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AFAB I-II > Exam #3 (Lecture 10; Joints-Coracoacromial arch) > Flashcards

Exam #3 (Lecture 10; Joints-Coracoacromial arch) Flashcards

1
Q

clavicle like a strut holding the scapula:

A

Sternoclavicular

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2
Q

firmly attaches the scapula to clavicle:

A

acromioclavicular

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3
Q

not a true anatomic joint
an interface between bones
movements are linked to the movements at the SC and AC
the position of the scapula provides the base for the GH joint

A

scapulothoracic

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4
Q

most distal and mobile portion of the whole complex

A

glenohumeral

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5
Q

what are 3 features of the shoulder complex? (3)

A

series of kinematic links
cooperate to maximize ROM
weakened, painful or unstable link decreases the effectiveness of the entire UE

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6
Q

elevation: _______ slide
depression: ________ slide

A

superior
inferior

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7
Q

protraction: medial border slides _______
retraction: medial border slides _________

A

ant/lat
post/med

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8
Q

upward rotation: inferior angle rotates _______ direction. glenoid fossa faces _______. UE ________
downward rotation: inferior angle rotates ________ direction. UE ________

A

superior-lateral direction. upward. elevation

inferior-medial direction. downward

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9
Q

what 3 things connect at the SC joint?

A

medial end of clavicle
clavicular facet on sternum
superior border of cartilage of the first rib

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10
Q

what links the axial and appendicular skelton?

A

basilar joint of UE (base of clavicle)

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11
Q

the SC joint is ____ attached and allows _____ ROM

A

firmly
large

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12
Q

what is the shape of the SC joint?

A

irregular saddle shaped

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13
Q

longitudinal diameters:
_____ plane between _______ & _______ points

A

frontal plane
superior and inferior points

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14
Q

transverse diameters:
______ plane between _______ & _______ points

A

horizontal plane
anterior and posterior points

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15
Q

what ligaments attach at the SC joint?

A

anterior and posterior SC ligaments (reinforces capsule)
interclavicle ligament
costoclavicular ligament
articular disc (50% only)

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16
Q

what muscles cross across the SC joint?

A

SCM
sternothyroid
sternohyoid
subclavius muscles

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17
Q

how many DOF for SC joint?
what are the 3 kinematic motions of SC joint?

A

3 - sagittal, frontal, horizontal
elevates/depresses, protracts/retracts, rotates (posterior)

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18
Q

what is the goal of the SC joint?

A

to place scapula in optimal position for head of humerus

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19
Q

elevation and depression osteokinematics of SC joint:

parallel to _______ plane
axis -
______ degrees elevation
______ degrees degression
_______ motion is similar in scapula

A

frontal
near anterior-posterior
35-45
10
clavicular

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20
Q

elevation and depression arthrokinematics of SC joint:

along _____ diameter

elevation of clavicle:
- convex surface rolls _____ slides _____
- ______ ligament stretches - limits motion

depression of clavicle:
- convex surface rolls ______ slides ________
- _______ ligament/_______ portion of capsule stretches

A

longitudinal
superiorly; inferiorly
Costoclavicular
inferiorly; superiorly
interclavicular; superior

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21
Q

protraction and retraction osteokinematics of SC joint:

occurs parallel to _____ plane
axis:
_______ degrees each direction
associated with _______

A

horizontal
vertical
15-30
scapula

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22
Q

protraction and retraction arthrokinematics of SC joint:

occurs along _______ diameter

retraction:
- concave surface of clavicle rolls and slides ______ on convex surface of sternum
- stretches ________ ligament and ______ capsule

protraction:
occurs in _____ direction
stretches ________ ligament and ____ capsule
involves reaching ______

A

transverse

posteriorly
anterior CC ligament and anterior

anterior
posterior CC ligament and posterior
forward

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23
Q

rotation osteokinematics of SC joint:

rotates around _____ axis
UE elevation: posterior rotation ______ degrees

A

longitudinal
20-35

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24
Q

rotation arthrokinematics of SC joint:

rotation cannot occur without ______ and ______

A

flexion and abduction

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25
Q

what two things connect at AC joint?

A

lateral end of clavicle
acromion of scapula

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26
Q

what direction does the clavicular facet face on the acromion?

A

medial and slightly superior

27
Q

what is the capsule of AC joint reinforced by?

A

superior and inferior AC ligaments

28
Q

what two ligaments make up the coracoclavicular ligament?

A

trapezoid ligament
conoid ligament
- coracoid process to clavicle

29
Q

what type of motion happens at the AC joint?

A

subtle motions
optimize mobility and fit between scap and thorax

30
Q

how many DOF does AC joint have?

A

3
upward/downward rotation, internal/external rotation, anterior/posterior tilting

31
Q

upward rotation of scapula at AC:

swings ____ and _______ relative to end of clavicle
up to _____ degrees
contributes significantly to _______ motion

A

upward and outward
30
scapulothoracic

32
Q

what are rotational adjustment motions of the AC joint?

A

pivoting or twisting type motions of the scapula around lateral end of the clavicle
optimally align scapula against the thorax

33
Q

what motion of the AC joint is happening in the horizontal plane?
what axis is it?

A

internal rotation (also protraction) of glenoid fossa (and external rotation)
vertical axis

34
Q

what motion of the AC joint is happening in the sagittal plane?
what axis is it?

A

anterior tilting (elevation) or reverse: posterior tilting (depression)
medial-lateral axis

35
Q

what would happen without adjustments of the AC joint?

A

the scapula would have to follow the clavicle exactly and could not adjust the thorax

36
Q

what joint is not true joint with no direct contact?

A

scapulothoracic joint

37
Q

the scapulothoracic joint is separated by what muscles?

A

subscapularis
serratus anterior
erector spinae

38
Q

where does the scapula sit?

A

between 2nd and 7th ribs
medial border 6 cm lateral to spine

39
Q

scapulothoracic joint degrees:
- anterior tilt:
- upward rotation:
- internal rotation:

A

10 degrees
5-10 degrees
30-40 degrees

40
Q

scapulothoracic elevation is a summation of what?

A

elevation at the SC joint and downward rotation at AC joint

41
Q

in order to have protraction/retraction of ST joint, what summation must occur?

A

summation of horizontal motions at both AC (internal rotation) and SC (protraction)
protracting clavicle around SC joint, SC varies the amount of internal rotation

42
Q

scapulothoracic upward rotation is a summation of what?
full ____ degrees of upward rotation

A

elevation at the SC joint
upward rotation at AC joint

60 degrees

43
Q

general features of what joint?
large convex head, shallow concavity - glenoid fossa

A

glenohumeral joint

44
Q

why is the fibrous capsule of the GH joint loose fitting, thin and expandable?

A

to allow for mobility which is reinforced by external ligaments

45
Q

what is the axillary pouch in GH joint?

A

interior portion capsule slackened

46
Q

what is the primary stability in the GH joint?
active forces produced by?
what crosses superiorly over head of humerus?

A

passive tendon within embedded ligaments
active forces produced by local muscles specifically rotator cuff
LBB crosses superiorly over head of humerus

47
Q
  • fibrous connective tissue, interlacing collagen fibers
  • thickening of capsule, complex bands
  • limits extremes of rotation and translation
  • help keep a negative intra-articular pressure in GH joint
A

glenohumeral capsular ligaments

48
Q

superior GH capsular ligament resists:

A

resists ER/inferior and anterior translations

49
Q

what does the middle GH capsular ligament do?
slack in?
blends with?

A

stabilizes most motions esp anterior restraint in 45-90 abd and extremes of ER
slack in IR
blends with subscap

50
Q

what does the inferior GH capsular ligament support? resist?
how many portions? taught in?

A

supports suspended humeral head
resists inf/anterior posterior translations
3 portions (anterior, posterior, axillary pouch), taught in 90 deg abd
hammock like

51
Q

what is the strongest/thickest portions of the capsule?
primary ligamentous restraint to?
what motions are esp stressful?

A

anterior
anterior translation
abd and ER with forceful dynamic activities

52
Q

where is the coracohumeral ligament?

A

coracoid process to greater tubercle

53
Q

coracohumeral ligament blends with?

A

superior capsule and supraspinatus tendon

54
Q

coracohumeral ligament taut in?
restraint what?

A

taut in anatomical position
restraint inferior translation and ER humeral head

55
Q

what forms the coracoacromial arch?

A

coracoacromial ligament and acromion process

56
Q

what is under the coracoacromial arch?

A

subacromial space between arch and humeral head

57
Q

what does the coracoacromial arch and bursa contain?

A

supraspinatus muscle and tendon, subacromial bursa, LHB, superior capsule

58
Q

what impacts the height of subacromial space?

A

GH arthrokinematics and scapular motion

59
Q

what must the the critical minimum heights be to maintain a lack of compression of contents in subacromial space at:
- 20 deg abd:
- 85 deg abd:
- 150 deg abd:

A

7.5 mm
2.6 mm
5 mm

  • more space height is needed as you abduct/adduct arm. least amount of space needed is around 90 deg abd
60
Q

what degree range has the greatest potential for supraspinatus compression?

A

35-70 deg

61
Q

what is adhesive capsulitis?
what does it limit?

A

excessive thickening or stiffness in ICL
limits inferior slide of humeral head

62
Q

in adhesive capsulitis, a superior roll leads to what?
how many degrees does it roll before any slide happens?

A

jamming of the humeral head against coracoacromial arch
22 deg

63
Q

what is impingement syndrome?
abrasion may damage what?

A

unnatural and repeated compression. repeated compression may lead to this
abrasion may damage the SS tendon, subacromial bursa, LHB tendon or superior parts of capsule

AFAB I-II (23 decks)

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