引言
➢ 近年来,随着康复治疗的发展，脑卒中偏瘫后出现 的一些并发症逐渐受到关注，如肩痛、肩关节半脱 位以及肩手综合征等。
➢ 由于对肩关节的解剖和运动原理不清楚，致使其临 床治疗效果不佳。目前，对于脑卒中后肩痛的治疗 对策的研究成为热点。
引言
➢ 肩关节是人体最复杂的关节之一，由于其组成复杂， 国外学者引入了肩关节复合体(Shoulder Joint Complex)的概念。
脑卒中后肩痛的病因及处理
目录
➢ 引言 ➢ 第一章 概论 ➢ 第二章 病因及发病机制 ➢ 第三章 预防及对因处理 ➢ 第四章 对症处理 ➢ 结论
引言
引言
➢ 统计资料显示，我国每年大约有150万人因脑卒中 而死亡，其发病率、病死率及致残率均很高。
➢ 康复治疗逐渐发展成为一门重要的学科，它成为减 少脑卒中患者致残率、提高其生活质量的主要手段。
I – Medial border of scapula between superior angle and root of spine of scapula
N – Nerve root C3-5
F
scapular elevation retraction
Rhomboid Major
O–
Shoulder Joint Complex
盂肱关节： Glenohumeral
肩锁关节： Acromioclavicular
喙锁关节： Coracovicular
肩胛胸壁关节： Scapulothoracic
胸锁关节
Levator Scapulae
O – Transverse processes of C1-C4
N – spinal accessory
F–
Scapular depression, retraction and upward rotation
Serratus Anterior
O–
Outer surfaces and superior border of ribs 1-8
I–
Ventral scapular surface on medial border from superior angle to inferior angle
Minor – medial border at root of spine of scapula
N – Dorsal Scapular
Upper Trapezius
O–
Occiptal protuberance Medial 1/3 of nuchal line Upper part of
N –Musculocutaneous F–
GH flexion, adduction, Hor. Adduction
ligamentum nuchae C7 spinous process
I–
Posterior border of lateral 1/3 of clavicle
Acromion process
N – spinal accessory F–
Scapular elevation, retraction
Superior lip of spine of scapula
N – Spinal accessory F–
Scapular retraction
Lower Trapezius
O–
T6-T12 spinous processes
I–
Tubercle at apex of root of spine of scapula
Major – T2-T5 spinous processes
Minor – Ligamentum nuchae, C7-T1 spinour processes
I–
Major – Medial borde of scapula between spine and inferior angle
Rotation of head to opp. Side
Lateral flexion of head to opp. side
Middle Trapezius
O–
Inferior part of ligamentum nuchea
T1-T5 spinous processes
I–
Medial margin of acromion process
Fascia overlying corresponding intercostal muscles
I–
Medial border, superior surface of coracoid process
N–
Medial Pectoral
F–
Scapular depression, downward rotation, protraction
Glenohumeral Muscles
Biceps Brachii
O
Short head – coracoid process
Long head – supraglenoid tubercle of scapula
I–
Radial tuberosity
Biceps brachii aponeurosis
N–
Long Thoracic
F–
Scapular protraction, upward rotation
Scapular depression (lower fibers)
Scapular elevation (upper fibers
Pectoralis Minor
O–
Superior margins d outer surface ribs 3-5 near cartilages
N – Musculocutaneous
F–
Shoulder – flexion
Elbow – flexion, forearm supination
Coracobrachialis
O–
Coracoid process
I–
Medial surface of midhumerus, opposite to deltoid tuberosity