Shoulder & Arm 1
Transcript of Shoulder & Arm 1
Shoulder & Arm
Topographical views
Topographical views
Topographical views
Surface anatomy - shoulder
A. Clavicle
B. S-C joint
C. SCM muscle
D. A-C joint
E. Acromion
F. Coracoid process
G. Pectoralis major
H. Delotid
I. Deltoid tuberosity
J. Biceps brachii
K. Supraclavicular fossa
Surface anatomy - shoulderA. Spine of scapular
B. Med border of scapula
C. Supraspinatus
D. Infraspinatus
E. Teres minor
F. Trapezius
G. Lat border of scapula
H. Rhomboid muscle
I. Levator scapula
J. Post. Deltoid
K. Latissimus dorsi
L. Triceps brachii
M. Soft spot
Surface anatomy – upper arm
A. Acromion
B. Deltoid
C. Deltoid
tubersity
D. Briceps brachii
E. Triceps brachii
Bones of the shoulder and arm
Bony Landmarks
Bony landmark trail
Trail 1. Along the Edge a. spine of the scapula b. medial border c. inferior border d. superior border e. lateral border f. infraglenoid tubercle
Bony landmark trail
Trail 2. In the Trenches a. infraspinous fossa b. supraspinous fossa c. subscapular fossa
Bony landmark trail
Trail 3. Springboard Ledge a. acromion b. clavicle c. acromioclavicular and
sternoclavicular joints d. coracoid process e. deltoid tuberosity
Bony landmark trail
Trail 4. Two Hills and a Valley a. greater tubercle b. intertubercular
groove c. lesser tubercle
Deltoid
1. Clavicular part
2. Acromial part
3. Spinal part
Deltoid
Action Clavicular part: Anteversion, internal
rotation, adduction Acromial part: Abduction Spinal part: retroversion
Origin Clavicular part: Lateral third of the clavicle Acromial part: Acromion Spinal part: scapular spine
Insertion Deltoid tuberosity on the humerus
Innervation Axillary nerve (C5,6)
Deltoid Seated
Locate the spine of the scapula, the acromion and the lat. one-third of the clavicle (Note the “V” shape these landmarks form)
Locate the deltoid tuberosity
Palpate between these landmarks to isolate the superficial, convergent fibers of the deltoid.
If pt. alternately abduct and releases, do you
feel the fibers contract and relax?
Deltoid
Be sure to explore the deltoid’s most anterior and posterior aspects.
Test for deltoid
Test for deltoid
• Patient:Patient: Sitting
• Fixation:Fixation: If the scapular fixation muscles are weak, the the examiner must stabilize the scapula
• Test:Test: Shoulder abduction without rotation. When placing the shoulder in test position, the elbow should be flexed to indicate the neutral position of rotation
• Pressure:Pressure: Against the dorsal surface of the distal end of the humerus.
Test for anterior deltoid
• Patient:Patient: Sitting
• Fixation:Fixation: If scapular fixation muscles are weak, the scapula must be stabilized by the examiner
• Test:Test: Shoulder abduction in slight flexion, with the humerus in slight lateral rotation.
• Pressure:Pressure: Against the anteromedial surface of the arm, in the direction of adduction and slight extension
Test for posterior deltoid
• Patient:Patient: Sitting
• Fixation:Fixation: If scapular fixation muscles are weak, the scapula must be stabilized by the examiner
• Test:Test: Shoulder abduction in slight extension, with the humerus in slight medial rotaion.
• Pressure:Pressure: Against the posterolateral surface of the arm, above the elbow, in the direction of addduction and slight flexion