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The Shoulder

The Shoulder. Bones of the Shoulder Clavicle Scapula Sternum Humerus. Anatomy of the Shoulder. Acromio-clavicular Sterno-clavicular Gleno-humeral Coroco-clavicular. Joints of the Shoulder. Motions of the Shoulder. Flexion Extension Adduction Abduction Internal Rotation

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The Shoulder

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  1. The Shoulder

  2. Bones of the Shoulder Clavicle Scapula Sternum Humerus Anatomy of the Shoulder

  3. Acromio-clavicular Sterno-clavicular Gleno-humeral Coroco-clavicular Joints of the Shoulder

  4. Motions of the Shoulder • Flexion • Extension • Adduction • Abduction • Internal Rotation • External Rotation

  5. Ligaments of the Shoulder • Sterno-clavicular-ties sternum and clavicle • Acromio-clavicular-ties acromium and clavicle • Coroco-clavicular-ties corocoid process and clavicle • Transverse-holds long head of biceps in the bicepital groove • Gleno-humeral-ties glenoid and humerus • Superior • Middle • Inferior

  6. Ligaments of the Shoulder

  7. Sterno-cleomastoid Billaterally flexes the neck Unilaterallty rotates the head Pectoralis Major Shoulder Flexion Trapezius Elevates/Depresses shoulder Extends Head Adducts Scapula Protracts Shoulder Holds scapula to body Muscles of the Shoulder

  8. Rhomboids Elevates and protracts scapula Serratus Anterior Lack of development causes winged scapula Muscles of the Shoulder

  9. Deltoid Ties scapula and clavicle to deltoid tuberosity Anterior, Middle, and Posterior Abduction Latissimus Dorsi Forms posterior wall of the Axilla Seldom injured Internal rotation, extension, adduction, depression Muscles of the Shoulder

  10. Internal Muscles of the Shoulder • All are part of Rotator Cuff • Remember by acronym SITS • Commonly injured in throwing motions • Subscapularis • Supraspinatus • Infraspinatus • Teres minor

  11. Muscles of Rotator Cuff • Subscapularis • Most anterior muscle • Becomes stretched in a dislocation • Internal Rotation

  12. Muscles of the Rotator Cuff • Supraspinatus • Abduction • Infraspinatus • External Rotation • Teres Minor • External Rotation

  13. Shoulder Subluxation Fractured Clavicle Shoulder Dislocation AC Joint Injuries Rotator Cuff Impingement Humeral Fracture Biceps Tendonitis Bursitis Myositis Ossificans Frozen Shoulder Glenoid Labrum Injuries Shoulder Injuries

  14. Shoulder Subluxation • Shoulder slips out then reduces on it’s own. • Mechanism of injury is falling on an outstretched arm

  15. Fractured Clavicle • Most frequently fractured bone • Lateral 1/3 is the weakest portion • Ice and Immobilize

  16. Shoulder Dislocation • Mechanism of Injury is falling on outstretched arm • Types of Dislocation • Anterior • Inferior • Posterior

  17. AC joint Sprains • 1st degree • Some stretching of ligament • No obvious deformity • Pt tenderness over AC joint • 7-10 days • 2nd degree • Some or complete tearing of AC ligament • Joint Laxity • MD Referral • 3rd degree • Complete loss of AC and CC ligaments • Arm Hangs in place • Usually surgical repair is needed

  18. Rotator Cuff Impingement • Cuff is swollen or irritated • Pain in raising the arm

  19. The glenoid labrum deepens the glenoid cavity It is a cartilage ring Causing clicking in the shoulder Usually repaired or resected Labrum Tears

  20. Fractured Humerus • Caused by direct blow or falling on arm • Needs surgical repair

  21. Little League Shoulder • Caused by too many curve balls • Fx of epiphyseal plate • Rest for 2 weeks

  22. Biceps Tendonitis • Long head of biceps rubs transverse ligament • Severe cases becomes so inflamned it decays • Rest Modalities • Can lead to surgical intervention if not cared for

  23. Bursitis (Frozen Shoulder) • Sub Acromial Bursa inflamed • Could lead to Frozen Shoulder where bursa hardens and restricts motion

  24. Myositis Ossificans • Same as Quadriceps • Repeated blows to the same area • Frequently occurs in the belly of biceps

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