Shoulder & Arm 1

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Text of Shoulder & Arm 1

  • 1. Shoulder & Arm

2. Topographical views 3. Topographical views 4. Topographical views 5. Surface anatomy - shoulder

  • Clavicle
  • S-C joint
  • SCM muscle
  • A-C joint
  • Acromion
  • Coracoid process
  • Pectoralis major
  • Delotid
  • Deltoid tuberosity
  • Biceps brachii
  • Supraclavicular fossa

6. Surface anatomy - shoulder

  • Spine of scapular
  • Med border of scapula
  • Supraspinatus
  • Infraspinatus
  • Teres minor
  • Trapezius
  • Lat border of scapula
  • Rhomboid muscle
  • Levator scapula
  • Post. Deltoid
  • Latissimus dorsi
  • Triceps brachii
  • Soft spot

7. Surface anatomy upper arm

  • Acromion
  • Deltoid
  • Deltoid tubersity
  • Briceps brachii
  • Triceps brachii

8. Bones of the shoulder and arm 9. Bony Landmarks 10. 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

11. Bony landmark trail

  • Trail 2. In the Trenches
    • a. infraspinous fossa
    • b. supraspinous fossa
    • c. subscapular fossa

12. Bony landmark trail

  • Trail 3. Springboard Ledge
    • a. acromion
    • b. clavicle
    • c. acromioclavicular and sternoclavicular joints
    • d. coracoid process
    • e. deltoid tuberosity

13. Bony landmark trail

  • Trail 4. Two Hills and a Valley
    • a. greater tubercle
    • b. intertubercular
    • groove
    • c. lesser tubercle

14. Deltoid

  • Clavicular part
  • Acromial part
  • Spinal part

15. 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)

16. Deltoid

    • Seated
    • Locate thespine of the scapula , theacromion and the lat.one-third of the clavicle(Note theV shapethese landmarks form)
    • Locate thedeltoid 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? 17. Deltoid

    • Be sure to explore the deltoids most anterior and posterior aspects.

18. Test for deltoid 19. Test for deltoid

  • Patient:Sitting
  • Fixation:If the scapular fixation muscles are weak, the the examiner must stabilize the scapula
  • 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:Against the dorsal surface of the distal end of the humerus.

20. Test for anterior deltoid

  • Patient: Sitting
  • Fixation: If scapular fixation muscles are weak, the scapula must be stabilized by the examiner
  • Test: Shoulder abduction in slight flexion, with the humerus in slight lateral rotation.
  • Pressure: Against the anteromedial surface of the arm, in the direction of adduction and slight extension

21. Test for posterior deltoid

  • Patient:Sitting
  • Fixation:If scapular fixation muscles are weak, the scapula must be stabilized by the examiner
  • Test:Shoulder abduction in slight extension, with the humerus in slight medial rotaion.
  • Pressure:Against the posterolateral surface of the arm, above the elbow, in the direction of addduction and slight flexion