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Anatomy UE > Shoulder > Flashcards

Shoulder Flashcards

1
Q

the shoulder girdle includes what joints

A

Sternoclavicular (SC)
Acromioclavicular (AC)
Scapulothoracic joints (ST)
Glenohumeral joint (GH)
Subacromial space-

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2
Q

Shoulder Girdle function

A

Position hand in space for ADL
Transmit force

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3
Q

IR and ER throughout the movement restraints

A

It will be different at different parts of the movement – different restraint to motion at different positions

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4
Q

Horizontal abduction examples

A

can you touch the top of your shoulder, and wash the back of your head

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5
Q

GH motion

A

Flexion/extension - 120
Abduction/adduction - 120
External/internal rotation – 90° &≈ 65°
Horizontal abduction/ adduction

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6
Q

Glenohumeral Motion with other joints - example flexion

A

Responsible for 120 and scapula movement is responsible for the 60 degrees of movement

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7
Q

Shoulder Girdle Motion is a Coordinated Motion of

A

G-H joint
A-C joint
S-C joint
S-T joint

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8
Q

Glenohumeral Motion Arthrokinematics

A

Combine rotation & translation to keep humeral head centered on glenoid

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9
Q

what happens if the humerus​ starts to come off the glenoid

A

Once the H head starts the come off the joint – we start to get funtional problems

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10
Q

stability and mobility​ in the shoulder

A

the shoulders has more mobility and therefore has to sacrifice stability

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11
Q

Flexion GH

A

Anterior-Superior roll, Posterior-inferior glide

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12
Q

Extension GH

A

Posterior-inferior roll, anterior-superior glide

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13
Q

Abduction GH

A

Superior roll, inferior glide

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14
Q

External rotation GH

A

posterior roll, anterior glide

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15
Q

Internal rotation GH ortho

A

anterior roll, posterior glide

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16
Q

Horizontal Abduction GH

A

posterio-lateral roll, anteromedial glide

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17
Q

Horizontal Adduction GH

A

anterio-medial roll, posterio-lateral glide

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18
Q

GH Capsular tightness

A

results in abnormal arthrokinematics and limited joint motion

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19
Q

Glenohumeral Motion is controlled by

A

these are mechanism that keep H head centered
Passive restraints
Active restraints
Interaction of passive & active restraints

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20
Q

GH Passive Restraints

A

Bony geometry
Labrum
Capsuloligamentous structures - The capsule and its ligaments
Negative intra-articular pressure
Capsule is a closed structure

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21
Q

the Humeral head is covered with

A

Covered with articular cartilage

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22
Q

Humeral head faces

A

It faces superior – medially – posteriorly

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23
Q

necks of the humerus​

A

Anatomical Neck – attachment of capsule and mm
Surgical neck – the sight of attachment for muscles

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24
Q

what is the Glenoid

A

Pear-shaped surface with ave. upward lift of 5°

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25
Q

Glenoid faces what direction

A

Projects laterally – anteriorly

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26
Q

S.I.T.S - rotator cuff

A

supraspinatus
infrascpinatus
teres minor
subsacpular

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27
Q

S.I.T.S action

A

all act to compresses the H into the center of the G

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28
Q

supraspinatus action

A

Initiates and assists deltoid in abduction of arm and acts with rotator cuff muscles

compressing the sup portion of the H closer to the G allowing for elevation of the H head without the H-head sliding

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29
Q

Infraspinatus action

A

Shoulder ER
and acts with rotator cuff muscles

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30
Q

Teres Minor

A

Shoulder ER
and acts with rotator cuff muscles

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31
Q

Subscapularis action

A

Shoulder IR
and acts with rotator cuff muscles

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32
Q

tendon vascularity

A

The end of the tendon has bad vascularity

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33
Q

ringing out effect

A

Tension rings out the fluid that is in the tendon

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34
Q

why do we abd someones​ arm in post shoulder care

A

We do not want ringing out effect

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35
Q

Glenoid labrum

A

Fibrocartilaginous ridge arising from the glenoid

Primary attachment site for the glenohumeral ligaments

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36
Q

what does the Glenoid labrum give rise to

A

Long Head of Biceps (LHB) superiorly

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37
Q

how thick is the Glenoid labrum

A

Approx. 9 mm thick (deepens the joint socket)

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38
Q

how much does the glenoid labrum deepen the depth

A

50%

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39
Q

Glenohumeral ligaments

A

External layers of the anterior and inferior walls of the joint capsule are thickened by fibrous CT

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40
Q

IGHL complex parts

A

anterior band – thickening
posterior band – thickening
axillary pouch – everything else
Does not engage until 90 degrees

supporting the inferior aspect of the shoulder.

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41
Q

Coracohumeral ligament location

A

superior to SGHL

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42
Q

Coracohumeral ligament taut with what motion

A

taut with Adduction & inferior translation of the humeral head; ER

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43
Q

Function of GH Capsule

A

Stability

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44
Q

what is stability​ ​based on

A

dependent on joint orientation

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45
Q

ER restraint is dependent on what

A

Dependent on arm position

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46
Q

0 of Abduction: restrict​ to ER

A

C-H ligament
SGHL – sp GH ligament
Subscapularis

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47
Q

45 of Abduction: restraint

A

MGHL

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48
Q

90 of Abduction

A

Anterior band IGHL

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49
Q

Subscapularis - Restraints to External Rotation at what postion

A

Effective restraint to ER with arm at side - 0

Ineffective restraint to ER with arm abducted to 900

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50
Q

Restraints to Internal Rotation is dependent on

A

Dependent on arm position

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51
Q

Restraints to Internal Rotation - 0 of Abduction

A

Posterior band IGHL

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52
Q

Restraints to Internal Rotation - 45 of Abduction

A

Anterior and Posterior band IGHL

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53
Q

Restraints to Internal Rotation - 90 of Abduction

A

Anterior and Posterior band IGHL

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54
Q

properties of Posterior dislocation

A

very unstable, not seen often

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55
Q

Restraints to Inferior Translation - 0 of Abduction

A

SGHL and CH-L

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56
Q

Restraints to Inferior Translation - 90 of Abduction

A

IGHL

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57
Q

Acromioclavicular Joint

A

A and clavicle

58
Q

disc in the the AC joint

A

allows for translation motion, does not move that much – do not want to much movement

59
Q

Acromioclavicular Joint- Joint capsule is reinforced by

A

Reinforced superiorly & inferior by A-C ligaments

60
Q

Coracoclavicular ligaments is seen in what joint

61
Q

the two parts of the Coracoclavicular ligaments

A

conoid (medial)
trapezoid (lateral)

62
Q

Coracoclavicular Ligaments is what

A

combined ligament is the primary support ligament of the AC Joint

63
Q

Deltoid & Upper trap with the Acromioclavicular Joint

A

Deltoid & Upper trap cover the jt

64
Q

Acromioclavicular Joint Movements

A

Axial rotation of clavicle (spin)

Adjusts the angulation between scapula & clavicle

65
Q

Sternoclavicluar Joint is what kind of joint

A

Sellar Joint

66
Q

Sternoclavicluar Joint link what

A

links the appendicular skeleton with the axial skeleton, saddle (concave-vex

67
Q

Sup/inf direction Sternoclavicluar Joint

A

Proximal clavicle:
convex
Manubrium:
concave

68
Q

Ant/post Sternoclavicluar Joint

A

Proximal clavicle:
concave
Manubrium:
convex

69
Q

Sternoclavicular Joint Motions

A

Protraction/retraction (ant/post)
(concave surface is moving)

Elevation/depression (sup/inf)
(convex surface is moving)

Axial rotation (spin)

70
Q

Sternoclavicular Joint Intra-articular disc

A

strengthens articulation & acts as shock absorber

71
Q

Interclavicular ligament is part of which joint

A

Sternoclavicular Joint

72
Q

Interclavicular ligament

A

connects medial ends of left & right clavicles

Rare as injury

73
Q

Costoclavicular ligament is part of which​ joint

A

Sternoclavicular Joint

74
Q

Costoclavicular ligament runs from

A

Attached below to the upper and medial part of the cartilage of the first rib, and is fixed above to the costal tuberosity on the under surface of the clavicle

75
Q

sternoclavicular (SC) joint

A

is the linkage between the clavicle (collarbone) and the sternum (breastbone)

76
Q

is S-T joint a true of false joint

A

false - it is not a true joint

77
Q

Glenoid funtion for the humerous

A

Glenoid serves as platform for humeral head

78
Q

how many muscle attachment are there​ in the scapula

A

Site of muscle attachment (17)

79
Q

Scapula function

A

Serves to transfer force from trunk to upper extremity

80
Q

Resting Position of Scapula - humerol head

A

the h-head rest on the inferior lip of the G

81
Q

Resting Position of Scapula

A

Medial border nearly vertical
Abducted approximately 6 cm from spine
Tilted anteriorly approximately 200
5 – 10° of upward rotation
35° of IR

82
Q

Resting Position of Scapula - dominent side

A

Depressed
Downwardly rotated
Anteriorly tilted

83
Q

Support of Scapula

A

Scapular muscles

Suspension of scapula from clavicle at AC joint

Medial end of clavicle supported by SC joint

84
Q

Subacromial Space is bounded by

A

Humeral head inferiorly
Coraco-acromial arch superiorly

85
Q

Structures Within Subacromial Space

A

Long head of biceps

Superior capsule

Supraspinatus tendon

Upper margins of subscapularis & infraspinatus tendons

Subacromial bursa

Inferior surface of A-C joint

86
Q

Elevation of arm requires- greater trochanter

A

external rotation of humerus to clear greater tubercle

upward rotation of scapula to elevate lateral end of acromion

87
Q

Primary impingement

A

Narrowing of the space based on the

88
Q

Secondary impingement

A

functional stenosis of subacromial space due to abnormal arthrokinematics

89
Q

primer mover - Scapulohumeral

A

Deltoid
Pectoralis major
Latissimus dorsi
Teres major
Biceps
Coracobrachialis
Triceps

90
Q

Rotator Cuff Muscles

A

Supraspinatus
infraspinatus
teres minor
subscapularis

91
Q

h-head and the RC muscles

A

keep the h-head on the glenoid
all cover the humoral head

92
Q

Supraspinatus actions

A

Abductor – first 30
external rotator
Superior compressor

93
Q

supraspinatus innervation

A

Suprascapular Nerve

94
Q

Infraspinatus
actions

A

external rotator
Abductor
Posterior compressor

95
Q

infraspinatus innervation

A

Suprascapular Nerve

96
Q

Teres minor actions

A

external rotator
weak adductor
Posterior compressor

97
Q

teres minor innervation

A

Axillary Nerve

98
Q

Subscapularis action

A

internal rotator
Balance in the frontal plane for the ER
Depresses the h-head

99
Q

subscapularis innervation

A

U/L Subscapular Nerve

100
Q

RC fails to cover two regions of the capsule

A

Inferiorly and the rotator interval

101
Q

where is the rotator interval

A

A triangular area b/t supraspinatus, subscapularis, and the base of the coracoid

102
Q

The rotator​ interval is reinforce by

A

the long head of the tendon and corachumeral ligament

103
Q

in the shoudler where is the area of the most dislocations

A

Rotator interval – RIC
90-90

104
Q

Supraspinatus assists deltoid with what action

105
Q

what muscles depresses humeral head

A

teres minor, infraspinatus, and subscapularis

106
Q

Transverse plane force​ couple

A

anterior vs. posterior RC
Subscapularis (anterior) vs. Infraspinatus & Teres Minor (posterior)

107
Q

What direction does the transverse plane force couple pull

A

pull the glenoid into the humorous​

108
Q

Frontal plane force couple muscles

A

deltoid vs. inferior RC (INF, Teres Minor, Subscapularis)

109
Q

action of the frontal plane force couple

A

the deltoid raises the arm and the inferior RC counteracts this movement

RC contract - pulling the humorous centered inferior – becoming the inferior compressor

110
Q

Disruption of transverse plane results in

A

results in either anterior or posterior migration of humeral head

111
Q

Disruption in the transverse plane may occur as a result of

A

Weakness
Tear
Paralysis…

112
Q

Disruption of frontal plane force (superior vs. inferior) couple

A

results in superior migration of humeral head

113
Q

Ringing out effect only for what muscle

A

supraspinatus

114
Q

ringing out is seen with what action

115
Q

is the Supraspinatus needed in the forcce couples

A

Essential force couples maintained

We still need balance between the ant and post

116
Q

Supraspinatus tear strength & function

A

Normal strength & function possible

117
Q

Supraspinatus/Posterior Cuff tear result

A

Essential force couples disrupted

ER weakness

little elevation​ is possible

118
Q

Supraspinatus/Subscapularis tear

A

essential force couple is disrtupted

IR weakness

little elvation as possible

119
Q

Massive Tear in the rotator​ cuff

A

Essential force couples disrupted

Weakness with internal & external rotation

Little active elevation possible

more then one group is effected

120
Q

Pittsburgh Dynamic Shoulder Testing Model - 6 DF

A

Translation:
anterior/posterior
superior/inferior
medial/lateral

Rotation:
ER/IR
scapular plane abduction
horizontal abduction/adduction

121
Q

Global Rotator Cuff Tear

A

Rotator Cuff & Joint capsule – transected from inferior border of subscapularis tendon through infraspinatus & teres minor tendon

122
Q

Infraspinatus/Teres Minor reduce strain on what ligamant

A

Reduces strain on anterior band of IGHLC

123
Q

Biceps tendon force increases what

A

torsional rigidity​ for ER

124
Q

does the biceps tendon have an effect on the IGHL

A

No effect on strain of IGHLC- complex

125
Q

SLAP lesion effects what mucsle

A

long head of the biceps

This decrease the ability of the long head of the biceps to act a s a compressor

Sup labral lesion running ant to post

126
Q

biceps tendon does what kind of compression

A

Anterior Stabilizer as Capsuloligamentous Stability Decreases

127
Q

Scapulothoracic Muscles

A

Trapezius
Upper
Middle
Lower
Serratus anterior
Rhomboids
Levator scapulae
Pectoralis minor
Subclavius

128
Q

traps innervation

A

Spinal Accessory N.

129
Q

serratus anterior inv

A

long thoracic

130
Q

rhomboid (minor and major) inv

A

dorsal scapular

131
Q

levator scapulae inv

A

dorsal scapular

132
Q

pectoral minor inv

A

medial​ pectoral

133
Q

subclavius inv

A

nerve to subclavius

134
Q

Elevation/depression in the Scapulothoracic muscles

A

Composite of SC & AC joint rotations
Vertical axis

135
Q

Protraction/retraction in the Scapulothoracic muscles

A

Summation of horizontal plane rotations at SC & AC
Medial – lateral axis

136
Q

Upward/downward rotation Scapulothoracic muscles

A

Summation of clavicular elevation at SC joint & scapular upward rotation at the AC joint
The coupled rotations are essential to the full 60° of upward rotation
Normally follows a path close to it’s scapular plane

137
Q

Force Couple at Scapulothoracic Joint

A

Serratus anterior
Upper trapezius
lower/middlt rap

138
Q

total degree of elevation in the arm

A

180

120- GH
60 - ST

139
Q

Force Couple at Scapulothoracic Joint- serratus anterior

A

pulls the scapula anteriorly and medially

140
Q

Force Couple at Scapulothoracic Joint - upper trap

A

pulls the scapula medially

141
Q

Force Couple at Scapulothoracic Joint - middle and lower scapula

A

stabilizes the scapula during upward rotation

Anatomy UE (11 decks)

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