The Shoulder

1
The Shoulder
2
The Shoulder

• Anatomy
• Movements
• Injuries
• Evaluation
• Rehabilitation

3
Shoulder Anatomy

• Bones
• Joints
• Ligaments
• Muscles
• Bursa

4
Bones

• The two main bones of the shoulder are the
  humerus and the scapula (shoulder blade).
• The scapula extends up and around the shoulder
  joint at the rear to form a roof called the
  acromion, and around the shoulder joint at the
  front to form the coracoid process.

5
Bones
6
Shoulder joints

• Glenohumeral- The end of the scapula, called the
  glenoid, meets the head of the humerus to form a
  glenohumeral cavity that acts as a flexible
  ball-and-socket joint. The joint is stabilized by
  a ring of fibrous cartilage surrounding the
  glenoid called the labrum.
• Sternoclavicular
• Acromioclavicular

7
(No Transcript)
8
(No Transcript)
9
Shoulder Ligaments
10
Shoulder Movements

• Flexion
• Extension
• Abduction
• Adduction
• Internal rotation
• External rotation
• Circumduction

11
Rotator Cuff

• The Rotator Cuff is a group of muscles that work
  in the shoulder joint to keep the humerus from
  popping out. This makes the Rotator Cuff critical
  for shoulder stability.
• There are four muscles in the Rotator Cuff the
  Teres Minor, the Infraspinatus, the Supraspinatus
  and the Subscapularis.

12
Function of Rotator Cuff

• The main functions of the Rotator Cuff are
  shoulder joint stabilization and external
  rotation of the humerus.

13
Shoulder Muscles
14
(No Transcript)
15
Shoulder Bursa
16
Shoulder Injuries
17
Contusion
18
Contusion
19
(No Transcript)
20
Fractures

• Usually occurs due to impact to the shoulder
  area.

21
Clavicular Fx

• Greenstick Fx- bone does not fracture all the way
  through.

22
Mechanism of injury
23
(No Transcript)
24
(No Transcript)
25
Fx Clavicle brace
26
Muscle strain

• Usually to the rotator cuff.
• Can be 1st, 2nd, or 3rd degree strains.

27
(No Transcript)
28
(No Transcript)
29
(No Transcript)
30
Shoulder tendonitis

• Inflamation of the tendon.
• A result of overuse of the shoulder.

31
(No Transcript)
32
Bursitis

• Inflammation of the bursa sacs that protect the
  shoulder.

33
Bursitis
34
Impingement Syndrome

• Impingement syndrome is caused by the excessive
  squeezing or rubbing of the rotator cuff and
  shoulder blade. The pain associated with the
  syndrome is a result of an inflamed bursa
  (lubricating sac) over the rotator cuff, and/or
  inflammation of the rotator cuff tendons, and/or
  calcium deposits in tendons due to wear and tear.

35
Impingement Syndrome
36
Impingement
37
Impingement
38
Separated shoulder

• Another name for this injury is an
  acromioclavicular joint separation, or AC
  separation.
• Usually occurs by falling on the tip of the
  shoulder.

39
Separated Shoulder
40
Separated Shoulder
41
2nd degree Separated shoulder
42
(No Transcript)
43
3rd degree Separated shoulder
44
Piano Key sign

• Positive test 3rd degree separated shoulder

45
Shoulder subluxation

• Glenohumeral joint slides apart, but then goes
  back into place.

46
Shoulder dislocation

• When glenohumeral joint is put past its normal
  limits, and the head of the humerus pops out and
  stays out.

47
Dislocation
48
Dislocation
49
(No Transcript)
50
Shoulder dislocation
51
Reducing a Dx Shoulder
52
(No Transcript)