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Biomechanics of Shoulder joint 04
The document provides an overview of the anatomy of the glenohumeral (shoulder) joint, including: 1) It describes the bones that make up the joint - the scapula and humerus. 2) The joint is a ball and socket joint that allows movement in all three planes with the convex humeral head moving within the concave glenoid fossa. 3) Key supporting structures include the rotator cuff muscles, capsular ligaments, coracohumeral ligaments, glenoid labrum and long head of the biceps.
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Introduction to the glenohumeral joint (shoulder joint) and its components, including the shoulder girdle (scapula and clavicle) and the joint structure.
Details on the osteology of the glenohumeral joint, highlighting bones like the scapula and humerus, with emphasis on their anatomical features.
Exploration of the ball and socket structure of the GH joint, degrees of freedom, and arthrokinematics involved in shoulder movements.
Overview of the rotator cuff and ligaments that support the glenohumeral joint, enhancing its stability and function.
List of muscles associated with the GH joint, including deltoid, pectoralis major, latissimus dorsi, and the rotator cuff muscles.
Detailed analysis of muscle origins, insertions, actions, and innervation of shoulder muscles, emphasizing their roles in movement.
Discussion of common shoulder pathologies such as AC separation, fractures, dislocations, and rotator cuff tears.
Engaging activities to identify shoulder muscle functions and actions during physical tasks such as push-ups, promoting muscle recognition.
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Biomechanics of Shoulder joint 04
- 1. T H EG L E N O H UM E R A L (G H ) J O I N T THE SHOULDER JOINT
- 2. CLARIFICATION OF TERMS •Shoulder girdle = scapula and clavicle • Shoulder joint (glenohumeral joint) = scapula and humerus
- 3.
- 5. OSTEOLOGY OF THEGH JOINT(BONES) •Scapula •Glenoid fossa •Glenoid labrum •Subscapular fossa •Infraspinous fossa •Supraspinous fossa •Axillary border •Acromion process
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- 8. OSTEOLOGY OF THEGH JOINT(BONES)…CONT • Humerus • Head • Surgical neck • Anatomical neck • Shaft • Greater tubercle • Lesser tubercle • Deltoid tuberosity • Bicipital groove • Bicipital ridges
- 9.
- 10. Intertubercular Groove (bicepitalgroove) Deltoid Tuberosity Anatomical Neck
- 11. JOINT STRUCTURE OFTHE GH JOINT Ball and socket joint Movement in all three planes (3 degrees of freedom) Articulation between the humeral head of the humerus and the glenoid fossa of the scapula One of the most movable joints in the body and, consequently, one the stable.
- 12. JOINT MOVEMENT OFTHE GH JOINT • Osteokinematics • Flexion and Extension • Hyperextension • Abduction • Adduction • Medial rotation (internal rotation) • Lateral rotation (external rotation) • Horizontal abduction • Horizontal adduction • Circumduction
- 13. VISUAL EXERCISE • Watchyour partner perform the following movements and guesstimate the degrees of motion for each of the following: • Shoulder flexion: • Shoulder hyperextension: • Shoulder abduction: • Shoulder internal rotation: • Shoulder external rotation:
- 14. JOINT MOVEMENT OFTHE GH JOINT…CONT Arthrokinematics • Concave-convex rule • The convex humeral head moves within the concave glenoid fossa • The convex joint surface (humeral head) moves in a direction opposite to the movement of the body segment (humeral shaft) • Flexion – humeral head glides • Abduction – humeral head glides • Extension – humeral head glides • Adduction – humeral head glides • Internal rotation – humeral head glides • External rotation – humeral head glides
- 15. JOINT MOVEMENT OFTHE GH JOINT…CONT • Arthrokinematics • The articular surface of the humeral head is greater than that of the glenoid fossa • If the humeral head simply rotated in the glenoid fossa, it would run out of articular surface before full abduction occurred • So, as abduction occurs, the humeral head rolls across the glenoid fossa and glides inferiorly (thanks to the rotator cuff) • Complete abduction can occur only with full external rotation
- 16. SUPPORTING STRUCTURES OFTHE GH JOINT • Rotator cuff • SITS muscles surround humeral head and actively hold it against the glenoid fossa • Capsular ligaments • Relatively loose capsule attaches the rim of the glenoid fossa and anatomic neck of the humerus • Coracohumeral ligaments • Connects coracoid process and anterior side of greater tubercle • Glenoid labrum • A fibrocartilaginous ring that encircles the rim of the glenoid fossa, deepening the socket and sealing the joint • Long head of the Biceps • The proximal portion of the tendon wraps around the superior aspect of the humeral head, providing anterior stability
- 17. MYOLOGY OF THEGH JOINT (MUSCLES) • Deltoid • Pectoralis major • Latissimus dorsi • Teres major • Supraspinatus • Infraspinatus • Teres minor • Subscapularis • Coracobrachialis • Biceps brachii • Triceps brachii, long head
- 18. Anterior Deltoid: Anterior Origin Anteriorsurface of the lateral aspect of the clavicle Insertion Deltoid tuberosity of the humerus Action Sh flexion, HADD, Sh IR, Sh ABD Innervation Axillary n.
- 19. …strengthen the anteriordeltoid • Concentrically?
- 20. Middle Deltoid Deltoid: Middle OriginSuperior lateral surface of the acromion Insertion Deltoid tuberosity of the humerus Action Sh ABD, Sh flexion Innervation Axillary n.
- 21. Deltoid: Posterior Origin Spineof the scapula Insertion Deltoid tuberosity of the humerus Action Sh extension, HABD, Sh ER Innervation Axillary n.
- 22. Pectoralis Major Origin Clavicularportion: anterior margin of the medial portion of the clavicle Sternal portion: lateral margin of the manubrium and body of the sternum and cartilage of the first 6-7 ribs Insertion Crest of the greater tubercle of the humerus Action Clavicular: Shoulder flexion, IR and Horiz ADD Sternal: Sh IR, Sh ADD, Sh extension to anatomic position Innervation Clavicular: lateral pectoral n. Sternal: lat & medial pectoral n.
- 23. …stretch the pectoralismajor? …strengthen the pectoralis major eccentrically?
- 24. Latissimus Dorsi Origin Thoracolumbarfascia, spinous processes of lower thoracic and lumbar vertebrae, posterior iliac crest, lower 4 ribs and inferior angle of scapula Insertion Floor of intertubercular groove of humerus Action Sh ADD, Sh extension, Sh IR, scapular depression Innervation Thoracodorsal n. “tidbit” Necessary for “crutchwalking” and transfers!
- 25. …stretch the latissimusdorsi?
- 26. Teres Major Origin Inferiorangle of the scapula Insertion Crest of the lesser tubercle of the humerus Action Sh ADD, Sh extension, Sh IR Innervation Lower scapular n.
- 27. SITS • Supraspinatus • Infraspinatus •Teres Minor • Subscapularis
- 28. Supraspinatus Origin Supraspinous fossaof the scapula Insertion Greater tubercle of the humerus Action Sh ABD, stabilization of the GH, slight ER Innervation Suprascapular n. “Tidbit” One of the rotator cuff muscles
- 29. Infraspinatus Origin Infraspinous fossaof the scapula Insertion Greater tubercle of the humerus Action Sh ER, stabilization of the GH joint Innervation Suprascapular n. “tidbit” One of the rotator cuff muscles
- 30. Teres Minor Origin Posteriorlateral border of the scapula near the inferior angle Insertion Greater tubercle of the humerus (inferior to the infraspinatus) Action Sh ER, stabilization of the GH joint Innervation Axillary n.
- 31. Subscapularis Origin Subscapular fossaof the scapula Insertion Lesser tubercle of the humerus Action Sh IR, stabilization of the GH joint Innervation Upper and lower subscapular n. “tidbit” One of the rotator cuff muscles
- 32. Coracobrachialis Origin Coracoid processof the scapula Insertion Medial aspect of the proximal shaft of the humerus Action Assists with Sh flexion & add Innervation Musculocutaneous n.
- 33. Biceps Brachii Biceps Brachii Origin Longhead: supraglenoid tubercle of glenoid fossa Short head: coracoid process of the scapula Insertion Radial tuberosity of the radius Action Sh flexion, elbow flexion, forearm supination Innervation Musculocutaneous n. “tidbit” The actions of the biceps brachii are “perfect” in combination for opening a bottle of wine.“The Corkscrew effect”
- 34. …strengthen the bicepsbrachii isometrically? …stretch the biceps brachii?
- 35. Long Head ofthe Triceps Brachii Origin Infraglenoid tubercle of the scapula Insertion Olecranon process of the ulna Action Sh extension, elbow extension Innervation Radial n.
- 36. MYOLOGY OF THEGH JOINT (MUSCLES)…CONT • Anatomical Relationsips • Muscles that stabilize are deep to muscles that move. • Therefore, glenohumeral joint muscles are superficial to shoulder girdle muscles • Deltoid: forms a superficial cap over the anterior, lateral and posterior sides of the shoulder • Anteriorly, pectoralis major covers most of the superficial chest wall • Biceps brachii and triceps brachii encompass most of the anterior and posterior arm, respectively • If the trapezius were removed, you would see the supraspinatus above the scapular spine and in descending order, the infraspinatus, teres minor and teres major below the scapular spine • The latissimus dorsi covers the lumbar and lower thoracic region of the back
- 37. MYOLOGY OF THEGH JOINT (MUSCLES)…CONT • Anatomical Relationsips
- 38. MYOLOGY OF THEGH JOINT (MUSCLES)…CONT • Summary of Muscle Action: Action Muscles Flexion Anterior deltoid, pectoralis major (clavicular) Extension Posterior deltoid, lattisimus dorsi, teres major, pectoralis major (sternal) Hyperextension Latissimus dorsi, posterior deltoid Abduction Deltoid, supraspinatus Adduction Pectoralis major, teres major, latissimus dorsi Horizontal abduction Posterior deltoid, infraspinatus, teres minor Horizontal adduction Pectoralis major, anterior deltoid Lateral rotation Infraspinatus, teres minor, posterior deltoid Medial rotation Latissimus dorsi, teres major, subscapularis, pectoralis major, anterior deltoid
- 39. MYOLOGY OF THEGH JOINT (MUSCLES)…CONT • Summary of Muscle Innervation: Lippert, p143 Muscle Nerve Segment Subscapularis Upper and lower subscapular C5, C6 Teres major Lower subscapular C5, C6 Pectoralis major Lateral and medial pectoral C5, C6, C7 & C8, T1 Latissimus dorsi Thoracodorsal C6, C7, C8 Supraspinatus Suprascapular C5, C6 Infraspinatus Suprascapular C5, C6 Deltoid Axillary C5, C6 Teres minor Axillary C5, C6 Coracobrachialis Musculocutaneous C6, C7 Biceps Musculocutaneous C5, C6 triceps radial C7, C8
- 40. COMMON SHOULDER PATHOLOGY •AC separation: • Fractures: • Shoulder dislocation and subluxation: • Impingement: • Adhesive Capsulitis: • Rotator Cuff Tear: • Bicipital Tendonitis:
- 41. PIN THE TAILON THE DONKEY • Point to the… • Shoulder flexors • Shoulder extensors • Shoulder abductors
- 42. What upper extremitymuscles can you identify on him?
- 43.
- 44. During a pushup, there is a raising of the body and a lowering of the body. Identify what type of contraction the muscle is doing during each component of a push up: • Isometric • Concentric • Eccentric • No contraction
- 45. Raising the bodyLowering the body Biceps brachii Triceps brachii Protractors Retractors Abdominals