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EDKP-206 > Lecture 14 - Shoulder Biomechanics > Flashcards

Lecture 14 - Shoulder Biomechanics Flashcards

1
Q

What makes up the shoulder complex?

A
  1. Bone structure
  2. Joints and supporting structures
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2
Q

What is the bone structure?

A
  • Bones of the shoulder complex
  • Connects to the rest of the body via sternum and thorax
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3
Q

What are the bones of the shoulder complex?

A
  1. Clavicle
  2. Scapula
  3. Humerus
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4
Q

What are the joints of the shoulder complex?

A
  1. Sternoclavicular joint
  2. Acromioclavicular joint
  3. Scapulothoracic joint
  4. Glenohumeral joint
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5
Q

What are the supporting structures of the shoulder complex?

A
  1. Labrum
  2. Capsule
  3. Ligaments and musculature
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6
Q

What is the clavicle?

A
  • Crank shaped
  • Convex towards sternum
  • Concave towards humerus
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7
Q

What is the function of the clavicle?

A
  1. Attaches shoulder to axial skeleton
  2. Force transmission to scapula
  3. Contributes to ROM
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8
Q

What is the scapula?

A
  • Sits between T2 and T7
  • Can palpate acromion and coracoid process
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9
Q

What is the function of the scapula?

A

Muscle attachment

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10
Q

What is the alignment of the scapula?

A
  • Superior aspect 30-45 degrees anterior to frontal plane
  • Slight anterior inclination and upward rotation
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10
Q

What increases the depth of the glenoid fossa?

A

Fibrocartilaginous labrum (50% increase)

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11
Q

What does the labrum help with: mobility or stability?

A

Stability

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12
Q

What is the role of the tubercles on the humerus?

A

Externally rotate humerus for greater tubercle to clear acromion process and acromioclavicular ligament

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13
Q

What is the role of the intertubercular groove?

A

Radial nerve runs along it

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14
Q

What type of joint is the sternoclavicular joint?

A

Synovial

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15
Q

What type of joint is the acromioclavicular?

A

Synovial

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16
Q

What type of joint is the scapulothoracic joint?

A

Special

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17
Q

What type of joint is the glenohumeral joint?

A

Synovial

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18
Q

What is the role of the sternoclavicular joint?

A

Connects upper limb and axial skeleton

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19
Q

What are the 3 rotatory motions?

A
  1. Elevation/depression
  2. Protraction/retraction
  3. Upward/downward rotation
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20
Q

What is the seesaw affect of the clavicle due to the sternoclavicular joint?

A

Rotation of the joint about an axis causes the head and opposite end of clavicle to move in opposite directions

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21
Q

What are the ligaments of the sternoclavicular joint?

A
  1. Anterior sternoclavicular
  2. Posterior sternoclavicular
  3. Interclavicular
  4. Costoclavicular
  5. Intraarticular disc
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22
Q

What are the 3 rotatory motions of the acromioclavicular joint?

A
  1. Internal/external rotation
  2. Anterior/posterior tipping
  3. Upward/downward rotation
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23
Q

What does the acromioclavicular joint also allow?

A
  1. Additional ROM of the scapula on the thorax
  2. Force transmission through the upper extremity
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24
What supports the acromioclavicular joint?
1. Capsule 2. Coracoacromial ligament 3. Coracoclavicular ligaments
25
What is the function of the coracoacromial ligament?
Provides protection (doesn't cross the joint)
26
What is the function of the coracoclavicular ligaments?
1. Trapezoid -> Prevents medial displacement of acromion 2. Conoid
27
What are the two translational movements of the scapulothoracic joint?
1. Elevation/depression 2. Abduction/adduction
28
What are the 3 rotational movements of the scapulothoracic joint?
1. Upward/downward rotation 2. Internal/external rotation 3. Scapular tilt
29
What provides stability of the scapulothoracic joint?
1. AC joint 2. SC joint
30
What are the 5 essential functions of the scapulothoracic joint?
1. Increase ROM of shoulder (enhance reach) 2. Maintain favorable length-tension relationship for deltoid function (>90 degrees) 3. Maintain GH stability for overhead work 4. Shock absorption 5. Permits elevation of body
31
What is the glenohumeral joint?
- Ball and socket - Most mobile (but costs stability)
32
What are the supporting structures of the glenohumeral joint?
1. Labrum 2. Capsuloligamentous complex
33
What is the function of the labrum?
1. Deepens the glenoid fossa 2. Increases articular contact -> Increase stability and decreases stress
34
What makes up the capsuloligamentous complex?
1. Capsule 2. Glenohumeral ligaments a) Superior b) Middle c) Inferior 3. Coracohumeral ligament
35
What does the capsule of the capsuloligamentous complex do?
- Encircles joint - Provides protection against excessive rotation and translation
36
How many degrees of freedom exist at the glenohumeral joint?
3 DOF
37
What are the 3 DOF?
1. Flexion/extension 2. Adduction/abduction 3. Internal/external rotation
38
What occurs when elevation takes place)
- Reduces subacromial space - Requires rotation of humerus in GH joint in frontal/sagittal plane
39
What is the coracoacromial arch?
1. Coracoacromial ligament 2. Sub-acromial space 3. Roof of the GH joint -> Narrow with elevation and internal rotation
40
What is the function of the coracoacromial arch?
1. Protection of muscles, tendons and bursae 2. Prevention of superior dislocation of humerus
41
What is impingement?
- Irritation of structures in the subacromial space - Sustained or intermittent compression - Narrowing of sub-acromial space
42
What provides static stability of the glenohumeral joint?
1. Superior capsule 2. Coracohumeral ligament 3. Inactive supraspinatus
43
What provides dynamic stability of the glenohumeral joint?
1. Rotator cuff muscles 2. Biceps 3. Deltoids
44
What are the muscles of the rotator cuff?
1. Supraspinatus 2. Infraspinatus 3. Subscapularis 4. Teres minor
45
What do the dynamic stabilizes of the GH joint help with?
- Neutralize upward movement - Compress humerus head into glenoid fossa - Force couples
46
What are the primary movers of the arm?
1. Deltoid 2. Supraspinatus
47
What occurs during total shoulder movement?
- Contribution from all 4 joints - Scapular elevation is the movement of the scapulothoracic "joint" which indirectly elvetaes the sternoclavicular joint
48
What is the scapulohumeral rhythm?
Scapulothoracic and glenohumeral joints move simultaneously
49
What is the ratio of the scapulohumeral rhythm?
2:1 (GH:ST)
50
What is the role of the scapula in arm elevation?
1. Posterior tilt 2. Upward rotation 3. External rotation
51
What is the role of the humerus in arm elevation?
1. Anterior flexion 2. Abduction
52
What happens during arm-trunk elevation?
- Upward rotation of the scapula forces elevation of the clavicle - Scapula moves more than clavicle
53
What is the total ROM of upward/downward rotation?
60 degrees
54
What is the contribution to 180 degree arm elevation by the joints?
GH: 120 degree (abduction) ST: 60 degree (upward rotation) SC: 30 degree (elevation) AC: 30 degree (upward rotation)
55
What are the 3 groups of the muscles of the shoulder complex?
1. Axioscapular and axioclavicular 2. Scapulohumeral 3. Axiohumeral
56
What classifies the axioscapular and axioclavicular muscles?
Posses an attachment on the axial skeleton and on the shoulder girdle
57
What is the role of the axioscapular and axioclavicular muscles?
Moving the sternoclavicular and scapulothoracic joints
58
What are a few important axioscapular and axioclavicular muscles?
1. Trapezius 2. Serratus anterior
59
What is the role of the trapezius?
Adducts and upwardly rotates the scapula (each section has unique functions)
60
What is the force couple for upward scapular rotation?
- Upper/lower trapezius (+ serratus anterior) - Muscles pulling in different directions crease a net torque but no net force
61
What is the role of the serratus anterior?
Active when pushing anteriorly
62
What is winging of the scapula?
Cause: Weakness of the serratus anterior/injury to nerves Types: Medial and Lateral
63
What is the role of the scapulohumeral muscles?
- Provide motion and dynamic stabilization of the GH joint - Critical to mobility
64
What are the important scapulohumeral muscles?
1. Deltoid 2. Supraspinatus 3. Infraspinatus 4. Teres minor 5. Subscapularis 6. Teres major 7. Coracobrachialis
65
What is the function of the deltoid?
Causes humerus and humeral head to translate superiorly
66
What is the function of the supraspinatus?
Causes abduction of the humerus and compression of the humeral head
67
What is the function of the infraspinatus, subscapularis and the teres minor?
- Initially pull humeral head downwards and then externally rotate humerus - Muscles work to compress humeral head in glenoid fossa during arm elevation - Force couple with deltoid
68
What classifies the axiohumeral muscles?
- Attach to thorax and humerus - Large PCSA for additional strength
69
What are the 2 important axiohumeral muscles?
1. Pectoralis minor 2. Latissimus dorsi
70
What is the joint reaction force of the shoulder?
Compressive load maximum at 90 degree shoulder abduction
71
What can help alleviate shoulder pain/weakness?
Simple interventions (exp: holding a child closer to your body)

EDKP-206 (16 decks)

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