Shoulder Conditions Chapter 11

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

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

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

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.

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

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

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

Movements Flexion Extension Hyperextension Abduction Adduction Horizontal Adduction Horizontal Abduction Medial rotation (internal) Lateral rotation (external)

Shoulder Movements Scapulohumeral rhythm

Sternoclavicular Joint Sprain

Acromioclavicular Joint Sprain

Glenohumeral Joint Sprain

Glenohumeral Instability

Glenohumeral Dislocations and Subluxations

Glenoid Labrum Tears

Rotator Cuff/Impingement Injuries

Bursitis

Bicipital Tendinitis and Tendon Rupture

Thoracic Outlet Compression Syndroms

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

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

Epiphyseal and Avulsion Fractures Growth plates do not close until 18 to 25 years of age Excessive movements of these plates can cause fractures

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