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Kines Test 2 > Shoulder > Flashcards

Shoulder Flashcards

0
Q

WHat type of joint is SC?

A

plane synovial

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1
Q

What are the joints involved at the shoulder?

A

SC, AC, ST, GH

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2
Q

____ roll and ___ glide for elevation

A

superior, inferior – opposite – convex on concave

*frontal plane

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3
Q

___ roll and ___ glide for protraction

A

anterior roll , anterior slide - concave on convex

*transverse plane

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4
Q

Name the ligaments at the SC joint

A

Ant/Post SC ligs, costoclavicular lig, interclavicular lig

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5
Q

Ant/post SC ligs prevent what?

A

anterior and posterior translation of medial clavicle

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6
Q

what does costoclavicular lig prevent?

A

anterior and posterior fibers
ant fibers -> fan out laterally from rib to clavicle, limit elevation distal clavicle and contribute to inferior gliding of medial clavicle, also prevents superior translation
post –> prevent medial movement of clavicle and absorb force, limit elevation and contribute to inferior gliding of medial clavicle

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7
Q

Interclavicular lig

A

limits excessive depression of the distal clavicle and superior gliding of medial clavicle – this protects the brachial plexus

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8
Q

Motions permitted at the SC joint

A

3 degrees of freedom
rotary: Elevation/depression, protraction/retraction, posterior/anterior rotation

translatory: ant/post , med/lat, sup/inf

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9
Q

Motions permitted at AC joint

A

3 degrees of freedom
rotary: Internal/External rotation, upward/downward rotation, anterior/posterior tilting

translatory: ant/post , med/lat, sup/inf

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10
Q

Motions permitted at GH joint

A

3 degrees of freedom

rotary: Flex/ext, abd/add, internal/external rotation

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11
Q

Motion permitted at ST joint

A

rotary: **upward/downward rotation, anter/post tilit, internal/external rotation,
Translatory: protract/retract, elevation/depression

**primary movement

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12
Q

Ligaments at AC joint

A

superior and inferior AC ligs & coracoclavicular lig

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13
Q

SUperior/inferior AC ligs

A

help support the capsule; superior checks distal clavicle from moving posteriorly

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14
Q

Coracoclavicular lig

A

AC joint
Conoid - medial & vertical ; resist distal clavicular superior motion
Trapezoid - lat & hor; more restraint to posterior motion
*both limit upward rotation of scap & help posteriorly rotate clavicle

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15
Q

How much does the GH labrum deepen the socket?

A

50%

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16
Q

When is the GH capsule tight?

A

Humerus in abduction & external rotation = closed pack position

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17
Q

Where is the GH capsule tight/loose?

A

tight- superiorly
loose - anterior and inferior
*helps create intrarticular pressure

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18
Q

Ligaments of the GH joint

A

superior, middle and inferior GH ligs & coracohumeral

inferior = anterior, axillary pouch and posterior

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19
Q

Superior GH lig

A

labrum –> humerus and connects with coracohumeral lig

*provide anterior and inferior stability

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20
Q

The humerus is most likely to dislocate ..

A

anterior, inferior

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21
Q

Middle GH lig provides

A

anterior stability up to 60 degrees of abduction

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22
Q

Inferior GH lig provides

A

stability in abduction beyond 45 degrees; the axillary pouch resists inferior translation

  • if lateral roation is added, anterior band fans out to prevent anterior translation
  • if medial rotation added, posteior band provides post stability
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23
Q

All ligaments are taut in

A

humeral abduction, lateral or medial rotation

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24
Q

Coracohumeral lig

A

GH lig; inserts into supraspinatus and subscapularis;

limits inferior translation & lateral rotation when in abduction

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25
Q

how much Elevation/Depression

A

48/ 10

SC

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26
Q

how much Protraction/retraction

A

20 / 30

SC

27
Q

How much posterior rotation/ anterior rotation

A

50 / <10

SC

28
Q

how much ant/post tilt

A

20 / 40

AC

29
Q

how much upward/downward rotation

A

30

AC

30
Q

how much IR/ER

A

30

AC

31
Q

What is the orientation of the humeral head?

A

superior (130-150), medial, posterior (30) compared to the shaft and condyles

32
Q

Increased retroversion would cause

A

more external rotation, less internal rotation

33
Q

What other motion must happen at the GH joint to gain full elevatino of the arm?

A

external rotation to clear the greater tubercle

34
Q

Abduction is __ roll, ___ glide

A

superior, inferior

35
Q

flexion is a ___ roll , ___ glide

A

anterior , post

36
Q

Normal position of scapula on thorax

A

5 cm from midline, 2-7th ribs, internally rotated 30-45 degrees, tilited anterior 10-15 degrees and upward rotated 10 degrees

37
Q

amount of upward rotation possible

A

60 degrees

coupled with posterior rotation of SCJ & clavicular elevation

38
Q

At ST joint elevation/depression & protraction/retraction occur at ___ joint while IR/ER & ant/post tilting occur at ___ joint

A

SC, AC

39
Q

Scapulo humeral rythm

A

elevation of humerus, upward rotation of scap, post tilt
2: 1 (GH:ST)
120:60
maintain optimal length-tension relationship

40
Q

How many muscles act at the shoulder during elevation

A 
17;
3 deltoid
4 rotator cuff
pec major
pec minor
bicep
3 trap
Serratus
levator scap
2 rhomboid
tricep
41
Q

Upward scapula rotators

A

upper,middle & lower trap, serratus anterior

  • the MA for trap changes but the serratus MA always stays larger
  • the medial translatory of the trap offsets the lateral translatory of serratus
  • serratus also helps produce SC protraction and AC external rotation
  • paralysis of serratus causes winging * anterior tilit and IR
42
Q

Compression at the GH joint is caused by which muscles

A

Infraspinatus* - Infra and teres minor help with lateral rotation when
Teres minor* - lifting the arm ** teres minor = most
Subscap* - these 3 offset the deltoid ^^^
Supraspinatus
*their Fy component causes rotation but also compression into fossa

43
Q

Supraspinatus most active between ___ & __ degrees

A

0-60

*of abduction

44
Q

Deltoid is the ..

A

prime elevator for flexion and assist abduction after 15 degrees

45
Q

Deltoid vs supraspinatus in elevation

A

in 0 degrees abduction, supraspinatus has a larger MA
as abduction increases, MA for deltoid increases
*deltoid provides greater abduction force than supraspinatus
T=FxMA
less force to get the same torque

46
Q

Deltoid vs rotator cuff in elevation

A

without the offset of rotator cuffs, the large translatory component of deltoid would cause superior translation (into coacoacromial arch) rather than elevation at humerus

  • even though rotation is still possible – superior trasnlation would cause impingement
  • Fx in this case would cause a shear force rather than compressive force
47
Q

Static stabilization of GHJ

A

gravity causes inferior translation; rotator capsule vectors create force that compresses humeral head into socket; labrum creates neg intra-articular pressure;degree of glenoid inclination (upward tilt = more prevention of inferior translation)

48
Q

How does bicep help stabilize shoulder

A

by centering the head in the fossa and by reducing superior, inferior and anterior translation

49
Q

WHat is the painful arc?

A

60-120 degrees of humeral elevation

50
Q

Pain due to AC degeneration is found when

A

the arm is adducted across the body

51
Q

During flexion there is an average of __ lateral rotation at GHJ

A

51

52
Q

When elevating the arm, the scapula

A

posteriorly tilits, early it will internally rotate while later externally rotating,

53
Q

Shoulder depressors in weight-bearing

A

Lat & Pec major (sternal)

  • scap will rotate down and adduct
  • when the UE is weight bearing - lat will bring the pelvis up
  • these 2 muscles off set ant/post translation
  • pec minor will downward rotate, IR and ant tilt scap
54
Q

Trap is more active in __ than __

A

abduction than flexion

55
Q

Which muscle is more critical in producing scapular upward rotation ? Serratus or Trap?

A

Serratus

56
Q

The serratus causes ___ ___ & ___ at the scap

A

Upward rotation, post tilt and ER

57
Q

Rhomboids are ___ contracting during abduction

A

essentrically - because they are downward rotators of the scap
* also help prevent excessive IR

58
Q

Pec minor creates __ and __ at the scap

A

depression and abduction

59
Q

Which muscle offsets the downward rotation of rhomboids

A

Teres major

60
Q

Definition of GIRD

A
  • A loss of IR of 20 degrees or more compared to contralateral side
    _EX: 90 on the right 70 on the left
  • Greater than 5 degree loss in total motion
    _EX: I= 70 E=90 = 160 - good
    I= 65 E= 80 = 145 - bad ( less than 155)
61
Q

SLAP tear

A

Superior labrum anterior posterior

62
Q

Causes of gird

A

humeral retroversion, throwing causes ER torque, humeral head sits posterior in glenoid

63
Q

Serratus weakness causes

A

Long thoracic nerve palsy, scapular winging in flexion

64
Q

Upper trap wekaness causes

A

Spinal Accessory Nerve palsy (SNAP), positive scapular flip, depressed scapula, limited shoulder abduction

65
Q

Upper trap overuse

A

decreased upward rotation of scap and increased shoulder impingement

Kines Test 2 (4 decks)

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