Shoulder Flashcards

2
Q

What are the 4 joints of the shoulder

A

Glenohumeral, acromioclavicular, sternoclavicular, scapulothoracic

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3
Q

Glenohumeral joint classification

A

Synovial, simple, unmodified

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4
Q

Glenohumeral joint degrees of motion

A

3

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5
Q

Glenohumeral joint line of reference

A

Transverse axis through the centre of the head of the humerus

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6
Q

Glenohumeral joint flexion/extension osteokinematics

A

Pure spine about a transverse axis (through the centre of the head of the humerus) in a sagittal plane (from 35d ext to 55d flex). ROM = 90-110d flex, 60d ext.

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7
Q

Glenohumeral joint abduction/adduction osteokinematics.

A

Pure swing about a sagittal axis in a frontal plane. ROM = 80-90d abduct.

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8
Q

Glenohumeral joint IR/ER osteokinematics.

A

Pure swing until EOR about a vertical axis (superoinferior axis through the humerus) in a transverse plane. ROM = 70-90d IR, 60-100d ER.

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9
Q

Do the arthrokinematics of the glenohumeral joint follow the concave/convex rule?

A

No, the path of the articular glide is influenced by regional capsular tension which imposes articular translation during movement. In the inner ranges = minimal capsular tension and translation, whilst outer range = increased capsular tension and translation.

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10
Q

Glenohumeral joint arthrokinematics flexion

A

Spin mid range = no translation. Flex > 55d = slight anterior translation

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11
Q

Glenohumeral joint arthrokinematics extension

A

Spin mid range = no translation. Extension beyong 35d = slight posterior translation

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12
Q

Glenohumeral joint arthrokinematics abduction

A

First 30d = slight superior translation>30d = variable with no net translation. Inferior glide to allow space for supraspinatus tendon and subacromial bursa.

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13
Q

Glenohumeral joint arthrokinematics IR

A

Slight anterior translationAccompanying posterior glide is still required

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14
Q

Glenohumeral joint end feel

A

Capsular

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15
Q

Glenohumeral joint resting position

A

30d flexion, 30d abduction, 30d IR

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16
Q

Glenohumeral joint close packed position

A

Full abduction with ER

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17
Q

AC joint classification

A

Synovial, complex (if disc present), planar (functionally acts as an unmodified ovoid)

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18
Q

AC joint degrees of motion

A

3

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19
Q

AC joint osteokinematics

A

Permits slight movements of the scapula, contributes to scapulohumeral rhythm. Primary motions = upward rotation and downward rotation.

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20
Q

AC joint line of reference

A

Transverse axis through the acromion and clavicle.

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21
Q

AC joint upward/downward rotation osteokinematics

A

Impure swing about a sagittal ais in a frontal plane. Upwards rotation = up to 30d Note: upward rotation of the AC joint occurs as the scapula swings upward and outward in relation to the lateral clavicle, during shoulder abduction or flexion. Downwards rotation returns the scapula back to it’s anatomical position, during shoulder adduction or extension.

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22
Q

AC joint transverse plane osteokinematics

A

Impure swing about a vertical axis in a transfer plane. Note: these movements cause the medial border of the scapula to pivot away and towards the outer surface of the thorax.

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23
Q

AC joint sagittal plane osteokinematics

A

Impure spin about a transverse axis in a sagittal plane. Note: these movements cause the inferior angle of the scapula to tilt away or towards the outer surface of the thorax.

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24
Q

AC joint arthrokinematics

A

Slight interior, superior, anterior and posterior glides of the acromion on the clavicle occur during scapular, clavicle and arm movements.

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25
Q

AC joint end feel

A

Capsular for all directions

26
Q

AC joint capsular pattern

A

Pain at extremes of range, no specific limitations of ROM

27
Q

AC joint resting position

A

Arm side by side with support under the elbow

28
Q

AC joint closed pack position

A

Full upward rotation of scapular during arm flexion, abduction or elevation

29
Q

Sternoclavicular joint classification

A

Synovial, complex (disc), unmodified sellar (but functionally acts as an unmodified ovoid due to the disc presence which allows a spin or axial rotation component).

30
Q

Sternoclavicular joint degrees of motion

A

3

31
Q

Sternoclavicular joint line of reference

A

Transverse axis along the length of the clavicle.Note: clavicular movements are described as moving on a stationary manubrum

32
Q

Sternoclavicular joint osteokinematics elevation/depression

A

Impure swing around a sagittal axis in a frontal plane

33
Q

Sternoclavicular joint osteokinematics protraction/retraction

A

Impure swing about a vertical axis in a transverse plane

34
Q

Sternoclavicular joint osteokinematics posterior/anterior axial rotation

A

Spin about a transverse axis in a sagittal plane

35
Q

Sternoclavicular joint arthrokinematics elevation/depression

A

Inferior/superior glide respectively of the clavicle on the manubrium

36
Q

Sternoclavicular joint arthrokinematics protraction/retraction

A

A posterior then anterior (protraction) or anterior then posterior (retraction) glide respectively of the clavicle on the disc then disc and clavicle at EOR

37
Q

Sternoclavicular joint anthrokinematics posterior/anterior axial rotation

A

Posterior or anterior spine respectively of the medial end of the clavicle on the lateral surface of the articular disc.

38
Q

Sternoclavicular joint arthrokinematics inspiration and expiration

A

Posterior or anterior clavicular rotation respectively

39
Q

Sternoclavicular joint end feel

A

capsular for all directions

40
Q

Sternoclavicular joint capsular pattern

A

pain at extreme ranges, loss of rotation components

41
Q

Sternoclavicular joint closed pack position

A

Full elevation and posterior axial rotation of the clavicle

42
Q

Sternoclavicular joint resting position

A

Arm by the side with support under the elbow

43
Q

What shape is the articular surface of the humerus

A

1/3 of a sphere, convex in all directions

44
Q

What shape is the articular surface of the glenoid cavity

A

Concave, greater curvature in AP direction

45
Q

What is the glenoid labrum made of

A

Fibro cartilage

46
Q

Name the ligaments of the AC joint

A

Corocoacromial, corococlavicular (conoid and trapezoid) and acromioclavicular

47
Q

What fibres are there of the GH ligament

A

Superior, middle, inferior and posterior glenohumeral

48
Q

What bursae is there at the GH joint

A

Subacromial, subscapular, subdeltoid

49
Q

Describe the articular surfaces of the sternoclavicular joint

A

Clavicle = convex vertically and slightly concave AP. Manubrium = approximately reciprocal curvature, however the articular disc completely divides the joint

50
Q

Describe the AC joint articular surfaces

A

Approximately planar, either surface may be slightly convex with the other concave. Sometimes there is an articular disc.

51
Q

Name the muscles which flex the shoulder

A

Ant. fibres of deltoid, biceps brachii, coracobrachialis, clavicular portion of pec. major

52
Q

Name the muscles which extend the shoulder

A

Sternal portion of pec. major, teres major, lat. dorsi, posterior fibres of deltoid, triceps brachii

53
Q

Name the muscles which internally rotate the shoulder

A

Anterior fibres of deltoid, pec major, subscap, teres major, lat. dorsi

54
Q

Name the muscles which abduct the shoulder

A

Middle fibres of deltoid, supraspinatus

55
Q

Name the muscles which adduct the shoulder

A

Pec. major, teres major, lat. dorsi, teres minor

56
Q

Name the muscles which externally rotate the shoulder

A

Posterior fibres of deltoid, infraspinatus, teres minor

57
Q

Name some of the nerves innervating the shoulder muscles

A

Axillary nerve, pectoral nerve, musculocutaneous nerve, subscapular nerve

58
Q

Name the muscles acting on the scapula

A

Serratus anterior, pectoralis minor, levator scapulae, trapezius, rhomboids major and minor

59
Q

Name the nerves which innervate the muscles acting on the scapula

A

Long thoracic nerve, dorsal scapular nerve, accessory nerve.