shoulder complex Flashcards

1
Q

what are the trapezoid attachments

A

coracoid process to trapezoid line of clavicle

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2
Q

what are the conoid attachments

A

coracoid process to conoid tubercule of clavicle

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3
Q

what is the function of the coracoclavicular ligament

A

stabilizes AC joint

-limits medial displacement, protraction, elevation

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4
Q

what is the function of the acromioclavicular ligament

A

stabilizes AC joint

-limits superior migration of clavicle

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5
Q

what are the attachments of the acromioclavicular ligament

A

superior aspect acromial end of clavicle to adjacent acromion

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6
Q

what are the attachments of the coracoacrominal lig

A

lateral border coracoid process

acromion adjacent to clavicular articulation

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7
Q

what is the function of the coracoacrominal lig

A

prevents superior displacement of humeral head by forming the coracoacromial arch

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8
Q

what is the function of the coracohumeral lig

A

reinforces superoanterior aspects of joint capsule

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9
Q

what are the attachments of the coracohumeral lig

A

base of coracoid process

anterior aspect greater tubercule

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10
Q

what are the attachments of the costoclavicular lig

A

superior aspect of cartilage of first rib

undersurface of clavicle

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11
Q

what is the function of the costclav ligament

A

stabilizes SC joint

limits elevation of clavicle

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12
Q

what is the function of the superior transverse scapular lig

A

closes off suprascapular notch

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13
Q

what are the attachments of the superior transverse scapular lig

A

base of coracoid process

medial edge scap notch

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14
Q

what are the attachments of the glenoid capsule

A

circumference glenoid cavity to anatomical neck of humerus

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15
Q

what is the function of the superior GH lig

A

stabilizes against inferior translation of humerus on the glenoid with humerus at 0 degrees abduction

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16
Q

what is the function of the middle GH lig

A

stabilizies against anterior translation of humerus on glenoid

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17
Q

what is the function of the inferior GH lig

A

stabilizes against inferior translation of humerus on glenoic with humerus at 90 degrees abduction

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18
Q

what are the attachments of the GH ligaments

A

upper part medial margin of glenoid cavity
lesster tubercule
anatomical neck

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19
Q

which joints are synovial

A

all EXCEPT scapulothoracic

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20
Q

describe the joint surfaces at the SC joint

A
  1. clavicle is convex superior inferior
  2. manubrium concave superior inferior
  3. clavicle concave ant-pot
  4. manubrium convex ant-post
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21
Q

what are the ligaments of the SC joint

A

SC lig: ant and post
costcoclav lig
interclavicular lig

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22
Q

when is the costcoclav lig taught

A

with elevation and retraction

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23
Q

what kind of joint is the SC joint

A

saddle

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24
Q

what happens with protraction at the SC joint

A

anterior roll and glide of concave clavicle

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25
Q

what happens with retraction at the SC joint

A

posterior roll and glide

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26
Q

what happens with elevation at the SC joint

A

superior roll and inferior glide of convex clavicle

27
Q

what happens with depression at the SC joint

A

inferior roll and superior glide

28
Q

Discuss SC joint dislocation

A
  • very rare
  • direct trauma or blow to clavicle or FOOSH
  • MUCH more common to break clavicle
  • posterior type holds higher risk of injury to other structures
  • post=surgery
29
Q

what kind of joint is the AC joint

A

plane (gliding)

30
Q

which ligaments are in the AC joint

A
  • acromioclavicular

- coracoclav: trapezoid and conoid

31
Q

describe movements at the AC joint with shoudler girdle motion

A
  1. protraction-retraction of scap= AP glide

2. adbuction-adduction of scap= rotation of acromion on clavicle

32
Q

what is a separated shoulder

A

AC joint sprain

  • fall on acromion
  • progressive disruption of ligaments: AC joint, trapezoid, conoid
  • then graded by displacement
  • grades 1-3 can be managed nonsurgically
  • grades 4-6 surgery
33
Q

what kind of joint is the scapulothoracic joint

A

pseudo

34
Q

talk about the scapulothoracic joitn

A
  • muscular joint betwen scapula and trunk
  • required for full ROM at GH joint
  • no direct ligament attachment
35
Q

what are the 3 rotations at the scapulothoracic joint

A
  1. upward/downward
  2. IR/ER
  3. ant/post tilt
36
Q

what are the 3 purposes of scapulohumeral rhythm

A
  1. allows for greater shoulder ROM
  2. maintains optimal contact between humeral head and glenoid fossa
  3. assists with maintaing an optimal length-tension relationship of GH muscles
37
Q

Describe the role of the T spine with bilateral shoulder motion

A

10-30 degrees thoracic extension with full shoulder elevation

38
Q

Describe the role of the T spine with unilateral shoulder motion

A

10-30 degrees thoracic rot/sidebend

39
Q

what kind of joint is the GH

A

ball and socket

largets ROM and movement in body

40
Q

why is the GH the largets ROm and movement

A
  • shallow joint
  • extensive joint capsule
  • limited ligamentous support
41
Q

talk about the labrum

A
  • static stabilizer
  • glenoid fossa 1/4 size humeral head
  • glenoid fossa without cartilage is more flat than concave
  • concavity arises primarily due to labrum and to a less er extent from catilage
  • glenoid shallow socket faces lateral, anterior and superior
  • angle of inclination changes with position of scap
  • labrum deepens socket 50-75%
42
Q

talk about the joint capsule

A
  • static stabilizer

- anterior and inferior thicker

43
Q

what are the anterior GH ligaments and inferior pliable redundent ligamentous complex

A

static stabilizers

44
Q

what does the superior glenohumeral lig resist

A

inferior translation in adducted position

45
Q

what does the middle glenohumeral lig resist

A

ER at 45 degrees abduction/scaption

-courses along anterior joint from glenoid to humerus in superior inferior direction

46
Q

talk about the inferior glenohumeral ligament

A

main static stabilizer of the GH joint with arm at 90 degrees abducrtion

47
Q

what does hte anterior band inferior GH ligament resist

A

ER at 90 degrees abduction/scaption

48
Q

what resists ER at 0 degrees abduction

A
  • subscapularis 1st

- SGHL

49
Q

what resists ER at 45 degrees abduction

A
  • SGHL

- MGHL

50
Q

what resists ER at 90 degrees abduction

A

anterior band IGHLC

51
Q

what resists IR at 0 degrees abduction

A

posterior band IGHLC

52
Q

what resists IR at 45 degrees abduction

A

anterior and posterior IGHLC

53
Q

what resists IR at 90 degrees abduction

A

anterior and posteior band IGHLC

54
Q

what resists inferior translation at 0 degrees abduction

A

SGHL

coracohumeral lig

55
Q

what resists inferior translation at 90 degrees abduction

A

IGHLC

56
Q

what is a loose/open packed position for the GH joint

A

55 degrees abduction

30 degrees horizontal adduction

57
Q

what is a close packed position

A

end range abduction and ER

58
Q

what is the ER convex-concave rule

A

roll posterior

glide anterior

59
Q

what is the IR convex-concave rule

A

roll anterior

glide posterior

60
Q

what is the flexion convex-concave rule

A

roll superior

glide inferior

61
Q

what does the rotator cuff do

A

pulls head of humerus into glenoid fossa

62
Q

what does the deltoid do

A
  • large stabilizing component, regardless of humeral position
  • primary function to swing humerus
63
Q

what is subacromial impingement

A

-RTC tendon and/or LHB may get repeadetdly compressed, along with bursa

potential causes:

  1. RTC dysfunction
  2. scapular positioning
  3. shape of acromion
  4. GH joint mobility deficit or hypermobility