosity Axillary nerve
on lateral
(C5, C6)
humerus
Deltoid tuberosity Axillary nerve
on lateral
(C5, C6)
humerus
6:32:39 PM
Stabilization
Center
Proximal Arm
Distal Arm
extension, full ext
Muscle( Pectoralis major, upper fibers,
rotation, elbow
s)
Deltoid anterior fibers, Deltoid
extension
middle fibers, Deltoid posterior
fibers, Supra spinatus
Scapula to prevent UR
& elevation, Thorax to Recommended Patient is short
prevent lateral flex of Testing Position sitting with arm at
trunk
side and elbow
slightly flexed.
Close to anterior
acromion process
Resistance Hand Examiner is standing
Placement
behind patient giving
Parallel to midline of
resistance over arm
ant sternum
just above elbow.
Medial midline of
Patient Instruction Patient abducts arm
humerus
to 90 degrees
against maximal
downward pressure.
Special notes
Superiorly on
Suprascapula
greater tubercle nerve (C5)
of humerous
Distal Attachment
Innervation
Flat tendon 2 or 3 Medial pectoral
inches wide to nerve (C8, T1)
lateral lip of
intertubercular
groove of
humerus
Medial side of
Thoracodorsal
intertubercular (C6, C7, C8)
groove of
humerus, just
anterior to the
insertion of the
teres major
Recommended Supine, may be sitting
Testing Position or prone, G-H 00 flexextension, full
extension rotation,
elbow extension
Stabilization Scapula to prevent UR
& elevation, Thorax to
prevent lateral flex of
trunk
Center
Close to anterior
acromion process
Proximal Arm Parallel to midline of
anterior sternum
Distal Arm
Medial midline of
humerus
Motion
Muscle specific, list
or
↓
Muscle( Pectoralis major lower fibers,
s)
Lattissimus dorsi, Teres major
Recommended Stand behind the
Testing Position patient while the
patient to patient is
sitting erect.
Resistance Hand Place your stabilizing
Placement
hand upon the
acromion and your
resisting hand
proximal to the
elbow joint. Since
the pectoralis major
3
Joint Detail
Last saved by yatesh
Teres major
Motion:
Internal
Rotation
Range:
45 degrees
Plane:
Transverse
Axis:
Vertical
Agonists
muscle can be palpated
in the upper lumbar/lower
thoracic area during
extension from a flexed
position and throughout
most of its length during
resisted adduction from a
slightly abducted position
Just above latissimus
dorsi and below the teres
minor on the posterior
scapula surface, moving
diagonally upward and
laterally from theinferior
angle of the scapula
during resisted external
rotation
Palpation
4/30/2017
vertebrae, slips
from lower three
ribs
Posteriorly ion
inferior third of
lateral border of
scapula and just
superior to
inferior angle
Proximal
Attachment
Pectoralis major From medial end of
Medial half of
upper fibers
clavicle to the
anterior surface
intertubercular groove of of clavicle
the humerus, during
flexion and adduction
from the anatomical
position
Pectoralis major From the lower ribs and Anterior surface
lower fibers
sternum to the
of costal
intertubercular groove of cartilages of first
the humerus, during
six ribs, and
resisted extension from a adjoining portion
flexed position
of sternum
Lattissimus dorsi The tendon may be
Posterior crest of
palpated as in passes
ilium, back of
under the teres mahor at sacrum and
the posterior axillary wall, spinous
particularly during
processes of
resisted extension and lumbar and lower
internal rotation. The
six thoracic
muscle can be palpated vertebrae, slips
in the upper lumbar/lower from lower three
thoracic area during
ribs
extension from a flexed
Medial lip of
Axillary nerve
intertubercular (C5, C6)
groove of
humerus, just
posterior to the
insertion of the
latissimus dorsi
Distal Attachment
Innervation
Flat tendon 2 or 3 Lateral pectoral
inches wide to nerve (C5, C6,
lateral lip of
C7
intertubercular
groove of
humerus
Flat tendon 2 or 3 Medial pectoral
inches wide to nerve (C8, T1)
lateral lip of
intertubercular
groove of
humerus
Medial side of
Thoracodorsal
intertubercular (C6, C7, C8)
groove of
humerus, just
anterior to the
insertion of the
teres major
6:32:39 PM
muscle is a primary
adductor, move the
stabilizing hand
anteriorly and
inferiorly on the
acromion so that you
can palpate the
pectoralis major.
Patient Instruction Instruct the patient to
place his arm n a
few degrees of
abduction and shift
your resisting hand
so that your thumb
rests against the
medial aspect of his
humerus.
Special notes
Recommended Supine, arm in 900 of
Motion
Muscle specific, list
Testing Position abduction, forearm
or
↓
perpendicular to
Muscle( Pectoralis major upper fibers,
supporting surface & 00 s)
Pectoralis major lower fibers,
of pronation-supination,
Lattissimus dorsi, Teres major,
full length of humerus
Subscapularis
on supporting surface Recommended Patient is prone with
Stabilization Humerus to maintain Testing Position shoulder abducted to
900 abduction, scapula
90 degrees with
to prevent elevation &
folded towel placed
anterior tilting
under distal arm and
Center
Over olecranon process
forearm hanging
vertically over edge
Proximal Arm Parallel to or
of table.
perpendicular to floor
Distal Arm
Ulnar, using olecranon Resistance Hand Examiner stands at
Placement
test side giving
& ulnar styloid
resistance over volar
side of forearm just
above the wrist in a
downward and
forward direction.
Patient Instruction The other hand
provides
counterforce at the
elbow in a backward
and slightly upward
4
Joint Detail
Last saved by yatesh
Teres major
Subscapularis
position and throughout
most of its length during
resisted adduction from a
slightly abducted position
Just above the latissimus Posteriorly on
dorsi and below the teres inferior third of
minor on the posterior
lateral border of
scapula surface, moving scapula and just
diagonally upward and superior to
laterally from the inferior inferior
angle of the scapula
during resisted internal
rotation
Mostly inaccessible,
Entire anterior
lateral portion may be
surface of
palpated on supine
subscapularis
subject (arm in slight
fossa
flexion and adduction
with elbow lying across
abdomen); pull medial
border laterally with one
hand while palpating
between the scapula and
rib cage with other hand
(subject actively internally
rotates)
4/30/2017
6:32:39 PM
direction
Special notes
Medial lip
Lower
intertubercular subscapular
groove of
nerve (C5, C6)
humerus, just
posterior to the
insertion of the
latissimus dorsi
Lesser tubercle Upper and lower
of humerus
subscapular
nerve (C5, C6)
5
Joint Detail
Motion:
External
Rotation
Range:
45 degrees
Plane:
Transverse
Axis:
Vertical
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Agonists
Infraspinatus
Teres minor
Palpation
Just below the spine of
the scapula passing
upward and laterally to
the humerus during
resisted external rotation
Just above the teres
major on the posterior
scapula surface, moving
diagonally upward and
laterally from the inferior
angle of the scapula
during resisted external
rotation
Proximal
Attachment
Medial aspect of
infraspinatus
fossa just below
spine of scapula
4/30/2017
Distal Attachment
Innervation
Posteriorly on
Suprascapula
greater tubercle nerve (C, C6)
of humerus
Posteriorly on
Posteriorly on
Axillary nerve
upper and midlle greater tubercle (C5, C6)
aspect of lateral of humerus
border of scapula
6:32:39 PM
Recommended Supine, arm in 900 of
Motion
Muscle specific, list
Testing Position abd, forearm
or
↓
perpendicular to
Muscle( Teres minor, Infraspinatus
supporting surface & 00 s)
of pronation-supination, Recommended Patient is prone with
full length of humerus Testing Position shoulder abducted to
on supporting surface
90 degrees and
Stabilization Humerus to maintain
forearm hanging
900 abduction, scapula
vertically over edge
to prevent post tilting
of table.
Center
Over olecranon processResistance Hand Examiner stands at
Proximal Arm Parallel to or
Placement
test side at level of
perpendicular to floor
patient's waist. One
hand gives
Distal Arm
Ulnar, using olecranon
resistance at wrist
& ulnar styloid
while other hand
supports and
provides counter
pressure at the
elbow.
Patient Instruction Patient moves
forearm upward
through range of
external rotation.
Special notes
6