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Kines I final > Shoulder > Flashcards

Shoulder Flashcards

1
Q

3 joints of shoulder

A

Glenohumeral
Sternoclavicular
Acromioclavicular

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2
Q

in flexion/abduction, how much do the scapula and GH joint contribute

A

scapula 1/3

GH joint 2/3

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3
Q

What kind of joint is sternoclavicular?

A

synovial plane

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4
Q

SC disk- upper attachment

A
  • considered part of manubrium

- in elevation and depression, medial clavicle ROLLS AND GLIDES on stationary disk

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5
Q

SC disk- lower attachment

A
  • part of clavicle

- in protraction and retraction, SC disk and medial clavicle ROLL and SLIDE on manubrial facet

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6
Q

Functions of SC discs

A
  1. stability
  2. increase joint congruence
  3. absorbs forces transmitted from lateral to medial
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7
Q

What does SC disc limit

A

medial movement of clavicle

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8
Q

What ligaments comprise the joint capsule

A 
Sternoclavicular ligament (anterior and posterior)
Costoclavicular ligament (anterior and posterior)
Interclavicular ligament
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9
Q

What is the function of the sternoclavicular ligament?

A

reinforces joint capsule

limit A/P translation of medial clavicle

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10
Q

Bilaminar costoclavicular ligament function

A
  • limit elevation of lateral clavicle

- help inferior glide of medial clavicle

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11
Q

interclavicular ligament

A
  • limits excessive depression of lateral clavicle

- aids in superior glide of medial clavicle

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12
Q

SC joint motions

A

elevation/depression
protraction/retraction
anterior/posterior rotation

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13
Q

SC joint elevation and depression slide arthrokinematics

A

elevation- superior roll, inferior glide

depression- inferior roll, superior glide

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14
Q

SC joint elevation depression ROM

A

Elevation:

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15
Q

SC joint protraction/retraction arthrokinematics

A

protraction: anterior slide
retraction: posterior slide

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16
Q

concave/convex of protraction retraction of SC joint

A

concave: clavicle
convex: manubrium

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17
Q

SC joint protraction retraction ROM

A

protraction: 15-20º
retraction: >30º

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18
Q

SC joint anterior posterior rotation (spin) between what surfaces

A

saddle shape surface of medial clavicle and manubriocostal facet

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19
Q

anterior posterior rotation of SC joint motion

A

it can posterior rotate but it’s anterior rotation is just coming back to normal (it’s pretty limited)

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20
Q

SC joint anterior posterior rotation ROM

A

Anterior rotation:

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21
Q

SC joint and stress (degeneration)

A
  • SC joint does NOT undergo a lot of degenerative change like other shoulder joints
  • SC disc and Costclavicular ligament minimize stress
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22
Q

AC joint type

A

synovial plane

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23
Q

AC joint functions

A
  1. to allow scapula to rotate in 3D during arm movement so UE motion is increased
  2. allows transmission of forces from UE to clavicle
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24
Q

is the AC joint capsule weak or strong?

A

Weak. cannot maintain integrity without reinforcement of ligaments

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25
Q

ligaments of AC joint are…

A
  • superior and inferior Acromioclavicular ligament

- coracoclavicular ligament

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26
Q

what does the superior acromioclavicular ligament limit

A

limits movement caused by anterior forces

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27
Q

is superior AC ligament stronger or weaker than inferior AC ligament?

A

stronger

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28
Q

what reinforces fibers of superior AC ligament

A

aponeurotic fibers of traps and delts

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29
Q

function of coracoclavicular ligament

A
  1. unites clavicle and scapula
  2. provides most of the joints superior and inferior stability
  3. protect tendon of RTC
30
Q

describe the medial part of the coracoclavicular ligament

A
  • conoid

- provides restraint to translatory movement by superior directed forces to distal clavicle

31
Q

describe the lateral part of the coracoclavicular

A
  • trapezoid

- provides more restraint that the conoid to translatory movement caused by posterior directed forces.

32
Q

what do both portions (conoid and trapezoid) do together?

A
  • limit upward rotation of scapula

- prevent medial displacement of scapula (esp trapezoid)

33
Q

what are the motions that occur at the AC joint?

A

internal/external rotation
anterior/posterior tilting
upward/downward rotation

34
Q

AC joint internal external rotation ROM

A

I and E comibined: 30º

35
Q

Anterior/posterior tilting of AC joint ROM

A

anterior and posterior combined 20-40º

36
Q

upward and downward rotation of AC joint ROM

A

available ROM 30º

37
Q

AC joint and stress

A

yes, susceptible to trauma and degenerative stress

38
Q

Scapulothoracic (ST) joint closed pack position

A

abduction

ER

39
Q

motions of the scapula

A 
upward and downward rotation- primary scapular motion
elevation and depression- SC jt
protraction and retraction- SC jt
Internal and external rotation- AC jt
Anterior and Posterior tilting- AC jt
40
Q

Glenohumeral joint type

A

ball and socket

41
Q

what is the angle of inclination (GH joint)

A
  • axis through humeral head and neck in relation to longitudinal shaft of humerus
  • (between 130º and 150º: typically 135º)
42
Q

angle of torsion (GH joint)

A
  • axis through humeral head and neck in relation to an axis through humeral condyles
  • usually 30º
43
Q

Function of the labrum

A
  1. attachment for biceps long head
  2. resists translation of humeral head
  3. reduces joint friction
  4. enhances depth by 50%
  5. protects bony edge of labrum
44
Q

What makes up the GH capsule?

A

superior GH ligament
middle GH ligament
inferior GH ligament complex

45
Q

what does the superior GH ligament do? when is it active

A
  • contributes most to anterior and inferior joint stability

- at 0º abduction

46
Q

what does the middle GH ligament do? when is it active?

A
  • contributes mainly to anterior joint stability
  • absent in 30% people
  • at 0-60º abduction
47
Q

what does IGHLC do? when is it active?

A
  • has 3 parts: anterior, posterior ligaments with axillary pouch in between.
  • anterior ligament limits anterior translation at ER
  • posterior ligament limits posterior translation at IR
  • with at least 45º abduction, IGHLC resists inferior humeral head translation.
48
Q

Coraacoacromial arch limits what

A

inferior translation of humeral head

49
Q

what does Band 1 and Band 2 of coracoacromial ligament doe

A

Band 1: inserts onto supraspinatus and greater tubercle; joint superior GH ligament
Band 2: inserts onto subscapularis and lesser tubercle

both form tunnel for LONG head of biceps

50
Q

what is repetitive impingement?

A

inflammation, fibrosis, thickening of soft tissues;

further reducing subacromial space during arm elevation

51
Q

most important bursae of shoulder complex? function?

A
  • subacromial and subdeltoid bursae

- reduces friction to permit smooth gliding

52
Q

GH motions and ROM

A

Flexion (120º) and Extension (50º)
Abduction and Adduction
Medial and Lateral rotation (90º-120º)

53
Q

Scapulohumeral Rhythm

A
  • elevation of humerus
  • upward rotation of scapula
  • posterior tilt of scapula
  • 2:1 ration (GHJ:STJ)
54
Q

upward scapular rotators?

A

Upper, Middle, Lower trap

SA

55
Q

What muscles make up rotator cuffs (RTC)?

A

Supraspinatus
Infrapsinatus
Teres minor
Subscapularis

56
Q

What do RTC cause at the joint?

A

compression and joint stabilization

57
Q

What happens at glenohumeral elevation?

A

supraospinatus is most active 0-60 (initiates elevation)

deltoid is prime elvator for flexion, assist abduction AFTER 15 degrees.

58
Q

describe what happens with the deltoid and supraspinatus during arm elevation (MA of deltoid and supraspinatus, deltoid force)

A
  • deltoid has small MA during early elevation
  • supraspinatus has longer MA during early elevation
  • deltoid MA improves in mid range (gets longer)
  • deltoid provides greater abduction force tha nsupraspinatus
    Overall: deltoid is good abductor after 15 degrees. Deltoid MA increases so it becomes stronger to abduct amr.
59
Q

Describe the deltoid and the rotator cuff during arm elevation?

A
  • deltoid causes superior glide of humerus (lead to impingement bw humerus and acromion)
  • RTC causes inferior glide
    Overall: deltoid has superior pull; RTC has inferior pull
60
Q

Shoulder depressors in WB

A

lats

pec major

61
Q

if teres major is weak, what happens to scapula?

A

wings out

62
Q

what is the antagonis of the teres major? what is it’s function

A
  • rhomboids

- Rhomboids need to stabilize the scap so it prevents IR to keep the scapula in good position so it doesn’t fly off.

63
Q

scapular depression and abduction muscle

A

pec minor

64
Q

What is GIRD?

A

Gleohumeral IR Deficit

- loss of IR of 20 degrees or more compared to other side

65
Q

How can you get GIRD

A
  • shoulder overuse injury
  • impingement
  • RTC tears
  • SLAP tears
66
Q

what does GIRD cause (torsion) and why

A

Humeral retroversion because after years of throwing constantly, the shaft of the humerus begins to rotate, so humeral heads sits posteriorly on glenoid.

67
Q

serratus anterior weakness causes and what does it cause?

A

causes: long thoracic nerve palsy and disuse

will cause: scapular winging IN FLEXION

68
Q

Upper trapezius weakness- causes and what does it cause

A

causes: Spinal accessory nerve palsy (SNAP)

will cause: scapular flip, trap atrophy, depressed scap, trap weakeness, limited shoulder abduction

69
Q

how to tell if it’s serratus weakness or trapezius weakness

A

if scap wings in
Abduction= upper traps
Flexion= SA

70
Q

what can cause RTC weakness?

A 
tear
suprascalular n pinch
C5-C6 radiculopathy
bursitis
CVA
disuse
71
Q

what is hemiplegic shoulder?

A

when joint is sublaxed (not even sitting in glenoid

fix posture first then muscles (supraspinatus, delts)

72
Q

resting position of scap

A

UR 5-10
AT 10-15
ARot 35-45

Kines I final (1 decks)

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