conditions of the shoulder Flashcards
what does the sternoclavicular joint attach
it attaches the axial skeleton to the appendicular skeleton (clavicle to the sternum)
what muscles attach to the SC joint
pec major and SCM
what mvt does the sc joint do
flex/ext, int and ext rotation, abd and add
what injuries can occur at the sc joint
foosh (compression of that joint, protecting yourself while falling), direct trauma, contact to lateral sh (bumped into wall), sprain (ant and post, big could be torn 1 or 2 degrees) and dislocation (ant, post)
which one is most common; ant dislocation of sc joint or post?
ant dislocation
what is so bad about a post dislocation of the sc joint
it can compromise abc (lung, trachea and esophagus are there)
S/S of sc joint sprain (7)
pain w mvt of gh joint (shearing forces)
pain w breathing (especially deep breathing; m. that help with breathing will move the clavicle too)
pain w upright posture (opposite w post sprain)
pain w sleeping on side (compressing the sc joint)
clicking sensation at sc joint (lig torn so b on b rubbing)
bruising or swelling maybe present (if n. is affected)
where is the acromioclavicular joint
lateral aspect of the shoulder, clavicle and the acromion process of the scapula
what ligs stop the clavicle from moving ant and post on the acromion
ac ligament
what lig prevents the clavicle and acromion from moving post and inf
cc ligament
if inf ac joint sprain what m. do you need to strengthen
deltoid and pec major
what m. needs to relax if theres an inf ac joint sprain
utf
what injuries can occur at the ac joint
sprain of ac lig and or cc lig foosh (humerus jammed in subacromion) direct blow to the lateral shoulder blow to sup acromion (smt falls on side of sh) separated sh (ac joint vs dislocation)
structures involved and s/s of type 1 ac joint sprain
slight to partial damage of ac lig and capsule
point tenderness and no laxity or deformity
structures involved and s/s of type 2 ac joint sprain
rupture of ac lig and partial damage to cc lig
slight laxity and deformity of ac joint, slight step deformity
structures involved and s/s of type 3 ac joint sprain
complete tear of ac lig and cc lig, possible involvement of delts and traps fascia
obvious dislocation of the distal end of clavicle from acromion process
structures involved and s/s of type 4 ac joint sprain
complete tearing of ac and cc lig and tearing of deltoid and trap fascia
post clavicular displacement into the insertion of the uft
structures involved and s/s of type 5 ac joint sprain
complete tearing of ac and cc lig and tearing of deltoid and trap fascia (deformity is even larger than type 4)
displacement of the clavicle 3x height compared to other side
structures involved and s/s of type 6 ac joint sprain
complete tearing of ac and cc lig and tearing of deltoid and trap fascia (deformity is even larger than type 5)
displacement of clavicle inferiorly under coracoid
what types of ac joint sprain can’t be told appart by naked eye
type 3, 4 and 5 and diff by imaging
common s/s of ac joint sprain (4)
pain w mvt of gh joint (especially limited rom in flex/abd/CROSS FLEXION)
STEP DEFORMITY
some bruising may be present
pin point pain on ac joint
what is the most commonly fractured b of the upper body and where is it most commonly fx
clavicle and at the turn of it
what are the moi possible w clavicular fx (3)
direct impact, impact to lateral shoulder and foosh
diff btw clavicular fx and ac joint sprain
crepitus and if in the middle and not on the ac joint then its a fx
what to do if athlete has equipment for a clavicular fx
pmsc, check rom (will move more if ac and no fx), brush hand to check for major deformity and then palpate only if minor deformity
what structures are included in the gh joint and what type of joint is it
head of humerus and glenoid fossa of scap
dynamic joint; works w scap and clavicle to ensure full rom
what structures make up the gh joint
labrum (reduces friction and increases rom, deepens the joint) gh lig (sup, middle/ant, inf, post) biceps, rotator cuff, pec major, delts, triceps, lat dorsi, coracobrachialis
what instabilities are possible at the gh joint and what does that instability increase
ant, post, inf or multiple directions (some people can be hypermobile and born w it, can sublax no prob)
it will increase laxity and so rom too
instability at the gh joint is graded on what
joint play; mvt of head of humerus in glenoid fossa
what types of stability are possible at the gh joint and what structures does each one involve
passive stability; capsular lig and gh lig (all blend in together)
dynamic stability: ROTATOR CUFF M, and other gh muscles (pecs, traps, delts, biceps and triceps)
what test can be done to test gh instability
apprehension test; ant mvt of head of humerus
what is TUBS gh instability and how is it fixed
traumatic unidirectional instability usually treated w surgery (usually bankart lesion; little fx to rim of glenoid fossa= shearing forces)
what is AMBRI gh instability and how is it fixed
atraumatic, multidirectional frequently bilateral treated w rehab and/or inf capsular shift (shrink capsule to make it tighter to keep head of humerus in)