Chapter 7 Shoulder Flashcards
Joints of the shoulder/
Scapulothoracic (pseudo-joint), AC joint, glenohumeral, SC joint
Primary flexor?
Deltoid (anterior portion)
Primary extensors?
Lat dorsi, teres major, deltoid (posterior portion)
Primary external rotators?
Infraspinatus, teres minor
Subclavian artery passes bt which 2 muscles?
Anterior and middle scalenes–contracture of these muscles affects arterial supply but not venous drainage
When does subclavian a become axillary a?
Lateral border of 1st rib
1st major branch of brachial a?
Profunda brachial a–accompanies radial n in its posterior course of radial groove
What becomes the deep palmar arterial arch?
Radial a
Tx technique to relieve lymph congestion of UE?
1) Open thoracic inlet
2) Redome diaphragm
3) Posterior axillary fold technique
Degrees of motion during arm abduction?
120 degrees due to glenohumeral motion, 60 degree due to scapulothoracic motion
Most common somatic dysfunction of shoulder?
Restriction in internal and external rotation
Least common somatic dysfunction of shoulder?
Restriction in extension
Most common somatic dysfunction of SC joint?
Clavicle anterior and superior on sternum
“Step-off” seen at the AC joint?
Superior and lateral clavicle on acromion
Pathogenesis of supraspinatus tendinitis?
Continuous impingement of greater tuberosity against acromion as arm is flexed and internally rotated
“Painful arc”?
Pain exacerbated by abduction from 60-120 degrees in supraspinatus tendinitis
Aggravating factors in bicipital tenosynovitis?
Elbow flexion or supination
Location of pain in rotator cuff tear?
Tenderness just below tip of acromion
Etiology of frozen shoulder?
Prolonged immobility of shoulder
Most common shoulder dislocation?
Anterior and inferior–affects axillary n
Most common brachial plexus injury?
Erb-Duchenne’s palsy
What is paralyzed in Erb-Duchenne’s?
Abduction, external rotation, flexion, supination
Crutch palsy?
Radial n
Saturday night palsy?
Compression of radial n against humerus as arm is draped over back of chair
Most common cause of injury to radial n?
Humeral fracture
Most commonly affected nerve injured in UE due to direct trauma?
Radial n
Erb-Duchenne’s?
Upper trunk (C5-6)
Pathogenesis of winging of scapula?
Weakness of anterior serratus due to long thoracic n injury
When is pain elicited in frozen shoulder?
End of ROM
Motions most often affected in adhesive capsulitis?
Abduction, internal and external rotation (extension is preserved)
Most commonly affected rotator cuff muscle?
Supraspinatus
Pathogenesis of bicipital tenosynovitis?
Inflammation of tendon and its sheath of long head of biceps
Site of pain in supraspinatus tendinitis?
Tip of acromion
Sites of compression of nv bundle in thoracic outlet syndrome?
1) Bt anterior and middle scalenes
2) Bt clavicle and 1st rib
3) Bt pectoralis minor and upper ribs
Most common somatic dysfunction of AC joint?
Clavicle superior and lateral on acromion
Motion of clavicle during internal/external rotation?
Around transverse axis
Second most common somatic dysfunction of shoulder?
Restriction in abduction
For every 3 degrees of abduction…
Glenohumeral joint moves 2 degrees and the scapulothoracic joint moves 1 degree
Nerve roots of brachial plexus?
C5-T1
What becomes the superficial palmar arterial arch?
Ulnar a (Ulnar is Up in the palm)
Where does brachial a divide into ulnar and radial aa?
Under bicipital aponeurosis
When does the axillary a become the brachial a?
Inferior border of teres minor
Subclavian vein passes where?
Anterior to anterior scalene
Primary internal rotator?
Subscapularis
Primary adductors?
Pec major, lat dorsi
Primary abductor?
Deltoid (middle portion)
Rotator cuff muscles?
Supraspinatus, Infraspinatus, teres minor, Subscapularis (SItS)
Bones making up the shoulder?
Clavicle, scapula, humerus
