Shoulder Flashcards
What are the 3 true synovial joints?
Glenohumeral
Sternoclavicular
Acromioclavicular
What are the 2 functional joints?
Scapulothoracic - Functionally acts as a joint but lacks anatomic characteristics of a synovial joint; relies solely on muscular support btwn scapula and thorax
Suprahumeral
What are the two accessory joints of the shoulder joint?
Costosternal
Costovertebral
The spine of the scapula is at the level of ___
T3
The inferior border of scapula is at the level of ___
T7
What rotator cuff muscle is not palpable?
Subscapularis
Early shoulder abduction includes what joints?
Glenohumeral and suprahumeral
Mid-Late should abduction includes what joints?
Scapulothoracic + sternoclavicular + acromioclavicular
Flexion of shoulder
180* sagittal plane
Extension of shoulder joint
60* sagittal plane
Abduction of shoulder joint
180* coronal plane
Adduction of should joint
40-50* coronal plane
Internal rotation of shoulder
90*
External rotation of shoulder
90*
Horizontal abduction of shoulder
40-50* horizontal plane
Horizontal adduction of the shoulder
130-145* horizontal plane
What is circumduction?
Combination of movements causing the humeral head to travel in a small irregular circular and the hand in a wide circular motion
How do you evaluate the glenohumeral joint for SD?
Patient seated or supine
Block linkage at shoulder region and contact olecranon
Evaluate all ranges of motion
Next grip humeral head and other hand block linkage
Load into the GH joint and translate joint Ant/Inf and Post/Sup to assess for eas and restriction of glide
How do you evaluate the acromioclcavicular joint for SD ?
patient seated or supine
Doctor contacts AC joint and palpates for TART findings
Bring GH joint into 60* coronal abduction and 60* horizontal abduction to maximize AC joint motion
Internally and externally rotate the GH joint
IR of GH causes IR of AC
Expected ROM of AC joint with internal and external rotation
10* both ways
How do you evaluate the sternoclavicular joint for flexion/extension SD?
Pt supine
Place fingers bilaterally anterior to the medial clavicular heads next to sternum
Have patient flex shoulders to 90* and reach towards ceiling
Extension occurs as patient returns to neutral
What happens during horizontal flexion of SC joint?
Proximal clavicle moves posterior and distal clavicle moves anterior
What happens during horizontal extension of SC joint?
Proximal clavicle moves anterior and distal clavicle moves posterior
What SD is more common in SC joint horizontal movement?
Horizontal extension SD is more common
How do you evaluate SC joint for abduction/adduction SD?
Pt supine
Place index fingers on superior aspect of proximal clavicular heads and have pt shrug shoulders - abduction (proximal end moves inferiorly)
Have patient return to neutral - adduction (proximal end moves superiorly)
Describe the motion the scapulothoracic joint with elevation
Cephalad and parallel to spine and upper trapezius and levator scapulae responsible for motion
Describe the motion the scapulothoracic joint with depression
return from elevation and lower trapezius and lower rhomboids are responsible for the motion
Describe the motion the scapulothoracic joint with abduction
protraction; away from the spine, combined with lateral tilt around the thorax and serratus anterior responsible for the motion
Describe the motion the scapulothoracic joint with adduction
retraction; move closer to the spine and rhomboids and middle trapezius responsible for the motion
Describe the motion the scapulothoracic joint with upward rotation
forward tilt; serratus anterior and upper trapezius muscle responsible for motion
Describe the motion the scapulothoracic joint with downward rotation
backward tilt; levator scapulae, rhomboid major and minor, and latissimus dorsi muscles are responsible for the motion
What muscles flex the shoulder?
Deltoid and coracobrachialis
What muscles cause extension the shoulder joint?
Lats and teres major
What muscles abduct the shoulder joint?
supraspinatus (10-15*) and mid deltoid
What muscles adduct the shoulder joint
Pectoralis major and latissiumus dorsi
What muscles cause internal rotation of the shoulder joint
Subscapularis and pectoralis major
What test can be performed to test the strength of the internal rotation muscles of the shoulder joint?
Left off test: pt’s arm behind back/w dorsum of hand contacting low back. then have pt try to force their hand away from their back against your resistance
What causes external rotation of the shoulder joint?
Infraspinatus and teres minor
What muscles cause the shoulder joint to be able to “shrug”
trapezius and levator scapulae
The shoulder joint is made of what 3 bones?
Clavicle
Humerus
Scapula - coracoid and acromion
