Lecture Shoulder part 2 Deep Shoulder Flashcards

1
Q

What are the joints of the shoulder?

A
  • sternocalvicular joint
  • gleno-humeral joint
  • acromioclavicular joint
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2
Q

Where does clavicle articulate anteriorly?

A
  • at manubrium of sternum with sternoclavicular joint
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3
Q

Where does clavicle articulate laterally?

A
  • acromioclavicular joint
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4
Q

What articulates at gleno-humeral joint?

A
  • glenoid of scapula and head of humerus
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5
Q

What is the pectoral girdle?

A
  • clavicle and scapula
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6
Q

What type of joint is the sternoclavicular joint?

A
  • synovial joint
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7
Q

What is the only true boney articulation between upper limb and thorax?

A
  • sternoclavicular joint
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8
Q

Can the sternoclavicular joint move in multiple planes?

A
  • Yes it is a multiaxial joint

-

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9
Q

What movements does the sternoclavicular joint have?

A
- elevation/depression
(clavicle and disc)
- protraction/retraction
(clavicle and sternum)
- rotation
(both)
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10
Q

Does dislocation of the sternoclavicular joint occur frequently?

A
  • no the clavicle is more likely to fracture from force first
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11
Q

What is the movement of plane joints?

A
  • they slide on each other
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12
Q

How does acromioclavicular joint dislocate?

A
  • upward force stretches or tears the ligaments in some way
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13
Q

What is a grade 1 separated shoulder?

A
  • acromioclavicular ligament sprain
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14
Q

What is a grade 2 separated shoulder?

A
  • acromioclavicular ligament tear
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15
Q

What is a grade 3 separated shoulder?

A
  • acromioclavicular and coracoclavicular ligaments are torn
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16
Q

What type of joint is the genlohumeral?

A
  • synovial capsule
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17
Q

Is the glenohumeral joint strong?

A
  • no it is weak but very mobile
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18
Q

What reinforces the glenohumeral joint?

A
  • tendons of the rotator cuff muscles
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19
Q

Long tendon of pierces the capsule and attaches to supraglenoid tubercle of scapula and glenoid labrum

A

-bicheps brachii

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20
Q

What forms roof of glenoid fossa and attaches coracoid process to acromion?

A
  • coraco acromial ligament
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21
Q

What forms roof of glenoid fossa?

A
  • coraco acromial ligament
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22
Q

What are bursa?

A
  • pillows of synovial fluid
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23
Q

Dislocation of glenohumeral joint is?

A
  • dislocation of shoulder
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24
Q

Dislocation of acromioclavicular joint is?

A
  • separated shoulder
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25
Q

what is the most common dislocation direction?

A
  • downward (inferior) direction but described as anterior
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26
Q

What prevents upward dislocation?

A
  • the coracoacrominal structures and rotator cuff
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27
Q

_____ dislocations are more rare

A
  • posterior
28
Q

Who do anterior dislocations occur most commonly in?

A
  • young adults, especially athletes
29
Q

How do the dislocations happen?

A
  • hyperextension with lateral rotation
  • humeral head is forced in infero-anterior direction
  • fibrous layer of joint capsule and glenoid labrum may tear
30
Q

What nerve do we worry about with shoulder dislocation?

A
  • axillary nerve
31
Q

What muscles does the axillary nerve supply?

A
  • deltoid
  • teres minor
  • triceps brachii (radial nerve more common)
32
Q

Axillary nerve supplies sensory from:

A
  • shoulder joint

- skin covering the inferior deltoid

33
Q

What is frozen shoulder?

A
  • adhesive capsulitis
34
Q

What is adhesive capsulitis?

A
  • chronic inflammation in the glenohumeral joint can lead to fibrosis between joint capsule, rotator cuff muscles and synovial bursa
35
Q

What range of motion does frozen shoulder affect?

A
  • abduction affected, compensatory scapular movements
36
Q

Who is frozen shoulder common in?

A
  • individuals 40-60 years of age
37
Q

______ can be initiated by glenohumeral dislocation, supraspinus tendinitis, bicipital tendinitis and or rotator cuff tears

A
  • adhesive capsulitis
38
Q

How do you treat adhesive capsulitis?

A
  • interscalene block to numb nerves of shoulder

- manual maniupulation to break apart adhesion to allow normal range of motion

39
Q

The deltoid can perform all actions except?

A
  • adduction
40
Q

What are the rotator cuff muslces?

A
  • subscapularis
  • supraspinatus
  • infraspinatus
  • teres minor
41
Q

where does the deltoid attach proximally?

A
  • lateral 1/3 of clavicle, acromion and spine of scapula
42
Q

Where is the distal attachment of the deltoid?

A
  • deltoid tubersoity of humerus
43
Q

what nerve innervates the deltoid?

A
  • axillary nerve (C5, C6)
44
Q

What are the actions of the deltoid?

A
  • flexes
  • medially rotates
  • abducts
  • extends
  • and laterally rotates humerus
45
Q

What cord does the axillary nerve come from?

A
  • posterior cord of brachial plexus
46
Q

Where does the teres major attach proximally?

A
  • posterior surface of inferior angle of scapula
47
Q

Where is the distal attachment of the teres major?

A
  • medial lip of intertubercular (bicipital) grooce of humerus
48
Q

What are the actions of teres major?

A
  • adducts and medially rotates humerus
49
Q

What innervates the teres major?

A
  • lower subscapular nerve (C5 and C6)
50
Q

Where do the supra spinatus teres minor and infra spinatus converge?

A
  • greater tubercle
51
Q

What rotator cuff muscle attaches to the lesser tubercle of humerus?

A
  • subscapularis
52
Q

what is the action of the supraspinatus muscle?

A
  • initiates abduction of humerus then deltoid takes over at 25-30 degrees
53
Q

Where is the insertion of the supraspinatus?

A
  • superior facet of the greater tubercle of humerus
54
Q

What innervates the supraspinatus?

A
  • suprascapular nerve
55
Q

Where is the origin of the infraspinatus?

A
  • infraspinatus fossa of scapula
56
Q

Where is the insertion of infraspinatus?

A
  • middle facet of greater tubercle of humerus
57
Q

where is the origin of the supraspinatus?

A
  • supraspinous fossa of scapula
58
Q

what innervates the infraspinatus?

A
  • suprascapular nerve
59
Q

What muscle has the same function as the infraspinatus?

A
  • teres minor
60
Q

Where is the proximal attachment of the teres minor?

A
  • middle part of lateral border of scapula
61
Q

Where is the distal attachment of the teres minor?

A
  • inferior facet of greater tubercle of humerus
62
Q

What is the action of the teres minor?

A
  • laterally rotates humerus, helps hold humeral head in place
63
Q

What inervates the teres minor?

A
  • axillary nerve
64
Q

What nerve innervates the subscapularis muscle?

A
  • upper and lower subscapular nerves
65
Q

What is the action of the subscapularis muscle?

A
  • adducts the humerus
66
Q

Where is the distal attachment of the subscapularis?

A
  • lesser tubercle of humerus
67
Q

Where is the proximal attachment of the subscapularis?

A
  • anterior surface of scapula (subscapular fossa)`