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DPT 702/3: AFAB > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

what is the sternoclavicular jt

A

clavicle like a strut holding the scapula

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2
Q

what is the acromioclavicular jt

A

firmly attaches the scapula to clavicle

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3
Q

what is the scapulothoraic jt

A

not a true jt
interface between bones
link to SC and AC
base of GH jt

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4
Q

what is the glenohumeral jt

A

most distal and mobile portion of the whole complex

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5
Q

what can happen to the shoulder complex when weakened or painful

A

decreases effectiveness of the entire UE

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6
Q

what are the slides of elevation and depression

A

ele- sup slide
dep- inf slide

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7
Q

where does the medial border of scapula slide in protraction and retraction

A

pro- ant and lat
re- post and med

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8
Q

describe the SC jt

A

basilar jt of UE
large ROM
irregular saddle shape
convex and concave with sternal facet reciprocally shaped

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9
Q

what is the longitudinal diameters in the SC jt

A

frontal plane
sup and inf points

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10
Q

what is the transverse diameters of SC jt

A

horizontal plane
ant and post points

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11
Q

what muscle can restrict the clavicle movement

A

subclavius

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12
Q

what muscles can affect the movement of SC jt

A

SCM
sternothyroid
sternohyoid
subclavius

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13
Q

where does the costoclavicular lig attach to

A

clavicle to 1st rib

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14
Q

what movements does the clavicle do

A

3 DOF- all 3 with UE elevation
ele/dep
protract/retract
rotates

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15
Q

what is the goal of SC

A

to place scapula in optimal position for head of humerus

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16
Q

what is the osteo of the SC joint

A

axis= AP
35-45 elevation
10 depression
clavicular promotes scapula motions

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17
Q

what is the arthro for SC elevation

A

convex surface rolls sup and slides inf
CCL ligament stretches

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18
Q

what is the arthro for SC depression

A

convex surface rolls inf and slides sup
ICL lig stretches

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19
Q

what is the osteo of SC protraction

A

axis- vertical
15-30 degrees
associated with scapula pro/re

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20
Q

what is the arthro of SC retraction

A

concave surface of clavicle rolls and slides post
stretches ant CCL and ant capsule

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21
Q

what is the arthro of SC protraction

A

concave surface of clavicle rolls and slides ant
stretches post CCL and post capsule

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22
Q

what is the osteo of SC rotation

A

longitudinal axis
20-35 degrees

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23
Q

what is the arthro of rotation of SC

A

spin of sternal end relative to lateral surface
linked with flx and abd

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24
Q

what is the coracoclavicular lig

A

extrinsic stability for AC
trapezoid and concoid
coracoid process to clavicle

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25
Q

what are the kinematics of AC jt

A

3 DOF
up/down rotation
secondary motion= rotational adjustment

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26
Q

describe upward rotation of scapula at AC

A

swings up and out
up to 30 degrees
contributes to scapulothoracic motion

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27
Q

describe the downward rotation of scapula at AC

A

return to anatomical position

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28
Q

describe the rotation of AC in horizontal plane

A

vertical axis
medial border moves away (IR)

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29
Q

describe the rotation of AC in sagittal plane

A

Tilting
ML axis
inferior angle moves away- ant or post tilting

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30
Q

describe the protraction of AC jt

A

internally rotates in horizontal plane
align ant surface of scapula and thorax

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31
Q

what happens to the scapula with IR

A

ant tilting
upward rotation

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32
Q

where does the scapula sit

A

between 2-7 ribs
medial border 6 cm lateral to spine

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33
Q

what are the ranges for the scapulathoracic jt

A

ant tilt- 10 degrees
upward rotation- 5-10
IR- 30-40

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34
Q

how is the motion for protraction/retraction of scapulothoracic jt

A

SC pro/re plus AC IR/ER

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35
Q

how is the motion of upward/downward rotation of scapulothoracic jt

A

SC elevation plus AC upward rotation
60 degrees upward rotation

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36
Q

how is the humeral head postioned

A

medial, superior, posterior

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37
Q

how is the glenoid fossa positioned

A

anterior-lateral in scapula

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38
Q

what is the axillary pouch

A

anatomic postion inferior portion of capsule is slackened

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39
Q

what lines the humeral head and glenoid fossa

A

articular cartilage

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40
Q

what is the potential size of the GH jt

A

2x humeral head

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41
Q

describe the fibrous capsule of GH jt

A

rim of glenoid fossa to anatomic neck
loose fitting
allows mobility and reinforced by ligaments

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42
Q

what allows for GH jt stability

A

passive tension of lig
active forces- RTC
long head of biceps crosses sup over head

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43
Q

describe GH superior capsular lig

A

resists ER and ant/inf translation

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44
Q

describe the GH middle capsular lig

A

stabilizes most motion
ant restraint of 45-90 abd and ER

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45
Q

describe the GH inf capsular lig

A

3 bands
taut in 90 abd
resists inf/ant-post translations

46
Q

what is the coracohumeral lig

A

blends with sup capsule
taut in anatomical position
restrain inf translation and ER

47
Q

what is the RTC interval

A

common site of dislocation
reinforced by LHB, coracohumeral lig and sup/mid capsule

48
Q

describe the LHB

A

supraglenoid fossa and labrum
intratubercle groove on ant humerus
resists ant translation
ABD

49
Q

describe the labrum

A

fibrocartilage
stabilzer

50
Q

describe the coracoacromial arch and bursa

A

arch= coracoacromial lig and acromion process
roof of GH jt
1 cm in adults

51
Q

what is contained in the coracoacromial arch and bursa

A

supraspinatus
subacromial bursa
LHB
sup capsule

52
Q

where is the subacromial space

A

between arch and humeral head

53
Q

what is the subacromial bursa

A

protects SS from acromial bone

54
Q

what is the subdeltoid bursa

A

limites friction between deltoid and SS tendon and humeral head

55
Q

describe the ABD and ADD of humerus

A

frontal A-P
120 degrees, also with 60 deg scap RT
convex rolls sup and slides inf on concave
opposite in ADD

56
Q

what is dynamic stability

A

supraspinatus tendon blends with superior capsule
contraction pulls capsule tight=no pinching

57
Q

what is adhesive capsulitis

A

excessive thickening or stiffness in ICL
limits inferior slide of humeral head (sup roll)

58
Q

what is impingement syndrome

A

unnatural and repeated compression/abrasion damaging the SS tendon, subacromial bursa, LHB tendon or sup capsule

59
Q

describe FLX of humerus

A

sagittal M-L
120 deg/180 with scap
most structures are taut
tension in post capsule= ant translation

60
Q

describe EXT of humerus

A

65 deg active/ 80 passive
slight ant tilt of scap= stretch capsular lig

61
Q

describe IR of humerus

A

horizontal plane SI
75-85 deg
rolls ant slides post

62
Q

describe ER of humerus

A

horizontal SI
60-70 deg(can be up to 90)
rolls post and slides ant
at 90 deg ER is all spinning

63
Q

what is scapulohumeral rhythm

A

natural rhythm between GH ABD and ST upward RT
after 30 degrees ABD= rhythm consistent
2 deg GH + 1 deg ST = 3 deg
full arc = 120 GH/60 ST

64
Q

what is the result of 60 deg of scapula with ABD at SC and AC jt

A

SC= elevation (30 deg)
AC= upward RT

65
Q

what does the clavicle do at the SC jt during full ABD

A

retract (15-20 deg)

66
Q

how is the scapula positioned at full ABD

A

tilts posteriorly (20 deg) and rotates outward

67
Q

how does the post tilt and ER of scapula in ABD help

A

keeps scapula flush with thorax
orients fossa

68
Q

how is the scapula normal positioned

A

ant tilt (10 deg)
IR (30-40 deg)

69
Q

what does the clavicle do during ABD

A

posteriorly RT along axis
20-35 deg
most predominant motion

70
Q

what happens to the clavicle during ABD if there is an subacromial impingement

A

reduced RT

71
Q

what happens to the humerus during ABD (beside the Arthro)

A

ER
allows to pass post acromion
25-50 deg before 70-80 deg of ABD

72
Q

what is the sensory innervation of the SC jt

A

C3-4

73
Q

what is the sensory innervation of the AC and GH jt

A

C5-6
suprascapular and axillary n

74
Q

what nerves come from the posterior cord

A

upper subscapular n
thoracodorsal n
lower subscapular n
axillary n

75
Q

what n come from the proximal segments of the brachial plexus

A

dorsal scapular
long thoracic
pectoral
suprascapular

76
Q

what are proximal stabilizers

A

originate from spine/ribs/cranium and insert on the scapula and clavicle

77
Q

what are distal mobilizers

A

originate on scapula and clavicle and insert on humerus or forearm

78
Q

what muscles elevate the ST

A

UT (CN 11)
levator scapulae (dorsal scapular)
rhomboids (dorsal scapular)

79
Q

what muscles retract ST

A

MT (cn 11)
rhomboids (dorsal scapular)
LT (cn 11)

80
Q

what muscles depress ST

A

LT (cn 11)
Lat dorsi (thoracodorsal)
Pec minor (medial pectoral)
subclavius (subclavian)

81
Q

what muscles protract ST

A

SA (long thoracic)
pec minor (medial pectoral)

82
Q

what muscles upward rotate ST

A

SA (long thoracic)
U/MT (cn 11)

83
Q

what muscles downward rotate ST

A

rhomboids (dorsal scapular)
pec minor (medial pectoral)

84
Q

what is the function of the elevators

A

support the posture of the sh girdle

85
Q

what can happen if elevator m support is lost

A

can damage underlying structures

86
Q

how is the Lat dorsi a depressor

A

pulls humerus inf leading to indirect depression

87
Q

what can the pec minor limit if tight

A

retraction

88
Q

what are the retractors main function

A

proximal stabilizers anchoring scapula to axial skeleton
essential for pulling activities

89
Q

what 3 groups of m help elevate the arm and their function

A

muscles that elevate the humerus at GH
scapular m that control up RT of ST
RTC m that control dynamic stability and arthro of GH

90
Q

what muscles elevate the humerus

A

ant/mid deltoid (axillary)
supraspinatus (supraclavicular)
coracobrachialis (musculocutaneous)
biceps brachii (musculocutaneous)

91
Q

when are the m that elevate the humerus activated with ABD

A

between 60-90 deg
ant/mid deltoid and SS share equally

92
Q

what are the roles of the upward RT of ST

A

drive up RT and RT adjustments
provide stable attachments for distal mobilizers (deltoid and RTC)

93
Q

what can happen if you have paralysis of the trap

A

with full ABD (very difficult) = T spine extends 10-15 deg
control of scapula changes
excessive protraction

94
Q

what can happen if you have paralysis of the SA

A

downward RT position
abnormal ant tilt and IR
can not resist the deltoid and SS pull in ABD

95
Q

what is scapular dyskinesis

A

abnormal position or movement of the scapula
reduced up RT
excessive down RT, IR, ant tilt/elevation

96
Q

what are type 1 and 2 prominences of the inf and med border of the scapula indicating

A

labrial lesions

97
Q

what does type 3 prominence of superomedial border of scapula indicating

A

impingement and RTC lesions

98
Q

what is function of RTC m during elevation of arm

A

regulators of dynamic jt stability and control jt arthro
compensates for natural laxity
RT, compress, and stabilize in fossa

99
Q

what m FLX the humerus

A

ant deltoid (axillary)
coracobrachialis (musculocutaneous)
biceps brachii (musculocutaneous)

100
Q

what m ABD the humerus

A

mid deltoid (axillary)
supraspinatus (suprascapular)

101
Q

where does the RTC distally attach

A

blends into capsule before attaching to humerus

102
Q

what is the action of the SS when ABD of GH

A

rolls humeral head sup while compressing for stability

103
Q

what is the action of the IS, SubS, and TMin when ABD of GH

A

downward translation on humeral head due to SS sup translation

104
Q

what other action is IS and Tmin doing during ABD of GH

A

ER humerus to create clearance

105
Q

what m ADD and EXT the sh

A

post delt (axillary)
lat dorsi (thoracodorsal)
LH triceps (radial)
pec major (med and lat pectoral)
IS (supraclavicular)
Tmin (axillary)

106
Q

what is required for the sh to ADD/EXT

A

scapula stabilization with rhomboids

107
Q

what m IR the sh

A

subscapularis (lower subscapular)
pec major (med and lat pectoral)
lat dorsi (thoracodorsal)
teres major (lower and upper subscapular)
ant deltoid (axillary)

108
Q

what m ER the sh

A

infraspinatus (suprascapular)
Tmin (axillary)
post deltoid (axillary)

109
Q

what m has the greatest moment arm of IR and which has the least

A

subscapularis
ant deltoid

110
Q

which movement (IR or ER) has the greatest mass and torque

A

IR by 40-70% of torque

111
Q

in throwing sports what movement (IR or ER) has the most internal torque and which has the strongest deceleration force

A

IR largest torque
ER largest deceleration

112
Q

what muscle contraction has peak force

A

eccentric forces

DPT 702/3: AFAB (7 decks)

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