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POTH 225: BIOMECHANICS > lecture 9: shoulder > Flashcards

lecture 9: shoulder Flashcards

1
Q

what is shoulder fucntion

A

key factor that will orient the upper extremity to the ttrunk

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2
Q

what are the movements possible at the shoulder movement

A

extension/flexion
adduction/abduction
medial/lateral rotation
circumduction

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3
Q

what is harder to do lateral or medial extension

A

lateral

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4
Q

what are the bones of the shoulder complex

A

humerus
scapula
clavicle
(acromion and coracoid process)

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5
Q

what is the shape of the clavicle

A

crank shaped strut

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6
Q

expain the shape of the clavicle

A

convex towards sternum (neurovascular structures) / concave towards humerus

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7
Q

what are the function of the clavicle

A

attaches shoulder to axial skeleton
force transmission to scapula
contributes to ROM

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8
Q

where is the scapula located

A

between T2-T7

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9
Q

what is the primary fucntion of the scapula

A

muscle attachment

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10
Q

how do they evaluate internal rotation of the scapula

A

via distance from T7

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11
Q

the coracoid process is located anterior or lateral

A

anterior

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12
Q

the acromion process is located anterior or lateral

A

lateral

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13
Q

what forms the roof over the humerus

A

acromion

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14
Q

what are the 3 types of the acromion variations (bigliani)

A

type 1: flat
type 2: slightly curved
type 3: hook shaped

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15
Q

what acromion variation contributes to compression structures

A

type 3 (hook shaped)

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16
Q

only 25-30% of humeral head is in contact with the fossa, so what is added to increase contact area

A

labrum

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17
Q

what part of labrun is most vulnerable

A

superior aspect is vulnerable to tears = slap lesions
(because of bicep insertion)

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18
Q

stability in the shoulder is increased by what in the glenoid fossa

A

labrun

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19
Q

the superior aspect of the scapula is located to what degrees in the plane

A

superior aspect is 30-45 anterior to frontal plane

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20
Q

true or false: scapula also has slight anterior inclination and upward rotation

A

true

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21
Q

true or false: scapula also has slight BLANK inclination and BLANK rotation

A

slight anterior and upward rotation

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22
Q

where is the radial n located in the humerus

A

in the spiral/radial groove

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23
Q

what is the inclination of the humeral head

A

135

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24
Q

what is the angle of torsion of the humerus

A

30

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25
Q

true or false: the humeral head is in retroversion

A

true

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26
Q

why is there inclination and torsion of the humerus

A

so the humeral head can articulate in a continuous manner with the glenoid fossa

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27
Q

what are the 4 joints of the shoulder

A

acromioclavicular
sternoclavicular
glenohumeral
scapulothoracic

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28
Q

what type of joint is the AC joint

A

synovial joint

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29
Q

what are the 3 rotatory motion of the AC joint

A

internal/external rotation
anterior/posterior tipping
upward and downward rotation

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30
Q

what are the 3 translatory motions of the AC joint

A

anterior/posterior
medial/lateral
superior/inferior

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31
Q

what is the function of the AC

A

allows additional ROM of the scapula on the thorax and force transmission trhough UE

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32
Q

what are the ligaments of the AC joint

A

coracoclavicular (trapezoid and conoid)
acromioclavicular lig (surrounded by joint capsule)

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33
Q

what does AC jt limit

A

limits superior displacement

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34
Q

medial stability during medially directed blow to shoulder is faciliated by what

A

trapezoid ligament

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35
Q

what is the function of the trapezoid ligament

A

helps prevent medial displacement of the acromion on clavicle during a medial blow to the shoulder

prevents medial displacement of acromion on clavicle

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36
Q

explain the function of conoid ligament

A

arm elevation: intially clavicle and scapula in upward rotation together

scapula continues to rotate upwards and CONOID tightens and eventually restricts this motion

clavicle becomes pulled in upwards rotation

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37
Q

as the scapula moves away from the clavicle during arm-trunk elevation, the conoid ligament is pulled taut and causes the clavicle to do what

A

rotate upwardly

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38
Q

what is a grade 1 AC jt injury

A

AC ligament stretched of partially torn

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39
Q

what is a grade 2 AC injurty

A

AC ligament completely torn

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40
Q

what is a grade 3 AC injury

A

AC jt seperation, tear of AC and coracoclavicular ligament and capsule

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41
Q

what type of joint is the sternoclavicular jt

A

synovial joint

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42
Q

what are the 3 rotary motions of the SC joint

A

elevation and depression
protraction and retraction
anterior and posterior rotation

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43
Q

what are the 3 translatory motions

A

anterior/posterior
medial/lateral
superior/inferior

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44
Q

what is the function of the SC

A

connects upper limb and axial skeleton

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45
Q

what are the ligaments of the SC joint

A

anterior/posterior sternoclavicular
interclavicular
costcoclavicular
intraarticular disk

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46
Q

where is the anterior/posterior sternoclav lig located

A

1st rib and clavicle

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47
Q

what ist eh function of the interclavicular lig

A

limits lateral movement

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48
Q

what is the function of the intrarticular disk of the SC joint

A

shock absorb

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49
Q

what jt moves opposite to the SC joint

A

AC

50
Q

rotation of the SC joint about an axis causes the head and opposite end of clavicle to move in same or opposite directions

A

opposite (see saw)

51
Q

shoulder elevation-depression is aka

A

shoulder shrug

52
Q

what is the movement (degrees) in elevation of the SC jt

A

50

53
Q

what is the movement (degrees) in depression of the SC jt

A

10

54
Q

what is the movement of clavicle at SC joint

A

elevation
depression
upward/downward slide

55
Q

what is protraction of the shoulder

A

lateral end of clavicle and scapula move away from rib cage and scapular abduction

56
Q

what is retraction of the shoulder

A

lateral end of the clavicle and scapula move psoteriorly and scapular adduction

57
Q

what is the degrees of sternoclavicular ROM in protraction and retraction

A

30-60 degrees

58
Q

true or false: in the scapulathoracic joint there are true articulations

A

false, there are none

59
Q

what are the 2 translateion of the scapulothoracic jpint

A

elevation and depression
abduction-adduction

60
Q

what are the 3 rotation movements of the scapulothoracic jt

A

upward-downward rotation
internal-external rotation
scapular tilt

61
Q

explain upward rotation of the scapula

A

glenoid fossa moves in superior direction

62
Q

explain downward rotation of the scapula

A

glenoid fossa moves in inferior direciton

63
Q

what is the total upward/downward ROM of the scpula

A

60

64
Q

true or false: upward rotation of the shoulder depends only on scapula

A

false, upward rotation also relies on clavicular elevation and posterior rotation

65
Q

define anterior scapula tilt

A

superior border of scapula tips forward

66
Q

define posterior scapula tilkt

A

superior border of scapula tips backward

67
Q

what are the 5 essential functions of the scapulothoracic joint

A

1) increase ROM of shoulder to enhance reach
2) maintain favourable length-tension relationship for the deltoid to function greater than 90
3) maintain G-H stability for overhead work
4) shock absorption
5) permits elevation of body (ex: push up)

68
Q

what type of jt is the glenohumeral joint

A

ball and socket

69
Q

how many degrees of freedom are in GH joint

A

3 degrees of freedom

70
Q

true or false the GH joint has poor stability despite GH ligaments

A

true

71
Q

the capsule of the GH joint is large and loose inferiorly or superiorly

A

inferiorly (adhesive capsulitis)

72
Q

what is the close packed position of the GH joint

A

adbctuon and external rotation

73
Q

what is the ration of scapulohumeral ryhtm and arm elevation

A

2:1 (for every 2 degrees of GH joint there is 1 degree of scapulothoracic)

74
Q

in 180 arc of movement, if the GH joint moves 120 degrees, how much does the ST joint move

A

60 degrees

75
Q

what is the movement of scapula during scapulohumral rhytm and arm elevation

A

posterior tilt, upward rotation, external rotation

76
Q

what is the movement of humerus during scapulohumral rhytm and arm elevation

A

anterior flexion and abduction

77
Q

what are the shoulder joints and therir total contribution to the 180 arm elevation

A

GH: 120 abduction
ST: 60 upward rotation
SC: 30 elevation
SC_ rotates postiior
AC: upward rotation 30 degrees

78
Q

what are some examples of static glenohumeral stability

A

coracohumeral lig
glenohumeral ligs
labrum
capsule
joint contact
scapular inclination
intraarticular pressure

79
Q

what are the dynamic stabilizers of the shoulder

A

rotator cuff muscles
biceps
deltoid

80
Q

what is the test for inferior instability of the shoulder joint

A

sulcus sign

81
Q

what is the test for anterior instability

A

apprehension sign

82
Q

what are the shoulder instability classifications

A

etiology (traumatic vs atruamatic)
degree of instability (subluxation vs dislocation)
unidirectional vs multidirectional
general ligamentous laxity

83
Q

what forms the coracoacromial arch

A

coracoacrominal lig

84
Q

what space lies uner the coracoacromial lig

A

sub-acromial space

85
Q

what forms the roof of the glenohumeral joint

A

coracoacromial arch

86
Q

what forms the floor of the GH joint

A

head of the humerus

87
Q

when does the coracoacromial arch narrow

A

with elevation and internal rotation

88
Q

what is locatied in the subacromial space

A

supraspinatus and bursa
and long head tendon of biceps

89
Q

what is shoulder impingement

A

irritation of structures in the subacromial space

90
Q

what normally gets impinged in the subacromial space

A

supraspinatus and long head of the biceps

91
Q

true or false: impingement must always be sutained

A

false, sustained and intermittent compression

92
Q

impingement of shoulder is narrowing of what

A

subacromial space

93
Q

subacromial space reduction can be caused by both intrisina nd extrinsic mechanisms?

A

true

94
Q

what is an example of an intrinsic mechanism for subacromial space reduction

A

factors within tendon (cuff degeneration)

95
Q

what are some examples of an extrinsic mechanism for subacromial space reduction

A

glenohumeral kinematics
anatomical/boney factors
scapular kinematics
allignment
ergonomic/sports factors

96
Q

give an example of a sport that causes impingement and give the reasoning

A

butterfly swimming
because repetitive internal rotation and abduction (narrows subacromial space)

97
Q

what are the 2 tests for impingements

A

neers test
hawkins test

98
Q

what is the neers test

A

for impingement
full forward flexion and internally rotates

99
Q

what is the hawkins test

A

for impingement
forward flexion (but only at 90 degrees) and bring into internal rotation

100
Q

true or false: rotator cuff tears can only be traumatic

A

false, both wear and tear and also traumatic

101
Q

what muscles are glenohumeral stabilizers

A

supraspinatus
infraspinatus
teres minor
subscapularis
biceps
deltoid

102
Q

the deltoid causes the humerus and humeral head to translate where

A

superiorly

103
Q

true or false: the deltoid alone can independantely fully abduct (elevate) the arm

A

false

104
Q

what does the supraspinatus do for glenohumeral stabilization

A

abduction of the humerus and compression of the humeral head

105
Q

what is the function of the infraspinatus, subscapularis, teres minor for GH stability

A

initially pull humeral head downwards and then externally rotate humerus (positioning of greater tubercle)

all muscles work to compress humeral head in glenoid fossa during arm elevation

106
Q

what muscles “force couple: with deltoid

A

infra, subscap and teres minor

107
Q

the upwards pull of the deltooid is balanced by what muscles

A

by the downward pull of the inspraspinatus, teres minor, and subscapularis muscles

108
Q

what muscles are scapular stabilizers

A

serratus anterior
trapezius
rhomboids
pectoralis minor
levator scapula

109
Q

wjat is the force couple for the scapula for upward scapular rotation

A

for upward scapular rotation
upper/lower trapezius and serratus anterior
(maintains tension)

110
Q

what is medial winging of the scapula caused by

A

serratus anterior weakness/long thoracic nerver
(trapezius overpulling)

111
Q

what is lateral winging caused by

A

trapezial weakness/spinal accessory nerve
(serratus overpulling)

112
Q

injury to the long thoracic n or serratus anterior weakness will cause medial or lateral winging

A

medial

113
Q

injury to the spinal accessory n or trapezial weakness will cause medial or lateral winging

A

lateral

114
Q

wjat is the force couple for the scapula for downward scapular rotation

A

pectoralis minor
levator scap
rhomboids

115
Q

what are the large muscle movers of the shoulder

A

lat dorsi
teres major
pectoralis major
coracobrachialis

116
Q

shoulder depression/weight bearing is caused by what muscle

A

latissiumus dorsi/pec major

117
Q

when is compressive load on the joint highest of the shoulder

A

at 90

118
Q

when is abductor muscle force highest of the shoulder

A

at 90

119
Q

which ligament helps AC joint stabilization with a medially directed foreces

A

trapezoid

120
Q

the moment arm of the weight of the upper extremity is largest at what degree

A

90

121
Q

what will you see if there is no rotator cuff function

A

difficulty abduction
humeral head displacing too far superiorly (leads to impingement)

POTH 225: BIOMECHANICS (15 decks)

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