Shoulder 1 - Anatomy PDF

Orthopedic Treatment FT400 PT600 Shoulder Module Section 1 - Anatomy  Shoulder Complex The shoulder is the most mobile joint of the body. The function of the shoulder complex is to position or move the arm in space for the purpose of hand function. Shoulder movements are a resul...

Orthopedic Treatment FT400 PT600 Shoulder Module Section 1 - Anatomy  Shoulder Complex The shoulder is the most mobile joint of the body. The function of the shoulder complex is to position or move the arm in space for the purpose of hand function. Shoulder movements are a result of a multiple joint complex system. This multi-joint complex system must work sequentially and in a coordinated manner to achieve optimal and efficient movement. Unfortunately, due to the nature of increased mobility, stability is sacrificed and this can lead to many orthopedic problems. Orthopedic Treatment 400FT / 600PT Copyright VCMT 2  Muscles Palpate & MMT Bones and Joint Deltoid - All fibers Joint axis, structure, type: LIGAMENTS What do they check for? Subscapularis Concave surface : Coracohumeral: Teres Minor Convex surface: Teres Major Transverse Humeral: Closed packed position : Supraspinatus Resting position : Trapezoid: Coracobrachialis Capsular Pattern : Levator Scapula/Rhomboids Conoid: Palpation Serratus Anterior Greater/Lesser Tubercle Costoclavicular: Infraspinatus Bicipital Groove Pectoralis Major Acromion Process/ Coracoid Process Interclavicular: Latissimus Dorsi Scapula ( 3 Angles, Spine, 3 Fossas, 3 Trapezius - All Fibers Borders) *Review Diagrams* Orthopedic Treatment 400FT / 600PT Copyright VCMT 3  Range of Motion Strength (REMEX) Stretch (REMEX) Practice, Protocol and End feels Flexion Flexion Flexion Extension Extension Extension Abduction Abduction Abduction Adduction Adduction Adduction External Rotation External Rotation External Rotation Internal Rotation Internal Rotation Internal Rotation *Review Jt Mobs* Orthopedic Treatment 400FT / 600PT Copyright VCMT 4 Orthopedic Treatment 400FT / 600PT Copyright VCMT 5 Orthopedic Treatment 400FT / 600PT Copyright VCMT 6 Orthopedic Treatment 400FT / 600PT Copyright VCMT 7 Orthopedic Treatment 400FT / 600PT Copyright VCMT 8 Orthopedic Treatment 400FT / 600PT Copyright VCMT 9 Orthopedic Treatment 400FT / 600PT Copyright VCMT 10 Orthopedic Treatment 400FT / 600PT Copyright VCMT 11 Orthopedic Treatment 400FT / 600PT Copyright VCMT 12 Orthopedic Treatment 400FT / 600PT Copyright VCMT 13 Orthopedic Treatment 400FT / 600PT Copyright VCMT 14 Innervation Suprascapular C4,5,6 Axillary C5,6 Lateral Pectoral C5,6,7 Musculocutaneous C5,6,7 Orthopedic Treatment 400FT / 600PT Copyright VCMT 15 Deep Tendon Reflex Testing C5 - biceps C6 - Brachio C7 - Triceps Orthopedic Treatment 400FT / 600PT Copyright VCMT 16 Bursae - Subacromial/Subdeltoid - Subscapular - deep to tendon ,superficial to joint capsule Orthopedic Treatment 400FT / 600PT Copyright VCMT 17 Blood Supply Subclavian Axillary Brachial * Supraspinatus - considered hypovascular Orthopedic Treatment 400FT / 600PT Copyright VCMT 18 Scapulothoracic Mechanism Although it doesn’t fit the characteristics of a joint, this mechanism plays an important role in the multi-joint complex system of the shoulder. Scapulothoracic movements are accompanied by both sternoclavicular and acromioclavicular movement. Altogether, the three create a kinetic chain in which movement of one joint effects and causes movement in the others. Orthopedic Treatment 400FT / 600PT Copyright VCMT 19 Comparative anatomy Orthopedic Treatment 400FT / 600PT Copyright VCMT 20 Orthopedic Treatment 400FT / 600PT Copyright VCMT 21 Orthopedic Treatment 400FT / 600PT Copyright VCMT 22 Orthopedic Treatment 400FT / 600PT Copyright VCMT 23 Orthopedic Treatment 400FT / 600PT Copyright VCMT 24 Joint Mobilisations Review: One bone is __________________________ Arthrokinematic movement One bone is __________________________ ______________________________________________________ Osteokinematic movement One surface is concave ______________________________________________________ One surface is convex Spin ______________________________________________________ Roll ______________________________________________________ Slide/Glide _______________________________________________________ Orthopedic Treatment 400FT / 600PT Copyright VCMT 25 Joint Mobilisations Review: Concave/Convex rule If a concave surface is mobilised on a convex surface, glide/slide will be ______________________________________ as osteokinematic movement If a convex surface is mobilised on a concave surface, glide/slide will be _______________________________________ as osteokinematic movement Orthopedic Treatment 400FT / 600PT Copyright VCMT 26 Joint Mobilisations Review: Orthopedic Treatment 400FT / 600PT Copyright VCMT 27  The FACET @ Sternal End of the Clavicle is Ant/Post: The Facet is Concave Sup/Inf: The Facet is Convex The FACET @ Clavicular Notch of the Manubrium is Ant/Post: The Facet is Convex Sup/Inf: The Facet is Concave Orthopedic Treatment 400FT / 600PT Copyright VCMT 28  The FACET @ Sternal End of the Clavicle is Ant/Post: The Facet is Concave Sup/Inf: The Facet is Convex The FACET @ Clavicular Notch of the Manubrium is Ant/Post: The Facet is Convex Sup/Inf: The Facet is Concave Orthopedic Treatment 400FT / 600PT Copyright VCMT 29  Inf/Sup Facets = Convex on Concave Arthrokinesiology → Roll SUPERIOR, Glide INFERIOR Orthopedic Treatment 400FT / 600PT Copyright VCMT 30  Ant/Post Facets = Concave on Convex Arthokinesiology → Roll POSTERIOR Glide POSTERIOR Orthopedic Treatment 400FT / 600PT Copyright VCMT 31 Orthopedic Treatment 400FT / 600PT Copyright VCMT 32  Scapular plane: Requires 20 degrees of horizontal adduction Scaption - Horizontal abduction in frontal plane Orthopedic Treatment 400FT / 600PT Copyright VCMT 33 Full range of scapulohumeral and scapular motion for normal overhead elevation of the arm in flexion or in abduction requires adequate length in the pectoralis major, pectoralis minor, latissimus dorsi, teres major, subscapularis and rhomboids. Take a look at what muscle connects where and try to visualize them functioning together & how an imbalance can potentially cause dysfunction Orthopedic Treatment 400FT / 600PT Copyright VCMT 34