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Joint Detail
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4/30/2017
2:12:37 AM
Shoulder joint Specifically known as Glenohumeral Joint
Name: Dominique Grady, Traves Yelder, LaJoy Paige,
Date: 9/1/10
Lindsey Robinson
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 & Flexion 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 anterior fibers,
90-100
depressor can be held
intertubercular groove of clavicle
lateral lip of
C7
Pectoralis major upper
degrees
between teeth for
the humerus, during
intertubercular
fibers
Plane:
reference
flexion
and
adduction
groove
of
Recomm
Patient is
Sagittal
from
the
anatomical
humerus
Stabilization
Shoulder
girdle
is
ended
short sitting
Axis:
position
stabilized
to
prevent
Testing
with arms at
Frontal
flexion of thoracic &
Deltoid anterior From the clavicle toward Anterior lateral
Deltoid tuberosity Axillary nerve
Position sides, elbow
lumbar spine
fibers
the anterior humerus
third of clavicle on the lateral
(C5, C6)
slightly
during resisted flexion or
humerus
Center
Over the external
flexed, and
horizontal adduction
auditory meatus
forearm
supinated
Proximal Arm Perpendicular or parallel
to ground
Resistanc Examiner
Distal Arm
With base of nares or e Hand stands at
parallel to longitudinal Placemen test side
with one
axis of tongue depressor t
hand giving
maximal
resistance
over distal
humerus
and other
hand
stabilizing
shoulder.
Patient Patient
1
Joint Detail
Motion:
Extension
Range:
40-60
degrees
Plane:
Sagittal
Axis:
Frontal
Motion:
Abduction
Range:
90-100
degrees
Last saved by ws-is
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 major 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
Posteriorly 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
Pectoralis major From medial end of
Medial half of
upper fibers
clavicle to the
anterior surface
intertubercular groove of of clavicle
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
Flat tendon 2 or 3 Lateral pectoral
inches wide to nerve (C5, C6,
lateral lip of
C7
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Instructio raises arm
n
off table
keeping
elbow
straight.
Special
notes
Recommended Prone, head facing
Ext Motion
Muscle specific, list
Testing Position away from involved
en or
↓
shoulder, G-H 00
sio
abduction & rotation, n
elbow slight flex, 00 of Muscle( Pectoralis major lower fibers,
pronation-supination
s)
Latissimus dorsi, Teres major
Stabilization Scapula to prevent
Recommended Patient is prone with
elevation, anterior tilting Testing Position arms at sides and
Center
Close to acromion
shoulder internally
process
rotated.
Proximal Arm Midaxillary line of
Resistance Hand Examiner stands at
thorax
Placement
test side and applies
maximal resistance
Distal Arm
Lateral midline of
over posterior arm
humerus, lateral
just above elbow.
epicondyle
Patient Instruction Patient raises arm
off table keeping
elbow straight.
Special notes
Recommended Supine, may be sitting
Testing Position or prone, G-H 00 flexextension, full ext
rotation, elbow
extension
Abd
ucti
on
Mus
cle(s
Motion
or
Muscle specific, list
↓
Pectoralis major, upper fibers,
Deltoid anterior fibers, Deltoid
2
Joint Detail
Plane:
Frontal
Axis:
Sagittal
Motion:
Adduction
Range:
0 degrees
Plane:
Frontal
Axis:
Sagittal
Last saved by ws-is
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
Supraspinatus 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 major 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
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intertubercular
groove of
humerus
2:12:37 AM
Stabilization
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
Center
Proximal Arm
Distal Arm
Scapula to prevent UR
& elevation, Thorax to
prevent lateral flex of
trunk
Close to anterior
acromion process
Parallel to midline of
ant sternum
Medial midline of
humerus
)
middle fibers, Deltoid posterior
fibers, Supraspinatus
Recommended Patient is short
Testing Position sitting with arm at
side and elbow
slightly flexed.
Resistance Hand Examiner is standing
Placement
behind patient giving
resistance over arm
just above elbow.
Patient Instruction Patient abducts arm
to 90 degrees
against maximal
downward pressure.
Special notes
Superiorly on
Suprascapula
greater tubercle nerve (C5)
of humerus
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 Add Motion
Muscle specific, list
Testing Position or prone, G-H 00 flex- ucti or
↓
extension, full
on
extension rotation,
Muscle( Pectoralis major lower fibers,
elbow extension
s)
Lattissimus dorsi, Teres major
Stabilization Scapula to prevent UR Recommended Stand behind the
& elevation, Thorax to Testing Position patient while the
prevent lateral flex of
patient to patient is
trunk
sitting erect.
Center
Close to anterior
Resistance Hand Place your stabilizing
acromion process
Placement
hand upon the
Proximal Arm Parallel to midline of
acromion and your
anterior sternum
resisting hand
proximal to the
Distal Arm
Medial midline of
elbow joint. Since
humerus
the pectoralis major
muscle is a primary
adductor, move the
3
Joint Detail
Last saved by ws-is
Teres major
Motion:
Internal
Rotation
Range:
45 degrees
Plane:
Transverse
Axis:
Vertical
Agonists
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 the inferior
angle of the scapula
during resisted external
rotation
Palpation
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 major 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
position and throughout
most of its length during
4/30/2017
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
2:12:37 AM
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 Inter Motion
Muscle specific, list
Testing Position abduction, forearm
nal or
↓
perpendicular to
Rota
supporting surface & 00 tion
of pronation-supination,Muscle( Pectoralis major upper fibers,
full length of humerus
s)
Pectoralis major lower fibers,
on supporting surface
Lattissimus dorsi, Teres major,
Stabilization Humerus to maintain
Subscapularis
900 abduction, scapula Recommended Patient is prone with
to prevent elevation & Testing Position shoulder abducted to
anterior tilting
90 degrees with
Center
Over olecranon process
folded towel placed
under distal arm and
Proximal Arm Parallel to or
forearm hanging
perpendicular to floor
vertically over edge
Distal Arm
Ulnar, using olecranon
of table.
& ulnar styloid
Resistance Hand Examiner stands at
Placement
test side giving
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 ws-is
Teres major
Subscapularis
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
2:12:37 AM
direction
Medial lip
Lower
intertubercular subscapular
groove of
nerve (C5, C6)
humerus, just
posterior to the
insertion of the
latissimus dorsi
Special notes
Lesser tubercle Upper and lower
of humerus
subscapular
nerve (C5, C6)
5
Joint Detail
Motion:
External
Rotation
Range:
45 degrees
Plane:
Transverse
Axis:
Vertical
Last saved by ws-is
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 middle greater tubercle (C5, C6)
aspect of lateral of humerus
border of scapula
2:12:37 AM
Recommended Supine, arm in 900 of Exte Motion
Muscle specific, list
Testing Position abduction, forearm
rnal or
↓
perpendicular to
Rota
supporting surface & 00 tion
of pronation-supination,Muscle( Teres minor, Infraspinatus
full length of humerus
s)
on supporting surface Recommended Patient is prone with
Stabilization Humerus to maintain Testing Position shoulder abducted to
900 abduction, scapula
90 degrees and
to prevent post tilting
forearm hanging
Center
Over olecranon process
vertically over edge
of table.
Proximal Arm Parallel to or
perpendicular to floor Resistance Hand Examiner stands at
Placement
test side at level of
Distal Arm
Ulnar, using olecranon
patient's waist. One
& ulnar styloid
hand gives
resistance at wrist
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