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Movement > Shoulder > Flashcards

Shoulder Flashcards

1
Q

What is the glenohumeral joint?

A

Articulation between glenoid fossa (scapula) and head of humerus

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2
Q

Why isn’t the glenohumeral joint very stable?

A

Thin joint capsule, and poor articulation of surfaces

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3
Q

What increases the stability of the GH joint? (4)

A
  • glenoid labrum
  • biceps tendon
  • rotator cuff muscles
  • ligaments
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4
Q

Which 3 ligaments help to stabilise the GH joint?

A
  • Glenohumeral
  • Coracohumeral
  • Transverse humeral
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5
Q

Where is the GH joint weakest?

A

Inferiorly

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6
Q

What is the glenoid labrum?

A

Ring of cartlidge around the glenoid fossa - helps to improve the fit of the head of humerus

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7
Q

What is the coracoacromial arch and what is its function?

A

Consists of acromion process, coracoid process and coracoacromial ligament.
-Prevents sup displacement of humerus

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8
Q

What are the 2 bursae of the GH joint?

A
  • Subscapular

- Subacromial

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9
Q

What can chronic inflammation of the bursa lead to?

A

Calcification of bursa

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10
Q

What is painful arc syndrome?

A

Pain wh en upper limb is abducted between 50* and 130* due to calcific bursitis.

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11
Q

What is the only connection of the scapula with the axial skeleton?

A

Clavicle

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12
Q

Is the clavicle concave or convex?

A

Lat 1/3 = concave

Med 2/3 = convex (allows passage of neurovascular bundle to upper limb)

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13
Q

What are the 4 rotator cuff muscles?

A

Supraspinatus
Infraspinatus
Subscapularis
Teres minor

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14
Q

What do the tendons of the rotator cuff muscles do?

A

Keep head of humerus in glenoid fossa

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15
Q

Where do the 4 rotator cuff muscles attach to the humerus?

A

Supraspinatus, infraspinatus and teres minor - Greater tubercle (sup/mid/inf facets)

Subscapularis - Lesser tubercle

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16
Q

What is the origin, insertion and innervation of the supraspinatus muscles?

A

Origin - Supraspinous fossa (scapula)

Insertion - Greater tubercle of head of humerus Innervation - Suprascapular nerve(C5,C6)

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17
Q

What is the action of the supraspinatus muscle and what is the test for its function?

A

Action: initiates abduction of the arm (first 15) and stabilizes the glenohumeral joint
Test: Abduct the arm against resistance (from 0)

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18
Q

What is the origin, insertion and innervation of the infraspinatus muscle?

A

Origin: Infraspinous fossa (scapula)
Insertion: Greater tubercle of the head of the humerus Innervation: Suprascapular nerve (C5, C6)

19
Q

What is the action of the infraspinatus muscle and what is the test for its function?

A

Action: Lat rotator of humerus and stabilizers the glenohumeral joint
Test: Lat rotate the arm against resistance

20
Q

What is the origin, insertion and innervation of the teres minor muscle?

A

Origin: Mid of lat border of scapula
Insertion: greater tubercle of the head of the humerus Innervation: Axillary nerve (C5,C6)

21
Q

What is the action of the teres minor muscle and what is the test for its function?

A

Laterally rotates and adducts the humerus (with infraspinatus) and stabilises the glenohumeral joint
Test: Laterally rotate the arm against resistance

22
Q

What is the origin, insertion and innervation of the subscapularis muscle?

A

Origin: Subscapular fossa Insertion: Lesser tubercle of the head of the humerus Innervation: Upper and lower subscapular nerves (C5 - 6)

23
Q

What is the action of the subscapularis muscle and what is the test for its action?

A

Action: Medial rotator and adductor of the humerus and stabilises the glenohumeral joint
Test: Place the dorsum of the hand to the mid lumbar spine then lift the dorsum of the hand off the back

24
Q

What is the origin, insertion and innervation of the teres major?

A

Origin: inferior angle of the scapula
Insertion: Medial lip of intertubercular of humerus
Innervation: Lower subscapular nerve (C5-6)

25
Q

What is the function of teres major?

A

Adducts and medially rotates humerus

26
Q

What tendon is most commonly torn in rotator cuff tears?

A

Supraspinatus

27
Q

What is the test for a rotator cuff tear?

A

Abduct arm fully, lower arm slowly - will fall suddenly at about 90*

28
Q

What is the most common cause of GH joint dislocation? Which direction?

A

Excessive extension and lat rotation of humerus

Anteroinferior (inf is weakest point)

29
Q

What nerve can be damaged by inferior dislocation at GH joint?

A

Axillary nerve

30
Q

What 4 things does a patient with a damaged axillary nerve following dislocation of the gelnohumeral joint typically present with?

A
  • prominent acromion process
  • flattened shoulder
  • prominent humeral head
  • anaesthesia in upper arm skin
31
Q

What are the 4 movements of the GH joint?

A
  • flexion/extension
  • abduction/adduction
  • circumduction
  • med & lat rotation
32
Q

What muscles are involved in arem abduction?

A
  • Supraspinatus (1st 15*)

- Deltoid

33
Q

In abduction of the upper limb above 90 degrees muscles other than the supraspinatus and deltoid are involved, what are they and what is there action?

A

Teres minor - laterally rotates the humerus

Trapezius and serratus anterior rotate the scapula laterally

34
Q

How does paralysis of suprspinatus impair abduction?

A 
Suprascapular nerve (C5, C6) damage - supraspinatus is responsible for first 15*. 
Patient can compensate by leaning and allowing gravity to do it
35
Q

How can the deltoid muscle become paralysed and what is the consequence of this?

A 
Axillary nerve (C5,C6) damage due to shoulder dislocation/humerus fracture (surgical neck).
Arm cannot be lifted above 90*
36
Q

What structures travel through the quadrangular space?

A
  • Axillary nerve

- Post circumfex humeral artery & vein

37
Q

What are the boundaries of the quadrangular/quadrilateral space?

A

Lateral - surgical neck of the humerus
Medial - Long head of triceps brachii (muscle)
Superior - Teres minor
Inferior - Teres major

38
Q

What is quadrangular space syndrome? What are the symptoms?

A

Post humeral circumflex artery and axillar nerve blockage.

Shoulder pain and paraesthia down arm

39
Q

What are the attachments of deltoid?

A

ORIGINS: inf edge of spine of scapula, lat margin of acromion, ant border of lat 1/3 of clavicle
INSERTIONS: Deltoid tuberosity of humerus

40
Q

What is the innervation of deltoid?

A

Axillary nerve (C5, C6)

41
Q

What are the actions of the ant/post fibres of deltoid, and the muscle as a whole?

A

ANT - flew arm at GH joint
POST - extend arm at GH joint
WHOLE - abductor of arm above 15*

42
Q

What is frozen shoulder syndrome?

A

Pain and limited movement at shoulder. May be due to injury/overuse/diaebetes.

43
Q

How is frozen shoulder syndrome treated?

A
  • Corticosteroids

- Capsular distension

Movement (12 decks)

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