Exam 3: Shoulder anatomy/injury Flashcards
What are the 4 articulations that make up the shoulder complex?
- Sternoclavicular joint
- acromioclavicular joint
- glenohumeral joint
- scapulothoracic articulation
What are the primary ligaments of the sternoclavicular joint?
- articular capsule
- anterior sternoclavicular ligament
- posterior sternoclavicular ligament
- interclavicular ligament
- costoclavicular ligament - superior costal cartilage of first rib to inferior clavicle
What are the primary ligaments of the acromioclavicular joint?
- articular capsule
- acromioclavicular ligament
- coracoclavicular ligament
a. trapezoid ligament
b. conoid ligament
Key points of glenohumeral joint
- ball and socket joint
- glenoid labrum - fibrocartilagenous disc in glenoid
- designed for mobility, not stability
- stability from ligaments and muscles
Where is the glenoid labrum, and what does it do?
fibrocartilagenous disc around the margin of the glenoid that widens and deepens the cavity
What are the primary ligaments of the glenohumeral joint?
- articular cartilage
- coracohumeral ligament
- glenohumeral ligaments
- superior glenohumeral
- middle glenohumeral
- inferior glenohumeral
- posterior capsule - transverse humeral ligament - across bicipital groove to hold tendon of long head of bicep in place
What are the names and positions of the 4 glenohumeral ligaments?
- superior glenohumeral - 12-1 o’clock
- middle glenohumeral - 1-3 o’clock
- inferior glenohumeral - 3-7 o’clock
- posterior capsule - 7+
What is the break position for the supraspinatus?
90 degrees
thumb up
Flexion of glenohumeral joint
Anterior deltoid
Pectoralis major
coracobrachialis
Extension of the glenohumeral joint
Latissimus dorsi
Teres major
Abduction of the glenohumeral joint
Deltoid
Supraspinatus
Adduction of the glenohumeral joint
Latissimus dorsi
Teres major
Medial rotation of glenohumeral joint
Subscapularis Latissimus dorsi Teres major Anterior deltoid Pectoralis major
Lateral rotation of glenohumeral joint
Infraspinatus
Teres minor
Horizontal adduction
Pectoralis major
Horizontal Abduction
Posterior deltoid
What are the 4 muscles of the rotator cuff?
- supraspinatus
- infraspinatus
- subscapularis
- teres minor
Supraspinatus
Origin: supraspinous fossa of scapula
Insertion: greater tuberosity of humerus
Action: Initiates shoulder abduction
Innervation: Suprascapular nerve (c5-6)
Subscapularis
Origin: subscapular fossa
Insertion: Lesser tuberosity of humerus
Action: Shoulder internal rotation
Innervation: Upper & Lower subscapular nerves (c5-6)
Infraspinatus
Origin: Infraspinous fossa of scapula
Insertion: greater tuberosity of humerus
Action: Shoulder external rotation
Innervation: suprascapular nerve (c5-6)
Teres Minor
Origin: lateral border of scapula
Insertion: greater tuberosity of humerus
Action: Shoulder external rotation
Innervation: axillary nerve (c5-6)
Impingement syndrome
- structures above:
- coracoid process
- coracoacromial ligament
- acromion - structures below:
- head of humerus - structures that get pinched:
- supraspinatus tendon
- long head biceps brachii
- subacromial bursa
Types of impingement
Primary impingement: __
Secondary impingement: weak supraspinatus causes humeral head to come up and pinch the structures
What is a grade 1 AC joint sprain?
a Stretch of the AC ligament
What are the signs and symptoms of a Grade 1 AC joint sprain?
- Palpation - pain over AC joint
- Pain in shoulder motions
- Horizontal adduction shows most pain
- no obvious deformity
- minimal effusion
- MMT - decrease strength from pain
- negative x-rays
What happens in a grade 2 AC joint sprain?
RUPTURE of the AC ligament
What are the signs and symptoms of a grade 2 AC sprain?
- Palpation - lots of pain over AC joint
- lots of Pain in shoulder motions
- Horizontal adduction shows most pain
- no obvious deformity
- minimal effusion
- MMT - decrease strength from pain
- negative x-rays??
What happens in a grade 3 AC joint sprain?
- rupture of acromioclavicular ligament
- Rupture of coracoclavicular ligament
Functional throwing progression for pitcher rtp
- Full ROM - no pain
- Normal strength and endurance
- Short toss - 30’ - 20-50 throws
- Gradual increase distance increments by 15’ to 160’
- Regulation pitching distance - 50% velocity
- Increase to max velocity
- Specialty pitches
- Simulated game on sidelines for 1-9 innings
- Full play
