shoulder

Question 1

What is the main function of the shoulder

Answer 1

to position and stabilize the arm in space

Question 2

the 4 anatomic articulations of the shoulder

Answer 2

1) Glenohumeral joint
2) sternoclavicular joint
3) acrominoclavicular joint
4) scapular thoracic joint

Question 3

the 6 biomechanics articulations of the shoulder

Answer 3

1) Glenohumeral joint
2) sternoclavicular joint
3) acrominoclavicular joint
4) scapular thoracic joint
5) coraco-aromial arch
6) upper thoracic spine

Question 4

motion of the shoulder

Answer 4

flexion/extension
abduction/adduction
internal/external rotation
horizontal abduction/adduction

Question 5

the GH joint

Answer 5

is a ball and socket joint but is much more shallow (more mobile less stable)

Question 6

structural stability of the GH

Answer 6

is minimal
has the glenoid labrum that slightly deepens,muscle tendons, ligaments

Question 7

ligamentous support of the GH

Answer 7

not very many
anterior and posterior GH ligaments

Question 8

muscular support of the GH

Answer 8

rotator cuff is critical. need to maintain integrity, strength, and motor control and head of the bicepts

Question 9

arthrokinematics at the GH joint

Answer 9

convex humerus moving on a concave glenoid cavity.
roll and side occur in opposite directions. Inferior glide needs to occur with elevation.

Question 10

scapular mobility

Answer 10

medial and lateral translation at the acromioclavicular joint allows for upward and downward rotation of the scapula. need scapular movement with shoulder flexion and abduction

Question 11

scapular thoracic cardial planes

Answer 11

retraction
protraction
elevation
depression
upward and downward rotation
(all are component motions of physiologic shoulder mobility and all can be created passively with our with GH joint motion)
only retraction, protraction, elevation, and depression can occur actively in isolation

Question 12

scapulohumoral rhythm

Answer 12

combined and integrated motion must occur across the 4 anatomic joints
(1/3) of elevation comes from scapulothoracic joint and 2/3 from GH

Question 12

Active shoulder mobility functions (codman’s paradox)

Answer 12

is the idea that when there is shoulder abduction greater then 30 degrees there has to be component external roation at the GH

Question 13

shoulder flexion need:

Answer 13

120-GH
60-scap

Question 14

shoulder abduction needs:

Answer 14

125 -GH
55- Scap
also need external rotation

Question 15

elevation and depression of the clavicle axis

Answer 15

occur on the anterior and posterior axis

Question 16

protraction and retraction of the clavicle

Answer 16

occur on the vertical axis

Question 17

rotation of the clavical

Answer 17

occur on the medial to lateral axis

Question 18

behind the back (low) scratch test

Answer 18

extension and internal rotation

Question 19

behind the back (high) scratch test

Answer 19

flexion and external rotation

Question 20

the superior anterior GH ligament

Answer 20

gets tense with arm at side

Question 21

the middle anterior GH ligament

Answer 21

gets tense with 45 degrees of abduction

Question 22

the inferior anterior GH ligament

Answer 22

gets tense with abduction above 90 degrees

Question 23

what position of the humerus is necessary to asses joint play for anterior glide hypermobility?

Answer 23

90 degrees of abduction
90 degrees of external rotation
90 degrees of flexion
(the apprehension test)

Question 24

what ligaments must tear if there is a dislocation of the acromioclavicular joint

Answer 24

The AC ligament and the coracoclavicular ligaments (conoid and trapezoid)

Question 25

what are the 4 functional muscle groups at the shoulder

Answer 25

cuff protectors and stabilizers scapular positioners GH powers Upper extremity Propellers

Question 26

the cuff protectors and stabilizers

Answer 26

rotator cuff (SITS) and long head of the biceps

Question 27

scapular positioners

Answer 27

traps (upper, med, and low) Rhomboids,pect minor, seratus anterior

Question 28

GH propellers

Answer 28

deltoid, pect major, and Lats

Question 29

the subacrominal/coraco-acromial arch

Answer 29

the area between the coracoid process to the acromion process: underneath the coracoacromial ligament

Question 30

what passes under the coraco-acromial arch/ subacromial arch

Answer 30

sub deltoid bursa rotator cuff and long head of the biceps boney aspects of the head of the humerus

Question 31

subacromial impingement

Answer 31

can be caused by bursa, swollen tendon, thick ligament, or hooked clavicle as the arm raises the ball slides down. an impingement stops the space at the top of the joint closing up and keeps good contact between the joint surfaces

Question 32

neuro bundle impingements (sensitive spot)

Answer 32

anterior and medial scaleless subclavian to the 1st rib pac minor creates space for the brachial plexus

Question 33

dislocation of the GH anteriorly

Answer 33

superior, middle, and inferior GH ligmants

Question 34

dislocation of the sternoclavicular

Answer 34

anterior and posterior sternoclavicular ligaments, interclavicular ligament, costeoclavicular ligament

Question 35

function of the posterior delt

Answer 35

extension and external rotation at 90 degrees it can do horizontal abduction

Question 36

function of the anterior delt

Answer 36

flexion with internal rotation

Question 37

function of the middle delt

Answer 37

abduction

Question 38

force couples at the scapulothoracic joint

Answer 38

2 or more muscles at opposing sides of a joint working together to provide rotation and stability example: upper trap, lower trap, and serratus anterior work together to rotate the scapula up

Question 39

force couples across the GH joint

Answer 39

muscles that have to work together to get proper function at the shoulder ex: suprapinatus and anterior delt in shoulder flexion

Question 40

zones of avascularity

Answer 40

cartilage, bone (heals well unless it is fractured at sight of blood vessels), cruciate ligaments and meniscu, labrum at the hip, glenoid labrum (SLAP tear might occur where the biceps tendon anchors to the labrum)

Question 41

avascularity at the supraspinatus tendon

Answer 41

worse with arm at the side because with out stretching the tendon the blood supply is not able to flow through

Question 42

avascularity with adhesive capsulitis

Answer 42

immobility, trauma or idiopathic inflammation of the joint capsule leads to fibrous adhesions to form

Question 43

biomechanical rehab goal with upper cross syndrome

Answer 43

open the subacromial space stretch the anterior muscles (pect.) Strengthen the scapular positioners improve upper thoracic mobility into extension