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| shoulder joint | ball & socket joint with movement in all three planes and around all three axes. Therefore, the joint has three degrees of freedom. The humeral head articulating with the glenoid fossa of the scapula. One of the most movable and least stable joints
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| four groups of motions possible at the shoulder joint: | 1)flexion, extension, and hyperextension 2)abduction and adduction 3) medial and lateral rotation; and 4)horizontal abduction and adduction
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| flexion | is from 0-180 degrees
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| extension | is the return to anatomical position
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| hyperextension | apporximately 45 degrees past anatomical position
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| abduction and adduction | occur in the frontal plane around the sagittal axis with 180 degrees of motion possible
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| medial and lateral rotation | occur in the transverse plane around the vertical axis. sometimes the terms internal and external are used in place of medial and lateral
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| horizontal abduction and horizontal adduction | also occur in the transverse plane around the vertical axis
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| scaption | motion is similar to flexion or to the sagittal or frontal plane
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| soft tissue stretch | the normal end feel for all shoulder joint motions
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| glenoid fossa | shallow, somewhat egg-shaped socket on the superior end, lateral side; articulates with the humerus
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| glenoid labrum | fibrocartilaginous ring attached to the rim of the glenoid fossa, which deepens the articular cavity
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| subscapula fossa | includes most of the area on the anterior (costal) surface, providing attachment for the subscapularis muscle
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| infraspinous fossa | below the spine, providing attachment for the infraspinatus muscle
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| supraspinous fossa | above the spine, providing attachment for the supraspinatus muscle
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| axillary border | providing attachment for the teres major and teres minor muscles
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| acromion process | broad, flat area on the superior lateral aspect, providing attachment for the middle deltoid muscle
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| humerus | longest and largest bone of the upper extremity
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| humerus head | semirounded proximal end; articulates with the scapula
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| surgical neck | slightly constricted area just below tubercles where the head meets the body
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| anatomical neck | circumferential groove separating the head from the tubercle
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| shaft | or body, the area between the surgical neck proximally and the epicondyles distally
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| greater tubercle | large projection lateral to head and lesser tubercle; provides attachment for the supraspinatus, infraspinatus, and teres minor muscles
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| lesser tubercle | smaller projection on the anterior surface, medial to the greater tubercle; provides attachment for the subscapularis muscle
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| deltoid tuberosity | on the lateral side near the midpoint; not usually a well-defined landmark
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| bicipital groove | also called the intertubercular groove, the longitudinal groove between the tubercles, containing the tendone of the long head of the biceps
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| bicipital ridges | also called the lateral and medial lips of the bicipital groove or the crests of the greater and lesser tubercles, respectively.
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| lateral lip | (crest of the greater tubercle) provides attachment for the pectoralis major
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| medial lip | (crest of the lesser tubercle)provides attachment for the latissimus dorsi and teres major
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| joint capsule | thin-walled, spacious container that attaches around the rim of the glenoid fossa of the scapula and the anatomical neck of the humerus
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| superior, middle, and inferior glenohumeral ligamnets | reinforce the anterior portion of the capsule. these are not well-defined ligaments but actually pleated folds of the capsule
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| coracohumeral ligament | attaches from the lateral side of the coracoid process and spans the joint anteriorly to the medial side of the greater tubercle. it strengthens the upper part of the joint capsule
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| rotator cuff | is the tendinous band formed by the blending together of the tendinous insertions of the subscapularis, suprasinatus, infraspinatus, and the teres minor muscles.
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| thoracolumbar fascia | (lumbar aponeurosis) is a superficial fibrous sheet that attaches to the spinous processes of the lower throacic and lumbar vertebrae, the supraspinal ligament, and the posterior part of the iliac crest, covering the sacrospinalis muscle.
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| muscles of the shoulder joint | deltoid, pectoralis major, latissimus dorsi, teres major, supraspinatus, infraspinatus, teres minor, subscapularis, coracobrachialis, biceps brachii, triceps brachii (long head)
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| deltoid muscle | superficial muscle that covers the shoulder joint on three sides, giving the shoulder its characteristic rounded shape. functionally, separated into anterior, middle and posterior
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| anterior deltoid muscle | attaches on the outer third of the clavicle and runs down and out to the deltoid tuberosity, which is located on the lateral aspect of the humerus near the midpoint. it is effective in abduction, flexion and medial rotation. and horizontal adductor
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| middle deltoid muscle | attaches on the lateral side of the acromion process and runs directly down to the deltoid tuberosity. vertical line of pull is lateral to joint axis, it is most effective in abducting the shoulder joint
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| posterior deltoid muscle | attches to the spine of the scapula and runs obliquely down to its attachment with the anterior and middle fibers on the deltoid tuberosity. oblique line of pull is post to jt axis, strong in shd abduct, ext, hyperext & lat rot. and horizontal abduction
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| acromioclavicular separtation | term commonly used to describe the various amounts of ligament injury at the acromioclavicular jt
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| clavicular fractures | account for the mos frequently broken bone in children. usually result from a fall on the lateral aspect of the shoulder or on the outstretched hand. clavicle usually breaks in it's midportion
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| midhumeral fractures | often caused by a direct blow or twisting force
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| pathological fractures | of the humerus may be caused by benign tumors or metastatic carcinoma from primary sites such as the lung, breast, kidney and prostate
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| anterior shoulder dislocation | one of the most common joint dislocations. tends to be forced shd abduction and lateral rotation that causes the humeral head to slide anteriorly out of the glenoid fossa
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| glenohumeral subluxation | commonly seen in people who have had a stroke and paralysis of the shoulder muscles leaves them no longer able to hold the head of the humerus in the glenoid fossa. combined with the pull of gravity and weight of arm, causes partial dislocation
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| impingement syndrome | is an overuse condition that involves compression between the acromial arch, humeral head and soft tissue structures such as the coracoacromial ligament, rotator cuff muscles, long head of biceps & subacromial bursa
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| adhesive capsulitis | refers to the inflammation and fibrosis of the shoulder joint capsule, which leads to pain and loss of shoulder range of motion. also known as frozen shoulder
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| torn rotator cuff | involves the distal tendinous insertion of the supraspinatus, infraspinatus, teres minor, and subscapularis on the greater/lesser tubercle area of the humerus. tears can be from acute trauma or degeneration
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| calcific tendonitis | chronic inflammation of the suprasinatus tendon can lead to an accumulation of mineral deposits
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| bicipital tendonitis | usually involves the long head of the biceps proximally as it crosses the humeral head, changes direction and descends into the bicipital groove. the biceps long head tendon commonly ruptures during repetitive or forceful overhead positions
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