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Fundamentals
Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
The upper limb bones are the humerus in the arm, the ulna and radius in the forearm, and the carpals, metacarpals, and phalanges of the hand. The shoulder girdle consists of the clavicles (collarbones), which attach to the sternum (breastbone) medially, and the scapulae (shoulder blades). The scapulae are connected to the trunk by muscular attachments only. The major joints of the upper limb are the shoulder, elbow, wrist, and the articulations of the individual digits.
In-Patient Rehabilitation of the Coronary Artery Bypass Surgery Patient and the Heart Transplantation Patient
Published in Mary C. Singleton, Eleanor F. Branch, Advances in Cardiac and Pulmonary Rehabilitation, 2018
Depending on his medical/hemodynamic stability, the patient begins active-assisted exercises, progressing to active arm and leg exercises. The leg exercises have been described previously. The arm exercises include bilateral shoulder flexion and extension, shoulder abduction and shoulder elevation within the patient’s comfort. These range of motion exercises are necessary to avoid muscle shortening in the shoulder girdle musculature, and are done bilaterally to avoid shifting of the sternum and to allow normal healing to occur. Active exercises of neck rotation, flexion, extension and lateral flexion may be started. In the intensive care unit (ICU), care must be taken to avoid shoulder flexion and abduction beyond 90 degrees if the patient has a Swan-Ganz catheter in position, as movement may move the balloon tip out of position.29
Upper limb
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
The shoulder girdle (scapula and clavicle) is controlled and supported by muscles crossing between the spine, thorax, scapula and humerus. The sternoclavicular joint is the only synovial joint between the upper limb and the axial skeleton. The glenohumeral joint is most closely controlled by the deltoid and rotator cuff muscles (subscapularis, supraspina- tus, infraspinatus and teres minor). The scapula is integral to shoulder motion, both gliding and rotating on the posterior surface of the thorax (Figure34.1).
The effect of experimental shoulder pain on contralateral muscle force and activation
Published in Physiotherapy Theory and Practice, 2021
Scott K. Stackhouse, Brett A. Sweitzer, Philip W. McClure
Shoulder pain in the general population has a point prevalence between 7% and 26% (Luime et al., 2004), and painful conditions of the shoulder have been shown to impair muscle function and to be related to outcomes (Andersen, Holtermann, Jorgensen, and Sjogaard, 2008; Celik, Sirmen, and Demirhan, 2011; Joensen, Couppe, and Bjordal, 2009; MacDermid et al., 2004; McClure et al., 2004; Merolla et al., 2010; Sokk et al., 2007). The shoulder girdle is heavily reliant on muscle action to maintain stability, and abnormal EMG activation patterns of muscles surrounding the shoulder have been well documented in patients with painful shoulder conditions (Bigliani and Levine, 1997; Chester, Smith, Hooper, and Dixon, 2010; Glousman et al., 1988; Graichen et al., 2001; Lucas, Rich, and Polus, 2010; Ludewig and Cook, 2000). Therefore, experiencing shoulder pain may adversely affect a patient’s ability to recruit and drive the firing rate of key muscle groups.
Trunk Control and Upper Limb Function of Walking and Non-walking Duchenne Muscular Dystrophy Individuals
Published in Developmental Neurorehabilitation, 2021
Ana Lucia Yaeko da Silva Santos, Flaviana Kelly de Lima Maciel, Francis Meire Fávero, Luis Fernando Grossklauss, Cristina dos Santos Cardoso de Sá
Throughout the disease progression, the muscles responsible for shoulder girdle stability have their function compromised,26 which makes it necessary to raise the upper limbs.27 Shoulder girdle stability is assessed from the upper thoracic control, as from this level, the individual needs to maintain the upper limb in abduction in a static, active, and reactive manner. Most non-walking individuals did not have shoulder girdle stability nor difficulty in raising their upper limbs. These results indicate that the decline in muscle function is accompanied by adaptations or functional limitations that DMD individuals present throughout the progression. Therefore, clinical assessments such as PUL can detect muscle weakness early in the disease and allow preventive contracture interventions and minimization of functional decline.28
The extent of brachial plexus injury: an important factor in spinal accessory nerve to suprascapular nerve transfer outcomes
Published in British Journal of Neurosurgery, 2020
Kevin Rezzadeh, Megan Donnelly, Dorice Vieira, David Daar, Ajul Shah, Jacques Hacquebord
Our study established a statistical association between multiple levels of brachial plexus injury and shoulder strengths postoperatively. The poorer results seen in patients with greater extent of injury could be explained in part by innervation of muscles involved with shoulder abduction or external rotation outside of the upper brachial plexus.3,17–19,23 The shoulder girdle involves numerous muscles. Several of these muscles are innervated by intraplexal nerves. Therefore, while their contribution to shoulder motion is less pronounced than the rotator cuff or deltoids, they nevertheless do play a meaningful role.23 Therefore, the greater extent of the brachial plexus injury, the fewer of these muscles will be present to function on the shoulder girdle. However, we do not believe that the significant decrease in patients that obtain MRC scores greater than or equal to 4 can be largely attributed to muscles such as the rhomboids, upper trapezius, or pectoralis minor that contribute on scapulothoracic motion.3