injuries to the shoulder
DESCRIPTION
Injuries to the Shoulder. Anatomy of the Shoulder. Bones of shoulder complex: clavicle (collar bone) scapula (shoulder blade) humerus Provide points of connection between upper extremities and axial skeleton. Articulations of the Shoulder. Sternoclavicular (SC) joint - PowerPoint PPT PresentationTRANSCRIPT
Injuries to the Shoulder
Anatomy of the ShoulderAnatomy of the Shoulder
• Bones of shoulder complex:– clavicle (collar bone)– scapula (shoulder blade)– humerus
Provide points of connection between upper extremities and axial skeleton
Articulations of the Shoulder
• Sternoclavicular (SC) joint – Articulation between the sternum and clavicle
• Acromioclavicular (AC) joint– Articulation between clavicle and acromium
process
• Glenohumeral joint– Articulation between head of humerus and
scapula (ball and socket joint)
ROM of Shoulder Joint
• Flexion
• Extension
• Abduction
• Adduction
• External rotation
• Internal rotation
• Horizontal abduction
• Horizontal adduction
• Circumduction
Muscles of the Shoulder Joint
• Deltoid
• Teres Major
• Rotator Cuffs– Supraspinatus– Infraspinatus– Teres minor– Subscapularis
Rotator Cuff Tear
Main Muscles of Upper Arm
• Biceps brachii• Brachialis• Triceps brachii
– Attaches humerus to shoulder girdle
• Trapezius• Rhomboids• Serratus anterior• Pectoralis Major
– Attaches shoulder girdle to trunk of body
Major Arteries and Veins of ArmMajor Arteries and Veins of Arm
• Arteries
– Subclavian
– Axillary
– Brachial
– Radial & Ulnar
• Veins
– Radial & Ulnar
– Brachial
– Axillary
– Subclavian
Major Nerves of the ArmMajor Nerves of the Arm
• Brachial Plexus– Axillary– Musculocutaneous – Radial - extensors– Medial - flexors– Ulnar – flexors
Nerve damage results in numbness, pain, and/or tingling
Injuries to the Shoulder• Fractures
– Usually clavicle or head of humerus
Mechanism of Injury 1. direct blow 2. falling on outstretched hand 3. landing on acromiom process
Symptoms– pain, swelling, deformity– hanging arm to side– and unable to lift arm
• Fractures Special Tests– Percussion Test
• Lightly tap distal aspect of involved arm
– Compression Test• Compress area above and below injured site• Be careful not to place hands on injured area
• Immediate Treatment– Place in sling or splint– Ice only if will not increase pain– Send to physician or call EMS
Injuries to the Shoulder• Dislocation / Subluxations
– Dislocation = head of humerus displaced– Subluxation = partial dislocation
Mechanism of Injury1. Falling on outstretched arm (Anterior)2. Arm in 90° flexion forced back (Posterior)
Symptoms• Pain• Loss of strength & ROM• “dead arm”• Slipping sensation
• Immediate Treatment– Place in comfortable position– Check for loss of circulation– Immobilize the joint & apply ice– Send to physician
** if loss of circulation is present, call EMS
Injuries to the Shoulder• Contusions
Mechanism of Injury– Direct blow
Symptoms
1. point tenderness
2. loss of ROM
3. discoloration
Immediate Treatment– Ice– Protect
Injuries to the Shoulder• Sprains
– Stretching or tearing of ligaments around AC joint, SC joint, and glenohumeral joint capsule
Mechanism of Injury• Outstretched arm• Direct blow
Symptoms1. Point tenderness 3. Swelling2. Weakness 4. Decreased ROM
• Special Tests for Glenohumeral Joint Instability– Sulcus
• Downward distraction of the humerus to assess multidirectional instability of GH joint
– Apprehension• Standing behind the athlete with their arm
abducted 90°, grab their wrist and externally rotate the arm. At the sign of apprehension, stop.
• Assesses instability of anterior GH joint capsule