242 Part Three Injuries and Conditions of the Upper Body, Thorax, Abdomen, and Spine Shoulder and Upper Arm Glenohumeral joint Humeral head Greater tubercle Bicipital groove Lesser tubercle Humerus Acromioclavicular joint Scapula Sternoclavicular joint Clavicle Supraspinatus Spine of scapula Infraspinatus Teres minor Teres major Lateral head Long head Medial head Triceps brachii Fig. 8 1 Anterior view of the bones and joints of the shoulder. Humerus Clavicle Deltoid Fig. 8 3 Deep muscles of the posterior shoulder and upper arm. Biceps brachii Pectoralis major Coracobrachialis Medial head of triceps brachii Brachialis Fig. 8 2 Superficial muscles of the anterior shoulder and upper arm. Coracoacromial ligament Acromion Tendon of supraspinatus muscle Coracohumeral ligaments Transverse humeral ligament Tendon of subscapularis muscle Tendon of biceps brachii muscle Acromioclavicular ligament Coracoid process Glenohumeral ligaments Humerus Coracoclavicular ligaments Clavicle Articular capsule Scapula Fig. 8 4 Anterior view of the glenohumeral and acromioclavicular joints. glenohumeral (GH) joint sprain (Fig. 8 4). A sprain, for instance, could result from a football linebacker tackling a running back, using only the right arm and causing violent abduction, external rotation, and extension of the arm. Sprains to the sternoclavicular (SC) joint are caused by indirect forces placed on the clavicle, which may occur with a fall on the outstretched arm, direct compression on the lateral shoulder, or traction and torsion forces. Acromioclavicular (AC) joint sprains are the result of the acromion process being forced away from the clavicle or the clavicle being forced away from the acromion. This mechanism can occur with a fall on the outstretched hand, flexed elbow, or tip of the shoulder; direct force to the acromion; or repetitive forces and overhead activities (Fig. 8 5). AC joint sprains
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