Shoulder and Hip Joints

Question 1

Classify the glenohumeral joint. What movements can it perform?

Answer 1

Synovial ball and socket. Flex/extension, ab/adduction, lateral/medial rotation.

Question 2

What is the most common direction of dislocation of the GH joint?

Answer 2

Anterior.

Question 3

What are the articular surfaces of the GH joint?

Answer 3

Glenoid fossa and head of humerus.

Question 4

What is the function of the glenoid labrum?

Answer 4

Deepen the glenoid fossa.

Question 5

The fibrous capsule forms a cylindrical sleeve between the scapula and humerus. Is it loose or tight?

Answer 5

Loose

Question 6

What travels in the opening in the anterior surface of the joint capsule of the GH joint?

Answer 6

Long head of biceps tendon.

Question 7

What is the name of the ligament that covers this opening, and where does it attach?

Answer 7

Transverse humeral ligament. Between greater and lesser tuberosity of humerus.

Question 8

Name the 3 ligaments that strengthen the GH joint.

Answer 8

Glenohumeral, coracohumeral and coracoacromial ligaments. However, the rotator cuffs are more important in stabilising the GH joint.

Question 9

What are the rotator cuff muscles of the shoulder?

Answer 9

Teres Minor, infraspinatus, supraspinatus, subscapularis.

Question 10

What structure is formed by the coracoacromial ligament, and what does this structure do?

Answer 10

Superior fibro-osseous arch. Prevents superior displacement of the humerus.

Question 11

What is the function of bursae?

Answer 11

cushion to reduce friction between structures. They commonly lie between muscles/tendons and bone.

Question 12

What is the main bursa of the shoulder region, and where does it lie?

Answer 12

Subdeltoid. Separates deltoid + coracoacromial arch from supraspinatus tendon and GH joint.

Question 13

What nerves innervate the GH joint?

Answer 13

Articular branches from suprascapular, axillary, subscapular, lateral pectoral and musculocutaneous nerves.

Question 14

Name 3 sources of pain from the shoulder region.

Answer 14

1) Injury/inflammation to the shoulder joint.
2) tendonitis/bursitis (inflammation of supraspinatus /subdeltoid bursa) Due to osteophytes/microtrauma.
3) referred pain. e.g. from pleura due to phrenic nerve.

Question 15

What forms the acetabulum?

Answer 15

Ischium, ilium and pubis

Question 16

Describe the acetabulum

Answer 16

articular portion (with hyaline cartilage) surrounds the acetabular fossa (a non articular portion containing a fat pad).

Question 17

What is the acetabular notch?

Answer 17

Where the acetabulum is deficient inferiorly. This is closed by the transverse ligament.

Question 18

Is the fibrocartilage capsule of the iliofemoral joint tight or loose?

Answer 18

Tight. It forms a sleeve around the neck of femur and hip joint. It is strengthened by muscles and ligaments.

Question 19

Name the 3 main ligaments that stabilise the hip joint.

Answer 19

Iliofemoral, ischiofemoral and pubofemoral ligaments.

All 3 become relaxed on flexion and taught on extension, which maximises stability when standing.

Question 20

Which nerves innervate the hip joint?

Answer 20

Femoral, obturator, sciatic and superior gluteal nerves.

Question 21

Name 4 anatomically relevant pathologies of the Hip

Answer 21

1) Fractured NoF. Common in elderly. Possible avascular necrosis.
2) Congenital Hip dysplasia. abnormal hip development –> instability of hip joint. More easily dislocated.
3) Slipped femoral capital epiphysis. Occurs in growth stage (10-15yo). Fracture through proximal epiphyseal cartilage.
4) osteoarthritis. affects hyaline cartilage and subchondral bone.