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K&B Test 1 > Shoulder > Flashcards

Shoulder Flashcards

0
Q

What is the function of the shoulder joints

A

Link the upper extremity to the trunk
Provide extensive movement of the arm in space.
Provide stability for the elbow and hand for skills of forceful movements

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1
Q

Anatomical and functional structures and function of the shoulder joints

A

Anatomical:
Sterno-clavicular
Acromioclavicular
Glenohumeral

Functional–scapulothoracic and coracromial arch

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2
Q

Structural stability of the joint complex depends on?

A

Shape of the articulation

Bony incongruity

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3
Q

Muscles, ligaments, and soft tissues maintain what

A

Joint integrity

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4
Q

Joint stability is due to what

A

Dynamic muscular control

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5
Q

_____ is a segment that depends on more muscles and ligaments than on bony configuration for structural integrity

A

Dynamic stability

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6
Q

____ normal position of the scapula in relation to the trunk in all three planes.

A

Alignment

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7
Q

What connects the cervical and thoracic spine to the scapula

A

Muscles

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8
Q

What are the positional relationships regarding the planes of the scapula

A

Due to the spherical shape of the trunk:
Transverse plane the scapula is rotated anteriorly
Frontal plane the scapula is rotated anteriorly

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9
Q

The plane of the scapula is oriented approximately ____ to the frontal plane

A

30-45 degrees

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10
Q

The glenoid fossa is directed ____ with respect to the body

A

Anteriorly

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11
Q

Movement in the plane of the scapula in a range between 30-45 degrees anterior to the frontal plane.

A

Elevation or scaption

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12
Q

Joint capsules in elevation or caption are in what position

A

Loose-packed position

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13
Q

Is there impingement of the supra humeral joint if shoulder motions occur in the plane of the scapula in regards to scaption

A

No

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14
Q

What is the function of the glenoid fossa being rotated anteriorly

A

Alignment: less stress on the capsule and musculature

Strength: optimal length-tension relationship for shoulder abductors and rotators. Supraspinatus and deltoid are optimally aligned for elevation.

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15
Q

How much movement is involved in elevation at the humerus

A

Little or no rotation of the humerus in elevation

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16
Q

What is the position of the scapula relative to the spine

A

Superior angle is at T2 spinous process
Inferior angle is at T7 spinous process
5-6 cm between the spine and the medial scapular border (at T4)
Alterations from the ideal alignment may indicate functional impairments

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17
Q

Ideal alignment from the side view

A

Acromion- in line with the mastoid process. 20 degree anterior tilt between the lateral border of the scapular border and vertical.
Alterations from the ideal alignment may indicate functional impairments.

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18
Q

What is the angle of inclination

A

In the frontal plane

130-150 degree angle is created between the axis of the head and the shaft of the humerus.

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19
Q

What is the angle of torsion–> retroversion

A

Transverse plane: the humeral head is rotated 30 degrees posteriorly relative to the epicondyles. It orients the humeral head in the scapular plane for articulation with the glenoid fossa. It increases stability

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20
Q

What are the functions of the clavicle

A

Strut to hold shoulder onto axial skeleton
Site for muscular attachment
Protect underlying nerves and blood vessels
Contributes to increased range of motion of the shoulders
Transmit muscle forces to the scapula

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21
Q

Describe the arthrology of the sternoclavicular joint

A

Bony connection of the upper limb to the axial skeleton. It’s triaxial and a saddle joint. There are three degrees of freedom and some people argue its a ball in socket joint. It is reciprocally convex/concave

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22
Q

Stability of the sc joint depends on ____ and _____

A

Capsule and ligaments

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23
Q

What is the periarticular connective tissue of the sc joint

A 
Joint capsule 
Intraarticular disc
Sternoclavicular (capsular) ligament (A and P)
Interclavicular ligament 
Costoclavicular ligament
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24
Q

____ principle stabilizing structure of the sterno-clavicular joint. It secures the clavicle to the first rib and limits extremes of all clavicular motion except depression.

A

Costoclavicular ligament

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25
Q

What are the axis of the Costoclavicular ligament

A

Protraction/retraction

Elevation/depression

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26
Q

______ lines the superior aspect of the joint capsule. It checks anterior and posterior movement.

A

Anterior and posterior sternoclavicular ligament

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27
Q

What does the anterior and posterior sternoclavicular ligaments restrain

A

Posterior–protraction

Anterior–retraction

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28
Q

What does the articular disc do in the sc joint

A

It is Fibrocartilage and absorbs shock and helps prevent dislocation

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29
Q

The articular surface of the ____ is greater than the _____ which results in joint instability

A

Clavicle

Sternum

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30
Q

_____ increases the articular surface between the clavicle and sternum

A

Intra-articular disc

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31
Q

_____ helps block medial movement of the clavicle and helps distributes forces

A

Intra-articular disc

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32
Q

The force to the lateral shoulder pushes the clavicle _____

A

Medially

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33
Q

Osteokinematic motion is always names for the direction of the movement ______

A

At the end of the lever

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34
Q

What are the osteokinematics of the sc joint

A 
Plane synovial joint but sometimes considered a saddle 
3 degrees of freedom
   Elevation/depression 
   Protraction/retraction 
   Rotation
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35
Q

Osteokinematics at the sc joint of elevation and depression

A

Frontal plane
A-P axis at the Costoclavicular ligament
Elevation 45 degrees
Depression 5-15 degrees

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36
Q

Osteokinematics of protraction/retraction at the sc joint

A

Transverse plane
Vertical axis at the Costoclavicular ligament
Protraction 15-30 degrees
Retraction 15-30 degrees

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37
Q

Osteokinematics of rotation at the sc joint

A

Longitudinal axis through the clavicle

30-40 degrees of spin

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38
Q

Arthrokinematics of the sc joint

A

Elevation and depression occur along the longitudinal diameter
Protraction and retraction occur along the transverse diameter

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39
Q

Explain the arthrokinematics of elevation at the sc joint

A

Convex clavicular surface rolls superiorly and slides inferiorly on the concavity of the sternum.

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40
Q

Explain depression for arthrokinematics of the sc joint

A

Convex clavicular surface rolls inferiorly and slides superiorly

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41
Q

Arthrokinematics of retraction at sc joint

A

Concave articular surface of the clavicle rolls and slides posteriorly on the convex surface of the sternum

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42
Q

Arthrokinematics of protraction of the sc joint

A

Concave articular surface of the clavicle rolls and slides angrily on the convex surface of the sternum

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43
Q

Arthrokinematics of rotation at the sc joint

A

Spin of the head of the clavicle about the disc

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44
Q

The closed pack position at the sc joint is ____

A

Posterior rotation

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45
Q

_____ is a gliding or plane synovial joint with 3 degrees of freedom.

A

Acromioclavicular joint

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46
Q

At the ac joint describe the proximal and distal components

A

Proximal–convex lateral end of the clavicle

Distal–concave acromion process of the scapula

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47
Q

What is the periarticular connective tissue at the ac joint

A

Superior and inferior ac ligaments
Coracoclavicular ligament
Conoid and trapezoid
Articular disc

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48
Q

_____ reinforces the joint capsule, prevents post dislocation! and limits tipping

A

Superior and inferior AC ligaments

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49
Q

____ binds the clavicle to the scapula–major stabilizing structure

A

Coracoclavicular ligament

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50
Q

____ limits excessive superior glide

A

Conoid

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51
Q

____ protects against shearing forces

A

Trapezoid

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52
Q

What are the primary and secondary motions at the ac joint

A

Primary– upward and downward rotation
Secondary–horizontal plane adjustments–internal and external rotation
Sagittal plane adjustments–anterior and posterior tilting

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53
Q

Osteokinematics of upward and downward rotation in the scapular plane

A

Primary motion at the ac joint
Glenoid fossa tilts up or down
Closed packed position and fully upward rotation
A-P axis: 1st 30 degrees–axis at base of spine of scapula
Last 30 degrees–axis at the ac joint

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54
Q

Osteokinematics of external/internal rotation

A

Horizontal plane adjustment

Vertebral border of the scapula moves out around a vertical axis at the ac joint.

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55
Q

Scapular internal/external rotation occurs with what?

A

With scapular abduction/adduction

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56
Q

What would happen if abduction and adduction were pure translatory movement

A

Only the vertebral border of the scapula would contact the ribs

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57
Q

Osteokinematics of anterior and posterior tilting at the scapula

A

Sagittal plane adjustment

Titling of the scapula–horizontal axis

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58
Q

Anterior and posterior tilting of the scapula occurs with what movement

A

Scapular elevation and depression

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59
Q

Describe the movement of anterior tilting

A

Inferior angle moves away from the thoracic wall

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60
Q

What joint of the shoulder is not a true anatomical joint

A

Scapulothoracic joint

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61
Q

How does the st joint function as a joint

A

The proximal component–convex rib cage

Distal component–concave anterior scapular surface

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62
Q

What is the function of the st joint

A

Orientation of the glenoid fossa

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63
Q

What does scapular motion serve to do at the st joint

A

It serves to move the glenoid fossa into a position where it can provide a stable base for the humeral head regardless of arm movement.

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64
Q

Where does the st joint lie

A

In the scapular plane not the frontal plane

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65
Q

Sc, ac, and st joints are

A

Closed kinematic chain

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66
Q

St joint movements require simultaneous movements at the _______ joints

A

Sc and ac

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67
Q

Osteokinematics of the st joint

A

Elevation/depression
Abduction/adduction
Upward/downward rotation

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68
Q

Osteokinematics of elevation and depression at the st joint

A

Elevation–entire scapula moves superiorly
Depression–entire scapula moves inferiorly
Composite of sc and ac rotations–sc is elevation and depression and ac is tipping/tilting

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69
Q

Osteokinematics of the st joint with adduction/abduction (protraction/retraction)

A

Side to side translation of the scapula on the ribs (parallel). It’s moving towards or away from the spine.

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70
Q

What movements are happening at the ac and sc joints with st joint adduction/abduction

A

Sc–protraction/retraction

Ac–internal/ external rotation

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71
Q

Describe protraction and retraction at the st joint

A

Protraction–upward forward reach

Retraction– pulling toward the body

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72
Q

Osteokinematics of the st joint for upward rotation

A

Glenoid fossa faces superiorly, inferior angle slides laterally and anteriorly.

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73
Q

Upward rotation at the st joint occurs with?

A

It occurs with flexion, abduction, or elevation of the arm (raise arm overhead)

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74
Q

What movements are happening at the sc and ac joints with upward rotation at the st joint

A

Sc–clavicular elevation

Ac–scapular upward rotation

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75
Q

Osteokinematics of the st joint for downward rotation

A

Glenoid fossa faces inferiorly, the inferior angle slides medially and posteriorly upward. The inferior angle moves away from the vertebra.

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76
Q

What motions are occurring at the ac and sc joints for st joint downward rotation

A

Sc–clavicular depression

Ac–scapular downward rotation

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77
Q

Example of st joint downward rotation

A

Reaching under your desk

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78
Q

Arthrology of the GH joint

A

There is little bony congruity
There is passive tension on the periarticular connective tissue
There is active muscle tension

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79
Q

At the GH joint ____ and _____ are exchanged for _______

A

Congruency and stability

Mobility

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80
Q

What is the periarticular connective tissue in the GH joint

A

Capuloligamentous complex–capsule and axillary pouch
Glenoid labrum
Glenohumeral and Coracohuneral ligaments
Coracoacromial arch

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81
Q

_____ is the rim of the glenoid fossa–>anatomical neck of the humerus and allows for extensive mobility

A

Capsule of the capsuloligamentous complex

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82
Q

_____ is Fibrocartilage surrounding the fossa and deepens the fossa. It increases the articular contact, improves osseous stability, improves articular congruity.

A

Glenoid labrum

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83
Q

The glenoid labrum increases the fossa’s depth by ___

A

50%

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84
Q

The _____ decreases the humeral head translation

A

Glenoid labrum

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85
Q

_____ reinforce the capsule and serve as the major static restraints

A

Glenohumeral and Coracohuneral ligaments

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86
Q

The ______ is the anterior capsular reinforcement for the GH joint

A

Subscapularis

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87
Q

______ are the posterior reinforcement of the GH joint

A

Supraspinatus
Infraspinatus
Teres minor

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88
Q

The glenohumeral ligament provides _____ thickening of the joint capsule

A

Anterior

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89
Q

The glenohumeral ligament is ____ in normal rom

A

Lax

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90
Q

______ limits translation and rotation of humeral head on the glenoid. It prevents extremes of range and is useful in joint stabilization

A

Glenohumeral ligament

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91
Q

____ is attached at the supra glenoid tubercle and the lesser tuberosity

A

Superior glenohumeral ligament

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92
Q

_____ is taut with full adduction, inferior and anterior and posterior translation

A

SGHL

93
Q

Where does the mghl attach

A

Labrum and anatomical neck

94
Q

______ anterior restraint to the GH joint, resists anterior translation of the humerus. 45-60 decrees abduction and external rotation

A

MGHL

95
Q

Where does the IGHL attach

A

Anterior inferior and glenoid labrum

Inferior anatomical neck of the humerus

96
Q

Where are all fibers taut for the IGHL

A

90’degrees abduction

97
Q

Where does the Coracohuneral ligament attach

A

Lateral coracoid process

Anterior greater tubercle

98
Q

What is the strongest supporting GH ligament

A

Coracohumeral ligament

99
Q

Where is the Coracohuneral ligament taut

A

At extremes of external rotation, flexion, and extension

100
Q

What is the primary restraint in the inferior and posterior translation in the adducted arm

A

Coracohuneral ligament

101
Q

_____ counteracts the downward pull on gravity on the humerus

A

Coracohumeral ligament

102
Q

GH static stability primary

A

Fossa oriented upward

Combine force of coracohumeral ligament, superior capsule and force of gravity

103
Q

GH static stability secondary

A

Supraspinatus and posterior deltoid–active forces parallel to superior capsule.
Decreases superior capsule equals muscle weakness and poor posture

104
Q

What makes up the coracromial arch

A

Coracromial ligament and acromion process
GH roof–protective
Subacromial space—supraspinatus, Subacromial bursa, biceps-long head, capsule

105
Q

Closed packed position of GH joint

A

Full abduction with external rotation

Max congruency between the glenoid fossa and humeral head

106
Q

Osteokinematics of GH joint abduction

A

Frontal plane rotation
A-P axis at the center of the humeral head
120 degrees abdcuction at GH joint

107
Q

Arthrokinematics of the GH joint for abduction

A

Convex humeral head rolls superiorly and glides inferiorly

108
Q

Kinematics of abduction of the GH joint

A

Humeral head is greater than the glenoid fossa

Rolling without inferior sliding of the humeral head–> impingement of supraspinatus tendon and Subacromial bursa.

109
Q

Osteokinematics of the GH joint for flexion and extension

A

Sagittal land rotation.
Med-lateral axis
Flexion. At 120
Extension. 40-55

110
Q

Arthrokinematics of the GH joint for flexion and extension

A

Flexion–posterior spinning of the humeral head

111
Q

Osteokinematics of the GH joint for internal and external rotation

A

Axial rotation of the humerus in the horizontal plane

Vertical or longitudinal axis

112
Q

Rom in neutral abdcuction. For GH joint

A

Er– 60-70

Ir– 75-80

113
Q

Rom in 90 degrees abduction

A

Er 90

Ir75-90

114
Q

Arthrokinematics of external rotation at the GH joint

A

Humeral head rolls posteriorly and slides anteriorly

115
Q

Arthrokinematics of internal rotation at the GH joint

A

Humeral head rolls anteriorly and slides posteriorly

116
Q

_____ is the simultaneous kinematic movement of all shoulder joints

A

Scapulohumeral rhythm

117
Q

_____ is a coordinated series of synchronous movements which distributes motion between the GH and ST joints {sc and ac}

A

Scapulohumeral rhythm

118
Q

What is the function of the Scapulohumeral rhythm

A

Permits larger ROM with less compromise to stability.

Maintains the humeral head in an optimal position in the glenoid fossa.

Muscles acting on the humerus maintain a good length-tension relationship.

119
Q

How many principles of the Scapulohumeral rhythm are there

A

6

120
Q

What is principle 1

A

2:1 Scapulohumeral rhythm. Active abduction of 180 degrees occurs as a result of simultaneous 120 degrees of glenohumeral abduction and 60 degrees of scapulothoracic upward rotation.
For every 2 degrees of GH movement there is 1 degree of scapular rotation. Ratio is 2:1

121
Q

What is principle 2

A

60 degrees of scapulothoracic upward rotation –> simultaneous motion at the sc and ac joints
Sc elevation
Ac upward rotation

122
Q

What is principle 3

A

The clavicle retracts at the sc during full abduction.

Clavicular retraction assists ac to position the scapula optimally.

123
Q

What is principle 4

A

The scapula posteriorly tilts (at AC) and externally rotates during full shoulder abduction.

External rotation occurs as a net rotation based on sc and ac movements.

124
Q

What is the function of Scapulohumeral rhythm principle 4

A

Moves the coracoacromial arch away from the advancing humeral head

Limits likelihood of impingement

Decreases the mechanical stress on the capsule and the rotator cuff.

125
Q

What is principle 5

A

Posterior rotation of the clavicle. The Coracoclavicular ligament attaches the scapula to the clavicle. As the serratus anterior and lower trap upwardly rotate the scapula, the Coracoclavicular ligament gets taut.

126
Q

In principle ______ the clavicular elevation pulls on the Coracoclavicular ligament and the S-shaped clavicle rotates posteriorly around its longitudinal axis.

A

5

127
Q

Principle 5 allows for the last _____ of ______

A

30 degrees

Upward rotation

128
Q

In principle ______ the GH externally rotates during shoulder abduction. External rotation allows the greater tubercle to pass posterior to the acromion and avoids impingement of Subacromial space contents.

A

6

129
Q

A muscle’s ability to produce movement in a plane is dependent on?

A

Location of the muscle action line

Axis of rotation

130
Q

Attached to axioskeleton and shoulder girdle

A

Axioscapular and axioclavicular

131
Q

Attach scapula to humerus (includes rotator cuff)

A

Scapulohumeral

132
Q

Attach thorax to humerus

A

Axiohumeral

133
Q

_____ a weak agonist, a tight agonist, or a combination of the two

A

Muscle imbalance

134
Q

_____ shorten and tighten in dysfunction

A

Postural muscles

135
Q

______ lengthen and weaken in dysfunction

A

Phasic muscles

136
Q

What are the postural muscles of the axioscapular muscles

A

Upper trap
Levator scapulae
Pec minor

137
Q

What are the phasic muscles in the axioscapular muscles

A

Rhomboids
Middle trap
Lower trap
Serratus anterior

138
Q

Postural muscles of the Scapulohumeral muscles

A

Subscapularis

139
Q

What are the phasic muscles of the Scapulohumeral muscles

A

Deltoid
Supraspinatus
Infraspinatus
Teres minor

140
Q

What are the postural muscles of the Axiohumeral muscles

A

Pec minor–clavicular portion

141
Q

What are the postural muscle of the cervical and stromatgnathic muscles

A

Sternocleidomastoid
Suboccipitals
Scaleni
Supra hyoid

142
Q

What are the phasic muscles for the cervical and stomatognathic muscles

A

Longus capitus

Infra hyoid

143
Q

What is the primary role of the axioscapular muscles

A

Position the scapula

144
Q

What are the muscles of the axioscapular muscles

A 
Trapezius
Serratus anterior 
Levator scapulae
Rhomboids
Pectoralis minor
145
Q

Muscles of the Axiohumeral group

A

Latissimus Dorsi

Pectoralis major

146
Q

Action of the trap

A

Upper fibers elevate
Middle fibers retract
Lower fibers depress

Upper and lower work together for upward rotation of the scapula

147
Q

Weakness in _____ is seen with decreased elevation strength; depression, adduction and forward tilt of the scapula

A

Upper trapezius

148
Q

______ weakness is seen with deceased scapular adduction and posture

A

Middle trap

149
Q

______ weakness is when there is difficulty stabilizing the scapula during upward rotation

A

Lower trap

150
Q

How can you tell if there is tightness in the upper traps

A

There is elevated shoulders or asymmetrical head positions, decreased neck rom, only upper is tight–upward rotation of the scapula

151
Q

What are the actions of the serratus anterior

A

Scapular abduction and upward rotation = protraction

And elevation

152
Q

Weakness in the serratus is known as

A

Winging

153
Q

Weakness in the serratus is seen when

A

During upward rotation (flexion, elevation or abduction)

Seen at rest or passively–restricted GH rom or postural abnormalities.

154
Q

During winging the scapula is pushed into ____

A

Adduction

155
Q

Serratus anterior weakness can also been seen as _____ with resisted shoulder _____

A

Winging

Flexion

156
Q

What causes decreased shoulder medial rotation winging?

A

Not a result of serratus weakness. There is no full internal rotation because of compensation. The forward position of the scapula is the compensation. It is more tipped forward. This is due to tightness in structures and winging is the compensation

157
Q

What is the action of the levator scapulae

A

Elevator and downward rotator

158
Q

The levator is a _____ of the neck

A

Lateral flexor

159
Q

What actions would you see weakness in if the levator was weak

A

Reaching back
Pulling
Rowing

160
Q

If you have a weak levator what could posture look like

A

Round shoulders

161
Q

If the levator was tight what would the scapula be doing

A

The scapula is tilted–the glenoid is downward and forward

162
Q

Action of the rhomboids

A

Retract scapula
Downward rotation (to depress the glenoid cavity)
Fix scapula to the thoracic wall

163
Q

How would weakness of the rhomboids present

A

Pulling behind back
Rowing
Round shoulders
Lateral rotation of scapula

164
Q

Action of pec minor

A

Stabilizes the scapula by drawing it inferiorly and anteriorly against the thoracic wall
Scapular depression and downward rotation.

165
Q

If the pec minor is weak there will be difficulty in what

A

Difficulty controlling shoulder during weight bearing.

166
Q

How can you tell if the pec minor is tight

A

Anterior scapular tilt
Round shoulders
Increased internal rotation
Increased impingement

167
Q

Action of the Latissimus dorsi

A

Extends adducts and internally rotates the humerus
Raises body towards the arms during climbing
Shoulder depression

168
Q

Tightness in ______ limits shoulder rom in flexion and external rotation

A

Latissimus dorsi

169
Q

How can you check for tightness in the Latissimus dorsi

A

Flexion in the upper t spine–supine, knees to chest and arms straight over Your head

170
Q

Action of pec major

A 
Flexion
Adduction
Internal rotation
Horizontal adduction of the arm 
Clavicular--flexes humerus 
Sternal--extends humerus 
Attaches the trunk to the humerus
171
Q

Tightness in the ______ limits rom in horizontal abduction and external rotation

A

Pec major

172
Q

______ muscles working together to produce a purposeful movement

A

Functional movement

173
Q

Axioscapular elevation is elevation of the _____ and _____

A

Scapula and clavicle

174
Q

Axioscapular elevation is synergistic action of

A

Upper trap

Levator scapula

175
Q

What muscles do axioscapular depression

A

Scapular depressors
Lower trap–pulls scapula down
Latissimus dorsi–pulls scapula down
Pec minor–depresses scapula from the coracoid process

Humeral depressors
Latissimus dorsi
Pectoralis major
Both pull humerus down

176
Q

What is the function of axioscapular depression

A

Closed chain scapular depression

Raise thorax on a fixed scapula.

177
Q

What are some examples of axioscapular depression

A

Getting up from a wheelchair
Push up
Blocks
Crutch walking

178
Q

What are the primary and secondary muscles of axioscapular retraction

A

Primary– middle trap
Secondary– lower trap and rhomboids
(Synergistic action between these two) they are upward and downward rotators

179
Q

______ elevation of the rhomboids is neutralized by depression of the lower traps. The line of fives of both muscles combine, however, to produce pure retraction

A

Vigorous retraction.

180
Q

Describe axioscapular protraction

A

Scapula–serratus anterior pulls the scapula forward

Humerus–pec major pulls the humerus and assists if the arm is at the side

181
Q

What muscles produce upward rotation of the scapula

A

Upper and lower traps

Serratus anterior

182
Q

The ____ lifts up lateral clacivle and acromion process in upward rotation

A

Upper trap

183
Q

______ pulls on the medial end of the spine and scapula in upward rotation

A

Lower trap

184
Q

_____ pulls on the inferior angle of the scapula (where the majority of the fibers insert) to pull it laterally on the chest wall

A

Serratus anterior

185
Q

The traps and serratus are a _____ in upward rotation of the scapula

A

Force couple

186
Q

What muscles produce downward rotation of the scapula

A

Synergistic action of levator scapula, rhomboids, and pec minor

These are a force couple

187
Q

What is the function of downward rotation of the scapula

A

Return from upward rotation
Swimming, crawling, pulling down the window
Shoulder adduction with extension

188
Q

What axioscapular muscles do humeral extension

A

Rhomboids stabilize the scapula
Teres major and Latissimus dorsi extend the humerus
Active during upper extremity weight bearing

189
Q

______ provide motion and dynamic stabilization to the GH joint

A

Scapulohumeral group

190
Q

What are the Scapulohumeral muscles

A 
Deltoid 
Supraspinatus 
Infraspinatus 
Teres minor 
Subscapularis 
Teres major 
Corachobrachialis
191
Q

Action of the deltoid

A

Entire muscle abducts the GH
Anterior: flexes and horizontal adduction with medial rotation of the arm
Middle: abducts the arm
Posterior: extends, laterally rotates the arm and horizontally abducts.

192
Q

What would happen with deltoid paralysis

A

Supraspinatus would do abduction. It would elevate the arm by substitution of scapula upward rotation and lateral trunk flexion.

193
Q

_____ weakness would cause decreased shoulder flexion strength, decreased internal rotation, abduction, and horizontal adduction

A

Anterior deltoid

194
Q

_____ weakness would cause decreased shoulder abduction strength

A

Middle deltoid

195
Q

_______ weakness should cause decreased shoulder extension strength

A

Posterior deltoid

196
Q

______ tightness would cause decreased shoulder extension and external rotation rom

A

Anterior deltoid

197
Q

_____ tightness would cause decrease shoulder adduction rom

A

Middle deltoid

198
Q

____ would cause decreased shoulder flexion and internal rotation rom

A

Posterior deltoid

199
Q

What is the action of the supraspinatus

A

Abduction of shoulder throughout rom
External rotation of the shoulder
Stabilizes GH joint

200
Q

____ weakness would cause decreased strength and endurance of shoulder abduction

A

Supraspinatus

201
Q

_____ tightness would cause decreased internal rotation with shoulder extension and decreased shoulder adduction across the plane of the body.

A

Supraspinatus

202
Q

Action of teres minor and infraspinatus

A

Lateral rotation of GH

203
Q

______ weakness would cause decreased strength of external rotation and shoulder impingement

A

Infraspinatus and teres minor

204
Q

_______ tightness would cause decreased rom of shoulder internal rotation and horizontal adduction.

A

Infraspinatus and teres minor

205
Q

______ tightness can cause closed kinetic chain winging

A

Teres minor and infraspinatus

206
Q

Action of subscapularis

A

Medial GH rotation

207
Q

______ weakness causes decreased strength of internal rotation and contributes to anterior instability of the GH joint and also causes shoulder impingement

A

Subscapularis

208
Q

______ tightness would cause decreased external rotation rom

A

Subscapularis

209
Q

action of teres major

A

Extends and medially rotates the arm

Pulls scapula when humerus is fixed

210
Q

______ weakness causes decreased strength in internal rotation, extension, and adduction

A

Teres major

211
Q

_______ tightness causes restriction in shoulder rom– external rotation, flexion, and abduction. Can be seen in resting position or at the st joint

A

Teres major

212
Q

What muscles do glenohumeral flexion

A

Deltoid
Supraspinatus
Long head of the biceps
Coracobrachialis.

213
Q

Muscles of full rom of glenohumeral flexion

A

Anterior deltoid
Coracobrachialis
Long head of biceps

214
Q

Assists of glenohumeral flexion

A

Coracobrachialis and biceps- the First 90 degrees of flexion

215
Q

What are the terminal GH flexors

A

Scapulothoracic abduction and upward rotation- necessary for the distal slide of the humeral head

216
Q

What are the prime movers for flexion abduction and elevation

A

Deltoid and supraspinatus

217
Q

What muscles initiate abduction and reach max emg at 90 degrees abducton

A

Deltoid and supraspinatus

218
Q

Where are the deltoid and supraspinatus at their shortest length

A

90 degrees of abduction

219
Q

____ activity in all rotator cuff muscles and deltoid throughout the range of active abduction.

A

EMG

220
Q

Both ____ and _____ contribute to large compression components for GH stability

A

Deltoids and supraspinatus

221
Q

What is the function of the supraspinatus

A

Stabilizing

222
Q

______ synergistically contract continuously during flexion and abduction thereby eliminating external rotation and internal rotation components, depress the humeral head, and prevent humeral head compression from the unchecked Deltoid

A

Teres minor, infraspinatus, and subscapularis.

223
Q

What are the regulators of dynamic stability

A

Deltoid
Supraspinatus
Subscapularis, infraspinatus, and teres minor

224
Q

What does the deltoid do in regulating dynamic stability

A

Superior line of force rolls the humeral head upward

225
Q

How does the supraspinatus regulate dynamic stability

A

Rolls the humeral head into abduction and compresses the joint (stability)

226
Q

How do the infraspinatus, subscapularis, and teres minor regulate dynamic stability

A

They work synergistically–canceling IR and ER components

They have a downward translational force on the humeral head (slide)- counteract superior translation

227
Q

What are the internal rotators

A

Subscapularis–pure ir
Teres major and Latissimus dorsi–it with adduction and extension
Pec major–ir with adduction

228
Q

What muscles perform external rotation

A

Infraspinatus
Teres minor
Posterior deltoid
Supraspinatus can assist when GH is between neutral and full external rotation

229
Q

When can the supraspinatus assist external rotation

A

When the GH is between neutral and full ER

230
Q

What is the interrelationship of the shoulder girlie to the spine

A

Musculoskeletal
Biomechanical
Postural
Neurogenic

K&B Test 1 (4 decks)

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