Shoulder Flashcards
What does Axillary pouch do
it supports the humeral head above 90 abduction, limiting inferior translation while anterior band tightens on lateral rotation and posterior band tightens on medial rotaion
superior glenohumeral ligament
limiting inferior translation in adduction, restrains anterior translation and lateral rotation upto 35 degree abduction
middle glenohumeral ligament
absent in 30 % of population, limits lateral rotation between 45-90%
Excessive lateral rotation such as throwing may lead…
stretching of anterior portion of the ligament and capsule, increasing glenohumeral laxity
coracohumeral ligament primarily limits
inferior translation helps limit lateral rotation below 60 degree abduction
Which two tendons coracohumeral ligament unites
Supraspinatus and Subscapularis
Rotator interval consists
coracohumeral ligament, superior glenohumeral ligament, glenohumeral joint capsule, part of the tendons of supraspinatus and subscapularis
coracoacromio ligament limits
superior translation of glenohumeral joint
paratenonitis
outer covering of the tendon whether or not it is lined with synovium.
Tendinosis
actual degeneration of the tendon itself
Primary ligaments of the Glenohumeral joint and which is important
Superior, middle and inferior Glenohumeral ligament
Inferior glenohumeral ligament is most important, has anterior and posterior band with thin axillary pouch in between.
TUBS type instability
Traumatic onset, Unidirectional anterior with Bankart lesion responding to Surgery
AMBRI type instability
Atraumatic cause, Multidirectional with Bilateral shoulder findings with Rehabilitation as appropriate treatment and rarely Inferior capsular ship surgery
SICK scapula
malposition of Scapula prominence of Inferior medial border of scapula, Coracoid pain and malposition, and scapular dysKinesia
step deformity
acromioclavicular dislocation with the distal end of the clavicle lying superior to the acromion process. Indicates acromioclavicular and coracoclavicular ligaments have been torn
Fountain sign
welling anterior to acromioclavicular joint. indicating degeneration has caused communication between the acromioclavicular joint and swollen subacromial bursa underneath
sulcus deformity
multidirectional instability or loss of muscle control due to nerve injury or a stroke, leading to inferior subluxation of the glenohumeral joint. This deformity is lateral to the acromion and should not be confused with a step deformity
scapular dyskinesia
aka scapular dysfunction, excessively protracted scapula during arm motion
Primary scapular winging
implies the winging is the result of muscle weakness of one of the scapular mm stabilizers that in turn, disrupts the normal mm force couple balance of the scapulothoracic complex
secondary scapular winging
normal movement of the scapula is altered because of pathology in the glenohumeral joint
Dynamic scapular winging
winging with movement may be caused by a lesion of the long thoracic nerve affecting serratus anterior, rhomboid weakeness, multidirectional instability, voluntary action or a painful shoulder resulting in splinting of the glenohumeral joint which in turn causes reverse scapulohumeral rhythm
Spinal accessory nerve palsy
CN XI AKA trapezius palsy, scapula to depress and move laterally with the inferior angle rotated laterally. If Trapezius is weak or paralyzed,the winging of the scapula occurs before 90 degree abduction and there is little winging on forward flexion