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Kinesiology > Shoulder > Flashcards

Shoulder Flashcards

1
Q

what type of joint is the SC?

A

functions as a saddle

structurally it is basically a planar

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2
Q

how is the SC joint stabilized?

A
  1. a disc between the clavicle and manubrium improves congruency
  2. Passive stabilizers
  3. Dynamic stabilizers
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3
Q

List the structures that passively stabilize the SC joint

A
  1. fibrous joint capsule
  2. A/P sternoclavicular ligaments
  3. Costoclavicular ligament (posterior and anterior bundle)
  4. interclavicular ligmanet
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4
Q

what motion does the fibrous joint capsule of the SC joint limit?

A

anterior and posterior translation of medial clavicle

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5
Q

what motion does the A/P sternoclavicular ligament limit?

A

Anterior = posterior translation of clavicle

Posterior = anterior translation of clavicle

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6
Q

what are the 2 portions of the costoclavicular ligmanet and what do they limit?

A

Anterior and Posterior bundle

limit elevation of clavicle

contribute to inferior glide of medial clavicle in elevation

shock absorption

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7
Q

what does the interclavicular ligament limit?

A

excessive depression and superior glide of clavicle

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8
Q

List the structures that dynamically stabilize the SC joint

A
  1. SCM
  2. Sternohyoid
  3. Sternothyroid
  4. Subclavius
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9
Q

what osteokinematic motions are available at the SC joint?

A
  1. elevation/depression
  2. protration/retraction
  3. anterior/posterior rotation
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10
Q

describe the arthrokinematics of the SC joint during elevation/depression

A

convex on concave

elevation = lateral clavicle rotates upward (superior roll, inferior glide)

depression = lateral clavicle rotates downward (inferior roll, superior glide)

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11
Q

describe the arthrokinematics of the SC joint during protraction/retraction

A

concave on convex

protraction = lateral clavicle moves anterior (anterior roll and glide)

retraction = lateral clavicle moves posterior (posterior roll and glide)

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12
Q

Describe the SC for the following:

closed pack

open pack

capsular pattern

A

closed pack = full posterior rotation (full arm elevation)

open pack = arm resting at side

capsular pattern = pain at end range with arm overhead

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13
Q

what is the joint type of the acromioclavicular (AC) joint?

A

planar synovial

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14
Q

T/F: an AC joint disc is always present

A

FALSE
it may or may not be there

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15
Q

List the passive structures that support the AC joint

A
  1. weak joint capsule
  2. Superior AC ligament
  3. Inferior AC ligament
  4. Coracoclavicular ligaments
    1. Trapezoid ligaments
    2. Conoid ligaments
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16
Q

what does the Superior Acromioclavicular ligmanet limit at the AC joint?

A

resists anterior clavicular/posterior acromion translation

reinforced by deltoid and trapzeius

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17
Q

what do the coracoclavicular ligmanets limit/resist at the AC joint?

A

limit superior clavicular/inferior scapular translation

and posterior rotation of clavicle

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18
Q

what is the primary function of the AC joint?

A

allow the scapula to rotate during arm movement

increases UE motion

positions glenoid beneath humeral head

maintains congruency of scapula on thorax

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19
Q

what osteokinematic motions are available at the AC joint?

A
  1. internal/external rotation
  2. A/P tilting (tipping)
  3. upward/downward rotation
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20
Q

describe the associated arthrokinematics for the osteokinematic motions at the AC joint

A

none are well defined

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21
Q

how is internal/external rotation of the AC joint important for motion at the scapula?

A

it maintains contact of scapula on curved thorax during protraction and retraction of clavicle

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22
Q

how is A/P tipping of the AC joint important to scapular motion?

A

important for maintaining contact of scapula on curved thorax during elevation and depression of clavicle

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23
Q

what is the significance of upward/downward rotation of the AC joint?

A

important for positioning of glenoid fossa in optimal position

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24
Q

describe the following for the AC joint:

closed pack position

open pack position

capsular pattern

A

closed pack = arm at 90 degrees

open pack = arm by side

capsular pattern = pain at end range with arm overhead

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25
Q

due to the structure of the AC joint, what injury is it susceptible to?

A

dislocation due to slopped nature of the articular coupled w/high probability of receiving large shear forces

can lead to development of posttraumatic OA

26
Q

T/F: the scapulothoracic joint is a true anatomic joint and has all the assocaited structures expected of a synovial joint

A

FALSE

27
Q

what osteokinematic motions are available at the scapulothoracic joint?

A
  1. primary
    1. elevation/depression
    2. protraction/retraction
    3. upward/downward rotation
  2. Secondary
    1. anterior/posterior tilting
    2. internal/external rotation
28
Q

what motions occur at the SC and AC joint to allow for scapulothoracic protraction?

A

SC = protraction

AC = slight IR

29
Q

what motions occur at the SC and AC joint to allow for scapulothoracic upward rotation?

A

summation of SC elevation and AC upward rotation

30
Q

what is the angle of inclination of the GH joint?

A

130-150 degrees in frontal plane

31
Q

what is the angle of torsion of the GH joint?

A

30 degrees posterior in the transverse plane

32
Q

what is retroversion describing at the GH joint?

A

the posterior orientation of humeral head with regards to the condyles

33
Q

increased humeral retroversion may result in what?

A

increased ER ROM and reduced IR ROM

observed a lot in dominant arm of throwing athletes

34
Q

list the passive structures that support the GH joint

A
  1. Glenoid labrum
  2. Joint capsule
  3. S/M/I GH ligaments
  4. Coracohumeral ligament
35
Q

describe the characteristics of the GH joint capsule

A
  1. significant laxity, minimal stability provided
  2. reinforced by thicker external ligaments
  3. inferior portion is slack in ADD position creating an axillary pouch
36
Q

what is the clincial significance of a tight posterior GH capsule?

A

linked to shoulder impingement

tightness may produces increased anterior humeral head translation which decreases the subacromial space

37
Q

what does the superior glenohumeral ligament limit?

A

ER, anterior and inferior translation at O degrees of abduction

slackens when abducted beyond 35-45 degrees

38
Q

what does the middle GH ligament limit?

A

anterior translation from 45-90 degrees abduction

and extremes of ER

39
Q

what does the inferior GH ligament limit?

A

primary stabilizer beyond 45 degrees of abduction

stabilizes during combing abduction w/rotation

40
Q

what does the coracohumeral ligament limit?

A

downward dislocation

inferior translation and ER of humeral head w/arm hanging at side

41
Q

list the dynamic structures that support the GH joint

A

Rotator cuff

42
Q

what are 2 places the rotator cuff does not reinforce the GH joint?

A
  1. inferiorly
  2. region between subscapularis and supraspinatus (rotator cuff interval)
43
Q

describe the arthrokinematics for each osteokinematic motion at the GH joint

A

convex on concave

(roll and glide will be opposite for every motion)

44
Q

how does shoulder flexion impact the GH joint capsule?

A

causes tension throughout capsule

slight anterior translation may occur at end range flexion due to tension in posterior capsule

45
Q

in order for full GH abduction to occur, what else must occur?

A

ER

46
Q

what is the closed pack position for the GH joint?

A

90 degrees abducted and full ER

OR

full abduction and ER

47
Q

what is the open pack position for the GH joint?

A

abducted 55 degrees, then horizontally adducted 30 degrees with slight ER

48
Q

what is the capsular pattern for the GH joint?

A

ER > ABD > IR

49
Q

what is the ratio of motion in the scapulohumeral rhythm?

A

2 degrees of glenohumeral

to

1 degree of scapular motion

50
Q

what is the ideal shoulder girdle position?

A

slightly elevated and relatively retracted scapula

*results in glenoid fossa facing slightly upward

51
Q

List some pathologies that reduce musclar support of the shoudler

A
  1. Stroke
  2. muscular dystrophy
  3. Guillan-Barre
  4. impinged nerve
52
Q

how does gravity effect scapulothoracic posture?

A

results in depressed, protracted, and excessively downward rotated scapula

53
Q

what is the impact that rounded shoulders can have on an individual’s shoulder complex?

A

can lead to biomechanical stress on SC and GH

slight depression, downward rotation and protraction of scapula

can lead to stressed portions of joint, subluxations at worse and compression of arteries and nerves

54
Q

describe how the rhomboids and traps function together

A

pure retraction

traps tend to elevate scapula and rhomboids tend to depress scapula = neutralized and pure retraction

55
Q

describe how the deltoid and supraspinatus function together

A

work to acheive full abduction

56
Q

if the deltoid is paralyzed, is full abduction of GH possible?

A

yes, but torque is reduced

57
Q

if the supraspinatus is paralyzed is full GH abudction possible?

A

yes but only through compensations and in very specific cases

58
Q

describe how the supraspinatus and mid trap function together

A

middle trap functions to stabilize scapula

while supraspinatus ER the shoulder

59
Q

what would occur if the middle trap was paralyzed?

A

scapular dyskinesis

scapula would move into IR as the GH ER

60
Q

describe how the serratus anterior, upper trap and low trap function together

A

contract simulataneously to produce upward rotation of scapular during GH abduction

61
Q

how does the infraspinatus, teres minor and subscapularis stabilize the GH joint?

A

exert a depressive force on humeral head

62
Q

what is scapular dyskinesia?

A

any abnormal position or movement of the scapula

alters effectiveness of muscle actions and distorts arthrokinematics resulting in stress

Kinesiology (13 decks)

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