Exam 3: Shoulder anatomy/injury Flashcards

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1
Q

What are the 4 articulations that make up the shoulder complex?

A
  1. Sternoclavicular joint
  2. acromioclavicular joint
  3. glenohumeral joint
  4. scapulothoracic articulation
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2
Q

What are the primary ligaments of the sternoclavicular joint?

A
  1. articular capsule
  2. anterior sternoclavicular ligament
  3. posterior sternoclavicular ligament
  4. interclavicular ligament
  5. costoclavicular ligament - superior costal cartilage of first rib to inferior clavicle
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3
Q

What are the primary ligaments of the acromioclavicular joint?

A
  1. articular capsule
  2. acromioclavicular ligament
  3. coracoclavicular ligament
    a. trapezoid ligament
    b. conoid ligament
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4
Q

Key points of glenohumeral joint

A
  1. ball and socket joint
  2. glenoid labrum - fibrocartilagenous disc in glenoid
  3. designed for mobility, not stability
  4. stability from ligaments and muscles
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5
Q

Where is the glenoid labrum, and what does it do?

A

fibrocartilagenous disc around the margin of the glenoid that widens and deepens the cavity

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6
Q

What are the primary ligaments of the glenohumeral joint?

A
  1. articular cartilage
  2. coracohumeral ligament
  3. glenohumeral ligaments
    - superior glenohumeral
    - middle glenohumeral
    - inferior glenohumeral
    - posterior capsule
  4. transverse humeral ligament - across bicipital groove to hold tendon of long head of bicep in place
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7
Q

What are the names and positions of the 4 glenohumeral ligaments?

A
  1. superior glenohumeral - 12-1 o’clock
  2. middle glenohumeral - 1-3 o’clock
  3. inferior glenohumeral - 3-7 o’clock
  4. posterior capsule - 7+
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8
Q

What is the break position for the supraspinatus?

A

90 degrees

thumb up

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9
Q

Flexion of glenohumeral joint

A

Anterior deltoid
Pectoralis major
coracobrachialis

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10
Q

Extension of the glenohumeral joint

A

Latissimus dorsi

Teres major

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11
Q

Abduction of the glenohumeral joint

A

Deltoid

Supraspinatus

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12
Q

Adduction of the glenohumeral joint

A

Latissimus dorsi

Teres major

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13
Q

Medial rotation of glenohumeral joint

A
Subscapularis
Latissimus dorsi
Teres major
Anterior deltoid
Pectoralis major
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14
Q

Lateral rotation of glenohumeral joint

A

Infraspinatus

Teres minor

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15
Q

Horizontal adduction

A

Pectoralis major

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16
Q

Horizontal Abduction

A

Posterior deltoid

17
Q

What are the 4 muscles of the rotator cuff?

A
  • supraspinatus
  • infraspinatus
  • subscapularis
  • teres minor
18
Q

Supraspinatus

A

Origin: supraspinous fossa of scapula
Insertion: greater tuberosity of humerus
Action: Initiates shoulder abduction
Innervation: Suprascapular nerve (c5-6)

19
Q

Subscapularis

A

Origin: subscapular fossa
Insertion: Lesser tuberosity of humerus
Action: Shoulder internal rotation
Innervation: Upper & Lower subscapular nerves (c5-6)

20
Q

Infraspinatus

A

Origin: Infraspinous fossa of scapula
Insertion: greater tuberosity of humerus
Action: Shoulder external rotation
Innervation: suprascapular nerve (c5-6)

21
Q

Teres Minor

A

Origin: lateral border of scapula
Insertion: greater tuberosity of humerus
Action: Shoulder external rotation
Innervation: axillary nerve (c5-6)

22
Q

Impingement syndrome

A
  • structures above:
    - coracoid process
    - coracoacromial ligament
    - acromion
  • structures below:
    - head of humerus
  • structures that get pinched:
    - supraspinatus tendon
    - long head biceps brachii
    - subacromial bursa
23
Q

Types of impingement

A

Primary impingement: __

Secondary impingement: weak supraspinatus causes humeral head to come up and pinch the structures

24
Q

What is a grade 1 AC joint sprain?

A

a Stretch of the AC ligament

25
Q

What are the signs and symptoms of a Grade 1 AC joint sprain?

A
  1. Palpation - pain over AC joint
  2. Pain in shoulder motions
  3. Horizontal adduction shows most pain
  4. no obvious deformity
  5. minimal effusion
  6. MMT - decrease strength from pain
  7. negative x-rays
26
Q

What happens in a grade 2 AC joint sprain?

A

RUPTURE of the AC ligament

27
Q

What are the signs and symptoms of a grade 2 AC sprain?

A
  1. Palpation - lots of pain over AC joint
  2. lots of Pain in shoulder motions
  3. Horizontal adduction shows most pain
  4. no obvious deformity
  5. minimal effusion
  6. MMT - decrease strength from pain
  7. negative x-rays??
28
Q

What happens in a grade 3 AC joint sprain?

A
  • rupture of acromioclavicular ligament

- Rupture of coracoclavicular ligament

29
Q

Functional throwing progression for pitcher rtp

A
  1. Full ROM - no pain
  2. Normal strength and endurance
  3. Short toss - 30’ - 20-50 throws
  4. Gradual increase distance increments by 15’ to 160’
  5. Regulation pitching distance - 50% velocity
  6. Increase to max velocity
  7. Specialty pitches
  8. Simulated game on sidelines for 1-9 innings
  9. Full play