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AET: Injury Prevention > Shoulder complex > Flashcards

Shoulder complex Flashcards

1
Q

What bones make up the shoulder complex?

A

scapula, clavicle, humerus

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2
Q

What ligaments make up the shoulder complex?

A 
coracoacromial;
coracoclavicular- conoid/trapezoid
acromioclavicular;
glenohumeral;
sternoclavicular
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3
Q

How many shoulder joints are there and what are they?

A

3: Glenohumeral, acromioclavicular, sternoclavicular

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4
Q

Where is the sternoclavicular joint?

A

between the sternum and manubrium

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5
Q

Where is the acromioclavicular joint?

A

between the clavicle and acromion process

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6
Q

Where is the glenohumeral joint?

A

Between the glenoid cavity of the scapula and the head of the humerus

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7
Q

Where is the coracovicular joint?

A

on the coracoid process and clavicle: made up of two ligaments–> trapezoid and conoid.

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8
Q

Where is the scapulothoracic joint?

A

runs along the medial border of the scapula and thorax

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9
Q

What are the muscles that make up the shoulder joint?

A 
rotator cuff complex;
triceps;
biceps;
latissimus dorsi;
pectoralis major/minor;
deltoid;
trapezius
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10
Q

What muscle acting on the humerus abducts the arm with slight external rotation ?

A

supraspinatus

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11
Q

what muscle acting on the humerus externally rotates the arm with slight adduction?

A

infraspinatus

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12
Q

what muscle acting on the humerus internally rotates the arm?

A

subscapularis

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13
Q

what muscle acting on the humerus adducts, extends and internally rotates the arm?

A

teres major

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14
Q

what muscle acting on the humerus externally rotates the arm?

A

teres minor

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15
Q

What muscle acting on the humerus flexes and adducts the arm?

A

coracobrachialis

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16
Q

What muscles acting on the humerus flexes, adducts, & internally rotates the arm?

A

pectoralis major

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17
Q

What muscle acting on the humerus extends, adducts & internally rotates the arm; also pulls the shoulder down?

A

latissimus dorsi

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18
Q

What muscle acting on the humerus abducts the arm, with anterior fibers flexing & internally rotating and posterior fibers extending & externally rotating?

A

deltoid

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19
Q

What muscle acting on the scapula elevates or depresses, rotates, adducts, & stabilizes the scapula?

A

Trapezius

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20
Q

What muscles acting on the scapula adducts, stabilizes, and rotates while lowering the lateral angle?

A

rhomboid major/minor

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21
Q

what muscle acting on the scapula elevates the scapula; allows neck side flexion when scapula is fixed?

A

levator scapulae

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22
Q

What muscle acting on the scapula draws the scapula anteriorly and downward?

A

pectoralis minor

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23
Q

what muscle acting on the scapula stabilizes, abducts, and rotates the scapula?

A

serratus anterior

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24
Q

where are the bursae located for the shoulder complex?

A

subacromial: lies in subacromial space; cushions rotator cuff muscles from acromion; compressed during overhead actions
subcoracoid;
subscapularis

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25
Q

what can you do to prevent shoulder injuries?

A

where proper protective equipment; do physical conditioning such as flexibility/mobility and strength; proper skill techniques when doing throwing or falling motions.

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26
Q

What is some functional anatomy of the shoulder complex?

A

it has the greatest degree of mobility but is the least stable joint.

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27
Q

what are the articulation points of the shoulder joint?

A

humeral head articulates with glenoid fossa

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28
Q

what provides dynamic stability?

A

rotator cuff muscles and long head of the biceps

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29
Q

what compresses the head while other rotator cuff muslces depress the humeral head during overhead motions?

A

supraspinatus

30
Q

what is scapulohumeral rhythm?

A

180 degrees total from neutral to full abduction.
movement occurs in a 2-1 ratio
- 120deg glenohumeral
- 60deg scapulothoracic

31
Q

how many degrees of abduction is glenohumeral?

A

20

32
Q

What are acute injuries to the shoulder?

A 
contusions (deltoid)
sprains- SC, AC, GH
strains- delts, bis, tris
ruptures- bis
fractures- clavicular, humeral
GH dislocation/subluxations
33
Q

What are chronic injuries to the shoulder?

A

rotator cuff impingement, bicipital tendonitis, subacromial bursitis

34
Q

What causes a contusion to the shoulder?

A

direct blow

35
Q

what are S&S of contusions?

A

pain on palpation, ecchymosis, swelling, pain with AROM, transitory paralysis and inability to use arm

36
Q

How do you manage a contusion?

A

PIER, NSAIDs, protect with padding.
refer to physician if does not resolve or concerned with myositis ossificans
DO NOT MASSAGE

37
Q

What is a common mechanism of injury for shoulders?

A

FOOSH

38
Q

What does FOOSH stand for?

A 
falling
on
out
stretched
hands
39
Q

What occurs in a sterno-clavicular sprain?

A
  1. FOOSH
  2. traction force when arm is at 90 and then pulled forcefully away from body
  3. blunt trauma
40
Q

What are severity levels of a SC Joint injury?

A

1st, 2nd, 3rd degree

41
Q

What are signs and symptoms of a 1st degree SC joint sprain? How would you treat it?

A

pain & slight disability

PIER

42
Q

What are signs and symptoms of 2nd degree SC joint sprain? how would you treat it?

A

pain, subluxation with deformity, swelling, point tenderness, decreased ROM.

PIER, reduction if necessary

43
Q

What are S&S of 3rd degree SC joint sprains? What is treatment?

A

gross deformity(dislocation), pain, swelling, decreased ROM, possibly life threatening if it dislocates posteriorly

PIER; if unstable and neurological or vascularly compromised needs surgery

44
Q

What causes acromioclavicular sprains?

A

FOOSH;

direct blow with the tip of the shoulder (ie. hitting boards in hockey, landing on shoulder in football)

45
Q

How many grades of AC injuries are there?

A

6

46
Q

What occurs at a grade 1 injury? What is the course of treatment?

A

mild tenderness over AC joint;
painful horizontal adduction;
no disruption of AC joint.

REST, ICE, immoblizize in cuff’n collar slight (1 week max continuously)

47
Q

What are S&S of a grade 2 AC injury? What is the course of treatment?

A

tear or rupture of AC ligament;
partial displacement of lateral end of clavicle;
pain;
point tenderness;
decreased ROM (ABD/DD)
REST, ICE, Immobilization in cuffncollar slight

48
Q

What are s&s for grade 3 AC injuries? What is the course of treatment?

A

severe pain;
moderate to severe step;
rupture of AC and CC ligaments.

rest, ice, immobilization unlesss surgery is required.

49
Q

What are the S&S of a grade 4 AC injury? what is course of treatment?

A

posterior separation of clavicle

surgery

50
Q

What are S&S of grade 5 AC injuires? Treatment?

A 
loss of AC and CC ligametns;
tearing of the deltoid and trap muscle attachments;
gross deformity;
severe pain;
decreased ROM

Surgery

51
Q

What are S&S of grade 6 AC injuries? Treatment?

A

displacement of clavicle behind the coracobrachialis

surgery required

52
Q

What occurs in an anterior glenohumeral subluxation/dislocation?

A

humeral head displaces anteriorly/inferiorly

53
Q

What is the MOI for a GH subluxation/dislocation?

A

FOOSH with arm externally rotated;

direct blow to the hand or forearm when the shoulder is abducted to 90 and the elbow is bent

54
Q

What are S&S of an anterior dislocation of the GH?

A 
flattened deltoid;
prominent humeral head in the axilla;
arm carried in slight ABduction/ER
moderate pain and disability
positive apprehension test
sulcus sign
55
Q

What occurs in a posterior GH dislocation?

A

humeral head displaces posteriorly and inferiorly

56
Q

What is the MOI for a posterior GH dislocation?

A

FOOSH with arm internally rotated;

forced adduction and internal rotation

57
Q

what are S&S of posterior GH dislocations?

A 
severe pain and disability;
arm carried in ADD & IR
prominent acromion and coracoid process
limited ER and elevation
possible decreased radial pulse
numbness or parsthesia into arm or hand due to compression of brachial plexus or axillary nerve
58
Q

What is the apprehension test?

A

special test where shoulder is brought to 90 with external rotation

59
Q

What tissues can be damaged with GH dislocations?

A

capsule, ligaments, tendon, labrum, blood vessels, nerves and potential fractures

60
Q

What is the treatment for GH injuries?

A

immobliize with sling and swathe, immediate referral to physician for reduction
immobilized for 3 weeks following reduction

61
Q

What are possible complications from shoulder dislocations?

A

bankart lesions- permanent anterior defect of labrum
hill sachs lesions- caused by compression of bone against anterior glenoid rim creating divot in humeral head
SLAP lesion- defect in superior labrum that impacts attachment of long head of biceps on labrum
brachial nerves/vessels compromised; rotator cuff injuries; fractures; bicipital tendon subluxation and transverse ligament rupture

62
Q

What is the most common point of fracture for the clavicle?

A

middle 1/3 where the bone changes shape and direction

63
Q

What are MOI for clavicular fractures?

A

direct impact
FOOSH
fall on tip of shoulder

64
Q

What are S&S of clavicular fractures?

A

upward displacement of medial clavicular segment due to pull of SCM;
generally present with supporting arm, head tilted toward injured side
clavicle may appear lower
palpation- pain, swelling, point tenderness

65
Q

what is treatment for clavicular fracture?

A

reassess athlete, sling/swathe in most comfortable position, transport to hospital

66
Q

What questions should you ask during assessment of shoulder complex?

A

what is cause of pain, MOI, previous history, location, duration, intensity of pain;
crepitus, clicking, catching, numbness, tingling, heat;
weakness or fatigue
what provides relief

67
Q

What are the ROM for shoulder complex assessment?

A

flexion, extension
abduction, adduction
IR/ER

68
Q

What are the special tests for the shoulder complex?

A

sulcus test and apprehension test

69
Q

What are the bony landmark palpations for the shoulder complex?

A 
sternoclavicular joint
clavicular shaft
acromioclavicular joint
coracoid process
acromion process
humeral head
great/less tuberosity
bicipital groove
spine of scapula
scapular medial/lateral borders
superior/inferior angles of scapula
70
Q

what are the wrapping techniques for the shoulder?

A

shoulder spica and 4S (spica/sling/swathe/support)

AET: Injury Prevention (11 decks)

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