Shoulder and Elbow Flashcards
Lies horizontally at the root of the neck and connects the upper limb from the trunk and allows the limb to move freely from the trunk
Clavicle
What number of the ribs does the scapula lies on
2nd-7th
Where does the scapula articulates
Acromnion and head of the humerus
Articulations of humerus
- Glenoid cavity of the scapula at the GH joint
2. Head of the radius and trochlear notch of the ulna
Normal ROM of Shoulder adduction
0-60
Normal ROM of shoulder IR
0-90
Muscles of Shoulder Flexion
Anterior Deltoid
Pectoralis Major, clavicular
Biceps Brachii
Corachobrachialis
Muscles of Shoulder Extension
Posterior Deltoid Latissimus Dorsi Teres Major Triceps, long head Pectoralis Major, sternocostal
Muscles of Shoulder Abduction
Middle Deltoid
Supraspinatus
Muscles of Shoulder Adduction
Pectoralis Major Latissimus Dorsi Teres Major Coracobrachialis Infraspinatus Long head, triceps Anterior and posterior deltoid
Muscles of Shoulder IR
Subscapularis Pectoralis Major Latissimus Dorsi Anterior Deltoid Teres Major
Muscles of Shoulder ER
Infraspinatus
Teres Minor
Posterior Deltoid
Supraspinatus
Shoulder joint that has fibrocartilaginous disk between articulating surfaces
Sternoclavicular joint
Clavicle must elevate how many degrees to allow upward rotation of scapula and shoulder abduction
40 degrees
Where acromioclavicular joint is located
Lateral end of clavicle with acromion process of scapula
Ligaments of the weak joint which is susceptible to sprain and separation
AC and CC Ligament & thin fibrous capsule
Components of Glenohumeral joint
Glenoid fossa and humerus Labrum Glenohumeral capsule Glenohumeral ligaments Dynamic shoulder stabilizers Static shoulder stabilizers
The fibrocartilage structure that help stabilize the joint
Glenoid Labrum
How many percent does then humeral head is in contact with glenoid during elevation of shoulder
25 to 30%
Ligament that provides a buffer for the rotator cuff muscle tendons
Coracoacromial Ligament
A ligament that attaches to the glenoid to reinforce the shoulder capsule and joint. It also provides stability and prevent translation of the head of the humerus from the glenoid fossa
Glenohumeral ligaments
In what angle of the GH ligament in which it prevents anterior shoulder translation
Middle GH ligament
In what angle of the GH ligament in which it is the primary anterior ligament stabilizer above 90
Inferior GH Ligament
In what angle of the GH ligament in which it prevents translation and provides stability of the shoulder form 0 to 90 of abduction
Superior GH ligament
What is Subluxation in GH joint injuries
Incomplete separation of the humeral head from the glenoid fossa with immediate reduction
It is a type of GH joint injury where there is translation of the humeral head on the glenoid fossa that may result in subluxation or dislocation
Instability
Scapular stabilizers
Trapezius and Serratus Anterior
What is Apprehension Test
A feeling of anterior shoulder instability with 90° shoulder abduction and external rotation
What is Relocation Test
Supine apprehension test with a posterior-directed force applied to the anterior aspect of the shoulder not allowing anterior dislocation. Positive if the force relieves the feeling of apprehension
What is Anterior load-and-shift test
Modified from of the anterior drawer test and humeral head is loaded against the glenoid and then passively displaced anteriorly
What is the indication and response of Sulcus Sign
If an indentation develops between the acromion and the humeral head, the test is positive. This suggests increased laxity in the GH joint or called as multidirectional GH instability
In what muscle is impingement syndrome common
Supraspinatus
The primary movers of abduction/flexion and how many percent
deltoid 50%
rotator cuff 50%
What are the muscles and action during humeral head stabilization
Early: teres minor depresses head
Late: subscapularis & infraspinatus stabilize head
What happens to the rhomboid during adduction & extension
Downwardly rotates & retracts
What is the accompanying movements of adduction & extension
retraction, depression, downward rotation with anterior clavicular rotation
What happens to the pectoralis minor during adduction & extension
Depresses & downwardly rotates
Muscles for Horizontal Adduction
Pectoralis Major & Anterior Deltoid
Muscles for Horizontal Abduction
Infraspinatus
Teres Minor
Posterior Deltoid
Subacromial bursae
Cushions rotator cuff muscles (supraspinatus) from laying directly on acromion process
Rotator Cuff tears
Pain may feel crepitus, clicking, or catching on overhead activities
Rotator Cuff tears
- Pain may be nocturnal
- Tenderness over the greater tuberosity or inferior to the acromion on palpation
- Atrophy of the involved muscle resulting in a gross deformity at the respective area
Neer impingement sign
Pain indicates the supraspinatus tendon is compressing between the acromion and greater tuberosity
Hawkin’s impingement sign
Supraspinatus tendon is compressing against the coracoacromial ligament
Empty can (supraspinatus) test
Pain and weakness with arm flexion abduction and internal rotation
Drop arm test
Patient is unable to maintain the arm in abduction with or without a force applied
Biceps Tendonitis and Rupture
Inflammation of the long head of the biceps tendon occurs at bicipital groove of the humeral head
Yergason’s Test
Pain at the anterior shoulder with flexion of the elbow to 90 deg and supination of the wrist against resistance
Speed’s Test
Pain at the anterior shoulder with flexion of the shoulder, elbow extended and supinated against resistance
Degree of active flexion w/ forearm supinated
135-145 deg
Degree of passive flexion
150-160 deg
Muscles of Elbow Flexion
Brachialis
Biceps Brachii
Brachioradialis
Pronator Teres
Muscles of Elbow Extension
Triceps
Anconeus
Muscles of Forearm supination
Supinator
Biceps Brachii
Muscles of Forearm pronation
Pronator quadratus
Pronator Teres
Flexor Carpi Radialis
Muscles that are active in push ups
Flexors and Extensors
Muscle that assist the triceps and stabilizer during supination and pronation
Anconeus
Works in Flexion in all movements of the forearm
Brachialis
A muscle that is active insufficiency in full flexion with shoulders flexed
Biceps
A muscle that has no activity in slow ecc flexor movements in supination. Has a mod activity when a load is applied with FA midrange or in full pronation
Brachioradialis
Distal end of the radius
Styloid Process
Proximal end of the ulna
Olecranon process
This bone has a notch on its anterior surface which articulates with the trochlea of the humerus
Trochlear Notch
Below the answer in no. 63 is the triangular 1.______ which has on its lateral surface the 2. ______ for articulation with the head of the radius
- Coronoid process
2. Radial notch
SRUJ Ligaments
Annular Ligaments
Quadrate Ligaments
Oblique Cord
It is a fibrous tissue with an oblique orientation from the radius to the ulna
Interosseous Membrane
Muscles of the Posterior Fascial Compartment of forearm
- Supinator
- Abductor Pollicis Longus
- Extensor Pollicis Brevis
- Extensor Pollicis Longus
- Extensor Indicis
The blood supply of posterior fascial compartment of the forearm
Posterior and Anterior Interosseous Arteries
Muscles of the Lateral Fascial Compartment of the Forearm
Brachioradialis and Extensor Carpi Radialis Longus
Nerve supply of the posterior fascial compartment of the forearm
Deep Branch of the Radial Nerve
Blood supply of the Lateral Fascial Compartment of Forearm
Radial and Brachial Arteries
Nerve supply of the Lateral Fascial Compartment of Forearm
Radial Nerve
Anterior Osseofascial Cmpartment of the Forearm
Superficial Group
- Pronator Teres
- Flexor Carpi Radialis
- Palmaris Longus
- Flexor Carpi Ulnaris
Intermediate Group
1. Flexor Digitorum Superficialis
Deep Group
- Flexor Pollicis Longus
- Flexor Digitorum Profundus
- Pronator Quadratus
Blood supply of the anterior osseofascial compartment
Ulnar and Radial Arteries
Nerve supply of the anterior oesseofascial compartment
Median Nerve
Inflammation of the common flexor tendon at the elbow
Golfer’s Elbow or Little Leaguer’s (Children) or Pitcher’s Elbow
Pain may be reproduced with resisted wrist flexion and pronation
Golfer’s Elbow
Ulnar Neuropathy symptoms may occur secondary to valgus stretch of the nerve
Golfer’s Elbow
Pain and weakness in grip strength
Lateral Epicondylitis
Pain in the lateral epicondyle is seen with the patient making a fist, pronating the forearm, and radially deviating and extending the wrist against resistance by the examiner
Cozen’s Test
Passive extension of the elbow with forced flexion of the wrist with radial deviation may precipitate pain at the lateral epicondyle
Mill’s Test