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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
Lower Trapezius
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
Trapezius Kinesiology
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
Latissimus Dorsi
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
Latissimus Dorsi Kinesiology
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
General Topography
Rhomboid Major | Rhomboid Minor
30
Rhomboid Major
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
Rhomboid Minor
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
Levator Scapulae
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
Elevation
Upper trapezius Levator scapulae Rhomboids
34
Depression
``` Latissimus Dorsi Lower trapexius Pec Major Serrates Anterior Pec Minor Gravity ```
35
Retraction
Middle trapezius Rhomboids Latissimus dorsi
36
Upper Rotation
Upper trapezius Lower trapezius Serrates anterior
37
Downward Rotation
``` Levataor Scapulae Rhomboids Latissimus Dorsi Pec Major Pec Minor Gravity ```
38
Scapular & Posterior Shoulder Muscles
Deltoids: Anterior, Middle, Posterior Teres Major Rotator cuffs: Supraspinatus, infraspinatus, teres minor, subscapularis Triceps brachii: long head, lateral head, medial head
39
Deltoid- Anterior
O: Lat. 1/3 clavicle I: deltoid tubercle A: abduction, flexion, horizontal adduction IN: Axillary nerve
40
Deltoid- Middle
O: Acromion I: Deltoid tubercle A: Abduction IN: Axillary Nerve
41
Deltoid- Posterior
O: Scapular spine I: Deltoid tubercle A: Abduction, extension, horizontal abduction IN: Axillary nerve
42
Teres Major
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
Supraspinatus
``` 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
Infraspinatus
O: Infraspinous fossa of scapula I: Middle facet greater tuberosity of humerus A: External rotation IN: Suprascapular nerve
45
Teres Minor
O: Upper part of lateral border of scapula I: Inferior facet of greater tubercle of humerus A: External rotation IN: Axillary Nerve
46
Subscapularis
O: Subscapular fossa (anterior scapula) I: Lesser tubercle of humerus A: Internal rotation IN: Upper and lower subscapular nerve
47
Triceps-Long Head
O: Infraglenoid tubercle of scapula I: Olecranon process A: Elbow extension, shoulder extension IN: Radial nerve
48
Scapula Abduction (Protraction)
``` Scapula move laterally away from spinous processes without rotation Exercise -Push up pluss Agonists -Serratus anterior -Pectoralis minor ```
49
Scapula Adduction (Retraction)
``` Return from abduction Occurs with retractions Agonists: Middle trapezius Rhomboids ```
50
Scapula (Upward Rotation)
Lateral & upward movement | Agonist - Upper trapezius, lower trapezius, serratus anterior
51
Scapula (Downward Rotation)
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
Scapula (Elevation)
Lifting scapula without rotation in anatomic position Shoulder shrug Agonists: levator scapular, upper trapezius, rhomboid
53
Shoulder (Depression)
Bodyweight triceps dip | Agonists: Lower trapezius, pectorals minor
54
Retraction v. Protraction
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
Winging Scapula
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
Protraction Exercise
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
Retraction Exercise
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
Rotator Cuff Pathology
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
Rotator Cuff limited blood supply
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
Shoulder Impingement
``` 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) ```

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