Shoulder Complex Flashcards

1
Q

4 Joints that make up shoulder complex

A

GH, SC, AC, ST Joints

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2
Q

True Joints

A

GH, AC, SC Joints

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3
Q

Functional Joint (not a true “joint”)

A

ST “joint”

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4
Q

Dynamic Stabilization

A

-active forces or dynamic muscular control

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5
Q

What type of joint is the Sternoclavicular (SC) joint?

A

-Synovial with 3 DOF;
-Saddle-shaped;
-Reciprocal convex-concave surfaces

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6
Q

SC fibrocartilage disc

A

-Improves stability
-Increase congruence between the articulating surfaces and dissipates joint loads

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7
Q

A/P SC Ligaments

A

-Reinforces capsule
-Restraint A/P translations

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8
Q

SC-Costoclavicular Ligament (A/P laminae)

A

-Limit lateral elevation and medial translation of clavicle
-Absorb and transmits superior forces

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9
Q

SC-Interclavicular Ligament

A

-Limits excessive depression of lateral clavicle
-Limits superior gliding of medial clavicle

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10
Q

Interclavicular ligament protect?

A

-Brachial plexus and subclavian artery

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11
Q

Joint connecting UE to axial skeleton?

A

-SC Joint

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12
Q

Coracoclavicular Ligament Critical Function

A

-Couple posterior rotation of the clavicle + upward rotation of scapula

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13
Q

Resting position of scapula

A

-Approx. 5cm from midline
-Betw. ribs 2-7
-Tilted ant. 10-15 degrees from vertical
-Up. rotated 10-15 degrees from vertical
-IR 34-45 degrees from coronal plane

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14
Q

SC Open-packed position

A

-arm resting by the side

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15
Q

SC Close-packed position

A

-Max UE elevation

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16
Q

SC Osteokinematics

A

Elevation/Depression
Protraction/Retraction
A/P Rotation

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17
Q

Subacromial Space structures

A

-Rotator cuff tendons
-LH of biceps tendon
-Subacromial bursae

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18
Q

Coracoacromial arch (Osteoligamentous vault over humeral head) Consists of…

A

coracoid process
acromion
coracoacromial ligament
AC joint

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19
Q

ST “joint” Functions

A

-Orient contact of scapula with thorax, glenoid fossa with humeral head
-Provide stable base for controlled motions between humeral head and glenoid fossa
-Add range to elevation of arm

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20
Q

Muscles Synergistically Stabilizing GH joint

A

-Rotator cuff muscles + Deltoid

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21
Q

Full elevation of arm, ST “joint” needs to

A

-Up. rotate, post. tilt, and ER to open subacromial space

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22
Q

The upper trap, serratus anterior, and lower trap fire _______________ to produce scapular upward rotation while the rhomboids fire ______________ to stabilize this motion.

A

-concentrically; eccentrically

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23
Q

What type of joint is the Acromioclavicular (AC) Joint?

A

-Incongruent Plane synovial w/ 3 DOF

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24
Q

Primary function of the AC Joint

A

-allow scapula to rotate in 3D; increasing UE motion, positions glenoid beneath humeral head, max scapula contact with thorax

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25
Q

AC Osteokinematics

A

IR/ER
A/P Tilting
Up/Down Rotation

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26
Q

AC Open packed position

A

Arm resting by side

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27
Q

AC Close-Packed position

A

90 degrees ABd.

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28
Q

AC superior and inferior ligaments

A

-assist capsule in apposing the articular surfaces
-provide horizontal stability and prevent superior dislocation of the AC joint

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29
Q

Superior AC ligament

A

-Stronger than inferior;
restrain movement caused by anterior forces to lateral clavicle

30
Q

AC-Coracoclavicular ligament

A

-Provide joint’s superior, inferior and rotational stability

31
Q

AC-Coraco. Conoid Ligament

A

-Triangular/vertical oriented
-restrain inferior translation of acromion related to lateral clavicle

32
Q

AC-Coraco. Trapezoid ligament

A

-Quadrilateral /horizontal oriented;
-restrain posterior translations of lateral clavicle relative to acromion

33
Q

Conoid and Trapezoid ligaments together

A

-limit up. rotation of scapula at AC joint

34
Q

What type joint is the Scapulothoracic (ST) Joint?

A

-Functional joint, not a true joint

35
Q

ST Osteokinematics

A

Elevation/Depression
Pro/Retraction
Up/Down Rotation
IR/ER
A/P tilting

36
Q

What type joint is Glenohumeral (GH) Joint?

A

Synovial Ball-and-Socket with 3 DOF

37
Q

GH Osteokinematics

A

Flexion/Extension
Abduction/Adduction
IR/ER

38
Q

Open-packed Position of GH joint

A

-55 degrees ABd, 30 degreed Horiz. ADd, slight ER

39
Q

Close-packed position of GH Joint

A

Full ABd, full ER

40
Q

GH proximal articulation

A

Glenoid fossa rests lateral, inferior and anterior relative to head of humerus

41
Q

GH distal articulation

A

Humeral head rests medial, superior and posterior relative to shaft of humerus

42
Q

GH Distal articulation Angle of inclination and torsion

A

Inclination: normal 130-150 degrees
Torsion: normal 30 degrees posteriorly (retroversion)

43
Q

GH - Glenoid labrum

A

-enhances total available articular surface;
-resists humeral head translations
-protect bony edges
-min joint friction
-dissipate joint contact forces

44
Q

When the arm is at rest at the side, the superior glenohumeral (GH) capsule is ______ whereas the inferior capsule is ______.

A

Taut;slack

45
Q

GH Superior Ligament

A

-Ant/Post stability
-limit ant. / inferior translations of the humeral head when 0 deg ABD

46
Q

GH Middle ligament

A

-Ant. stability
-limit ant. humeral translation when 60 deg ABD

47
Q

GH Inferior ligament (IGHLC)

A

-Joint stability when ABD beyond 45 deg or combined ABD and Rotation

48
Q

GH- Coracohumeral ligament

A

-Limits inf. translation of humeral head in dependent arm position
-resists humeral ER with arm ADD
-2ndry stabilizer for humerus when rotator cuff muscles impaired

49
Q

Scapulohumeral Rhythm - Shoulder Elevation

A

-ABD. or Flexion
-2:1 ratio (120 GH : 60 ST)

50
Q

Humeral contributions with shld. elevation that clear greater tuberosity from CC arch

A

lateral rotation (ER)

51
Q

Scapular contributions with shld. elevation that opens SA space

A

-Posterior tilt, ER @ end-range elevation
-early flexion: protraction and IR

52
Q

Muscles stabilizing ST joint

A

Upward rotation:
-upper traps
-serratus anterior
-lower traps

53
Q

With elevation of the lateral clavicle, at the sternoclavicular joint the medial clavicle rolls __________ and glides ______.

A

(superiorly; inferiorly)

54
Q

With depression of the lateral clavicle, at the SC joint the medial clavicle rolls _______ and glides _______.

A

(inferiorly, superiorly)

55
Q

With protraction of the lateral clavicle, at the SC joint the medial clavicle rolls _______and glides _________.

A

(anteriorly; anteriorly)

56
Q

With retraction of the lateral clavicle, at the SC joint the medial clavicle rolls _____ and glides _________.

A

(posteriorly; posteriorly)

57
Q

At the SC joint, the clavicle rotates primarily posteriorly from neutral, bringing the inferior surface of the clavicle to face _______.

A

anteriorly

58
Q

From a posteriorly rotated position, at the SC joint the clavicle can then rotate ________ to return to neutral.

A

anteriorly

59
Q

At the AC joint with IR, the medial border moves _____, glenoid fossa moves _____ and _____.

A

(away; anteriorly; in)

60
Q

At the AC joint with ER, the medial border moves _____, glenoid fossa moves _____ and _____.

A

(towards; posteriorly; out)

61
Q

At the AC joint with anterior tilt, the acromion moves _______, inferior angle moves _______ and ______from ribcage.

A

(anteriorly; posteriorly; away)

62
Q

At the AC joint with posterior tilt, the acromion moves _______, inferior angle moves _______ and _____ the ribcage

A

(posteriorly; anteriorly; towards)

63
Q

At the AC joint with upward rotation, inferior angle will move ______, while the glenoid fossa moves ______.

A

(laterally; superiorly)

64
Q

At the AC joint with downward rotation, inferior angle will move ______, while the glenoid fossa moves ______.

A

(medially; inferiorly)

65
Q

Flexion at the GH joint involves ______ roll and an ________glide of the head of the humerus.

A

(anterior; posterior)

66
Q

Extension at the GH joint involves ______ roll and an ________glide of the head of the humerus.

A

(posterior; anterior)

67
Q

Abduction at the GH joint involves ______ roll and an ________glide of the head of the humerus.

A

(superior; inferior)

68
Q

Adduction at the GH joint involves ______ roll and an ________glide of the head of the humerus.

A

(inferior; superior)

69
Q

IR at the GH joint involves ______ roll and an ________glide of the head of the humerus.

A

(anterior; posterior)

70
Q
A