shoulder complex

Question 1

5 typical features of a synovial joint

Answer 1

1. articular cartilage (avascular and aneural)
2. fibrous capsule
3. intrinsic ligaments to stregthen capsule
4. extrinsic ligaments - primary stablisers
5. synovial membrane

Question 2

what acts to reinforce the fibrous capsule of synovial joints

Answer 2

stabilizer muscles
intrinsic ligaments
extrinsic ligaments

Question 3

what does synovial membrane line within the synovial joint

Answer 3

lines all non-articular surfaces

Question 4

what is a labrum

Answer 4

fibrocartilaginous rim

Question 5

what are the functions of a labrum in a joint

Answer 5

• deepens socket in ball and socket joints

- provides attachment for the origin of a muscle (tendon)

Question 6

is the fat pad in a joint intra or extrasynovial

Answer 6

extrasynovial

Question 7

function of a fat pad in joints

Answer 7

slides backwards and forwards - spreading the synovial fluid around

Question 8

what is a bursae

Answer 8

a sac that contains a small amount of synovial fluid

Question 9

where are bursae found

Answer 9

where there is lots of friction

Question 10

function of discs and menisci

Answer 10

shock absorb and may weight bear.

Question 11

explain the blood and nerve supply of joint discs

Answer 11

blood and nerve supply to the outer third

Question 12

what are the 2 joints of the clavicle

Answer 12

• sternoclavicular joint

- acromioclavicular joint

Question 13

what is the shoulder joint called

Answer 13

the glenohumeral joint

Question 14

what is the scapulo-thoracic joint?

Answer 14

where the scapula moves against the chest wall

Question 15

common fracture sites of the humerus

Answer 15

• surgical neck (common in elderly)
• mid shaft
• supracondylar

Question 16

what nerves do the common humeral breaks endanger

Answer 16

surgical neck - endangers axillary nerve
mid shaft - endangers radial nerve
supracondylar - endangers median nerve and branchial artery

Question 17

at what time in gestation is ossification complete of the long bones

Answer 17

8 weeks (embryo to foetal transition)

Question 18

explain the curves of the clavicle

Answer 18

medial 2/3 - convex

lateral 1/3 - concave

Question 19

which ligaments does the clavicle have grooves for

Answer 19

coracoclavicular ligament

costoclavicular ligament

Question 20

where is the commonest site for clavicle fracture

Answer 20

at the max change of curvature between the 2 ligaments

Question 21

2 key features of the sternoclavicular joint

Answer 21

• intra-articular disc

- strong capsule

Question 22

what is the main ligament that provides stability to the capsule of the sternoclavicualr joint

Answer 22

costoclavicular ligament

Question 23

function of the intra-articular disc in the sternoclavicular joint

Answer 23

increases the complexity of movement on each side of it

Question 24

key stabiliser of the sternoclavicular joint

Answer 24

the capsule

Question 25

what is the danger if you were to subluxate the sternoclavicular joint

Answer 25

rupture subclavien vein or subclavien artery that are right behind the joint

Question 26

what is the function of the coracoclavicular ligament for the acromioclavicular joint

Answer 26

prevents upwards displacement of the clavicle

Question 27

which plane is the acromioclavicular joint in

Answer 27

sagittal plane

Question 28

main stabiliser of the acromioclavicular joint

Answer 28

coracoclavicular ligament (2 parts separated by bursa)

Question 29

explain the grades of acromioclavicular subluxation

Answer 29

1 - stretch of the fibres

2. AC ligaments torn and disrupted
3. • AC and coracoclavicular ligaments ruptured - wide separation of joint

Question 30

what are the 5 layers of the glenohumeral joint

Answer 30

1. bones
2. labrum
3. capsule
4. tendons (rotator cuff)
5. coraco-acromial ligament/arch and subacromial bursa

Question 31

what is weird about the glenohumeral joint in regards to the size of the bones

Answer 31

disproportionate (large) size of the humeral head to (shallow) glenoid fossa - unstable

Question 32

which structures does the labrum of the glenohumeral joint provide origin for

Answer 32

long head of biceps

glenohumeral ligaments

Question 33

what is the function of the labrum in the glenohumeral joint

Answer 33

deepens the socket

attempts to overcome the instability of the joint

Question 34

where does the capsule of the glenohumeral joint attach to

Answer 34

the anatomical neck of the humerus

Question 35

what are the two deficiences in the capsule of the glenohumeral joint

Answer 35

• long head of biceps

- subscapular bursa

Question 36

what causes frozen shoulder

Answer 36

when the glenohumeral capsule tightens - preventing ROM into abduction

Question 37

what are the 4 muscles of the rotator cuff

Answer 37

• suprapsinatus - on top
• subscapularis - infront
• intraspinatus and teres minor behind

Question 38

what is the primary abductor of the shoulder

Answer 38

deltoid (has help by supraspinatus)

Question 39

function of the rotator cuff muscles

Answer 39

primary role as stabilisers

Question 40

what can lead to impingement of supraspinatus

Answer 40

if the rotator cuff is weak, the humerus is susceptible to slide upwards with the pull of deltoid

Question 41

what ligament helps stabilise the glenohumeral joint

Answer 41

subacromial ligament

Question 42

does the subscapula bursa communicate with the joint?

Answer 42

no

Question 43

in which direction is shoulder dislocation most prominent and why

Answer 43

anterior - little support inferiorly of the joint –> therefore joint moves anteriorly and then inferiorly

Question 44

which nerve is endangered by inferior dislocation of the shoulder

Answer 44

axillary nerve

Question 45

how do you assess for axillary nerve damage in a patient with a dislocated shoulder

Answer 45

pin prick over the insertion of deltoid