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Neurological, neuromuscular and musculoskeletal disease > Functional and clinical anatomy of the shoulder > Flashcards

Functional and clinical anatomy of the shoulder Flashcards

1
Q

What are the 3 bones which make up the shoulder?

A
  1. Clavicle
  2. Humerus
  3. Scapula
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2
Q

What are the different regions of the proximal humerus?

A
  1. Head
  2. Anatomical neck
  3. Surgical neck
  4. Greater tubercle
  5. Inter-tubercular groove
  6. Lesser tubercle
  7. Deltoid tuberosity
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3
Q

What is the anatomical neck of the humerus?

A

The anatomical neck is where the proximal large globular head of the humerus meets the shaft

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4
Q

What is the functional importance of the anatomical neck?

A

The epiphysis is located here and so this is where growth occurs

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5
Q

What is the surgical neck of the humerus?

A

The most narrow part of the humerus

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6
Q

What is the clinical relevance of the surgical neck of the humerus?

A

Stresses are accumulated here when we fall and fractures are likely in this region, hence the name ‘surgical neck’

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7
Q

Which tendon passes through the inter-tubercular groove and where does this tendon insert?

A
  • Biceps long-head tendon

- Inserts onto the glenoid

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8
Q

What is the glenoid?

A

It is a shallow socket in the shoulder blade

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9
Q

Where does the humeral head rest?

A

In the glenoid

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10
Q

What is the labrum?

A

Soft fibro-cartilagenous ring that sits around the glenoid cavity

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11
Q

What is the role of the labrum?

A

It surrounds the glenoid (socket) and helps to stabilise the joint by deepening the socket

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12
Q

What is the importance of the deltoid tuberosity?

A

This is where the deltoid muscle inserts

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13
Q

What is sergeant’s stripes loss of sensation?

A

Surgical neck fracture impacts the axillary nerve which winds around the surgical neck and provides sensation over the shoulder tip (where the sergeant’s stripes would normally be)
- So there is loss of sensation and motor activity to the shoulder tip!

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14
Q

What are the coracoclavicular ligaments?

A

The trapezoid ligament (lateral)

The conoid ligament

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15
Q

What is the role of the coracoclavicular ligaments?

A

Connect the scapula to the trunk via the clavicle

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16
Q

Route of the coracoclavicular ligaments?

A

From the coracoid process to the clavicle

17
Q

How does the clavicle connect to the acromion of the scapula?

A

Via the acromioclavicular joint and the coracoacromial ligament

18
Q

What is the coracoacromial ligament?

A

The coracoacromial ligament is a strong triangular ligament between the coracoid process and the acromion

19
Q

What is the function of the coracoacromial ligament?

A

The function of the coracoclavicular ligament is to allow complex shoulder movement without separation of the scapula from the clavicle

20
Q

How does the shoulder attach to the body?

A

Via the clavicle

21
Q

The humerus attaches to the scapula, but how do the humerus and scapula connect to the main trunk?

A

Through the acromioclavicular joint and the sternoclavicular joint

22
Q

What are the most common movements of the shoulder-clavicle motion?

A
  1. Around the vertical axis: facing the glenoid anteriorly

2. Around the horizontal axis: facing the glenoid more supero-laterally

23
Q

What makes the shoulder joint unstable?

A

The glenoid cavity is very small compared to the area of the humeral head (ball)
- Ball = 4 x socket area

24
Q

How is the shoulder joint stabilised? Give specific examples

A

By ligaments which sit over the joint capsule, they deepen and support the joint superiorly, making up for the difference in area between ball and socket

  • Glenohumeral ligaments
  • Coracohumeral ligament
  • Coracoacromial ligament
25
Q

What is the clinical relevance of the labrum?

A

We can suffer from labral tears which is often the cause for shoulder dislocations

26
Q

What are the two different groups of muscles around the shoulder?

A
  • Intrinsic vs extrinsic

- Those which connect the humerus to the scapula and those which connect the scapulo-humeral complex to the trunk

27
Q

What are the different intrinsic muscles of the shoulder?

A
  1. Deltoid
  2. Teres major
  3. Rotator cuff (teres minor, subscapularis, supraspinatous & infraspinatous)
28
Q

What are the extrinsic muscles of the shoulder?

A

Superficial: trapezius, latissimus dorsi
Deep: levator scapulae, rhomboids

29
Q

What are the different muscles of the rotator cuff?

A
  1. Supraspinatous
  2. Infraspinatous
  3. Subscapularis
  4. Teres minor
30
Q

Role of the rotator cuff muscles?

A

Control the position of the head in relation to the glenoid cavity
- Maintain function of the joint during all its movements

31
Q

Different shoulder movements?

A
  1. Flexion
  2. Extension
  3. (internal) Medial rotation
  4. (external) Lateral rotation
  5. ABduction
  6. ADDuction
32
Q

What is a bursa?

A

Fluid filled bag which allows movement of the muscle and tendon in relative to the bone = MASSIVELY REDUCING FRICTION

33
Q

Where are bursae found?

A

Between the supraspinatous muscle, tendon and acromial process (between skin and bone)

34
Q

Clinical relevance of bursae?

A

Can become inflamed (SUPRASPINATOUS BURSITIS) making it difficult to abduct the arm = ‘PAINFUL ARC’ of abduction

35
Q

What is the ‘painful arc’ of abduction? Explain how the arc of pain associates with structures found in the shoulder

A

When abducting the arm starts at a specific point and ends at a particular angle in the arc

Posteriorly:

  • 45-60 degrees = glenohumeral painful arc
  • 170-180 degrees = acromioclavicular painful arc

Anteriorly:
- 60-120 degrees = subacromial painful arc

36
Q

Give another cause of the painful arc of abduction?

A

Inflammation of the tendon rather than the bursa = SUPRASPINATOUS TENDINITIS

37
Q

What is shoulder dislocation?

A

When the humeral head slips out of the glenoid fossa
- When dislocation occurs, the short muscles around the shoulder (teres major, minor and infraspinatus) go into spasm and pull the humeral head medially

Neurological, neuromuscular and musculoskeletal disease (36 decks)

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