II.

Physiology of Shoulder Joints

1. Flexion
2. Extension
3. Abduction
Abduction is defined as joint motion away from the midline of the body
(Abdurachman, et. Al. 2017). The midline referred to here is an imaginary line that
runs from the top of the head to between the legs in an upright position. During the
abduction motion, several muscles in the shoulder region contract. These muscles
include m. deltoid and m. supraspinatus. The deltoid muscle is innervated by n.
axillaris (C5, C6) which is a branch of the superior fasciculus of the brachial plexus
while m. supraspinatus innervated n. suprascapularis (C5, C6) which is a branch of
the truncus superior plexus brachialis. The ROM (Range of Motion) of the shoulder
joint abduction motion is 0 - 180 °.
The abduction of the shoulder joint is described as follows:

Source: Video Tramed Examination of Motion Tools for FK UNAIR

Meanwhile, Abdurachman, et. al. (2017) states that the muscles and nerves involved
in the process of abduction of the shoulder joint include:
 Muscle Origo Insertion Innervation ROM Picture
M. deltoid pars Acromion The humeral deltoid N. axillaris (C5, C6) 0 - 180º
acromialis tuberosity

(Paulsen & Waschke, 2011)

M. supraspinatus Fossa supraspinata Tuberculum majus N. suprascapularis
(C5, C6)

(Paulsen & Waschke, 2011)

M. biceps brachii The tuberosity of Radii tuberosity, N.
caput longum the supraglenoidalis fascia antebrachii musculocutaneous
scapulae (C5, C6, C7)

(Paulsen & Waschke, 2011)

4. Adduction
Adduction is defined as joint motion that approaches the midline of the body
(Abdurachman, et. Al. 2017). During the adduction movement of the shoulder joint,
several muscles contract. These muscles include m. pectoralis major, m. teres major,
and m. latissimus dorsi. The pectoralis major muscles are innervated by: 1) n.
pectoralis medialis (C8, T1) which is a branch of the fasciculus medialis plexus
brachialis; 2) n. pectoralis lateralis (C5, C6, C7) which is a branch of the fasciculus
lateral plexus brachialis. The musculus teres major is innervated by n. inferior
subscapularis (C5, C6) which is a branch of the posterior fasciculus plexus brachialis.
The latissimus dorsi muscles are innervated by n. thoracodorsalis (C6, 7, 8) which is a
branch of the posterior fasciculus plexus brachialis. Meanwhile,
The adduction movement of the shoulder joint is described as follows:

Source: Video Tramed Examination of Motion Tools for FK UNAIR

 Meanwhile, Abdurachman, et. al. (2017) states that the muscles and nerves
involved in the adduction movement of the shoulder joint include:
 Muscle Origo Insertion Innervation ROM Picture
M. pectoralis 2/3 of the medial Crista tuberculi N. pectoralis
major: a. pars clavicula sternum majoris humeri lateralis (C5, C6,
clavicularis and ribs 1-6 vaginal C7) and N.
b. pars musculi recti pectoralis medialis
sternocostalis abdominis (C8, T1)
c. pars abdominalis

(Paulsen & Waschke, 2011)

M. latissimus dorsi Spinous Processus Crista tuberculi N. thoracodorsalis
VT7-12, VL 1-5 to minori humeri (C6, C7, C8)
crista iliaca

0 - 45º

(Paulsen & Waschke, 2011)

M. teres major The inferior Crista tuberculi Inferior
angulus of the minoris subscapularis (C5,
scapulae and margo C6)
axillaris

(Paulsen & Waschke, 2011)

M. biceps brachii Processus Radii tuberosity, N. musculocutaneus
caput brevis coracoideus fascia antebrachii (C5, C6)
scapulae

(Paulsen & Waschke, 2011)

M. triceps brachii The infraglenoid The posterior N. radialis
caput longum tuberosity surface of the
processus olecrani
ulnae

(Paulsen & Waschke, 2011)

M. deltoid: Spina scapulae, The humeral N. axillaris (C5, C6)
a. pars spinalis lateral clavicula deltoidea tuberosity
b. pars clavicularis

(Paulsen & Waschke, 2011)

5. Endorotation

Rotation is defined as the motion of the bone segment on the vertical axis to
the transverse plane (Abdurachman, et. Al. 2017). The rotational motion can be
divided into endorotation and exorotation. Endorotation motion is a rotational motion
approaching the midline or inward. Several muscles are involved in the endorotation
movement of the shoulder joint. The muscles include m. deltoid pars clavicularis, m.
latissimus dorsi, and m. teres major. Each of these muscles is innervated by n.
axillaris (C5, C6) which is a branch of the posterior fasciculus of the brachialis
plexus, n. thoracodorsalis (C6, C7, C8) which is a branch of the posterior fasciculus of
the brachialis plexus, and n. the inferior subscapularis (C5, C6) which is a branch of
the posterior fasciculus of the brachialis plexus. On the other hand the ROM (Range
of Motion) of the shoulder joint endorotation motion is 0 - 80 °.

The endorotation movement of the shoulder joint is described as follows:

Source: Video Tramed Examination of Motion Tools for FK UNAIR

Meanwhile, Abdurachman, et. al. (2017) states that the muscles and nerves
involved in the process of shoulder joint endorotation include:
 Muscle Origo Insertion Innervation ROM Picture
M. deltoid pars 1/3 lateral to the The humeral deltoid N. axillaris (C5, C6)
clavicularis anterior of the tuberosity
clavicula

(Paulsen & Waschke, 2011)

M. latissimus dorsi Spinous Processus Crista tuberculi N. thoracodorsalis
VT7-12, VL 1-5 to minori humeri (C6, C7, C8)
crista iliaca

0 - 80º

(Paulsen & Waschke, 2011)

M. teres major The inferior angulus Crista tuberculi Inferior
of the scapulae and minoris subscapularis (C5,
margo axillaris C6)

(Paulsen & Waschke, 2011)

6. Exorotasi

Exorotation motion is a rotational motion away from the midline or inward.

Several muscles are involved in the endorotation movement of the shoulder joint. The
muscles include m. deltoid pars spinalis, m. infraspinatus, and m. teres minor. Each of
these muscles is innervated by n. axillaris (C5, C6) which is a branch of the posterior
fasciculus of the brachialis plexus, n. suprascapularis (C5, C6) which is a branch of
the superior truncus of the brachial plexus, and n. axillaris (C5, C6) which is a branch
of the posterior fasciculus of the brachial plexus. On the other hand the ROM (Range
of Motion) of the shoulder joint endorotation motion is 0 - 90º.

The endorotation movement of the shoulder joint is described as follows:

Source: Video Tramed Examination of Motion Tools for FK UNAIR

Meanwhile, Abdurachman, et. al. (2017) states that the muscles and nerves
involved in the process of exorotation of the shoulder joint include:
 Muscle Origo Insertion Innervation ROM Picture
M. deltoid of pars The inferior edge of The humeral deltoid N. axillaris (C5, C6)
spinalis the spina scapulae tuberosity

(Paulsen & Waschke, 2011)

M. infrapinastus Fossa infraspinata Fascia articularis N. suprascapularis
scapulae and deep media tuberculi (C5, C6)
fascia majoris humeri

0 - 80º

(Paulsen & Waschke, 2011)

M. teres minor 2/3 over the The inferior surface N. axillaris (C5, C6)
posterior surface of of the tuberculum
the lateral edge of majus humeri
the scapulae

(Paulsen & Waschke, 2011)

Reference:

Abdurachman, et al. 2017. Anatomy and Motion Kinetics in Humans. Malang: Media
Intelligence.

Paulsen, F & Waschke, J. 2011. Sobotta Atlas of Human Anatomy Latin Nomenclature.
Munich: Elsevier