Shoulder complex Flashcards

(70 cards)

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
what can you do to prevent shoulder injuries?
where proper protective equipment; do physical conditioning such as flexibility/mobility and strength; proper skill techniques when doing throwing or falling motions.
26
What is some functional anatomy of the shoulder complex?
it has the greatest degree of mobility but is the least stable joint.
27
what are the articulation points of the shoulder joint?
humeral head articulates with glenoid fossa
28
what provides dynamic stability?
rotator cuff muscles and long head of the biceps
29
what compresses the head while other rotator cuff muslces depress the humeral head during overhead motions?
supraspinatus
30
what is scapulohumeral rhythm?
180 degrees total from neutral to full abduction. movement occurs in a 2-1 ratio - 120deg glenohumeral - 60deg scapulothoracic
31
how many degrees of abduction is glenohumeral?
20
32
What are acute injuries to the shoulder?
``` contusions (deltoid) sprains- SC, AC, GH strains- delts, bis, tris ruptures- bis fractures- clavicular, humeral GH dislocation/subluxations ```
33
What are chronic injuries to the shoulder?
rotator cuff impingement, bicipital tendonitis, subacromial bursitis
34
What causes a contusion to the shoulder?
direct blow
35
what are S&S of contusions?
pain on palpation, ecchymosis, swelling, pain with AROM, transitory paralysis and inability to use arm
36
How do you manage a contusion?
PIER, NSAIDs, protect with padding. refer to physician if does not resolve or concerned with myositis ossificans DO NOT MASSAGE
37
What is a common mechanism of injury for shoulders?
FOOSH
38
What does FOOSH stand for?
``` falling on out stretched hands ```
39
What occurs in a sterno-clavicular sprain?
1. FOOSH 2. traction force when arm is at 90 and then pulled forcefully away from body 3. blunt trauma
40
What are severity levels of a SC Joint injury?
1st, 2nd, 3rd degree
41
What are signs and symptoms of a 1st degree SC joint sprain? How would you treat it?
pain & slight disability | PIER
42
What are signs and symptoms of 2nd degree SC joint sprain? how would you treat it?
pain, subluxation with deformity, swelling, point tenderness, decreased ROM. PIER, reduction if necessary
43
What are S&S of 3rd degree SC joint sprains? What is treatment?
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
What causes acromioclavicular sprains?
FOOSH; | direct blow with the tip of the shoulder (ie. hitting boards in hockey, landing on shoulder in football)
45
How many grades of AC injuries are there?
6
46
What occurs at a grade 1 injury? What is the course of treatment?
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
What are S&S of a grade 2 AC injury? What is the course of treatment?
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
What are s&s for grade 3 AC injuries? What is the course of treatment?
severe pain; moderate to severe step; rupture of AC and CC ligaments. rest, ice, immobilization unlesss surgery is required.
49
What are the S&S of a grade 4 AC injury? what is course of treatment?
posterior separation of clavicle surgery
50
What are S&S of grade 5 AC injuires? Treatment?
``` loss of AC and CC ligametns; tearing of the deltoid and trap muscle attachments; gross deformity; severe pain; decreased ROM ``` Surgery
51
What are S&S of grade 6 AC injuries? Treatment?
displacement of clavicle behind the coracobrachialis surgery required
52
What occurs in an anterior glenohumeral subluxation/dislocation?
humeral head displaces anteriorly/inferiorly
53
What is the MOI for a GH subluxation/dislocation?
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
What are S&S of an anterior dislocation of the GH?
``` flattened deltoid; prominent humeral head in the axilla; arm carried in slight ABduction/ER moderate pain and disability positive apprehension test sulcus sign ```
55
What occurs in a posterior GH dislocation?
humeral head displaces posteriorly and inferiorly
56
What is the MOI for a posterior GH dislocation?
FOOSH with arm internally rotated; | forced adduction and internal rotation
57
what are S&S of posterior GH dislocations?
``` 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
What is the apprehension test?
special test where shoulder is brought to 90 with external rotation
59
What tissues can be damaged with GH dislocations?
capsule, ligaments, tendon, labrum, blood vessels, nerves and potential fractures
60
What is the treatment for GH injuries?
immobliize with sling and swathe, immediate referral to physician for reduction immobilized for 3 weeks following reduction
61
What are possible complications from shoulder dislocations?
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
What is the most common point of fracture for the clavicle?
middle 1/3 where the bone changes shape and direction
63
What are MOI for clavicular fractures?
direct impact FOOSH fall on tip of shoulder
64
What are S&S of clavicular fractures?
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
what is treatment for clavicular fracture?
reassess athlete, sling/swathe in most comfortable position, transport to hospital
66
What questions should you ask during assessment of shoulder complex?
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
What are the ROM for shoulder complex assessment?
flexion, extension abduction, adduction IR/ER
68
What are the special tests for the shoulder complex?
sulcus test and apprehension test
69
What are the bony landmark palpations for the shoulder complex?
``` 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
what are the wrapping techniques for the shoulder?
shoulder spica and 4S (spica/sling/swathe/support)