Shoulder And Arm Flashcards by Emily Stephens

Bones of the shoulder

Clavicle
Scapula
Humerus

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List the shoulder joints

Stenoclavicular
Acromioclavicular
Glenohumeral
(Scapulothoracic)

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What type of joint is the glenohumeral joint?

Ball + socket

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Difference between the shoulder and hip joint

Glenohumeral joint is shallower - more mobile

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What type of bone is the scapula?

Irregular bnoe

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What is the articulation of the scapula?

Glenohumeral joint
Acromioclavicular joint

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What does the glenohumeral joint articulate?

Scapula - glenoid fossa
Humerus - head

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What does the Acromioclavicular joint articulate?

Clavicle - acromial facet
Scapula - acromion

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Bony landmarks on lateral surface of scapula

Glenoid fossa
Supraglenoid tubercle
Infraglenoid tubercle

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Bony landmarks on the posterior surface of the scapula

Spine
Acromion
Infraspinatus fossa
Supraspinous fossa

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What type of bone is the clavicle?

Long bone

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Location of the clavicle

Extends between manubrium of sternum + acromion of scapula

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Functions of the clavicle

Attaches upper limbs to trunk
Protects underlying neurovascular structures
Transmits force from the upper limb to axial skeleton

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Articulation of the clavicle

Sternoclavicular joint
Acromioclavicular joint

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What does the sternoclavicular joint articulate?

Manubrium of sternum
Clavicle - sternal facet

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Function of the shaft of the clavicle

Acts as a lint of origin + insertion for:
- deltoid
- trapezius
- subclaviculus
- pectoral major
- stenocleidomastoid
- sternohyoid

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What type of joint is the acromioclavicular joint?

Plane type synovial joint

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Function of the acromioclavicular joint

Small degree of axial rotation
Anteroposterior movemnent

Initiated by movement elsewhere due to no muscles directly on joint - passive

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What attaches to the acromial end of the clavicle and where?

Coracoclavicular ligament

Conoid ligament to consider tubercle
Trapezoid ligament to trapezoid line

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What are the atypical features of the acromioclavicular joint?

Articulate surfaces lined with fibrocartilage
Joint cavity partially divided by articular disc

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What normally lines the articular surfaces of joints?

Hyaline cartilage

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What is the articular disc in the joint cavity of he acromioclavicular joint?

A wedge of fibrocartilage
Suspended form upper part of capsule

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What are the stabilising ligaments of the acromioclavicular joint?

Acromioclavicular ligament
Coracoclavicular ligament - conoid + trapezoid

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Where is the acromioclavicular ligament between?

Acromion to lateral clavicle
Horizontally

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Where is the conoid ligament between?

Coracoid process of scapula to conoid tubercle of clavicle Vertically

Where is the trapezoid ligament between?

Coracoid process of scapula to trapezoid line of clavicle Vertically

What does the joint capsule of the acromioclavicular joint consist of?

- Loose fibrous layer - Synovial membrane lining > secretes synovial fluid

Function of the loose fibrous layer of the joint capsule of the acromioclavicular joint

Encloses two articular surfaces Gives rise to articular disc

What type of joint is the sternoclavicluar joint?

Saddle type synovial joint

What does the sternocalvicular joint consist of?

Sternal end of clavicle Manubrium of sternum Upper medial part of 1st costal cartilage

Atypical features of sternoclavicular joint

Articular surfaces lined with fibrocartilage

What does the articular disc of the sternoclavicular joint do? What is its function?

- Separates joint into two compartments - Allows clavicle + manubrium to slide over each other more freely

Mobility of sternoclavicular joint

Very mobile

Strength of sternoclavicular joint

Very strong

Movements of the sternoclavicular joint

Elevation/shrugging of shoulders Depression/drooping of shoulders Rotation Protraction Retraction

What is protraction?

Moving shoulder girdle anteriorly

What is retraction?

Moving shoulder girdle posteriorly

What does the proximal humerus articulate with?

Glenoid fossa Glenohumeral joint

What does the distal humerus articulate with?

Head of the radius Trochlear notch of ulna

Function of the intertubercular sulcus/groove

- Separates the two tubercles - Tendon of long head of bicep brachii runs through

What are the edges of the intertubercluar sulcus called?

Lips

What does ‘a lady between two majors’ refer to?

Insertions of the intertubercular sulcus + lips Lateral lip - pectoralis major Intertubercular sulcus - latissimus doris Medial lip- teres major

Insertion of lateral lip of intertubercular sulcus

Pectoralis major

Insertion of medial lip of intertubercular sulcus

Teres major

Insertion of intertubercular sulcus

Latissimus dorsi

What cartilage lines the glenohumeral joint?

Hyaline cartilage

What type of joint is the glenohumeral joint?

Ball + socket synovial joint

Is the glenoidhumeral joint more stable or mobile?

Highly mobile + flexible at the expense of stability

Why is the glenohumeral joint not very stable?

Shallow glenoid fossa

What is the glenoid labrum?

Rim of fibrocartilaginous tissue around edge of glenois fossa

Function of the glenoid fossa

Increases stability by deepening socket Decreased risk of dislocation

What makes the glenohumeral joint more stable?

Glenoid fossa Rotator cuff muscles Ligaments - superior, middle + inferior

What part of the glenohumeral joint is the weakest and why?

Inferior aspect No rotator cuffs to reinforce

List the glenohumeral ligaments

Superior GHL Middle GHL Inferior GHL

Where are the glenoidhumeral ligaments located?

Anterior aspect of the glenohumeral joint

Function of the glenohumeral joint

Reinforce the joint capsule Increase stability Decrease risk of anterior dislocation

List the ligaments of the shoulder

Superior GHL Middle GHL Inferior GHL Coracoclavicular ligament - conoid + trapezoid Transverse humeral ligament Coraco-acromial ligament

Where is the transverse humeral ligament?

Between the greater + lesser tubercles of humerus

Function of the transverse humeral ligament

Provides tunnel for long head of biceps

Where is the coraco-acromial ligament

Between the Coracoid process + acromion

Function of the coraco-acromial ligament

Provides tunnel for supraspinatus tendon Prevents superior dislocation

Mechanism of superior dislocation of shoulder

Falling on outstretched hand

List the superficial extrinsic shoulder muscles

Trapezoid Latissimus dorsi

List the deep extrinsic shoulder muscles

Levator scapulae Rhomboid minor Rhomboid major

List the intrinsic shoulder muscles

Deltoid Teres major Rotator muscles - supraspinatus - infraspinatus - teres minor - subscapualris

Origin of the trapezius muscle

External occipital protuberance Nuchae ligament Spinous processes C7-T12

Insertion of the trapezius

Clavicle Acromion Spine of scapula

Innervation of the trapezius

Spinal accessory nerve Proprioceptor fibres from C3-4

Action of the trapezius

Upper fibres - ABduction >90° Middle fibres - retract scapula Lower fibres - pull scapular inferiorly

Clinical test for the power of the trapezius muscle

Ask patient to shrug their shoulders whilst you attach to push them back down