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Kines Exam 1 > Shoulder Complex > Flashcards

Shoulder Complex Flashcards

1
Q

What are the components of the shoulder complex?

A 
Mobility with dynamic stability 
•Sternoclavicular joint
•Acromioclavicular joint
•Glenohumeral joint
•Scapulothoracic “joint”
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2
Q

What are the bones which make up the sternoclavicular joint?

A

Medial clavicle with notch formed by manubrium and 1st costal cartilage

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3
Q

What type of joint is the SC joint?

A

Saddle joint

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4
Q

How is the SC joint reinforced and stabilized?

Fibrous joint capsule

A

Posterior portion - restrain ant/post translation of medial clavicle

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5
Q

How is the SC joint reinforced and stabilized?

Anterior/posterior sternoclavicular lig

A

Restrict anterior and posterior translation of clavicle

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6
Q

How is the SC joint reinforced and stabilized?

Costoclavicular lig

A

Anterior and posterior bundles

  • Limit elevation of lateral clavicle
  • Contribute to inferior glide of medial clavicle in elevation
  • Shock absorption
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7
Q

How is the SC joint reinforced and stabilized?

Interclavicular lig

A

Limits excessive depression and superior glide of clavicle

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8
Q

Describe the osteo of the SC joint.

A

Elevation/depression
Protraction/retraction
anterior/posterior rotation

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9
Q

Describe the arthrokinematics of the SC joint.

A

Superior/inferior
anterior/posterior
spin

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10
Q

Describe Elevation/Depression at SC joint:

A

-Disc remains stationary
-Convex on concave movement
Elevation - Superior roll and inferior glide
Depression - Inferior roll and superior glide

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11
Q

Describe Protraction/Retraction at SC joint:

A

-Disc moves with clavicle
-Concave on convex movement
Protraction - Anterior roll and glide
Retraction - posterior roll and glide

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12
Q

Describe anter/posterior rotation at SC joint:

A

Posterior rotation - inferior surface moves anteriorly

Anterior rotation - Inferior surface returns to inferior position (minimal motion from neutral)

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13
Q

What is the open pack position and capsular pattern for the SC joint?

A

Open pack = arm resting at side

Capsular pattern = pain at end range with arm overhead

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14
Q

What are the bones which make up the acromioclavicular joint?

A

Lateral clavicle

Acromion

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15
Q

What type of joint is the AC joint?

A

Plane synovial

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16
Q

How is the AC joint reinforced and stabilized?

Joint capsule -

A

weak, requires reinforcement

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17
Q

How is the AC joint reinforced and stabilized?

Superior acromioclavicular lig

A
  • Reinforced by deltoid and trap

- Resists anterior clavicular/posterior acromion translation

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18
Q

How is the AC joint reinforced and stabilized?

Inferior acromioclavicular lig

A

Most susceptible to downward dislocation

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19
Q

How is the AC joint reinforced and stabilized?

Coracoclavicular lig

A
  • Trapezoid and conoid lig

- Limit superior clavicular/inferior scapular translation and posterior rotation of clavicle

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20
Q

Describe the osteo of the AC joint.

A

Internal/external rotation
Ant/post tilting (tipping)
Upward/downward rotation

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21
Q

Describe the arthrokinematics of the AC joint.

A

Ant/post
sup/inf
medial/lateral

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22
Q

Primary function of AC joint is:

A

Allow scapula to rotate during arm movement

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23
Q

Why is internal/external rotation at AC joint important?

A

Maintain contact of scapula on curved thorax during protraction and retraction of clavicle

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24
Q

Why is Anterior/posterior tilting (tipping) at AC joint important?

A

Maintain contact of scapular on curved thorax during elevation and depression of clavicle

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25
Q

Why is Upward/downward rotation at AC joint important?

A

-Important for positioning glenoid fossa in optimal position
Upward - scapula swing up and out (abduction or flex of shoulder)
Downward - scapula back to anatomical position (adduction or extension of shoulder)

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26
Q

What is the open pack position and capsular pattern for the AC joint?

A

Open pack = arm by side

Capsular pattern = pain at end range with arm overhead

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27
Q

What movements occur at the scapulothoracic “joint”?

A 
Primary =
Elevation/depression
protraction/retraction
upward/downward rotation
Secondary =
Anterior/posterior tilting
internal/external rotation
28
Q

Elevation/depression at scapulothoracic joint combines:

A

Elevation - combination of SC joint elevation and AC joint downward rotation (shoulder shrug)

29
Q

Protraction/retraction at scapulothoracic joint combines:

A

Protraction - combination of SC joint protraction and slight AC joint IR

30
Q

Upward/downward rotation at scapulothoracic joint combines:

A

Upward - summation of SC joint elevation and AC joint upward rotation

31
Q

What are the bones which make up the glenohumeral joint?

A

Glenoid foass and head of humerus

32
Q

What type of joint is the GH joint?

A

Ball and socket

33
Q

What is angle of inclination in frontal plane of GH joint?

A

130-150 in frontal plane

34
Q

What is angle of torsion in transverse plane of GH joint?

A

30 posterior

35
Q

What is retroversion of GH joint?

A

Posterior orientation of humeral head with regard to condyles

36
Q

Increased humeral retroversion may result in what changes in ER/IR ROM?
What athletes do we see this in?

A

Increased ER ROM
Decreased IR ROM
Dominant arm of throwing athletes which suggests retroversion may be 1 contributing factor for ROM adaptation (10-15 more)

37
Q

How is the GH joint reinforced and stabilized?

Glenoid Labrum

A
  • Enhances concavity and increase articular surface
  • Resists humeral head translations, dissipates forces, and protects bony edges
  • Attachment of GH ligaments and tendon of biceps long head
38
Q

How is the GH joint reinforced and stabilized?

Joint Capsule

A
  • Significant laxity, minimal stability
  • Reinforced by thicker external lig
  • Inferior portion is slack in adducted position creating axillary pouch
39
Q

Tightness in posterior shoulder capsule may produce ________(dec/inc) anterior humeral head translation which in turn _____(dec/inc) subacromial space

A
  1. Increased

2. Decreases

40
Q

What motions do the different ligaments limit at the GH joint?
Superior GH lig

A
  • Limit ER and ant/inf translation at ) abduction

- Slackens when abducted beyond 35-45 degress

41
Q

What motions do the different ligaments limit at the GH joint?
Middle GH lig

A

Limits anterior translation from 45-90 abduction and extremes of ER

42
Q

What motions do the different ligaments limit at the GH joint?
Inferior GH lig

A
  1. Ant band - strongest/thickest
  2. Posterior band
  3. Axillary pouch
    - Primary stabilizers beyond 45 degrees of abduction or with combined abduction and rotation
43
Q

What motions do the different ligaments limit at the GH joint?
Coracohumeral lig

A

Limits inferior translation and ER of humeral head with arm hanging at side

44
Q

Rotator Cuff
What does it do?
What 2 areas does the cuff not stabilize?

A
  1. Reinforces the GH joint capsule
  2. Protects and actively stabilizes GH joint with dynamic activities
    Does not reinforce:
  3. Inferiorly
  4. Region between subscap and supraspinatus (common dislocation site)
45
Q

Describe the osteo of the GH joint.

A

Flex/ext
Add/Abd
ER/IR

46
Q

Describe the arthrokinematics of the GH joint.

A

Spin
Roll
Sup/Inf glide
Ant/Post glide

47
Q

Flexion/Ext of GH joint arthro:

A

Flexion = anterior roll, posterior glide
Ext = posterior roll, anterior glide
-Flexion causes tension through capsule
-Slight anterior translation may occur at end range flexion due to tension in posterior capsule

48
Q

Add/Abd of GH joint arthro:

A

ADD = inferior roll, superior glide
ABD = superior roll, inferior glide
-Full abduction, ER will accompany
-Inferior GH lig tightens with abduction

49
Q

ER/IR of GH joint arthro:

A 
ER = posterior roll, anterior glide
IR = anterior roll, posterior glide
50
Q

What is the open pack position and capsular pattern for the GH joint?

A

Open pack = Abducted 55, then horizontally adducted 30, slight ER
Capsular pattern = ER > abduction > IR

51
Q

Describe the scapulohumeral rhythm.

A
  • Ratio of 2 degrees of GH. to 1 degree of scapular motion during arm elevation/abduction
  • Abduction of 180 = 120 GH and 60 scapulothoracic
52
Q

What is the ideal shoulder girdle posture?

A
  • slightly elevated and relatively retracted scapula

- results in glenoid fossa facing slightly upward

53
Q

What is the effect of gravity on scapulothoracic posture?

A

Results in depressed, protracted and excessively downwardly rotated scapula

54
Q

Describe the impact of rounded shoulders on an individual’s shoulder complex.

A

-Slight depression, downward rotation and protraction of scapula
-Predisposes to shoulder impingement
Possible causes - general laxity, muscle tightness, abnormal cervicothoracic posture/habit

55
Q

Describe how the rhomboids and low trap function together.

A

With retraction - elevation tendency of rhomboids neutralized by depression tendency of lower trap

56
Q

Describe how the deltoid and supraspinatus function together.

A

Paralysis of deltoid - surpraspinatus able to perform full abduction of GH with decreased torque

Paralysis of supra - full abduction difficult but achievable

57
Q

Describe how the serratus anterior, upper trap, and low trap function together.

A

Serratus anterior, UT and LT contract simultaneously to produce upward rotation during GH abduction

58
Q

What is scapular winging?

A

-Having excessive amount of IR of the scapula with attempted elevation of the arm

59
Q

Supraspinatus arthrokinematics on GH

A
  • Drives superior roll of humeral head
  • Compresses humeral head against glenoid
  • Restricts excessive superior translation of humerus
60
Q

Infraspinatus, teres minor, subscap arthro on GH:

A

Exert depression force on humeral head

61
Q

Infraspinatus and teres minor arthro on GH

A

ER humerus

62
Q

Describe how the infraspinatus and mid trap function together.

A

Middle trap acts to stabilize scapula while infraspinatus ER the shoulder

63
Q

Rhomboids act synergistically with teres major during strong resisted ______

A

adduction

64
Q

If middle trap was paralyzed, scapula would move into _______ rotation as the GH joint is ER which creates scapular ______

A
  • internal

- dyskinesia

65
Q

What is scapular dyskinesia?

A
  • Any abnormal position or movement of the scapula

- Alters effectiveness of muscle actions and distorts arthrokinematics resulting in increased stress

Kines Exam 1 (15 decks)

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