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Muskuloskeletal Physiotherapy > L4: Shoulder Anatomy & Physiology > Flashcards

L4: Shoulder Anatomy & Physiology Flashcards

1
Q

How is the shoulder joint anatomically and functionally classified?

A

Anatomically, it is a synovial ball and socket joint. Functionally, it is a diarthrosis and multiaxial joint.

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2
Q

What bones are involved in the articulation of the shoulder joint?

A

The glenoid cavity of the scapula and the head of the humerus.

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3
Q

What is the primary function of the shoulder joint?

A

To provide the greatest range of motion in the body, allowing upper limb movement across different planes for everyday tasks.

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4
Q

what physiological movements take place at the shoulder

A

flexion
extension
abduction
adduction
medial rotation
lateral rotation

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5
Q

what is the range of flexion at the shoulder

A

0-180°

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6
Q

what is the range of extension at the shoulder

A

0-45°/60°

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7
Q

what is the range of abduction at the shoulder

A

0-150°

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8
Q

what is the range of adduction at the shoulder

A

30-50°

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9
Q

what is the range of medial rotation at the shoulder

A

0-70/90°

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10
Q

what is the range of lateral rotation at the shoulder

A

0-90°

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11
Q

What four articulations make up the shoulder girdle

A

sternoclavicular (SCJ),
acromioclavicular (ACJ),
glenohumeral (GHJ),
and scapulothoracic (STJ)

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12
Q

which bones articulate in the shoulder joint

A

clavicle
scapula
humerus

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13
Q

define diarthrosis

A

a freely moveable joint

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14
Q

label key bony points of the shoulder

A
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15
Q

describe the sternoclavicular joint

A
  • saddle shaped
  • articulated between medial espect of the clavicle and menubrium of the sternum
  • has small amount of movement in scapular elevation/depression when humerus is flexed above 90°
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16
Q

desrcibe the acromioclavicular joint

A
  • the articulation between the lateral aspect of the clavicle and the acromion of the scapula
  • allows ROM for scapula to glide during shoulder movements
  • combination of joint capsule, ligaments and muscle attachments provide joint stability
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17
Q

describe acromioclavicular joint stability

A
  • weak fibrous capsule lined with synovial fluid
  • stability is maintained by coracoclavicular (made of trapezoid and conoid ligaments) and the acromioclavicular ligaments
  • the attachments of deltoid, trapezius and pectoralis major also contribute to joint stability
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18
Q

what are the major ligaments of the shoulder joint

A

biceps tendon
coracohumeral ligament
SGHL direct
MGHL

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19
Q

label the major ligaments of the shoulder joint

A
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20
Q

describe the glenohumeral joint

A
  • synovial ball and socket joint
  • it is the most mobile and consequently the least stable joint in the body
  • the articulation between head of humerus and glenoid fossa
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21
Q

describe glenohumeral joint stability

A
  • concavity compression (thick suction cup)
    • the labrum increases depth of fossa and increases contact with the humeral head
  • ligaments within joint capsule to maintain contact between head and fossa (static stability)
    • superior, middle and inferior glenohumeral ligaments as well as the coracohumeral ligament and the transverse humeral ligament
  • the rotator cuff tendons and long head of biceps tendon attach around the humeral head to provide stability (dynamic stability)
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22
Q

describe the scpulothoracic joint

A
  • not a ‘true’ joint-dependent on congruity of AC and SC joints
  • scapula attaches to thoracic wall via fascia and is able to ‘glide’ in a variety of movements
  • multiple muscular attachments
  • movement of the scapula is integral to normal shoulder kinesiology (scapulohumeral rhythm)
  • scapula provides stable base for controlled movements between humeral head and glenoid fossa
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23
Q

label borders of scapula

A
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24
Q

label bony points of the scapula

A
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25
Q

what muscles allow flexion of the shoulder

A

major muscles: anterior deltoid,
pectoralis major
assisting: biceps brachii, coracobrachialis,

26
Q

what muscles allow extension of the shoulder

A

major muscles: posterior deltoid, latissimus dorsi, teres major
assisting: long head of triceps

27
Q

what musces allow abduction of the shoulder

A

major muscles: middle fibres of deltoid (15-90°)
assisting: supraspinatus (0-15°), trapezius/ serratus anterior produce scapula rotation (90°+)

28
Q

what muscles allow adduction of the shoulder

A

major muscles: pectoralis major, latissimus dorsi, teres major

29
Q

what muscles allow medial rotation of the shoulder

A

major muscles: subscapularis, teres major
assisting: pectoralis major, latissimus dorsi, anterior deltoid

30
Q

what muscles allow lateral rotation of the shoulder

A

major muscles: infraspinatus, teres minor
assisting: posterior fibres of deltoid

31
Q

what muscles allow scapular elevation

A

levator scapulae, upper fibres of trapezius

32
Q

what muscles allow scapula depression

A

gravity! and the actions of the trapezius and latissimus dorsi

33
Q

what muscle allows scapula protraction

A

serratus anterior

34
Q

what muscles allow scapula retraction

A

rhomboid major, minor and middle fibres of trapezius

35
Q

what muscles allow upward rotation of the scapula

A

trapezius and serratus anterior

36
Q

what muscles allow downward rotation of the scapula

A

gravity, and rhomboids

37
Q

what is the origin and insertion of the anterior deltoid

A

origin: anterior border of lateral edge of clavicle
insertion: deltoid tuberosity of humerus

38
Q

what is the origin and insertion of medial deltoid

A

origin: lateral margin of acromion process
insertion: deltoid tuberosity of the humerus

39
Q

what is the origin and insertion of posterior deltoid

A

origin: inferior edge of spine of scapula
insertion: deltoid tuberosity of humerus

40
Q

what is the origin and insertion of the coracobrachialis

A

origin: tip of coracoid process
insertion: medial aspect of the humerus

41
Q

what is the origin and insertion of pectoralis major

A

origin: clavicle and anterior surface of sternum
insertion: intertubercular sulcus of the humerus

42
Q

what is the origin and insertion of biceps brachii

A

origin: Long head = supraglenoid tubercle of scapula. short head: tip of coracoid process
insertion: radial tuberosity

43
Q

what is the origin and insertion of latissimus dorsi

A

origin: spinous processes of thoracic T7–T12, thoracolumbar fascia, iliac crest and inferior 3 or 4 ribs
insertion: intertubercular sulcus of humerus.

44
Q

what is the origin and insertion of teres major

A

origin: posterior surfacce of inferior angle of scapula
insertion: medial lip of intertubercular sulcus on anterior surface of humerus

45
Q

what is the origin and insertion of teres minor

A

origin: lateral bored of scapula
insertion: greater tubercle of humerus

46
Q

what is the origin and insertion of long head of triceps

A

origin: infraglenoid tubercle of scapula
insertion: posterior part of alecranon process of unla

47
Q

what is the origin and insertion of supraspinatus

A

origin: supraspinatus fossa of scapula
insertion: greater tubercle of humerus

48
Q

what is the origin and insertion of the trapezius

A

origin: from nuchal line of occipital bone to spinous processes of T1-12 and C7
insertion: cest of spine of scapula and acromion.

49
Q

what is the origin and insertion of serratus anterior

A

origin: lateral surfaces of upper 8 ribs
insertion: medial border of scapula

50
Q

what is the origin and insertion of levator scapulae

A

origin: transerse process of C1-4)
insertion: medial border of scapula from superior angle to bottom of spine of scapula

51
Q

what is the origin and insertion of infraspinatus

A

origin: infraspinatus fossa of scapula
insertion: greater tubercle of humerus

52
Q

what is the origin and insertion of rhomboid major

A

origin: spinous process of T2-5
insertion: medial border of scapula to bottom of spine of scapula

53
Q

what is the origin and insertion of rhomboid minor

A

origin: spinous process of C7 and T1
insertion: medial border of sapula at the bottom of the spine of scapula

54
Q

what is a bursa

A

a fluid filled sac found within the joint space

55
Q

what is the purpose of a bursa

A

It contains synovial fluid whihc prevents friction during movement

56
Q

what bursa is found in the shoulder joint

A

subacromial bursa

57
Q

where is the bursa found in the shoulder joint

A

located between the acromion, corocoacromial ligament and the rotator cuff

58
Q

what nerves innervates the anterior part of the shoulder joint

A

Subscapular (C5/6) axillary, and lateral pectoral (C5/6 also)

59
Q

which nerves innervate the posterior part of the shoulder joint

A

suprascapular and small branches of axillary (C5/6)

60
Q

which nerves innervate scapula depression and elevation

A

Dorsal scapula nerve (C3-5)

61
Q

label the bony landmarks of the shoulder girdle

A

Muskuloskeletal Physiotherapy (7 decks)

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