Download shouldergirdle chp 8

Shoulder Girdle
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Shoulder Girdle

Shoulder Complex is the most mobile
joint in the body.
Scapula
 Clavicle
 Sternum
 Humerus
 Rib cage/Thorax

Shoulder Girdle

Points of interest

Scapula
• Acromion process
• Glenoid fossa
Shoulder Girdle

It also includes
Sternoclavicular joint
 Acromicoclaviulcar joint
 Glenohumeral joint
 Scapulothoracic articulation

Shoulder Girdle Ligaments

Sternoclaviular Joint-Joint connecting
the sternum to the clavicle on each
side of the body.
Shoulder Girdle Ligaments

Acromioclavicular Joint- joint
connecting the acromion process to
the clavicle at the distal end of the
clavicle.
Shoulder Girdle Joints

Glenohumeral joint- joint where the
humerus fits into the glenoid fossa of
the scapula.
Shoulder Girdle Ligaments

Scapulothoracic joint- joint where the
scapula slides over the thorax or rib
cage.
Shoulder Girdle Motions

Shoulder girdle is the motions at the
Acromioclavicular joint
 Sternoclavicular joint

• Elevation/depression
• Protraction/retraction
• Upward/downward rotation
Scapula Landmarks

Axillary border- lateral side between
glenoid fossa and inferior angle.
Scapula Landmarks

Vertebral border- between superior
and inferior angles medially. Where
the rhomboid and serratus anterior
muscles attach.
Scapula Landmarks

Spine of the scapula

Projection on posterior surface
running from medial border to the
acromion process.
Scapula Landmarks

Glenoid fossa- slightly concave
surface that articulates with humerus.
Scapula Landmarks

Acromion process-broad flat area on
superior lateral aspect.
Scapula Landmarks

Coracoid process-Projection on
anterior surface of scapula. (e)
Scapula landmarks

Inferior and Superior Angle- superior
medial and inferior point of the
scapula.
Shoulder Girdle Bones

Clavicle-S shaped bone that connects
upper extremity to the axial skeleton.
Shoulder Girdle Bones

Sternum-flat bone located in the
midline of the anterior thorax.
Manubrium-top
 Body-Middle
 Xiphoid process
bottom triangle

Shoulder Ligaments

Acromioclavicular ligament- connect
accromion to clavicle and help prevent
dislocation of the clavicle.
Shoulder Ligament

Coracoacromial Ligament- Connects
the coracoid process to the acromion
process.
Acromicavicular Separation


Also known as an AC sprain.
Occurs due to fall on outstretched arm or
tip of shoulder. May be due to blow to tip
of shoulder
AC separation

Signs and Sx
deformity
 Pain in vicinity of
AC
Special Test
 Shear Test
 Sulcus Sign


Treatment




Three grades –the
grade determines
treatment
Grade one is
exercise and ice
Grade two
immobilize 3
weeks and then
exercise
Grade three
immobilize 5
weeks and then
exercise
Joint motions

Shoulder







Flexion
Extension
Hyperextension
Adduction
Abduction
Medial rotation
Lateral rotation

Shoulder girdle







Up rotation
Down rotation
Scapular tilt
Down rotation
Up rotation
Protraction
Retraction
Scapulohumeral rhythm
The first 30 degrees of motion is
shoulder.
 After that the for every 2 degrees the
humerus moves the scapula upwardly
rotates 1 degree.

Lets try it



Stand next to a partner that you are
comfortable touching on their back.
Person in anatomical position, place your
hand on the axillary border of the scapula.
Ask them to abduction and see what
happens when they get above 30 degrees.
You feel upward rotation in flexion and
abduction
The scapula will start rotating upward
Muscles of shoulder girdle

Rhomboid- major and minor. They
get their name from Rhomboid shape,
they lie under the trapezius.
Muscles of shoulder girdle

Serratus Anterior- serrated shape can
be touched in full flexion. It is a
scapular protractor.
Serratus Anterior-winging
scapula

Weakness of the
serratus anterior
specifically and
the shoulder
girdle in general
causes the
scapula to wing
out.
Muscles of shoulder girdle

Pectoralis minor- only shoulder girdle
muscle on the anterior side, it lies
deep to the pectoralis major.
Muscles of shoulder girdle

Levator scapula- named for the
elevation of the scapula, its main
function.
Muscles of shoulder girdle

Trapezius- 3 lines of pull
Upper trapezius
 Middle trapezius
 Lower trapezius

Muscles of shoulder girdle

Trapezius-upper
Origin- nuchal ligament and occipital
bone
 Insertion- lateral third of the clavicle

Muscles of shoulder girdle

Trapezius-lower
Origin- spinous process of t4-t12
 Insertion- base of the scapular spine
