2 primary movers of the shoulder that move as a unit

Scapula

&

Clavicle

Manubrium

Corocoid Process

Acromion Process

Glenoid Fossa

Borders (Medial & Lateral)

&

Angles (Superior & Inferior)

Scapula Spine

Sternoclavicular jt (SC) movement

mutliaxial jt

arthrodial jt

moves 15 deg anteriorly w/protraction

-15 deg posteriorly w/retraction

-moves 45 deg superiorly w/up. rot.

-moves 5 deg inferiorly w/depression

some rot. of the clavicle during shoulder girdle movements result in slight rotary gliding movements @ SC jt.

supported ant. by anterior SC ligament

-posteriorly by post. ligament

-costoclavicular (ribs to clavicle)

-interclavicular (clavicle to other clavicle)

ligaments provide stability AGAINST SUPERIOR displacement

Acromioclavicular (AC) jt.

arthrodial jt. w/20-30 deg of total gliding and rotational movement

supported by coracoclavicular lig.

-superior and inferior acromioclavicular lig

coracoclavicular jt. is a syndesmotic joint w/ligs  that ^ AC jt. stability

Scapulothoracic jt.

not a true synovial jt. since its movement is dependent on SC & AC jt.

-no jt. capsule or ligs

helps w/scapular movement (25 deg ab/ad, 60 deg up. rot./down. rot. & 55 deg el/dep)

**supported only by surrounding muscles

between the ant. scapula and posterior rib cage

-articulates between 1st 9 ribs

-not a normal articulation

Processes to focus on during movement

Inferior angle (posteriorly)

Glenoid fossa (laterally)

Acromion process (anteriorly)

**all these scapular movements have their pivotal point where the sterum articulates @ the SC jt

Scapular/ Shoulder Girdle

Abduction (Ab.)

movement of scapular laterally from vertebrae

protraction

reaching for an object in front of the body

**scapula must rotate or tilt on its axis 

**NOT A PRIMARY MOVER but necessary for normal scapular movement

Scapular/Shoulder Girdle 

Adduction (Ad.)

scapula movement towards the vertebrae

retraction

pinching the shoulder blades together

**scapula must rotate or tilt on its axis 

**NOT A PRIMARY MOVER but necessary for normal scapular movement

Scapula/ Shoulder Girdle Movement

Elevation (el.)

upward/superior movement

shrugging shoulders

**scapula must rotate or tilt on its axis 

**NOT A PRIMARY MOVER but necessary for normal scapular movement

Scapula/Shoulder Girdle Movement

Depression (dep.)

downward/inferior movement

returning from shoulder shrug

**scapula must rotate or tilt on its axis 

**NOT A PRIMARY MOVER but necessary for normal scapular movement

Scapula/Shoulder Girdle Movement

Upward Rotation (up. rot.)

turning the glenoid fossa superolaterally (upward) 

-moving the inferior angle superolaterally from the vertebrae

Scapula/Shoulder Girdle Movement

Downward Rotation (down. rot.)

returning the inf. angle and glenoid fossa inferomedially back to its original position

-further down. rot. results in the sup. angle to become slightly superomedial

Scapula/Shoulder Girdle Movements

Lateral Tilt

occurs in the transverse plane w/vert. axis

consequential movement from ab.

scapula rotates to have posterior movement of medial border

-ant. movement of lateral border

*ex-reaching across the body

Scapula/Shoulder Girdle Movements

Medial tilt (inward)

occurs in transverse plane w/vert. axis

return from lateral tilt

extreme ad. when scapula rotates w/ ant. movement on medial border

-post. movement on lateral border

Scapula/Shoulder Girdle Movement 

Anterior tilt

rotation of sagittal plane w/frontal axis

upward tilt, arm moving into hyperextension w/arm behind back

superior border moves anteroinferiorly

-inferior angle moving posterosuperiorly

Scapula/Shoulder Girdle Movement

Posterior Tilt

occurs in sagittal plane w/frontal axis

hyperflexion w/ arm rotated upward near the head

superior border moving posteroinferiorly 

-inferior angle moving anterosuperiorly

Purpose of the shoulder girdle muscles

stabilizes the scapula

-allows the humerus to exert more force since the scapula is a more stable base

-movement of shoulder girdle is not dependent on shoulder jt. & muscles

shoulder jt. & girdle work together to carry out upper extremity exercises

N: pectoralis minor

O: anterior surface of 3rd & 5th rib

I: coracoid process of the scapula

A: ab. - draws scap. forward and tilts lower border away from ribs

-down. rot. - draws scap down while in ab.

-dep. - assists in dep. when scap does up. rot.

IV: medial pectoral nerve (C8-T1)

N: subclavius

O: superior aspect of 1st rib @ costal cart. jct.

I: inferior groove @ midpoint of clavicle

A: stabilization & protection of SC jt.

-dep.

-ab. (protraction)

IV: nerve fibers from C5-C6

N: serratus anterior, aka boxer's muscle

O: surface of the upper 9 ribs of the chest

I: anterior aspect of the scapula's whole medial border

A: abduction - draws the medial scap border away from vertebrae

-up. rot. - lower, longer fibers pull the scap inf. angle away from the vertebrae and slightly upward

IV: long thoracic nerve (C5-C7)

N: trapezius

O: upper - base of skull

-middle - spinous process of C7-T3

-lower - spinous process of T4-T12

I: upper- posterior aspect of the lateral 1/3 of the clavicle

-middle - medial acromion border

-lower - triangular space @ scapula spine base

A: upper - el./ex. & rot. of head & neck

-middle - el./up. rot. & ad. of scapula

-lower - dep. ad. & up. rot. of scapula

IV: Cranial nerve XI & branches of C3 & C4

N: rhomboid, deep to trapezius

O: spinous process @ C7, T1-T5

I: medial border of the scapula below the scapula spine base

A: ad. - draw scapula towards vertebrae

-down. rot. - draw scap in after up. rot.

-el. - slight upward movement w/ad.

IV: dorsal scapula nerve (C5)

N: levator scapulae

O: transverse process of C1-C4

I: medial border of scap. above the scapular spine

A: elevates medial margin of scap. w/weak down rot. & ad.

IV: dorsal scapular never (C5) & branches of C3 & C4

shoulder shrug

Components of Cervical Plexus

(C1-C4)

roots (rami) - directly from SC

branch

join @ plexus

branch again

Components of Brachial Plexus 

(C5-T1)

roots

trunks (upper, middle & lower) - come together

anterior & posterior divisions

corders

branches - nerves that travel to upper ex.

Girdle muscles that Abduct

pectoralis minor and serratus anterior

Girdle muscles that adduct

mid trap and rhomboids

Girdle muscles that upward rotate

middle trap, lower trap and serratus anterior

Girdle muscles that rotate downward

pectoralis minor and rhomboid

Girdle muscles that elevate

levator scapulae, upper trapezius and rhomboid

Girdle muscles that depress

lower trapezius and petoralis minor