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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
Coracohumeral lig
GH lig; inserts into supraspinatus and subscapularis; | limits inferior translation & lateral rotation when in abduction
25
how much Elevation/Depression
48/ 10 | SC
26
how much Protraction/retraction
20 / 30 | SC
27
How much posterior rotation/ anterior rotation
50 / <10 | SC
28
how much ant/post tilt
20 / 40 | AC
29
how much upward/downward rotation
30 | AC
30
how much IR/ER
30 | AC
31
What is the orientation of the humeral head?
superior (130-150), medial, posterior (30) compared to the shaft and condyles
32
Increased retroversion would cause
more external rotation, less internal rotation
33
What other motion must happen at the GH joint to gain full elevatino of the arm?
external rotation to clear the greater tubercle
34
Abduction is __ roll, ___ glide
superior, inferior
35
flexion is a ___ roll , ___ glide
anterior , post
36
Normal position of scapula on thorax
5 cm from midline, 2-7th ribs, internally rotated 30-45 degrees, tilited anterior 10-15 degrees and upward rotated 10 degrees
37
amount of upward rotation possible
60 degrees | coupled with posterior rotation of SCJ & clavicular elevation
38
At ST joint elevation/depression & protraction/retraction occur at ___ joint while IR/ER & ant/post tilting occur at ___ joint
SC, AC
39
Scapulo humeral rythm
elevation of humerus, upward rotation of scap, post tilt 2: 1 (GH:ST) 120:60 maintain optimal length-tension relationship
40
How many muscles act at the shoulder during elevation
``` 17; 3 deltoid 4 rotator cuff pec major pec minor bicep 3 trap Serratus levator scap 2 rhomboid tricep ```
41
Upward scapula rotators
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
Compression at the GH joint is caused by which muscles
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
Supraspinatus most active between ___ & __ degrees
0-60 | *of abduction
44
Deltoid is the ..
prime elevator for flexion and assist abduction after 15 degrees
45
Deltoid vs supraspinatus in elevation
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
Deltoid vs rotator cuff in elevation
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
Static stabilization of GHJ
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
How does bicep help stabilize shoulder
by centering the head in the fossa and by reducing superior, inferior and anterior translation
49
WHat is the painful arc?
60-120 degrees of humeral elevation
50
Pain due to AC degeneration is found when
the arm is adducted across the body
51
During flexion there is an average of __ lateral rotation at GHJ
51
52
When elevating the arm, the scapula
posteriorly tilits, early it will internally rotate while later externally rotating,
53
Shoulder depressors in weight-bearing
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
Trap is more active in __ than __
abduction than flexion
55
Which muscle is more critical in producing scapular upward rotation ? Serratus or Trap?
Serratus
56
The serratus causes ___ ___ & ___ at the scap
Upward rotation, post tilt and ER
57
Rhomboids are ___ contracting during abduction
essentrically - because they are downward rotators of the scap * also help prevent excessive IR
58
Pec minor creates __ and __ at the scap
depression and abduction
59
Which muscle offsets the downward rotation of rhomboids
Teres major
60
Definition of GIRD
- 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
SLAP tear
Superior labrum anterior posterior
62
Causes of gird
humeral retroversion, throwing causes ER torque, humeral head sits posterior in glenoid
63
Serratus weakness causes
Long thoracic nerve palsy, scapular winging in flexion
64
Upper trap wekaness causes
Spinal Accessory Nerve palsy (SNAP), positive scapular flip, depressed scapula, limited shoulder abduction
65
Upper trap overuse
decreased upward rotation of scap and increased shoulder impingement

Kines Test 2 (4 decks)

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