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BOC Prep > Shoulder > Flashcards

Shoulder Flashcards

1
Q

What is the general function of the upper extremity?

A

It works as a position servomechanism (position, velocity, acceleration) to position the hand for function.

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2
Q

What parts are included in the upper extremity?

A

Shoulder
Elbow
Wrist
Hand
Fingers

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3
Q

What bone is considered the arm?

A

Humerus

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4
Q

What bones are considered the forearm?

A

Radius
Ulna

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5
Q

What are parts of the shoulder region?

A

Shoulder joint
Shoulder girdle

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6
Q

What bones are in the shoulder joint?

A

Scapula
Humerus

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7
Q

What bones are part of the shoulder girdle?

A

Scapula
Thorax (ribs & sternum)
Clavicle

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8
Q

What are the fossa’s of the scapula?

A

Supraspinous fossa
Infraspinous fossa
Subscapular fossa
Glenoid fossa

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9
Q

What are the 3 scapular borders?

A

Superior
Lateral
Medial

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10
Q

What are the angles of the scapula?

A

Superior angle
Inferior angle

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11
Q

What are the other anatomical scapular things?

A

Acromion process
Coracoid process
Glenoid cavity
Spine of scapula
Neck of scapula

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12
Q

What are the anatomical points of the humerus?

A

Head of humerus
Neck of humerus
Deltoid tuberosity
Greater tubercle
Lesser tubercle
Bicipital groove

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13
Q

What joint does all upper extremity loads go through?

A

SC joint

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14
Q

What is the SC joint?

A

It is where the clavicle and sternum/manubrium articulate

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15
Q

What is the AC joint?

A

It is where the acromion process of the scapula and the clavicle articulate

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16
Q

What is the glenhumeral joint?

A

It is where the humerus articulates with the Glenoid cavity

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17
Q

At what joint does primary motion of the scapula occur?

A

SC joint

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18
Q

What is the scapulothoracic articulation?

A

Where the scapula makes some contact with the ribs during movement

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19
Q

What is the suprahumeral (subacromial) space?

A

The space or cave where Supraspinatus, long head tendon of biceps, & the subdeltoid & acromial bursae sit

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20
Q

What 3 bursae are in the shoulder?

A

Subdeltoid
Subacromion
Subcoracoid

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21
Q

What movements occur at the shoulder joint?

A

Flexion/ Extension
Abduction/ Adduction
External/ Internal Rotation
Horizontal Abduction/ Adduction

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22
Q

What shoulder movements happen at the shoulder girdle?

A

Elevation/ Depression
Protraction/ Retraction
Upward/ Downward Rotation
Anterior/ Posterior Tilting

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23
Q

Why is the shoulder more reliant on muscle for stability?

A

It has increased mobility and decreased stability

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24
Q

What is normal shoulder ROM?

A

Flexion= 0-180 deg
Extension= 0-60 deg
Abduction=0-180 deg
ER=0-90 deg at 90 deg shoulder abduction
IR= 0-70 deg at 90 deg shoulder abduction

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25
Q

Which motions have tissue stretch for their end feel?

A

Flexion
Extension
Abduction
ER
IR

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26
Q

Which motions have tissue approximation as their end feel?

A

Adduction

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27
Q

What are the ligaments of the SC joint?

A
  • anterior SC
  • posterior SC
  • costoclavicular
  • interclavicular
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28
Q

Does the SC joint have an articulated disc?

A

Yes

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29
Q

When is the SC joint in close-pack position?

A

Max shoulder elevation

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30
Q

What is open pack position for the SC joint?

A

Anatomical position

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31
Q

What are the ligaments of the AC joint?

A
  • acromioclavicular (synovial)
  • coracoclavicular
    • trapezoid
    • conoid
  • coracoacromial (“arch”)
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32
Q

What does the clavicle look like?

A

It’s s-shaped

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33
Q

What does the clavicle do?

A

It acts as a strut between the shoulder & thorax preventing the shoulder from collapsing forward

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34
Q

Does the AC joint have a cartilaginous disk?

A

Yes, but it disappears between age 20-30

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35
Q

What is close pack position for the AC joint?

A

30 degrees of abduction

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36
Q

What is open pack position for the AC joint?

A

Anatomical position

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37
Q

What type of joint is the GH joint?

A

Diarthroidal (only 2 articulating surfaces that’s a multiaxial ball & socket joint)

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38
Q

What does a ball & socket joint allow for?

A

Global movement

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39
Q

What are the bones of the GH joint?

A

Glenoid fossa of scapula
Humeral head

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40
Q

What makes the GH joint unique?

A
  • Only 25-33% of humerus contacts Glenoid fossa
  • bone contribution to GH joint is minimal
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41
Q

What is close pack position for the GH joint?

A

Full abduction & ER

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42
Q

What is open pack position for the GH joint?

A

55 degrees abduction & 30 degrees of horizontal adduction

43
Q

What are the osteokinematic movements of the GH joint?

A
  • roll
  • glide
  • spin
44
Q

Which osteokinematic movement is most important at the GH joint?

A

Spin

45
Q

What are the characteristics of the anterior GH joint capsule?

A

12-8 position
Very strong
Forms the GH ligaments

46
Q

What is the surface area of the capsule compared to the humeral head?

A

Twice the size of

47
Q

What are the characteristics of the posterior GH joint capsule?

A

8-12 position
Very thin
Provides minimal strength to the GH joint

48
Q

What are the ligaments of the GH joint?

A

Glenohumeral
- superior
- middle
- inferior
Coracohumeral
- suspension
Transverse humeral (not a true ligament)

49
Q

When in anatomical position is the superior joint capsule lax or taut?

A

Taut

50
Q

When in anatomical position is the inferior joint capsule lax or taut?

A

Lax

51
Q

When in 180 degrees of abduction is the superior joint capsule lax or taut?

A

Lax

52
Q

When in 180 degrees of abduction is the inferior joint capsule lax or taut?

A

Taut

53
Q

When does the joint capsule primarily function?

A

In the end ROM

54
Q

What is the primary stabilizer of the GH joint?

A

Muscle

55
Q

What is the ceiling of the suprahumeral space?

A

Acromion process & CA ligament

56
Q

What is the floor of the suprahumeral space?

A

Humeral head

57
Q

In anatomical position, what are the landmarks where the scapula is even with the thoracic spine?

A
  1. Medial border of spine & T3
  2. Inferior angle & T7 or T8
58
Q

How far anteriorly to the frontal plane does the scapula sit?

A

35-40 degrees

59
Q

What plane does the scapula sit in and move in?

A

Scapular plane

60
Q

What degree of tilt does the scapula have in anatomical position?

A

20 degrees of anterior tilt

61
Q

Is the scapula pivotal with force/energy transmission to delivery in movement?

A

Yes

62
Q

What muscles directly move the clavicle?

A

Subclavius
Sternocleidomastoid

63
Q

What muscles directly move the humerus?

A
  • Deltoids (all portions)
  • Pectoralis major
  • Latissimus Dorsi
  • Biceps (both heads)
  • Triceps (all heads)
  • Rotator cuffs (supra- & Infraspinatus, teres minor, subscapularis)
  • Coracobrachialis
64
Q

What muscles directly move the scapula?

A
  • Rhomboids
  • Trapezius
  • Serratus anterior
  • Pectoralis minor
  • Levator scapular
  • Teres major
65
Q

Where do the capsuloligamentous mechanoreceptors reside?

A

In the shoulders static structures

66
Q

What do the capsuloligamentous mechanoreceptors do?

A

Relay sensory info regarding joint proprioception & kinesthesia via neural afferent pathways to the CNS

67
Q

How does the brain help with joint stability at the GH joint?

A

The Glenoid labrum, joint capsule, & GH ligaments have mechanical & sensory functions that contribute to it

68
Q

What structures help with the sensorimotor control system?

A
  • Ruffini endings
  • Pacinian corpuscles
  • Golgi tendon organ-like
69
Q

What slow adapting receptors continuously sense joint position?

A

Ruffini endings & GTO- like

70
Q

What do the fast adapting receptors or Pacinian corpuscles do?

A

Provide info on joint motion & turn off shortly before being stimulated

71
Q

What do the muscle spindles do?

A

Provide info about muscle length & changes in muscle length

72
Q

What is the role of the tenomuscular mechanoreceptors?

A

They signal afferent info regarding the state of the muscle to the CNS to aid the dynamic restraint system

73
Q

Where does shoulder abduction occur?

A

Scapular plane

74
Q

What is the varying range of the scapulohumeral rhythm ratio?

A

1:1 to 1:4 ratio range

75
Q

What is the scaoulohumeral rhythm dependent on?

A
  • plane of movement
  • velocity of movement
  • resistance to arm
  • type of muscle tension (concentric vs. eccentric)
  • individual variance
76
Q

What are arthrokinematics?

A

The movement of joint surfaces

77
Q

What are osteokinematics?

A

Movement of bones around a joint

78
Q

What movements of the scapula occurs during the first 20-30 degrees of abduction?

A

It oscillates medially & laterally with very little movement

79
Q

What are the movements of the scapula beyond 20-30 degrees?

A

It upwardly rotates, elevates, retracts, & tilts posteriorly (following convexity of thorax)

80
Q

What is scapular movement dependent on?

A

Muscles & movement at both the SC (1deg) & AC (2 deg) joints

81
Q

What 7 things is scapular movement essential for maintaining during abduction?

A
  • instant center of rotation
  • length-tension relationship of deltoids
  • relationship btwn humeral head/glenoid fossa
  • protraction/retraction
  • posterior tilting & elevation of the acromion
  • distal to proximal link in the kinetic chain
  • overall shoulder ROM
82
Q

What is scapular dyskinesia?

A

An observable alteration in scapular position & motion pattern relative to the thorax

83
Q

What is normal scapular motion?

A

Combo of upward rotation, posterior tilt, & retraction during full arm elevation (reversal during arm lowering)

84
Q

What are scapular dyskinesia sub-types?

A
  • winging
  • dysrhythmia
85
Q

What is normal winging of the scapula?

A

It wings at rest but doesn’t wing during motion

86
Q

What is abnormal winging of the scapula?

A

It wings at rest & during motion

87
Q

What occurs at the medial border during winging of the scapula?

A

Scapular protraction occurs during shoulder abduction when the scapula should be retracting

88
Q

What occurs at the inferior angle during winging of the scapula?

A

The scapula tilts anteriorly when the scapula should be tilting posteriorly

89
Q

What is scapular dysrhythmia?

A
  • a lack of smooth scapulohumeral rhythm
  • most common pattern is early/ excessive scapular elevation
90
Q

Do winging & dysrhythmia often occur together?

A

Yes

91
Q

During abduction, what kinematics does the clavicle generally follow?

A
  • elevation
  • retraction
  • posterior rotation
    (Follows scapula kinematics)
92
Q

What is a force couple?

A

Parallel forces of equal magnitude applied to a structure of equal distance from the center of the mass, producing a resultant force

93
Q

What is force couple for muscles?

A

A synergistic balance of agonist & antagonist muscles to stabilize a joint statically and/or dynamically

94
Q

Do muscles work synergistically together to control movement or position of a joint

A

Yes

95
Q

What does synergistic balance demonstrate?

A

-the high reliance on the dynamic restraint system for stability (shoulder)

96
Q

What is the force couple for the GH joint with superior/inferior mvmt?

A

Stabilizing humeral head against superior/inferior movement
- deltoid & supraspinatus VS. infraspinatus & teres minor

97
Q

What is the force couple at the GH joint for anterior/posterior mvmt?

A

Stabilizing humeral head against anterior/posterior movement
- subscapularis VS. infraspinatus & teres minor

98
Q

What is the force couple for scapular upward rotation?

A

Lower trapezius & serratus anterior VS. upper trapezius

99
Q

What is the force couple for scapular stabilization?

A

Upper portion of trapezius VS. lower portion of trapezius & rhomboids VS. serratus anterior

100
Q

Why is the entire body used during the overhand throwing motion?

A

To maximize performance & minimize internal forces at the shoulder & elbow

101
Q

What is the progression of energy through the body as throwing occurs?

A

Leg > hip > trunk > scapula > arm > forearm > hand > ball

102
Q

Is neuromuscular control involved as energy is transferred from one unit to another during throwing?

A

Yes

103
Q

What is the muscle activation & peak intensity progression?

A

Contralateral internal/external obliques & rectus abdominis muscles > scapular stabilizers > deltoids > rotator cuff

BOC Prep (16 decks)

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