Joint G*H. Joint S*C. Joint A*C. Labrum. Humerus. Sternum. Scapula. Clavicle. Thorax. Articulation. Scapulo- Thoracic

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2 A*C Joint Scapulo- Thoracic Articulation Thorax Sternum Clavicle Scapula Humerus S*C Joint G*H Joint Labrum

3 AC Ligaments SC Ligaments SC JOINT AC Coracoacromial GH GH Ligament Complex Coracoclavicular Ligaments Trapezoid Conoid

4 Shoulder Joint Abduct Lateral ER IR No consistent pattern Flex Anterior X Posterior Extend Medial Adduct

5 Humeral Positioners Deltoids GH Protectors MUSCLE Propellors Pecs Lats Rotator Cuff Scapular Pivoters Serratus Anterior Traps Rhomboids Pec Minor Levator Scapulae

6 The Rotator Cuff

7 Shoulder Muscle Joint Interaction Motion Prime Mover(s) Flexion Extension IR ER Abduction Adduction

8 Scapula Muscle Joint Interaction Motion Prime Mover(s) Upward Rotation Downward Rotation Protraction Retraction

9 BURSA Subacromial

10 Fracture Humerus Fracture BONE Clavicle Shoulder Pointer

11 Dyskinesis Sprain Dislocation ST Sprain SC JOINT GH Labral Tear AC Adhesive Capsulitis Sprain

12 Impingement Syndrome Strains MUSCLE / TENDON Biceps Contusion Tendinitis Myositis Ossificans

13 Impingement Syndrome BURSA

14 Peripheral Nerves Nerve / Vascular Thoracic Outlet Syndrome

15 Palpation Guide for the Shoulder Anterior Structures Posterior Structures Sternal end of clavicle Shaft of clavicle Coracoid process Acromion process Head of Humerus Greater Tuberosity Bicipital Groove Lesser Tuberosity Humeral shaft Spine of Scapula Superior Angle Medial Border Inferior Angle SC Joint Deltoid Muscle Group Pectoralis Major Pectoralis Minor Biceps brachii - short head Coracobrachialis AC Joint Biceps brachii - long head Serratus Anterior Rotator Cuff Trapezius Levator scapulae Teres Major Latissimus Dorsi Triceps brachii

16 Palpation Strategies for the Shoulder Starkey and Ryan: Anterior Structures Humerus Scapula Posterior Structures Hoppenfeld: Bony Palpation Soft Tissue Palpation Zone I Rotator Cuff Zone II Subacromial and Subdeltoid Bursa Zone III Axilla Zone IV Prominent Muscles of the Shoulder Girdle

17 See Muscle GH Glide Apprehension Relocation ST Dyskinesis Sulcus Sign Sprain / Dislocation Posterior Apprehension SC Glide SC Sprain JOINT GH AC Sprain Labral Tear O Brien AC Glide AC Traction AC Compression

18 Goniometry - Shoulder Motion Normal ROM Stationary Arm Axis of Rotation Moving Arm Flexion Extension IR ER Abduction Adduction

19 Scapular Mobility Winging Dyskinesis Subscapularis Neer Gerber Lift Off Impingement Syndrome MUSCLE / TENDON Rotator Cuff Hawkins Empty/Full Can Yergason s Biceps Tendinitis Speed s Supraspinatus Ludington s

20 Peripheral Nerves Nerve / Vascular Adson s Thoracic Outlet Syndrome Military Brace Allen

21 Peripheral Nerve Injuries NERVE Suprascapular Inferior Subscapular Medial Pectoral Axillary Long Thoracic Musculocutaneous Median Ulnar MUSCLE WEAKNESS Subscapularis Latissimus Dorsi Pectoralis Major Rhomboids; Levator Trapezius Triceps; Forearm;Hand

22 SHOULDER COMPLEX CHECKLIST HISTORY General History INSPECTION General Inspection Position of Head Position of Arm Shoulder posture Anterior Level of shoulders Contour of clavicles Symmetry of deltoids Humerus and biceps Lateral Deltoid muscle group Acromion process Position of humerus Posterior Alignment of vertebrae Position of scapulae Muscle tone Position of humerus PALPATION Anterior Structures

23 Sternal end of clavicle SC Joint Shaft of clavicle Deltoid Muscle Group Pectoralis Major Coracoid process Pectoralis Minor Biceps brachii - short head Coracobrachialis Acromion process AC Joint Head of Humerus Greater Tuberosity Bicipital Groove Biceps brachii - long head Lesser Tuberosity Humeral shaft Serratus Anterior Posterior Structures Spine of Scapula Rotator Cuff Superior Angle Medial Border Trapezius

24 Levator scapulae Inferior Angle Teres Major Latissimus Dorsi Triceps brachii STRESS Joint Sternoclavicular Glide Test Acromioclavicular Glide Test Traction Test Compression Test Glenohumeral Glide Test Apprehension Test Relocation Test Posterior Apprehension Sulcus Sign O'Brien Apley's Scratch Passive ROM

25 Muscle / Tendon Glenohumeral Active ROM Resisted ROM Scapular Active ROM Resisted ROM Scapular Winging Impingement Neer Hawkins Rotator Cuff Empty Can / Full Can Gerber Lift-Off Biceps Yergason's Speed's Ludington's Nerve Dermatomes C4 Dermatomes C5 Dermatomes T1 Dermatomes T2 Dermatomes T3

26 Dermatomes T4 Dermatomes T5 Vascular Brachial Pulse Radial Pulse Thoracic Outlet Adson's Allen Military Brace Position

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