Shoulder Conditions

1
Shoulder Conditions

• Chapter 11

2
Articulations

• Sternoclavicular (SC)
• Acromioclavicular (AC)
• Coracoclavicular (CC)
• Glenohumeral (GH)
• Scapulothoracic

3
Sternoclavicular Joint

• Surrounded anteriorly and posteriorly by 4
  ligaments
• Interclavicular
• Costoclavicular
• Anterior sternoclavicular
• Posterior sternoclavicular
• SC enables rotation of the clavicle with respect
  to the sternum

4
Acromioclavicular Joint

• Acromion process of the scapula with the distal
  clavicle is the joint
• Superior and Inferior acromioclavicular ligaments
• Coracoacromial ligament
• AC enables limited motion in all three planes of
  movement

5
Coracoclavicular Joint

• Coracoid process of the scapula and the inferior
  surface of the clavicle.
• Coracoclavicular ligament
• Resists upward movement of the clavicle, downward
  movement of the scapula, and anteroposterior
  movement of the clavicle or scapula.

6
Glenohumeral Joint

• Articulation between the glenoid fossa of the
  scapula and the head of the humerus
• Superior, middle, and inferior glenohumeral
  ligaments
• Allows just about all ranges of motion in all
  three planes

7
Scapulothoracic Joint

• Muscles attaching to the scapula from the
  thoracic trunk area allow the scapula to move
• Stabilizes the shoulder-
• Permits many movements of the shoulder

8
Bursae

• Subcoracoid
• Subscapularis
• Subacromial
• Cushion the rotator cuff muscles from overlying
  bone

9
Movements

• Flexion
• Extension
• Hyperextension
• Abduction
• Adduction

• Horizontal Adduction
• Horizontal Abduction
• Medial rotation (internal)
• Lateral rotation (external)

10
Shoulder Movements

• Scapulohumeral rhythm

11
Sternoclavicular Joint Sprain
12
Acromioclavicular Joint Sprain
13
Glenohumeral Joint Sprain
14
Glenohumeral Instability
15
Glenohumeral Dislocations and Subluxations
16
Glenoid Labrum Tears
17
Rotator Cuff/Impingement Injuries
18
Bursitis
19
Bicipital Tendinitis and Tendon Rupture
20
Thoracic Outlet Compression Syndroms
21
Clavicular Fractures

• Blow or fall on the point of the shoulder
• Figure 8 brace is worn for 4 to 6 weeks
• Pain will be persistent on palpation and active
  movements

22
Scapular Fractures

• Spine of scapula, acromion process, coracoid
  process, or the glenohumeral joint
• Either direct trauma or a forceful contraction of
  the attaching muscle

23
Epiphyseal and Avulsion Fractures

• Growth plates do not close until 18 to 25 years
  of age
• Excessive movements of these plates can cause
  fractures

24
Humeral Fractures

• Violent compressive forces from a direct blow
• Fracture is commonly found in the surgical neck