Shoulder Flashcards
1
Q
What bones connect the upper extremity to the trunk?
A
The clavicle and the scapula
2
Q
What articulates with the scapula at the shoulder joint?
A
Humerus
3
Q
The scapula and the clavicle articulate with the bones of the thorax at one point only, where is this point?
A
The sternoclavicular joint
4
Q
What is the abbreviation for the sternoclavicular joint?
A
The SC joint
5
Q
The lateral end of the clavicle articulates with what projection on the scapula?
What joint does it form?
A
The acromion;
The acromioclavicular joint
6
Q
What is another name for the acromioclavicular joint?
A
The AC joint
7
Q
The clavicle has a (forward/backward) curve to its medial half
A
Forward
8
Q
What does the medial end of the clavicle articulate with ?
A
The sternum
9
Q
What does the lateral end of the clavicle articulate with?
A
The scapula
10
Q
The medial end of the clavicle is (larger/smaller) than the lateral end of the clavicle
A
Larger
11
Q
What is the name of the articular surface for the shoulder joint?
A
Glenoid fossa
12
Q
What are the names of the structures above and below the glenoid fossa?
A
Above - Supraglenoid tubercle
Below - Infraglenoid tubercle
13
Q
The lateral end of the spine of the scapula gives rise to a flat, angulated projection called the _____
A
Acromion
14
Q
Where does the clavicle articulate with the scapula?
A
The acromion
15
Q
What is the flat ligament that joins the coracoid process to the acromion ?
A
Coracoacromial ligament
16
Q
The medial end of the clavicle articulates with the superolateral surface of the manubrium to form what joint?
A
The sternoclavicular joint
17
Q
The most superior part of the humerus is called what?
A
The head of the humerus
18
Q
What is the name of the well marked groove on the anterior aspect of the humerus?
A
The bicipital groove
19
Q
What runs in the bicipital groove?
A
The tendon of the long head of the biceps
20
Q
What is another name for the bicipital groove?
A
Intertubercular groove of the humerus (it is between two tubercles)
21
Q
What two structures do you find at the proximal end of the bicipital groove?
A
The greater tubercle & the lesser tubercle
22
Q
Almost halfway down the lateral aspect of the humerus is a rough spot called the ____
A
Deltoid tuberosity
23
Q
What is the maximum amount of motion in terms of degrees that the glenohumeral joint can produce?
A
120
24
Q
What joints makeup the shoulder?
A
The glenohumeral joint, acromioclavicular joint, sternoclavicular joint, & the scapulothoracic joint
25
Out of the four shoulder joints, ____ are synovial joints and the ______ joint is a pseudo joint
3; scapulothoracic
26
What is the top portion of the sternum called?
Manubrium
27
The medial surface of the clavicle is (larger/smaller) than the lateral surface of the clavicle
Larger
28
The articular surface on the medial end of the clavicle is (convex/concave) running superior to inferior and (concave/convex) running anterior to posterior.
Convex; Concave
29
The sternoclavicular joint is a (saddle/hinge) joint
Saddle
30
A saddle joint is formed from when one part of a surface is concave and one part is convex ____ degrees from each other.
90
31
Articular cartilage is ____ cartilage
Hyaline
32
There is a complete (fibrocartilaginous/hyaline cartilage) disc that is really thick attaching superomedially on the upper aspect of the clavicle, coming down inferolaterally on the manubrium. This disc is attaching on the first costal cartilage and separating that joint into separate spaces.
Fibrocartilaginous
33
The sternoclavicular joint at max, produces how many degrees of elevation/depression?
60
34
The sternoclavicular joint at max, produces how many degrees of protraction/retraction?
30
35
As the sternoclavicular joint elevates there is going to be some _____ _____ rotation.
coupled posterior
36
What two kind of layers do capsules have?
A fibrous layer & a synovial layer
37
What are the two ligaments blended in with the capsule running from the clavicle to the manubrium?
Anterior sternoclavicular ligament & the posterior sternoclavicular ligament
38
What motions do the anterior sternoclavicular ligament & the posterior sternoclavicular ligament limit?
Anterior & posterior movement of the clavicle
39
What motion does the anterior sternoclavicular ligament resist?
For the most part these ligaments are so tight that the anterior ligament is going to resist the anterior motion and the posterior motion and viceversa.
40
What ligament runs from the superior aspect of the medial portion of the clavicle, running down along the capsule to the superior surface of the manubrium and back up to the other clavicle’s medial superior end?
The interclavicular ligament
41
What motion does the interclavicular ligament resist?
Depression of the lateral end of the clavicle
42
What ligament runs from the first costal cartilage to the proximal end of the clavicle?
The costoclavicular ligament
43
What motion does the costoclavicular ligament resist?
Elevation of the lateral end of the clavicle
44
The articular disk of the clavicle on/near the SC Joint has to be (thick/thin) to resist medial forces going through the clavicle. It is the only connection to the axial skeleton so it is going to take on a lot of force.
Thick
45
The thickness of the articular disk of the clavicle on/near the SC joint allows for (more/less) movement.
More;
| It allows the SC joint to get that 60 degrees of motion.
46
The acromioclavicular joint (A/C) is the junction between the (lateral/medial) end of the clavicle and the anteromedial surface of the acromion process.
Lateral
47
The articular surfaces of the acromioclavicular joint are relatively (flat/round).
Flat
48
What movements occur in joints that are relatively flat?
Translation (sliding) movements
49
There is an articular disk in the A/C joint that is typically (not complete/complete).
Not complete
Only 10% of the population will have a complete disk.
50
What type of joint is the AC joint?
A synovial joint
51
The joint capsule of the AC joint is (thin and loose/ thick and dense) and allows for small sliding motions (also called AC joint adjustments).
Thin and loose
52
The AC adjustments are between what two bones?
The clavicle and the scapula
53
The fibrous capsule of the AC joint has AC ligaments that are anterior, posterior, superior, and inferior that are thickenings of the fibrous capsule that are there to
do what?
Reinforce the capusle
54
The four ligaments of the AC joint and the fibrous capsule are (not very strong/very strong). Therefore it (needs/ doesn't need) some extra ligamentous help.
Not very strong; needs
55
The coracoclavicular ligament runs from the coracoid process to the (under/superior) surface of the clavicle.
Under
56
What two ligaments makeup the coracoclavicular ligament and what are they there to do?
The trapezoid ligament & the conoid ligament makeup the coracoclavicular ligament and are there to support the relationship of the clavicle to the scapula
57
The vertical orientation of the coracoclavicular ligament resists (inferior/superior) translation of the scapula and the clavicle.
Inferior
58
The trapezoid ligament has some fibers that run from the superolateral direction to the inferomedial direction they are going to resist forces in which direction?
Inferomedial
59
As the arm moves the scapula moves.
True or false?
True
60
The small adjustments that occur at the AC joint describe the movements that occur in the _____.
Scapula
61
What are the adjustments that occur at the AC joint in the anterior and posterior axis, medial lateral axis, and the superior inferior axis?
Anterior and posterior axis: Upward and downward rotation
Medial lateral axis: anterior and posterior tilting of the scapula
Superior inferior axis: Internal & external rotation of the scapula
62
The glenoid cavity (fossa) is a shallow cavity and is rather (small/large) in relation to the humeral head.
Small
63
On the top and bottom of the glenoid cavity are two roughen surfaces called the _____ tubercle and the _____ tubercle.
supraglenoid; infraglenoid
64
Based on the extensive articular surface of the humeral head there is (very little/ a lot of) contact between the articular surface of the humeral head and the glenoid fossa at any given time. This lends to the ability to have a (large/small) amount of motion which also means (less/more) bony stability.
Very little; large; less
65
Mobility and stability always has a balance. (Less/more) mobility means more stability and vice versa.
Less
66
What are the two major prominences on the humerus?
The greater tubercle and the lesser tubercle
67
The greater tubercle is more (lateral/medial) and the lesser tubercle is more (medial/lateral) and anterior.
lateral; medial
68
What lies between the greater tubercle and the lesser tubercle?
The intertubercular groove
69
Why is the surgical neck called the surgical neck?
It is the location where most proximal humeral fractions occur
70
What nerve from the brachial plexus runs right in front of the surgical neck of the humerus where a fracture could occur?
The axillary nerve
71
The glenoid labrum is a fibrocartilaginous ring that attaches to the (periphery/inside) of the glenoid fossa. It functions to (increase/decrease) the depth of concavity and resist translation of the glenohumeral joint.
periphery; increase
72
An intact glenoid labrum increases stability by ____%.
10-20
73
What type of joint is the glenohumeral joint?
A synovial joint
74
The glenohumeral joints’ capsule extends from the edge of the glenoid fossa and the labrum (it is attached to both) and is running out (laterally/medially) to the anatomical neck of the humerus.
laterally
75
Is the glenohumeral joints' capsule thin & loose or thick & dense?
Why is this important for functionality?
Thin and loose.
| The loose capsule allows for a lot of mobility.
76
Depending on the position of the arm, different parts of the glenohumeral’s joint capsule will be put on tension, while other parts will be loose. This capsule allows you to elevate the arm 120 degrees, but with the combination of all 4 joints, 180 degrees. To get that amount of motion we have to have an _____ recess that is seen on the _____ and _____ sides of the glenohumeral joint capsule. It is a folding and slacking of the capsule in the arms to the side.
axillary; anterior and posterior
77
Deep to the fibrous part of the gleonohumeral joint capsule there is a synovial capsule that is surrounding the joint from the (same/different) attachment sites of the fibrous capsule.
same
78
The synovial capsule has an extension of synovial lining called ___ sheaths that runs over the long head of the bicep tendon which is the tendon running in the intertubercular groove.
synovial
79
What are the muscles of the scapula called and what are the names of those muscles?
```
Rotator cuff;
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
```
80
The joint capsule of the glenohumeral joint has a very intimate relationship with the muscles of the _____
rotator cuff
81
The subscapularis runs off of the _____ fossa and attaches to the _____ tubercle.
subscapular; lesser
82
The supraspinatus muscle is found in the _____ fossa and runs superiorly over the top of the humerus attaching to the _____ tubercle.
supraspinous; greater
83
Below the spine of the scapula is the infraspinous fossa where you will find what muscle?
Infraspinatus
84
On the lateral boarder of the scapula you will find what muscle that attaches to the greater tubercle on the posterior aspect inferior to the infraspinatus?
Teres minor
85
Does the rotator cuff attach inferiorly?
No
86
The glenohumeral joint capsule reinforcing ligaments are thickenings of the glenohumeral joint capsule and they blend with the fibrous capsule. You (can’t/can) see them on the outside.
Can't
87
The only glenohumeral joint capsule reinforcing ligament that is external and that can potentially be seen on the outside is the _____ ligament that runs from the coracoid to the superior region of the anatomical neck.
Coracohumeral
88
The superior glenohumeral ligament, the middle glenohumeral ligament, and the inferior glenohumeral ligament complex provide extra (support/mobility) to the capsule at various angles of elevation and rotation.
Support
89
The superior, middle, & inferior glenohumeral ligament complex all attach between what region on the clock that Dr. Goodstadt described?
12-3
90
Because the superior, middle, & inferior glenohumeral ligament complex are running in different positions (they are/they aren't) going to be put on tension in different points in the range of motion.
They are
91
• The superior glenohumeral ligament runs from the top of the glenoid close to ___ o clock and coming off down and attaching to the humerus around ___ o clock.
12; 1
92
The middle glenohumeral ligament comes off around __ o clock and attaches between ___ and __ o clock on the clockface.
1; 4 & 5
93
How many parts does the inferior glenohumeral ligament complex have? Name them.
3;
| Anterior band, axillary pouch, & posterior band
94
All of the ligaments that we have discussed are on the (anterior/posterior) side of the shoulder except for the posterior band because due to the orientation of our scapula and our humerus bone we are more apt to dislocate (anteriorly/posteriorly) than we are in any other direction so we need extra ligamentous support to try and prevent that from happening.
anterior; anteriorly
95
In the shoulder joint, what % of the time is the dislocation anteriorly?
95
96
The ______ glenohumeral ligament and _______ ligament are in perfect position when the humerus is at our side to resist what motion?
Superior; coracohumeral; External rotation
97
At 45 degrees of abduction with an externally rotated humerus, the ____ glenohumeral ligament is at a great position to resist what motion?
Middle; External rotation
98
When the humerus is at 90 degrees and goes into internal rotation, the ___ band will be perfectly in line with the glenohumeral joint to resist what motion?
Posterior; Internal rotation
99
When we externally rotate the humerus from the 90 degree position the _____ band and the ____ pouch are in line to resist what motion?
Anterior; axillary; External rotation
100
The superior glenohumeral ligament, middle glenohumeral ligament, and the inferior glenohumeral ligament complex resist rotation at (different/similar) angles of elevation.
different
101
When the humerus goes above 90 degrees the ______ glenohumeral ligament complex gets (tighter/softer) to resist that motion.
Inferior: tighter
102
• The coracohumeral ligament, superior glenohumeral ligament, middle glenohumeral ligament, and the anterior band of the inferior glenohumeral ligament complex altogether resist what motion?
Anterior translation
103
The posterior band resists what motion?
Posterior translation
104
The rotator cuff blends with the capsule and tightens it up giving us an (active/static) stability.
active
105
Does the bone size of the humerus favour motion over stability or stability over motion?
Motion over stability
106
When a joint is in a neutral position ligaments (do not/do) provide much support.
do not
107
At the end range of a motion is when ligaments (do/do not) provide support and stability.
do
108
• The humerus moves in _ degrees of freedom and it has the ability to run in the frontal plane, sagittal plane, & transverse plane and has the ability to slide in each of the axis’.
6
109
The humerus is the only joint that has two different transverse plane movements, what are they?
Internal/external rotation &
| Horizontal abduction & adduction
110
The joint space between the serratus anterior and the subscapularis is called a what? It has muscle with fascia around it.
A fascial plane
111
When you aren’t a synovial joint, a cartilaginous joint, or a fibrous joint you are considered a ____ joint.
pseudo
112
What kind of joint is the scapulothoracic joint?
A pseudo joint
113
The fascial planes of the serratus anterior and subscapularis slide (against/towards) each other in the scapulothoracic joint.
against
114
In what joint does the adjustments have to occur in?
Acromioclavicular (AC) joint
115
What are the rotations that occur in the scapulothoracic joint?
Anterior/posterior tilts,
Internal/external rotation,
Upward/downward rotation
116
To determine an anterior or posterior tilt, the superior portion of the scapula at the fossa determines the tilt. So, when the superior portion rotates ___ that is a posterior tilt & viceversa.
posteriorly
117
If you see a scapula winging off the back and it is the whole medial boarder, that scapula is (medially/laterally) rotated.
medially
118
As the glenoid points up it is (upward/downward) rotation, as the glenoid points down it is (downward/upward) rotation.
upward; downward
119
What plane of motion do these motions occur in?
Anterior & posterior tilting -
Upward & downward rotation -
Internal / external rotation -
Anterior & posterior tilting - Sagittal
Upward & downward rotation - Frontal
Internal / external rotation - Transverse
120
Definition:
As the humerus moves, the scapula has to move. The clavicle and scapula have to move in coordination and they have to coordinate with the humerus and they have to occur in a specified pattern for it to work correctly.
Scapulohumeral rhythm
121
The scapulohumeral rhythm is extremely important in providing (dynamic/static) stability of the glenohumeral joint.
Dynamic
122
For the scapula to move in coordination with the humerus, what muscle group have to function properly?
Scapulothoracic muscles
123
What are the scapulothoracic muscles?
Serratus anterior, trapezius, levator scapulae, rhomboids, & the pectoralis minor
124
What is the most superficial structure in the subacromial/suprahumeral space?
The subacromial bursa
125
A bursa is a _____ space (it is like a sack or balloon with nothing in it. When it fills up with stuff that is usually not good).
potential
126
The next deep space in the subacromial/suprahumeral space after the subacromial bursa is the ____ tendon and it runs right under the acromion process and where the clavicle attaches.
supraspinatus
127
The _______ ligament creates the roof of the subacromial/suprahumeral space.
coracoacromial
128
The ____ creates the floor of the subacromial/suprahumeral space.
humerus
129
The superior portion of the ____ is the next structure deeper to the supraspinatus tendon in the subacromial/suprahumeral space.
glenohumeral joint capsule
130
• The ____ is the deepest structure in the subacromial/suprahumeral space and goes into the synovial capsule and attaches to the superior tubercle of the glenoid.
longhead of the bicep tendon
131
From superficial to deep, name the structures in the subacromial/suprahumeral space?
Subacromial bursa, supraspinatus tendon, superior portion of the glenohumeral joint capsule, longhead of the biceps tendon
