nguish the three-degree-of-freedom joint from the one- or
two-degree-of-freedom joint
4．从一个自由度和两个自由度关节中区分三个自由度的关节。
- To understand the effect of muscle synergies and the influence
of weakness or paralysis of any single muscle in force
generation
5．理解肌肉的协同收缩和任何单个肌肉在力量产生时，无力或瘫痪时的作用。
Reading 阅读
- Neumann DA (2002). Shoulder complex. In Neumann
DA: Kinesiology of the Musculoskeletal System: Foundations
for Physical Rehabilitation. Philadelphia: Mosby.
Chapter 5, pp. 91-132.
- Smith LK, Weiss EL, Don Lehmkuhl L (eds, 1996).
Brunnstrom's Clinical Kinesiology, 5th ed.
Philadelphia: FA Davis. Chapter 5.
- Jazrawi LM et al. (2001). Biomechanics of the
shoulder. In Nordin M & Frankel VH: Basic
Biomechanics of the Musculoskeletal System.
Philadelphia: Lippincott Williams & Wilkins. Chapter 12,
pp.318-339
Functions of the Shoulder Complex肩部复合体的功能
- To link the upper extremity to the trunk 连接上肢和躯干
-
- To provide mobility of the arm in space 提供手指在空间变动性
-
- the greatest mobility in the body 人体上最灵活的关节
- To provide stability for elbow and hand skillful or
forceful movements
- 提供手和肘部做熟练和有力动作的稳定性
Structure of the Shoulder Complex肩部复合体的结构
Articulations within the shoulder
complex肩部复合体的关节连接
·
glenohumeral joint：盂肱关节
shoulder joint 肩关节
·
sternoclavicular joint 胸锁关节
·
acromioclavicular joint 肩锁关节
·
scapulothoracic articulation：肩胸关节
muscle-bone articulation肌肉和骨的连接
Classified by Smith et al.,
1996史密斯等在1996的分类
·
bony
articulations 骨连接分类
·
glenohumeral joint 盂肱关节
·
sternoclavicular joint 胸锁关节
·
acromioclavicular joint 肩锁关节
·
functional joints 关节功能分类
·
scapulothoracic articulation 肩胸关节
·
suprahumeral articulation (subacromial articulation)： the
articulation between the coracoacromial ligament and the
humerus
肱上关节（肩峰下关节）：喙肩韧带和肱骨之间的关节
·
bicipital groove： the groove between the greater and lesser
tuberosities of the humerus 隆间沟：在肱骨大结节和小结节之间的凹槽
Related terminology相关的术语
-
plane of scapula 肩胛骨平面
-
dependent arm position 依赖于手臂位置
Glenohumeral joint盂肱关节
- proximal component： scapula 近端成份：肩胛骨
-
- distal component： humerus 远端成份：肱骨
-
·
joint type：
ball-and-socket joint (Note： not a
real socket)
关节类型：球窝关节（不是一个真正的窝）
·
motion：
convex on concave joint
动作：凸面与凹面连接
·
shoulder
flexion/
extension with posterior/
anterior
glide of the humeral head
肱骨头向后/向前滑动完成肩关节屈/伸
·
shoulder
abduction/
adduction with
inferior/ superior glide of the humeral head
肱骨头向下/向上滑动完成肩关节外展/内收
·
shoulder
internal/
external rotation with
posterior/ anterior glide of the humeral head
肱骨头向后/向前旋转完成肩关节内旋/外旋
·
DOF = 3三个自由度
·
rest position： 70° of shoulder flexion and 30° of
flexion (horizontal adduction)
休息位：肩屈曲70度和（水平内收）屈曲30度
·
close packed position： 90° of shoulder abduction
and full external rotation
锁定位：肩充分外旋外展90度
Sternoclavicular joint胸锁关节
·
proximal component：
sternum
近端成份：胸骨
·
saddle-shaped manubrium sterni
马鞍形胸骨柄
·
distal component： clavicle 远端成份：锁骨
·
saddle-shaped medial end of the clavicle 锁骨的中末端是马鞍形
·
articular disc between 2 articular surfaces
两个关节面见有关节盘
·
joint type：
saddle joint 关节类型：鞍状关节
·
movements： shoulder girdle motion 动作：肩胛带活动
·
clavicle elevation/ depression 锁骨上提/下降
·
clavicle protraction/ depression 锁骨前伸/回缩
·
clavicle posterior rotation 锁骨向后旋转
·
DOF = 3三个自由度
Note: It is a 3-degree-of-freedom saddle
joint.注解：它是三个自由度的鞍状关节
NOTE： clavicle 注解：锁骨
·
convex forward medially and concave forward
laterally
凹面中间向前凸面横向向前
·
quadripedal animals do not have clavicles
四足动物没有锁骨
·
isokinetic strength of shoulder flexor and
abductor decreases 50% if the clavicle is removed
如果没有锁骨肩屈肌和外展肌的等速力量将减小50%
Acromioclavicular joint肩锁关节
- proximal component： convex lateral end of the clavicle
- 近端成份：锁骨末端侧面凸面
- distal component： concave acromion process of the scapula
- 远端成份：肩胛骨肩峰凹面
- joint type： nearly plane joint (sometimes slightly
concave or slightly convex)
- 关节类型：接近平面关节（有时微凹面，有时微凸面）
- movements 动作：
-
- upward/ downward rotation 向上/向下旋转
- winging (horizontal plane adjustment) （水平面调整）
- tipping (sagittal plane adjustment) （矢状面调整）
- DOF = 3 三个自由度
Scapulothoracic articulation肩胸关节
- proximal component: convex rib cage 近端成份：胸腔凸面
- distal component: concave anterior surface of the scapula
远端成份：肩胛骨前面凹面
- Note： not a real anatomical joint 注解：不是一个真正的解剖关节
- movements at the scapulothoracic articulation are the results
of movements occurring at the
sternoclavicular and
acromioclavicular joints
- 肩胸关节的活动会导致肩锁和胸锁关节活动
-
- elevation/ depression 上提/下撤
- protraction/ retraction 前伸/后缩
- upward/ downward rotation 向上/向下旋转
Suprahumeral articulation肱上关节（肩峰下关节）
·
subacromial joint 肱上关节
·
coracoacromial arch： composed of the coracoacromial
ligament
喙肩弓：由喙肩韧带组成
·
spraspinatus tendon passing underneath this arch
冈上肌腱从弓下面穿过
·
not for joint stability 不足是为了增加关节稳定性
·
shoulder impingement occurs if the subacromial space is
insufficient
如果肩峰下空间不足肩部撞击综合症将发生
·
insufficient inferior
glide of the humeral head
during arm elevation
在手臂抬高时肱骨头下滑不充分
·
insufficient
external rotation of the humerus
during arm elevation
在手臂抬高时肱骨头外旋不充分
·
inflammation of the tendon of the supraspinatus
冈上肌肌腱发炎
·
hypertrophy of the tendon of the supraspinatus
冈上肌肌腱过度肥大
Bicipital groove (intertubercular groove)隆间沟（结节间沟）
·
groove between greater and lesser tubercles of the
humerus where the tendon of the long head of the biceps brachii
passes.
The roof of the groove is covered with transverse
humeral ligament. 肱骨大结节和小结节间的凹槽，肱二头肌腱通过的地方，这个凹槽上被肱横韧带所覆盖。
·
During shoulder motions, the humeral head slides on the
undersurface of the tendon of the long head of the biceps brachii
肩部活动时，肱二头肌腱在肱骨头下面滑动
·
intra-articular but extra-synovial 在关节内但在滑膜外
Plane of scapula肩胛骨平面
·
not parallel to the frontal plane 不平行于冠状面
·
definition： the plane at the angle of 30º anterior to the
frontal plane
定义：这个平面在冠状面之前30度
·
capsules in the rest position 关节囊在休息位
·
no impingement in the suprahumeral joint if shoulder
motions occurs in the plane of scapula
如果肩关节活动在肩胛骨平面的话，肱上关节不会产生冲撞。
Dependent arm position双手自然下垂位置
·
the
position that the arm is hanging down by the
side of the trunk
这个位置是手臂在躯干旁边自然下垂
Kinematics of the Shoulder Complex肩部复合体的运动学
·
shoulder motion 肩部动作
·
flexion/ extension 屈曲/伸展
·
abduction/ adduction 外展/内收
·
external/ internal rotation 外旋/内旋
·
combined motion 复合运动
·
horizontal abduction/ adduction 水平外展/内收
·
circumduction 环转
·
shoulder girdle (scapular) motion 肩胛带（肩胛）活动
·
elevation/ depression 上提/下降
·
protraction/ retraction 前伸/后缩
·
axial rotation 绕轴自转
·
clavicle rotation锁骨旋转
Shoulder flexion and
extension肩关节屈曲/伸展
·
joint involved 涉及关节
·
glenohumeral joint (principal joint) 盂肱关节（最重要的关节）
·
sternoclavicular joint 胸锁关节
·
acromioclavicular joint 肩锁关节
·
scapulothoracic articulation 肩胸关节
·
plane of motion：
sagittal plane 活动平面：矢状面
·
axis of rotation：
transverse axis through
the center of the humeral head
旋转轴：穿过肱骨头中心的冠状轴
·
osteokinematic movements 关节间活动
·
range of motion (ROM) 关节活动度
·
glenohumeral joint： 0-90º of shoulder flexion and 0-45º
or 60º of shoulder extension 盂肱关节：0-90º的肩关节屈曲和0-45º
或60º的肩关节伸展
·
closed kinematic chain motions 闭链运动
·
pull-up (引體向上)
·
rowing 划船
·
upper extremity cycling on an ergometer 上肢循环测力计
·
arthrokinematic movements 关节面活动
·
posterolateral
glide of the humeral head on the
glenoid cavity with shoulder flexion
肩关节屈曲时肱骨头在关节盂上向后外侧滑动
·
anteromedial glide of the humeral head on the glenoid
cavity with shoulder extension
肩关节伸展时肱骨头在关节盂上向前内侧滑动
·
factors limiting shoulder flexion肩关节屈曲的受限因素
·
inferior glenohumeral ligament (most important)
下面的盂肱韧带（最重要的）
·
tightness of the posterior joint capsule 后部紧密地关节囊
·
factors limiting shoulder extension 肩关节伸展受限的因素
·
superior and middle glenohumeral ligament (most
important)
上面和中间的盂肱韧带（最重要的）
Shoulder abduction and
adduction肩关节外展和内收
·
arm elevation = shoulder abduction or flexion
举手＝肩关节外展或屈曲
·
joint involved 涉及关节
·
glenohumeral joint (principal joint) 盂肱关节（最主要的关节）
·
sternoclavicular joint 胸锁关节
·
acromioclavicular joint 肩锁关节
·
plane of motion：
frontal plane 活动平面：冠状面
·
axis of rotation 旋转轴
·
GH joint：
sagittal axis through the center of the
humeral head
盂肱关节：穿过肱骨头中心的矢状轴
·
SC joint： sagittal axis through the center of the medial
end of the clavicle
胸锁关节：穿过锁骨中末端中心的矢状轴
·
osteokinematic movements 关节间活动
·
range of motion (ROM) 关节活动度
·
total range：0-165 or 175º 整个范围0-165或 175度
·
glenohumeral joint：0-120º of shoulder abduction
盂肱关节：0-120º肩外展
·
0-60º with full
internal rotation of humerus
0-60º肱骨充分内旋
·
0-90º with full
external rotation of humerus
0-90º肱骨充分外旋
·
sternoclavicular joint：0-30 or 45º
胸锁关节：0-30 或45º
·
most occurring in 1st 90º of arm elevation
大部分发生在举手的前90度
·
scapulohumeral rhythm 肩肱定律
·
Inman
et al. (1944) 英曼等人
·
GH: ST = 2:1 after 30º of abduction
盂肱关节：肩胸关节=2：1在外展30度后
·
measured frontal plane motion 测量冠状面的活动
·
Bagg and Forrest (1988)
·
GH: at the beginning and the end 盂肱关节：在开始和结束
·
ST: 80-140 º of abduction 肩胸关节：外展80-140 º
·
averaged ratio: 1.25:1 平均比例
·
measured
plane of scapula motion 测量在肩胛骨平面活动
·
arthrokinematic movements 关节面活动：
·
shoulder abduction肩外展
·
inferior
glide of the humeral head on the glenoid
cavity
肱骨头在关节盂内向下滑动
·
inferior glide of the clavicle on the sternum in most
people
在大多数锁骨在胸骨上向下滑动
·
factors limiting shoulder abduction 限制肩外展的因素
·
inferior glenohumeral ligament (most
important)下面的盂肱韧带（最主要的）
·
tightness of the inferior joint capsule of the
glenoumeral joint
盂肱关节下部紧密地关节囊
·
tightness of the costoclavicular and interclavicular
ligaments and the subclavicius muscles at the SC joint
紧密地肋锁或锁间韧带和肩锁关节的锁骨下肌肉
·
factors limiting shoulder adduction 限制肩内收的因素
·
trunk 躯干
Shoulder Internal/ External
rotation肩关节内/外旋
·
joint involved 涉及关节
·
glenohumeral joint 盂肱关节
·
plane of motion：
transverse plane活动平面：横切面
（水平面）
·
axis of rotation：
vertical axis through the
center of the humeral head
旋转轴：穿过肱骨头中心的垂直轴
·
osteokinematic movements 关节间活动
·
range of motion (ROM) 关节活动度
·
shoulder internal rotation： 0-70º as the arm at 90º of
shoulder
abduction and 90º elbow
flexion
肩关节内旋：当肩外展90度，肘屈曲90度时，内旋0-70度
·
shoulder external rotation： 0-90º as the arm at 90º of
shoulder abduction and 90º elbow flexion
肩关节外旋：当肩外展90度，肘屈曲90度时，外旋0-90度
·
Note： If the elbow is
extended, shoulder rotation
occurs simultaneously with forearm rotation.
注解：如果肘关节伸展，肩关节旋转和前臂旋转同时发生。
·
arthrokinematic movements 关节面活动
·
posterolateral
glide of the humeral head on the
glenoid cavity with shoulder internal rotation
肩关节内旋时肱骨头在关节盂内后外侧滑动
·
anteromedial glide of the humeral head on the glenoid
cavity with shoulder external rotation 肩关节外旋时肱骨头在关节盂内前内侧滑动
·
factors limiting shoulder internal rotation
限制肩关节内旋的因素
·
posterior capsule 后方的关节囊
·
factors limiting shoulder external rotation
限制肩关节外旋的因素
·
coracohumeral ligament 喙肱韧带
·
3 glenohumeral ligaments 三个盂肱韧带
Shoulder horizontal abduction/
adduction肩关节水平外展/内收
·
shoulder
flexion/
extension at 90º of
shoulder
abduction 在肩关节外展90度时屈曲/伸展
·
horizontal abduction： arm moves backward as the arm is at
90º of shoulder abduction
水平外展：在肩关节外展90度时手臂向后移动
·
horizontal adduction： arm moves forward as the arm is at
90º of shoulder abduction
水平内收：在肩关节外展90度手臂向前移动
·
joint involved 涉及关节
·
glenohumeral joint 盂肱关节
·
plane of motion：
transverse plane活动平面：水平面
·
axis of rotation：
vertical axis through the
center of the humeral head
旋转轴：穿过肱骨头中心的垂直轴
·
arthrokinematic movements 关节面活动
·
anteromedial
glide of the humeral head on the
glenoid cavity with shoulder horizontal abduction
肩关节水平外展时，肱骨头在关节盂内向前内侧滑动
·
posterolateral glide of the humeral head on the glenoid
cavity with shoulder horizontal adduction
肩关节水平内收时，肱骨头在关节盂内向后外侧滑动
Circumduction motions at shoulder
joint肩关节环形运动
·
A combination of
flexion,
abduction,
extension, and
adduction or in the reversed
sequence
一个环形运动由屈曲，外展，伸展，内收或相反的顺序
·
glenohumeral flexion à abduction à extension à
adduction
盂肱关节屈à外展à伸à内收
·
glenohumeral extension à abduction à flexion à
adduction
盂肱关节伸à外展à屈à内收
·
joint involved： glenohumeral joint 涉及关节：盂肱关节
·
pivot： center of humeral head 轴心：肱骨中心
·
tip of fingers moves in a circle path指端运动形成一个圆周
Frontal plane motions at shoulder
girdle肩胛带在冠状面的活动
·
elevation 上提
·
most occurring in 1st 90º of
arm elevation
大多部分发生在举手的前90度
·
joint involved：涉及关节
·
sternoclavicular joint 胸锁关节
·
scapulothoracic articulation 肩胸关节
·
ROM：30-45º 活动度：
·
arthrokinematic movement： with inferior
glide of SC joint in most people
关节面活动：大多数人胸锁关节向下滑动
·
limited by the costoclavicular and interclavicular
ligaments and the subclavicius muscle 靠肋锁和锁骨间韧带和锁骨下肌肉限制
·
depression 下降
·
important for crutch walking 对拐杖步行很重要
·
joint involved： 涉及关节
·
sternoclavicular joint 胸锁关节
·
scapulothoracic articulation 肩胸关节
·
ROM 关节活动度
·
10-15º of depression from resting position
从休息位下降10-15度
·
10-15 cm from maximum scapular elevated position
从肩胛骨上提位最多可有10-15cm
·
arthrokinematic movement：with superior glide of the SC
joint in most people
关节面活动：大多数人胸锁关节向上滑动
·
limited by first rib 被第一肋骨限制
Transverse plane motions at shoulder
girdle肩胛带水平面的活动
·
protraction 前伸
·
joint involved 涉及关节
·
sternoclavicular joint 胸锁关节
·
scapulothoracic articulation 肩胸关节
·
osteokinematic movements 关节间活动
·
15º of protraction of sternoclavicular joint
胸锁关节前伸15度
·
13-15 cm of
abduction of scapula
肩胛带外展13-15cm
·
limited by posterior sternoclavicular and costoclavicular
ligaments
被背侧的胸锁和肋锁韧带限制
·
retraction： 回缩
·
joint involved 涉及关节
·
sternoclavicular joint 胸锁关节
·
scapulothoracic articulation 肩胸关节
·
osteokinematic movements 关节间活动
·
15º of retraction of sternoclavicular joint
胸锁关节回缩15度
·
adduction of scapula 肩胛骨内收
·
limited by anterior sternoclavicular ligament
被前侧的胸锁前韧带限制
·
total range： 25º totally 整个活动范围：25度完全地。
Circumduction motions at shoulder girdle肩胛带的环形运动
·
A combination of elevation, protraction, depression, and
retraction or in the reversed sequence
一个环形运动由上提、前伸、下降、回缩或相反的顺序
·
SC joint as the pivot 胸锁关节是轴心
·
tip of shoulder moves in a circle path
肩峰的运动形成一个圆周轨迹
Rotation of shoulder girdle肩胛带的旋转
·
upward rotation 向上旋转
·
glenoid fossa facing upwards 关节窝向上
·
inferior angle of scapula slides laterally and anteriorly
肩胛下角向下向前滑动
·
downward rotation 向下旋转
·
glenoid fossa facing downwards 关节窝向下
·
inferior angle of scapula slides medially and posteriorly
肩胛下角向中间向后滑动
·
total range: 60º整个活动范围60度
Transverse rotation of clavicle锁骨的平面旋转
·
axis of rotation： longitudinal axis of the clavicle
旋转轴：锁骨纵轴
·
total range: 40º 整个活动范围40度
·
occurring after 90º of arm elevation due to tightening of
the coracoclavicular ligament
由于举手90度后喙锁韧带被绷紧开始旋转
·
arm elevation limited to 110º if this posterior rotation
is not taken place
如果向后旋不能产生，那么举手将在110度受限。
Muscle Actions at the Shoulder Complex肩部复合体的肌肉活动
·
The muscle at the shoulder complex act together as a team
to produce highly coordinated motions.
肩部复合体周围肌肉作为一个团队产生非常协调的活动。
Muscles for glenohumeral (shoulder)
motions盂肱（肩）活动的肌肉
Motion活动
|
prime movers主动肌
|
shoulder flexion肩屈曲
|
deltoid, anterior fibers三角肌前面纤维
coracobrachialis喙肱肌
biceps brachii, long head肱二头肌长头
pectoralis major, clavicular head
胸大肌锁骨头
|
shoulder extension肩伸展
|
latissimus dorsi背阔肌
teres major大圆肌
triceps brachii, long head肱三头肌长头
deltoid, posterior fibers三角肌后部纤维
|
shoulder abduction肩外展
|
Deltoid三角肌
supraspinatus冈上肌
biceps brachii, long head肱二头肌长头
|
shoulder adduction肩内收
|
pectoralis major胸大肌
latissmus dorsi背阔肌
teres major大圆肌
triceps brachii, long head肱三头肌长头
deltoid, posterior fibers三角肌后部纤维
|
shoulder external rotation
肩外旋
|
Infraspinatus冈下肌
teres minor小圆肌
deltoid, posterior fibers三角肌后部纤维
|
shoulder internal rotation
肩内旋
|
Subscapularis肩胛下肌
teres major大圆肌
pectoralis major胸大肌
latissimus dorsi背阔肌
deltoid, anterior fibers三角肌前部纤维
|
Muscles for scapulothoracic (shoulder girdle)
motions肩胸（肩胛带）活动的肌肉
Motion活动
|
prime movers
发动力、发起者
|
Motion活动
|
prime movers
原动力
|
scapular elevation肩胛上提
|
upper trapezius
上斜方肌
levator scapulae肩胛提肌
rhomboid major
大菱形肌
rhomboid minor
小菱形肌
|
scapular depression
肩胛下降
|
pectoralis minor胸小肌
lower trapezius
下斜方肌
latissmus dorsi
背阔肌
subclavius
锁骨下肌
|
scapular protraction
肩胛前伸
|
serratus anterior
前锯肌
pectoralis major
胸大肌
pectoralis minor
胸小肌
|
scapular retraction
肩胛回缩
|
Trapezius斜方肌
rhomboid major
大菱形肌
rhomboid minor
小菱形肌
|
scapular upward rotation
肩胛向上旋转
|
Trapezius斜方肌
serratus anterior
前锯肌
|
scapular downward rotation
肩胛向下旋转
|
levator scapula
肩胛提肌
rhomboid major
大菱形肌
rhomboid minor
小菱形肌
|
Serratus anterior前锯肌
·
saw muscle 锯齿样肌肉
·
origin： rib 1-9 起源于1-9肋骨
·
insertion： medial border of the scapula 附着在肩胛骨的内侧缘
·
motion： protraction + upward rotation 动作：前伸+向上旋转
·
winging scapula if paralyzed 如果麻痹形成翼状肩胛
·
displacement of medial border of the
scapula肩胛内侧缘产生位移
Rotator cuff旋转肌腱
·
supraspinatus 冈上肌
·
infraspinatus 冈下肌
·
teres minor 小圆肌
·
subscpularis肩胛下肌
Pectoralis minor胸小肌
·
origin： rib 2-5 起源：肋骨2-5
·
insertion： coracoid process of the scapula
附着：在肩胛骨喙突
·
depression + downward rotation 下降+向下旋转
·
agonists 主动作用
·
depressors 下降
·
downward rotators 向下回旋肌
·
antagonists： 拮抗作用
·
elevation + upward rotation 上提+向上旋转
·
stablizers 稳定作用
·
neutralizers 中和作用
·
for pure depression motion： 为单纯的下降活动
·
for pure downward rotation motion：为单纯的向下旋转
Important coupled muscles重要的成对肌肉
·
levator scapula 肩胛提肌
·
latissimus dorsi 背阔肌
·
pectoralis major 胸大肌
·
trapezius: upper, middle, and lower 斜方肌：上部、中部、下部
·
rhomboid major and minor 大/小菱形肌
Shoulder Complex Stability肩部复合体的稳定性
GHJ stability盂肱关节的稳定性
SCJ stbaility胸锁关节稳定性
ACJ stability肩锁关节稳定性
Factors that stabilize the glenohumeral
joint使盂肱关节稳定的因素
·
bony configuration： not important 骨结构：不重要
·
5º of superior inclination (upward tilt) of the glenoid
cavity 关节盂有5度的向上倾斜
·
shape of cartilage 软骨的形成
·
glenoid
labrum： to contribute 50% of overall depth
of the
glenoid cavity
肩盂唇：占关节盂深度的50%
·
tension of ligaments韧带张力
Ligament韧带
|
shoulder motions
to pull the ligament taut
韧带拉紧的肩部活动
|
humeral head motion
to pull the ligament taut
韧带拉紧的桡骨头活动
|
superior glenohumeral lig.上部的盂肱韧带
|
full adduction充分内收
|
inferior or anterior glide
向下或向前滑动
|
middle glenohumeral lig.
中部盂肱韧带
|
external rotation外旋
|
anterior glide向前滑动
|
inferior glenohumeral lig.下部盂肱韧带
anterior band
前部韧带
posterior band
后部韧带
|
abduction and external rotation
外展和外旋
abduction and internal rotation
外展和内旋
|
non specific没有具体的
|
coracohumeral lig.
喙肱韧带
|
extremes of flexion, extension, or external rotation
绝对极限的屈曲、伸展或外旋
|
inferior glide向下滑动
|
·
muscular arrangement： rotator cuff 肌肉排列：旋转肌腱
·
supraspinatus 冈上肌
·
infraspinatus 冈上肌
·
teres minor 小圆肌
·
subscapularis 肩胛下肌
·
capsule： not important 关节囊：不重要
Factors that stabilize the sternoclavicular
joint使胸锁关节稳定的因素
·
bony configuration： saddle shaped 骨结构：马鞍形
·
shape of cartilage 软骨的形状
·
interarticular disc to increase the congruity of the
irregular articular surface
关节间的潘增加了不规则关节表面的合适程度
·
tension of ligaments： 韧带活动：
·
costoclavicular ligament (most important) 肋锁韧带（最重要）
·
anterior sternoclavicular ligament 胸锁韧带前部
·
posterior sternoclavicular ligament 胸锁韧带后部
·
interclavicular ligament 锁骨间韧带
·
muscular arrangement： 肌肉排列
·
strenal head of the sternocleidomastoid muscle (anterior)
胸锁乳突肌前部的胸骨头
·
sternothyroiod and sternhyoid muscles (posterior)
胸骨舌骨肌和胸锁乳突肌后部
·
capsule关节囊
Factors that stabilize the acromioclavicular
joint使肩锁关节稳定的因素
·
bony configuration： flat shaped 骨结构：扁平状
·
shape of cartilage 软骨形状
·
fibrocartilage with a articular disc一个纤维软骨的关节盘
·
tension of ligaments： 韧带张力
·
superior acromioclavicular ligament 上部的肩锁韧带
·
inferior acromioclavicular ligament 下部的肩锁韧带
·
coracoclavicular ligament： conoid (medial) and trapezoid
ligaments (lateral)
喙锁韧带：圆锥形的（中间）和斜方韧带（侧方）
·
muscular arrangement： 肌肉排列：
·
deltoid 三角肌
·
trapezius 斜方肌
·
capsule关节囊
Mechanism of Injury at the Shoulder肩部损伤机制
direct stress直接应力
repeated stress反复应力
Direct stress直接应力
·
direct stress à
acromioclavicular (AC) joint
separation
直接应力à
肩锁关节的分离
·
anterior stress à
anteroinferior dislocation of
the humeral head
前面的应力à
肱骨头前下向的脱臼
Repeated stress反复应力
·
repeated shoulder rotation motions as the shoulder is
placed at 90º of abduction à repeated tensile stress on rotator
cuff à rotator cuff tendonitis
在肩关节外展90度为反复肩关节旋转à
反复的拉伸应力在旋转肌腱上à
肌腱炎
