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KNES 360 > KNES 360 EXAM 2 Shoulder & Pectoral Girdle > Flashcards

KNES 360 EXAM 2 Shoulder & Pectoral Girdle Flashcards

1
Q

Shoulder Anatomy

A 
3 Bones
-Humerus
-Scapula
-Clavicle
3 Joints
-Sternoclavicular 
-Acromioclavicular
-Glenohumeral
1 Articulation
-Scapulothoracic
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2
Q

Clavicle

A

Medial 2/3’s of the clavicle is mostly circular and bends forward convexly
Lateral 1/3 of the clavicle takes on a flattened appearance and bends concavely
At the point of changes: structural weakness
-This is where most fractures occur

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3
Q

Scapula

A

Flat, triangular shaped bone, located on the posterior aspect of the thorax and has three prominent projections

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4
Q

Humerus

A

The long bone of the upper arm
Greater and lesser tuberosities:
-The lesser tuberosity is anterior and medial (front nd inside)
-The greater tuberosity is higher and lateral
Bicipital groove between tuberosities, this is where the tendon of the biceps is located

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5
Q

Anatomical Landmarks- Scapula

A 
Medial border of the scapula
Inferior angle of the scapula
Acromion process
Coracoid process
Supra/infraglenoid tubercles
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6
Q

Anatomical Landmarks- Humerus

A

Greater tubercle
Lesser tubercles
Bicipital grooves
Deltoid tubercle

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7
Q

Sternoclavicular Joint

A

(SC)
clavicle meets the sternum
SC joint is the only direct connection between the upper extremity and the trunk of body
little motion

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8
Q

Acromioclavicular Joint

A

(AC)
Lateral end of the clavicle with the acromion process
limited range of motion

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9
Q

Glenohumeral joint

A 
ball-and-socket v. golf ball and tee
most mobile joint
passive stability: 
-Gelnoid labrum
-Joint capsule
-Ligaments
Muscular support:
-Rotator cuff muscles
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10
Q

Glenoid Labrum

A

Fibrous rim which deepens the glenoid fossa: increase depth ~50% or 2.5-5mm
Increase total surface contact area
Serves as a buttress in controlling GH translation
Most effective in mid-ROM

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11
Q

Rotator Cuff

A

S-Supraspinatus
I- Infraspinatus
T- Teres Minor
S- Supscapularis

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12
Q

Scapulothoracic Articulation

A 
(ST) 
Movements:
Protraction and Retraction
Upward and Downward
Elevation and Depression
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13
Q

Anterior Muscles

A 
Pectoralis Major
-Clavicular
-Sternal
Pectoralis Minor
Serratus Anterior
Biceps Brachii
-Long Head
-Short Head
Coracobrachialis
Brachialis
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14
Q

Pectoralis Major (Clavicular)

A

O: Medial half of clavicle
I: Lateral lip of bicipital groove
A: Should adduction and internal rotation and assists with flexion
IN: Lateral Pectoral Nerves

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15
Q

Pectoralis Major (Sternal)

A

O: Sternum, 6 coastal cartilages
I: Lateral lip of bicipital groove
A: Should adduction, horizontal adduction, and internal rotation; extends the shoulder from a flexed position
IN: Medial pectoral nerve

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16
Q

Pectoralis Minor

A

O: Ribs 3-5
I: Coracoid Process
A: Scapular protraction and downward rotation; rib elevation during forces inspiration
IN: Medial pectoral nerve

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17
Q

Serratus Anterior

A

O: outer surface of upper 8 ribs
I: Medial border scapula
A: scapular protraction and upward rotation; stabilizes scapular on thoracic wall
IN: long thoracic

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18
Q

Winging scapula

A

long thoracic nerve injury will affect serrates anterior function

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19
Q

Bicepts Brachii (Long head)

A

O: Supraglenoid tubercle
I: Radial tuberosity
A: elbow flexion, forearm supination, shoulder flexion
IN: Muscuolocutaneous nerve

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20
Q

Biceps Brachii (short head)

A

O: Coracoid process of scapula
I: Radial tuberosity
A: elbow flexion, forearm supination, shoulder flexion
IN: Muscolocutaneous nerve

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21
Q

Coracobrachialis

A

O: Coracoid process of scapula
I: Middle of medial border of humerus
A: Shoulder flexion and adduction
IN: Musculotaneous nerve

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22
Q

Posterior Back Muscles

A 
Trapezius 
-Upper
-Middle
-Lower
Latissimus dorsi
Rhomboids
Levator Scapulae
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23
Q

Upper Trapezius

A

O: External occipital protuberance, medial 1.3 of superior nuchal line, spinous process of C2-C7 (via ligamentum nuchae)
I: Lateral 1/3 of clavicle
A: Neck extension, lateral flexion, and rotation; scapular elevation, retraction, upward rotation
IN: Spinal Accessory Nerves (Cn XI), C3, C4 (sensory)

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24
Q

Middle Trapezius

A

O: Spinous process of T1-T6 (via ligamentum nuchae)
I: medial margin of the acromion; spine of scapula
A: Scapular retraction
IN: Spinal accessory nerve (CN XI), C3, C4 (sensory)

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25
Q

Lower Trapezius

A

O: Spinous Processes of T7-T12 (via ligamentum nuchae)
I: Medial border of the scapular spine
A: Scapular depression and upward rotation
IN: Spinal accessory nerve (CN X1) C3, C4 (sensory)

26
Q

Trapezius Kinesiology

A

Fiber direction (from to insertion) and function:
Superior portion: inferolaterally
Middle portion: transversely
Lower portion: superolaterally
Contraction of middle trapezius: retraction of scapula
-upper and lower fibers contract simultaneously to prevent scapular rotation
When weight is carried against gravity the upper fibers elevate the pectoral girdle
-Trapezius maintins optimal length tension in the deltoid and permits the deltoid to carry it’s heaviest distal level thru full ROM.

27
Q

Latissimus Dorsi

A

O: Thoracolumbar fascia; Spinous processes T6-T12 and L1-L5; sacrum; iliac crest;; lower 3-4 ribs
I: bicipital groove of humerus (floor); inferior angle of scapula
A: extends, adducts, and internally rotates the arm at the shoulder joint; elevates the trunks to arm
IN: Thoracodorsal Nerve

28
Q

Latissimus Dorsi Kinesiology

A

During movement of the upper limb the insertion on the inferior angle of the scapula to the thorax
Active during violent epxiration b/c it functions to compress the thorax and the abdomen due to its insertions to the ribs

29
Q

General Topography

A

Rhomboid Major

Rhomboid Minor

30
Q

Rhomboid Major

A

O: Spinous process of T2-T5
I: medial border of scapular between scapular spine and inferior angle
A: Elevation, retraction and downward rotation of the scapula; helps to fix scapular to the thoracic wall
IN: Dorsal scapular nerve

31
Q

Rhomboid Minor

A

O: Spinous process of C7-T1
I: Medial border of scapular superior to spine
A: elevation, retraction, and downward rotation or the scapula
IN: dorsal scapular nerve

32
Q

Levator Scapulae

A

O: Transverse process of C1-C4
I: Superior angle and upper medial border of scapula
A: scapular elevation and downward rotation; lateral neck flexion; neck extension (bilaterally)
IN: dorsal scapular nerve

33
Q

Elevation

A

Upper trapezius
Levator scapulae
Rhomboids

34
Q

Depression

A 
Latissimus Dorsi
Lower trapexius
Pec Major
Serrates Anterior
Pec Minor
Gravity
35
Q

Retraction

A

Middle trapezius
Rhomboids
Latissimus dorsi

36
Q

Upper Rotation

A

Upper trapezius
Lower trapezius
Serrates anterior

37
Q

Downward Rotation

A 
Levataor Scapulae
Rhomboids
Latissimus Dorsi
Pec Major
Pec Minor
Gravity
38
Q

Scapular & Posterior Shoulder Muscles

A

Deltoids: Anterior, Middle, Posterior
Teres Major
Rotator cuffs: Supraspinatus, infraspinatus, teres minor, subscapularis
Triceps brachii: long head, lateral head, medial head

39
Q

Deltoid- Anterior

A

O: Lat. 1/3 clavicle
I: deltoid tubercle
A: abduction, flexion, horizontal adduction
IN: Axillary nerve

40
Q

Deltoid- Middle

A

O: Acromion
I: Deltoid tubercle
A: Abduction
IN: Axillary Nerve

41
Q

Deltoid- Posterior

A

O: Scapular spine
I: Deltoid tubercle
A: Abduction, extension, horizontal abduction
IN: Axillary nerve

42
Q

Teres Major

A

O: Lower lateral border and inferior angle scapula
I: crest of lesser tubercle and medial lip of intertubercular sulcus
A: Adduction, internal rotation, extension
IN: Lower subscapular nerve

43
Q

Supraspinatus

A 
O: Supraspinous fossa of scapula
I: Superior facet of greater tuberosity of humerus
A: initiates ABD
Compression of the GH joint
IN: Suprascapular Nerve
44
Q

Infraspinatus

A

O: Infraspinous fossa of scapula
I: Middle facet greater tuberosity of humerus
A: External rotation
IN: Suprascapular nerve

45
Q

Teres Minor

A

O: Upper part of lateral border of scapula
I: Inferior facet of greater tubercle of humerus
A: External rotation
IN: Axillary Nerve

46
Q

Subscapularis

A

O: Subscapular fossa (anterior scapula)
I: Lesser tubercle of humerus
A: Internal rotation
IN: Upper and lower subscapular nerve

47
Q

Triceps-Long Head

A

O: Infraglenoid tubercle of scapula
I: Olecranon process
A: Elbow extension, shoulder extension
IN: Radial nerve

48
Q

Scapula Abduction (Protraction)

A 
Scapula move laterally away from spinous processes without rotation 
Exercise -Push up pluss
Agonists
-Serratus anterior
-Pectoralis minor
49
Q

Scapula Adduction (Retraction)

A 
Return from abduction
Occurs with retractions
Agonists:
Middle trapezius
Rhomboids
50
Q

Scapula (Upward Rotation)

A

Lateral & upward movement

Agonist - Upper trapezius, lower trapezius, serratus anterior

51
Q

Scapula (Downward Rotation)

A

Downward & Medial movement
Glenoid fossa is rotated downward when downward movement of shoulder joint occurs
Lat pull downs
Agonists: Pectoralis minor, rhomboid, and lat dorsi

52
Q

Scapula (Elevation)

A

Lifting scapula without rotation in anatomic position
Shoulder shrug
Agonists: levator scapular, upper trapezius, rhomboid

53
Q

Shoulder (Depression)

A

Bodyweight triceps dip

Agonists: Lower trapezius, pectorals minor

54
Q

Retraction v. Protraction

A

People with shoulder problems are usually unstable to stabilize the scapula in one of those positions
People with flexion intolerance in the lumbar spine may get relief with shoulder girdle retraction work

55
Q

Winging Scapula

A

Can be a neurological problem which is difficult to help with exercise
Most are simply weak serratus anterior when gravity pushing into retraction (push up position)

56
Q

Protraction Exercise

A

Push-Up Plus
regular push up with a little extra scapular protraction at the end
Start leaning into the wall then move to the floor
Can us stability ball to alter difficulty

57
Q

Retraction Exercise

A

Y’s, T’s, W’s
lying prone, make yourself into a Y, T, and W.
Lift arms off the ground slightly using scapular retractors and hold
Make sure no lumbar motion (turn on gluteus)
Progress to weights/Movement

58
Q

Rotator Cuff Pathology

A

Rotator cuff muscles pull the humeral head inferomedially (down and in)
-Compression of humeral head to glenoid fossa to stabilize the glenohumeral joint
-Prevents superior migration of the humerus
Scapula must rotate to maintain space and glenohumeral contact in excessive ranges
Subacromial impingement
-Compression of soft tissues between the humeral head and the acromion process
–supraspinatus
–Long head of the biceps
–Subacromial bursa

59
Q

Rotator Cuff limited blood supply

A

Repetitive over head activates (swimming, throwing) may decrease blood supply to supraspinatus tendon resulting in necrosis
Chronic impingement may be a predisposing factor to rotator cuff rupture
Tears and defects have been found in more than 25% of cadaver specimens

60
Q

Shoulder Impingement

A 
Restore normal biomechanics in order to maintain space
Strengthening of rotator cuff and scapula stabilizing muscles
Stretching of posterior and inferior joint capsule
Modify activity (control frequency and intensity)

KNES 360 (3 decks)

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