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KIN 440 > Shoulder > Flashcards

Shoulder Flashcards

1
Q

The shoulder complex is a coordinated function of:

A
  • glenohumeral (scapulo-humeral)
  • acromioclavicular
  • sternoclavicular
  • scapulothoracic
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2
Q

3 Joints of the shoulder complex:

A
  • sternoclavicular joint
  • acromioclavicular joint
  • glenohumeral (GH) joint
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3
Q

Sternoclavicular joint is a direct connection between ____ and _____.

A
  • UE

- trunk

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4
Q

Sternoclavicular joint is what type of joint?

A

weak synovial plane joint

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5
Q

Sternoclavicular joint is stabilized by…

A

strong ligaments and articular disc

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6
Q

Sternoclavicular joint moves with….

A
  • scapula

- actions of shoulder cause motion at this articulation

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7
Q

Acromioclavicular joint is a connection between ____ and ____.

A
  • scapula

- clavicle

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8
Q

Acromioclavicular joint is what type of joint?

A

weak synovial gliding joint

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9
Q

Acromioclavicular joint is stabilized by…

A

multiple strong ligaments

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10
Q

Acromioclavicular joint moves with…

A
  • UE

- actions of shoulder cause motion at this articulation

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11
Q

Scapulothoracic pseudo-articulation is …

A

not a true joint

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12
Q

Scapulothoracic pseudo-articulation movement pattern:

A
  • between the scapula and across the thoracic cage (ribs)
  • elevation, depression
  • protraction, retraction
  • rotation
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13
Q

Scapulothoracic pseudo-articulation dysfunction often results in…

A

stress or injury to shoulder joint from repetition of movement

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14
Q

With contraction of _____ stabilization muscles, a strong base for high level ___ ____ mobility of ____ is achieved.

A
  • scapular
  • GH joint
  • UE
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15
Q

GH joint:

A
  • ball and socket joint
  • multiaxial joint, mobile joint
  • articulation of head of the humerus with glenoid fossa or cavity of scapula
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16
Q

ROM of GH joint:

A
  • flexion, extension
  • abduction, adduction
  • medial rotation, lateral rotation
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17
Q

Labrum of the GH joint is called:

A

glenoid laburm

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18
Q

Functions of the glenoid labrum:

A
  • joint stability
  • deepens and increases glenoid depth approximately 2x
  • protects bone
  • lubricate joint synovial fluid
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19
Q

Glenoid labrum is continuous with …

A

tendon of long head of the biceps brachii

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20
Q

Injury to glenoid labrum:

A
  • labral stress
  • load
  • rotations with stress
  • extreme ROMs (past end ROM)
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21
Q

Capsule of the GH joint:

A
  • assists in joint stability

- rotator cuff tendons blend in for a dynamic capsular tightening (restricts extreme ROM)

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22
Q

Capsular injury of the GH joint can be…

A

acute or chronic injury

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23
Q

Functions of bursa of the shoulder:

A
  • aids mobility

- increases ROM

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24
Q

4 bursae in the shoulder:

A
  • subacromial bursa
  • subdeltoid bursa
  • subcoracoid bursa
  • subscapular bursa
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25
Bursae of the shoulder injury MOI:
- compression | - contusion/contact
26
Most common bursae injuries:
- subacromial bursa | - impingement
27
GH ligaments are the primary check against...
anterior and posterior dislocations
28
GH ligaments are critical structures for...
- joint stabilization | - overhead activities
29
Ligamentous support of ...
- GH joint | - AC joint, SC joint
30
If there is injury to the ligaments of the GH joint, there will be...
pain with ROM
31
3 components of neurovascular structures of shoulder joint and complex:
- arteries - veins - nerves
32
Important neuro structures of shoulder:
- brachial plexus - auxillary nerve - musculocutaneous n. - radial n. - scapula ulnar n. - median n.
33
Important vascular structures of shoulder:
- subclavian artery - axillary artery - brachial artery
34
DOI questions for shoulder:
- acute | - chronic (repetitive movements of arm)
35
MOI questions for shoulder:
- understand tissues under stress (fall on point, or repetitive motion) - not position of arm relative to joint (ie. FOOSH, at side, forcefully abducted and extended)
36
Pain questions for shoulder:
- region, referred or radiates (if yes, quadrant scan) - establish relationship with function and the pain - ADL, sleep (affected, positions of pain)
37
Unusual sounds and sensations questions for shoulder:
- crepitus - catching or clicking - give way - pop out
38
Function questions for shoulder:
- notable weakness | - affect function of the wrist and hand
39
Previous injury questions for shoulder:
- dislocations - MVA - whiplash - injury to neck or spine
40
Changes in sensations (unusual sensations) questions for shoulder:
- numbness - tingling - stabbing - any circulation changes (cold)
41
Activity/sport history questions for shoulder:
- any OH activities in sport, ADL, occupation (positions of pain) - changes to activity, training, strength training
42
Key observations to consider for the GH joint:
- all view points - scapular posture - position of shape of clavicle - muscle asymmetry - spinal alignment - scapulo-humeral rhythm
43
All view points includes:
- anterior - posterior - lateral - landmarks
44
What to look for with scapular posture:
- resting position of the scapula - bilateral position - scapular elevation - protraction position - winging - scapular deviations
45
Position and shape of clavicle:
- acromion process (height of, deformity of) - observe notable or remarkable postures - bony prominences
46
What to look for with muscle asymmetry:
- shape - girth - atrophy
47
What to look for with spinal alignment:
- position of head - t-spine - position of UE
48
Scapular dyskinesis:
- noting border prominences that are remarkable - protracted, retracted - rotated, tilted - winging
49
Acromion process deformity:
- AC joint | - piano key (sign for a sprain of AC ligaments)
50
Impact of spinal alignment with shoulder pain:
- CC: pain in ant. aspect of shoulder - observe thoracic spine (kyphotic posture) - impact on shoulder pain
51
Scapulo-humeral rhythm:
observation of a pattern or rhythm of the movement of the humerus (UE) in relation to the scapula
52
Full ROM at the shoulder is a combination of...
- complex - GH joint - SC joint - AC joint - scapulothoracic movement along with the spine
53
Full ROM movement can be compromised by...
- anything that changes the position of the scapula | - such as muscle imbalances
54
Purpose for effective movement pattern:
- to achieve full and functional ROM in a pain free ROM | - for efficient and effective strength and power in movement
55
Movement pattern for first ___ degrees abduction or first ____ degrees flexion:
- 30 - 45 - humerus moves - scapula is fixed to a position of stability on thorax
56
Movement pattern for beyond the initial range:
- the ratio of humerus to scapular movements is a 2:1 ratio | - scapular rotation facilitates GH movement
57
Degree of ROM is an assessment relative to...
positioning of the UE
58
How to assess degree of ROM:
- direct rotation of UE or observe for it - evaluate with elbow straight or bent elbow - can assess internal/external GH ROM in any degree of abduction or of flexion (ie rotation at 90/90) - transverse or horizontal abduction
59
When assessing ROM, we should assess _____ for ...
- bilaterally - pain - strength - degree of range
60
Notable or remarkable observations in ROM:
- painful arc pattern - starting positions for initiating movement - observation of the scapulo-humeral rhythm
61
Painful arc pattern describes a syndrome where there is...
- a common painful range of 60-120 degrees for flexion and abduction - painful at end of the ROM
62
Painful arc pattern IOS:
- subacromial dysfunction | - inflamed tendon presses against acromium
63
Structure of painful arc pattern:
- compressed, pinching | - AC joint, RTC tendon, subacromial bursa
64
Glenohumeral painful arc:
60-120 degrees
65
Acromioclavicular painful arc:
170+ degrees
66
MMT using UE positioning: deltoid:
- anterior, lateral, posterior | - flexion, abduction, extension
67
MMT using UE positioning: supraspinatus:
- abduction | - deltoid
68
MMT using UE positioning: biceps long head:
- flexion - 2 joint muscle (TJM) - anterior deltoid
69
Impingement positions are...
unwanted compression of soft tissue between 2 or more harder unyielding structures
70
Impingement positions leads to...
- pressure - inflammation - pain - loss of function
71
MOI for impingement positions:
typically repetitive OH actions
72
Impingement positions are evaluated in ....
- end range of AROM and PROM | - sign and a symptom
73
How to conduct a impingement test:
- position the UE to stress structures of the GH joint | - pinch, impinge, compress
74
Coracoacromial arch is made up of:
- acromion - coracoacromial ligament - coracoid process
75
Common impingement structures at the GH joint:
under coracoacromial arch
76
Apprehension test assesses...
- the integrity of stabilizing structures of the joint | - the client's feeling of instability in ROMs
77
Anterior apprehension test:
- positive test illicit apprehension in putting the humeral head into a position to stress the joint - leads to an IOS of GH joint instability (subluxation, dislocation)
78
Movements of function:
- in OH activities; as a weight-bearing joint | - load, compress, stress the joint and the shoulder complex (stress to structures; symptoms)
79
Movement of shoulder complex in combination of
- SC joint - AC joint - scapula: movement to positions of stability - GH joint - spine
80
Maintaining ____ while allowing for a high degree of _____ is critical for effective and full shoulder function.
- stability | - mobility
81
___ joint instability is often the cause of many specific shoulder injuries like...
- GH | - tendinitis, dislocation, subluxation
82
GH joint injuries result from...
- structural vulnerability - extensive freedom of movement - poor correlation between articular surfaces - great strength of surrounding musculature
83
While the GH joint is inherently _____, the coordinated and synchronous actions of the ____ and _____ structures provide joint stability.
- unstable - static - dynamic
84
GH joint has integrated function of ____ structures and _____ (____) structures such as....
- inert - contractile (dynamic) - joint - scapular stabilizing muscles - RTC muscles - joint capsule labrum and ligaments
85
What originates on axial skeleton to humerus?
- latissimus dorsi | - pec major
86
What originates from the scapula to humerus?
- deltoid, teres major, corochobrachialis | - subscapularis, teres minor, supraspinatus, infraspinatus
87
RTC in conjunction with biceps provide dynamic stability through...
- minimizing excessive humeral head displacement | - creates force couples to compress humeral head into glenoid fossa
88
_____ imbalances cause _____ mechanics.
- dynamic | - abnormal
89
Stability: which muscles go from axial skeleton/spine to scapula?
- pecs - lats - levator scap - rhomboids - serratus anterior - trapezius
90
____ stability aids _____ mobility of GH joint.
- scapular | - functional
91
Scapular muscles produce ....
- scapular motion | - dynamically position the glenoid for humeral motion
92
Collectively, scapular muscles work to ....
maintain consistent length-tension relationships with the glenohumeral musculature
93
Scapular muscles sustain _____ _____ through a larger portion of the ROM.
force production
94
Scapular muscles prevents _____ between the _____ and the _____ (____).
- impingement - humerus - acromion (scapula) - movement between the humerus and scapula is limited
95
Key scapular stabilizers:
- spinal posture | - scapular posture
96
What provides strength for the shoulder?
- scapular stabilizers | - RTC
97
At the shoulder, we are palpating for ...
- pain - TICS - integrity of the joint (AC, SC joints) - instability of the bones (clavicle, acromian, humerus) - soft tissue structures (muscles, tendons, ligaments, bursa) - pain (specific site = location of structure)
98
Structures in the shoulder:
- bone - joint - ligament - muscular - nerve - meniscus - bursa - capsule
99
Types of potential injuries:
- sprain - strain, tendonitis - bursitis - fracture - dislocation, subluxation - labral injury - brachial plexus/nerve injury - thoracic outlet syndrome
100
Severity is ranked by....
grade
101
Rehab considerations: ____ response to _____ controlled.
- tissues | - trauma
102
Rehab considerations: injured part should be ____/____.
rested/supported
103
Rehab considerations: restore...
- scapulothoracic control - ROM - rotator cuff function and endurance
104
Rehab considerations: assess...
- scapulohumeral rhythm | - posture
105
Rehab considerations: _____ control.
proprioceptive
106
Rehab considerations: how to have progressive return to function:
- activity modification | - equipment modification

KIN 440 (10 decks)

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