4 Articulations

Sternoclavicular
Acromioclavicular
Glenohumeral
Scapulothoracic

Osteology (sternum, scapula, humerus,

clavicle, ribs)
Characteristics
Extensive

ROM
Relative Instablity

3 angles
Inferior, superior, lateral

3 borders
Medial,

superior, lateral

2 processes
Coracoid,

acromion

4 fossa
Supraspinous,

glenoid

infraspinous, subscapular,

Spine of scapula
Supraglenoid tubercle
Infraglenoid tubercle

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Figure 14-3 Right scapula and right clavicle with surface markings.

Head of humerus
Faces

medially and superiorly

Anatomic Neck
2 tubercles form bicipital groove
Lesser tubercle
Subscapularis

attachment

Greater tubercle
Supraspinatus
Infraspinatus
Teres minor

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Figure 14-4 Right humerus with surface markings.

14-3

Trapezius
Levator scapulae
Rhomboids major and minor
Pectoralis minor
Serratus Anterior
Pectoralis major
Latissimus dorsi
Teres major
Deltoid
Rotator Cuff - SITS

Overview

Referral Area

Covers vast territory

Wide variety of functions
Neck, mastoid process, ear, temporal
region
Angle of the mandible

Manual Therapy

Petrissage
Pincer compression

Overview

Common site for pain in the neck and

shoulders
Raises scapula

Referral Area

Locally, medial border of scapula

Upper scapula to back of upper arm

Overview

Major source of upper back pain

Associated with tight pectorals

Referral Area

Medial border of scapula

Superior angle of scapula

Overview

Referral Area

Anchors scapula to the chest

Tightness can entrap the nerve causing numbness
in the arm
Anterior shoulder, chest
Arm and last three fingers

Caution!

Major brachial nerves and blood vessels pass

through this area

Overview

Works with pectoral muscle

Opposes the rhomboids

Referral Area

Side of the chest, middle of ribcage

Ulnar aspect of arm to last two fingers
Inferior angle of the scapula

Three Major
Pectoralis Major
Latissimus Dorsi (assisted by Teres MAJOR)
Deltoids

360 degrees of movement

Abduction / Adduction
Flexion / Extension
Horizontal Abduction / Horizontal Adduction
Medial and Lateral Rotation
Hyperextension
Circumduction

Overview

Referral Area

Important for postural alignment

Three sections
Ipsilateral breast and chest
Anterior shoulder
Forearm, middle, and ring fingers

Manual Therapy

Pincer compression
Compression/Broadening

Overview

Referral Area

Large and powerful muscle

Covers lower posterior torso
Interior angle of the scapula, axilla, back of
the arm, last two fingers

Manual Therapy

Pincer compression

Overview

Works with latissimus

Assists in formation of the rear border of the armpit

Referral Area

Middle deltoid area

Dorsal forearm

Overview

Three aspects cap the head of the humerus

Anterior and posterior are antagonists to each
other

Referral Area

Locally over area of muscle

SITS
Superspinatus
Infraspinatus
Teres

Minor
Subscapularis

Frequent injury to athletes that throw balls

Overview

Stabilizer of the glenohumeral joint

Initiates ABDUCTION of Humerus
Subject to overuse problems

Referral Area

Over the shoulder, middle deltoid

Down the radial side of arm

Overview

Lateral rotator and stabilizer of the

glenohumeral joint
Common trouble spot

Referral Area

Medial border of the scapula, middle and/or

anterior deltoid
Radial aspect of the arm in first two or three
fingers

Overview

Referral Area

SYNERGIST to infraspinatus
Over the outer upper arm

Manual Therapy

Stripping

Overview

Medial rotator of the shoulder

Stabilizer of the glenohumeral joint
FROZEN SHOULDER
SHOULDER usual suspect

Referral Area

Over the scapula, behind axilla

Posterior arm into wrist

Biceps brachii
Brachialis
Triceps brachii
Anconeus
Coracobrachialis

Overview

BI-two heads
Crosses two joints
Runs over humerus but has no attachments to
it

Overview

Prime flexor of the elbow

DEEP to Biceps Brachii
Biceps brachii must be moved massage this
muscle

Overview

Two of three heads cross only the elbow

joint
Long head crosses both elbow and
shoulder
ANTAGONIST to biceps brachii and
brachialis

Overview

Attaches to coracoid process of scapula

DEEP to Biceps Brachii

Caution!

In working in the axilla, take care to maintain

contact with the muscle and avoid the nerves and
blood vessels that pass under the coracoid process
into the arm

Overview

Powerful and efficient flexor of the elbow

Hammer

Overview

Cover the POSTERIOR of the forearm

EL and FM
Stabilize the wrist during hand movements
Can be treated as a group

Extensor Carpi Radialis Brevis

Extensor Carpi Radialis Longus
Extensor Carpi Ulnaris
Extensor Digiti Minimi
Extensor Digitorum
Extensor Indicis
Extensor Pollicis Brevis
Extensor Pollicis Longus
Abductor Pollicis Longus

Overview

Anterior forearm
EL and FM
Most tendons pass through the carpal tunnel
Swollen tendons indicate carpal tunnel syndrome
Can be massaged as a group

Flexor Retinaculum
Palmaris Longus
Flexor Carpi Radialis
Flexor Carpi Ulnaris
Flexor Digitorum Profundus
Flexor Digitorum Superficialis
Flexor Pollicis Longus

Anterior**
O- Transverse processes C3-C6
I First Rib
Middle
O Transverse processes C2-C7
I - First Rib
Posterior
O - Transverse processes C6-C7
I - Second Rib

AS A GROUP
O Trans. Process. C2-C7
I - Ribs 1 & 2
A - (Bilateral) Neck Flexion / Rib Elevation
(Unilateral) Lateral Flexion Neck / Rotation Opposite Side