Shoulder Flashcards
What elements of the shoulder increase its stability?
joint deeper with labrum
glenohumeral ligaments strengthen the capsule
scapula positions optimally with scapular stabilizers to support the humerus
Name the 4 joints comprising the shoulder girdle?
scapulocostal
sternoclavicular
acromioclavicular
genohumeral
Describe the sternoclavicular joint and its stabilizing ligament.
includes an articular disc, moving similar to a ball and joint socket
stabilized by anterior and posterior SC ligaments, along with the costoclavicular ligament
Name the respective ligaments that provide AP and vertical stability in the acromioclavicular joint.
AC ligament provides AP stability (coracoacromial ligament)
CC ligament provides vertical stability (coracoclavicular ligament)
Name the muscles of the rotator cuff and their actions.
subscapularis- internal rotation
theres minor and infrapsinatus- external rotation
supraspinatus- abduction
Name the muscles of the rotator cuff and their actions.
subscapularis- internal rotation
theres minor and infrapsinatus- external rotation
supraspinatus- abduction
What is force coupling regarding the action and movement of the shoulder?
the deltoid alone can only lift the shoulder up, it must couple with the rotator cuff pulling toward the midline in order to abduct the arm
Name the major support muscles to the scapula.
rhomboid, trapezius and serratus anterior muscles which primarily function to keep the scapula in a supportive position during movement of the humerus
Patient presents with acute shoulder injury, likely caused by trauma, what is in the differential?
AC separation (sprain) clavicle fracture SC sprain humerus fracture rotator cuff tear glenohumeral dislocation
Describe the mechanism of injury in a separated shoulder.
common in contact sport or any direct force to the acromion (edge of the shoulder), causing swelling, tenderness and possible deformity
Type I: only AC ligaments irritated
Type II- tear the AC ligaments
Type III- tear AC and CC- lots more movement
What is the treatment for AC separation?
non-surgical treatment for type I and II (AC ligament only torn or irritated)
refer to specialist for more severe cases
Patient presents with acute shoulder injury, likely caused by trauma, what is in the differential?
AC separation (sprain) clavicle fracture SC sprain humerus fracture rotator cuff tear glenohumeral dislocation
chronically: rotator cuff tear, sub lacrimal bursitis, tenden/bursa impingement
What is the treatment for AC separation?
non-surgical treatment for type I and II (AC ligament only torn or irritated)
refer to specialist for more severe cases
What is the mechanism and clinical findings of a glenohumeral dislocation?
mechanism of injury: forced external rotation and abduction; accompanied by tearing of the anterior labrum and capsule (Bankhart lesion)
clinically: loss of deltoid contour, anterior prominence and posterior defect, possible axillary nerve injury
What is the treatment for a glenohumeral dislocation?
reduce dislocation with careful neurologic exam following
use a sling for comfort; ROM and strength should be addressed with functional rehab
**high rate of recurrence in younger athletic populations, surgical stabilization can be important
