Shoulder Flashcards
What does the shoulder girdle consist of? (Bones)
The clavicle and scapula
What is the name of the shoulder joint?
Glenohumeral joint
What is the name of the joint where the sternum and the clavicle join?
The sternoclavicular joint (SCJ)
What is the sternoclavicular joint?
The joint between the sternum and the clavicle
What is the point at which the scapular and the clavicle join called?
The acromioclavicular joint (ACJ)
What is the acromioclavicular joint?
The point where the clavicle attaches to the scapula at the acromion
What is the scapulothoracic joint?
The point at which the scapula meets the rib cage
What is the name given to the slight lump on the lateral end of the clavicle?
The deltoid tubercle
What are the two ends of the clavicle called?
Acromial end (smaller) Sternal facet (larger/articulating surface)
What part of the humerus is ‘in the shoulder joint’?
The head of the humerus
What is the shape of the head of the humerus?
Circular (like a hemisphere)
What is the indentation called that is found just distal to the humerus head?
The anatomical neck of the humerus
What is the name given to the groove that runs down the proximal-lateral side of humerus?
Inter-tubercular groove/bicipital groove
What tendon is found in the bicipital groove?
The long head of the bicep
What are found either side of the inter-tubercular groove/bicipital groove? Which is which?
The lesser tubercle (anterior)
The greater tubercle (posterior)
What is the name given to the narrowing of the proximal humerus just distal of the greater/lesser tubercles?
The surgical neck of the humerus
What is the name of the anterior face of the scapula?
Blade
What is the glenoid fossa/glenoid cavity? Where is it found?
Articulating surface for the shoulder joint (glenohumeral joint), concave surface on the lateral side of scapula
What is the supraglenoid tubercle and where is it found?
Top of the glenoid fossa/cavity
What is the infraglenoid tubercle/where would you find it?
It is the base of the glenoid fossa/cavity
What is the posterior boney ridge called that arises from the dorsal surface of the scapula?
The spine
What are the surfaces that lie either side of the scapula’ spine called?
The supraspinous fossa (superior to spine)
The infraspinous fossa (inferior to spine)
What is the lateral of the spine of the scapula called?
The acromion
What bone joins to the acromion and what joint is created?
The clavicle
The acromioclavicular joint
What is the lateral/anterior structure extending from the scapula?
Coracoid process
What is the ligament that joins the acromion and the coracoid process?
The coracoacromial ligament
What type of joint is the glenohumeral joint?q
Synovial
What is the glenoid labrum?
The fibrous cartilage that surrounds the glenoid fossa, deepens the ‘shoulder socket’
What is the deltoid tuberosity?
A rough spot mid way down the lateral side of the humerus shaft
What is the cartilage forming the shoulder socket called?
Glenoid labrum
What is the rough spot mid way down the lateral aspect of the humerus called?
Deltoid tuberosity
What is the ligament called that runs across the intertubercular/bicipital groove?
The transverse ligament
Where is the coracohumeral ligament found?
Running from the coracoid process (scapula) to the greater tubercle (humerus)
Where is the inferior glenohumeral ligament found?
Running from the glenoid process (scapula) to the humerus
How many glenohumeral ligaments are there?
3
Name the 3 glenohumeral ligaments
Inferior–>
Superior–> glenohumeral ligament
Middle –>
What is the coracoclavicular ligament?
The ligament running between the coracoid (scapula) and the clavicle
How many rotator cuff shoulder muscles are there?
4
What are the names of the 4 rotator cuff muscles in the shoulder?
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
What nerve innervates the supraspinatus muscle?
Suprascapular nerve
What nerve innervates the infraspinatus muscle?
Suprascapular nerve
What nerve innervates the Teres minor muscle?
The axillary nerve
What nerve innervates the subscapularis muscle?
The upper and lower subscapular nerve
What are the rotator cuff muscles?
A group of 4 muscles that originate from the scapula and attach the humeral head.
They give the glenohumeral joint a lot of stability as well as having individual actions
What are the attachments of the supraspinatous?
Originates from the spraspinous fossa of scapula,
Attaches to the greater tubercle of humerus
What is the action of the supraspinatus muscle?
Abducts the arm 0-15 degrees and assists the deltoid 15-90 degrees
What are the attachments of the infraspinatus?
Originates from the infraspinous fossa of the scapula,
Attached to the greater tubercle of the humerus
What is the action of the infraspinatus muscle?
Laterally/externally rotates the arm
What are the attachments of the subscapularis?
Originates from the subscapular fossa (blade of scapula)
Attaches to the lesser tubercle of the humerus
(Effectively comes round the front from the armpit)
What are the attachments of the teres minor muscle?
Originates from the infraspinous fossa, adjacent to the lateral border
Attaches to the greater tubercle of the humerus
What is the action of the subscapularis muscle?
Medically/internally rotates the arm
What is the action of the teres minor muscle?
Laterally/externally rotates the arm
What is rotator cuff tendinitis?
It is inflammation of the tendons of the rotator cuff muscles (supraspinatus/infraspinatus/teres minor/subscapularis)
Which of the 4 rotator cuff muscles is most affected by rotator cuff tendinitis?
Supraspinatus
Why is supraspinatus most affected by rotator cuff tendinitis?
Because it rubs against the coracoacromial arch during abduction- causing inflammation overtime
What are the 3 main functions of the clavicle?
Attached the upper limb to trunk
Protects the underlying neurovascular structures supplying the upper limb
Transmits force from the upper limb to the axial skeleton
What is the large facet odd the eternal end of the clavicle for?
Articulation with the manubrium of the sternum at the sternoclavicular joint
Where does the costoclavicular ligament attach to the clavicle?
The interior surface of the sterna end, a rough oval depression
The shaft of the clavicle acts as a point of origin and attachment to several muscles, name the 7 muscles
Deltoid Trapezoid Subclavius Pectoralis major Sternocleidomastoid Sternohyoid
What is the conoid tubercle on the clavicle?
Attachment point of the conoid ligament, medial part of the coracoclavicular ligament (conoid + trapezoid ligaments)
Little lump
What is the trapezoid line on the clavicle?
Attachment point of the trapezoid ligament,
What is the most point of fracture in the clavicle?
The junction of the medial 2/3 and lateral 1/3
What happens to the lateral end of the clavicle after a fracture of the clavicle? Why?
It is displaces inferiorly
Due to weight of arm
It is displace medially
Due to action of pectoralis major
After a fracture, what happens to the medial end of the clavicle? Why?
It is pulled superiorly
By action of sternocleidomastoid muscle
What nerves may be damaged by a fracture in the clavicle?
The Suprascapular nerves (media, intermediate and later) may be damaged by the upwards movement of the medial part of the clavicle.
These nerves innervate the lateral rotators of upper limb- damage results in waiters’ tip position
What is glenohumeral osteoarthritis?
Socket wear and tear
How might someone itch glenohumeral osteoarthritis present?
Progressive pain and stiffness over years
Crepitus (cracking/popping off a joint)
How would you treat glenohumeral osteoarthritis?
Analgesia (pain killers)and exercise
Steroid injections
Eventually joint replacement (hemi/TSR/short stem/surface)
What is frozen shoulder?
Also called adhesive capsulitis
the connective tissue surrounding the glenohumeral joint of the shoulder, becomes inflamed and stiff, greatly restricting motion and causing chronic pain.
How would someone with adhesive capsulitis present?
Pain -severe, progressive, nocturnal, jerk pain
Progressive stiffness follows
Resolves after 2 or 3 year (pain disappears)
**x rays will be normal
How do you treat frozen shoulder?
Distension arthrography (stretching the capsule)
Manipulation under anaesthesia
Surgical release
Which way does a lateral clavicular fragment displace? Why?
It moves medial and inferiorly to the rest of the clavicle due to the weight of the arm
What parts of the brachial plexus are most at risk when there is a clavicular fracture?
The division of the brachial plexus
The suprascapular nerves may be damaged by the upward movement of the medial part of the fracture
Which artery and veins are most at risk of damage from a clavicular fracture?
Subclavian and axillary artery and veins depending on where exactly the break is
**Both vessels are running posteriorly to the brachial plexus
What is a possible complication of a clavicle fracture that need to be quickly ruled out? How would you do that?
Pneumothorax
Auscultation of the chest and an x ray
What is the blood supply of supraspinatus?
Suprascapular artery
What is the blood supply of infraspinatus?
Suprascapula artery and circumflex scapular artery
What is the blood supply of teres minor?
Circumflex scapular artery and posterior circumflex humeral artery
What is the blood supply of the subscapularis muscle?
Subscapular artery
