Shoulder Girdle Flashcards
1
Q
Why is the shoulder referred to as shoulder girdle?
A
It is a complete set of joints
2
Q
What is the commonly known joint most referred to as the shoulder?
A
Glenoidhumoral joint
3
Q
What is the Elbow joint actually, not a joint but a what?
A
elbow complex
4
Q
What are the four bones that make up the shoulder girdle?
A
Scapula, Clavicle, Humerus, Rib cage
5
Q
What determines the type of joint?
A
the attached connective tissue on the joint
6
Q
How many true joints are there for the shoulder girdle?
A
three
7
Q
What are the three True joints of the shoulder girdle?
A
1- Sternoclavicular Joint
2- Acromioclavicular Joint
3- Glenohumeral Joint
8
Q
Synarthrosis is also known as what joint?
A
Fibrous Joints
remember SAD
SYN (fibrous) AMPH (cartilaginous) DIARTH (synovial)
9
Q
How many functional joints are there related to the shoulder girdle?
A
three
10
Q
What is the function of Scapulo-thoracic Joint of the shoulder girdle?
A
Important for shoulder stability and shoulder structure
11
Q
Name the three functional joints of the shoulder girdle
A
1- Scapulo-thoracic Joint
2- Supra-humeral/ Sub-acromial Space
3- Long head of biceps within the bicipital groove
12
Q
What is the structures that hold the Scapular to the Thorax in the Scapulo-thoracic joint?
A
Subscapularis, Serratus Anterior, Rhomboid Major, Rhomboid Minor
13
Q
Supra-humeral/Sub-acromial Space is located where?
A
In between the Acromion process and the head of the humerus
14
Q
Why is it important to maintain the suprahumeral/subacromial space?
A
It houses the tendons of Infraspinatis, Supraspinatis, Long head of the Biceps brachii, and Subacromial Bursa
15
Q
What is the condition when the Subacromial/ Suprahumeral space is compromised?
A
Glenohumeral Impingment
16
Q
What might be the implication of the humeral head riding up and impinging the subacromial/suprahumeral space?
A
Rotator cuff tear and make contact with the rotator cuff
17
Q
What happens if the humeral head makes constant contact with the acromion?
A
Bone spur due to Wolff’s Law or Osteoblastic activity
18
Q
What is located in the Bicpital groove?
A
Long head of the biceps brachii
19
Q
What is the Medial border of the scapular also known as?
A
Vertebral border
20
Q
What is the Lateral border of the scapular also known as?
A
Axillary border
21
Q
Inferior angle of the scapular is at what level?
A
T7 spinous process
22
Q
Superior angle of the scapular is at what level?
A
T2 spinous process
23
Q
The subscapular fossa houses what?
A
Is the origin of the subscapularis muscle
24
Q
Clavicle medially is what convex or concave?
A
Convex anteriorly
25
Clavicle laterally is what convex or concave?
Concave anteriorly
26
How is the Coracoid process of the scapular oriented?
Anterior and Laterally
27
What nerve travels through the suprascapular notch of the scapular?
suprascapular nerve
28
What does the Suprascapular nerve innervate?
Supraspinatis and Infraspinatis muscles
29
What does the Suprasapular nerve dive under right before innervating the two posterior scapular muscles?
Acromion process
30
The Oval glenoid fossa and Humeral head is what ratio in size?
1:3 ratio Humeral head being much larger
31
What sort of joint is the Glenoid-humeral Joint?
Synovial joint with hyaline cartilage on the articulating surfaces
32
What is the bump on the apex of the Glenoidhumeral joint?
Supraglenoid tubercle
33
What attaches to the supraglenoid tubercle?
Origin point Long head of the biceps brachii
34
Where is the infraglenoid tubercle located?
outside the glenoid fossa just inferior to the fossa
35
What attaches to the infraglenoid tubercle?
origin point for Long head of the triceps brachii
36
What is the medial and lateral portion of the clavicle called?
Sternal end and acromional end
37
On the lateral size of the clavicle what are the two bumps called?
Trapezoid tubercle and Conoid tubercle
38
What attaches to the Trapezoid and Conoid tubercle?
Trapezoid and Conoid Ligament
39
Collectively what is the Trapezoid and Conoid Ligament called?
Coracoclevicular ligament
40
What ends at the anatomical neck of the humerus?
articular cartilage of the hyaline cartilage on the humeral head
41
Where does the surgical neck of the humerus get it's name?
Location of surgery due to a fracture there mostly a ORIF
42
What nerve and artery is attached to or around the surgical humeral neck?
Axillary nerve and posterior post humeral artery
43
Where is the Intertubercular groove aka Bicipital groove located?
Anterior surface in between the Greater tubercle and lesser tubercle
44
Where is the greater tubercle located?
Lateral and distal aspect of the humerus
45
Where is the lesser tubercle located?
Medial and distal aspect of the humerus
46
How many of the Rotator cuff muscles attach to the greater tubercle? and what?
three. Teres minor, Supraspinalus, Infraspinalus
47
What is the ridge of bones just inferior to the Greater Tubercle called?
Lateral lip of the bicipital groove or Crest of the Greater tubercle
48
How many of the Rotator cuff muscles attach to the lesser tubercle? and what?
one. Subscapularis
49
What inserts into the Lateral lip of the bicipital groove or Crest of the Greater tubercle?
Insertion point of pectoralis major. It isn't on the Greater Tubercle!!! it's in the larger space of the CREST of the greater tubercle. Distal, inferior, lateral to the tubercle
50
What inserts to the Medial lip of the bicipital groove or Crest of the Lesser tubercle?
Insertion point for Teres Major and Latissimus Dorsi. Also not on the Tubercle! on the crest
51
lateral aspect of 1/3 of the way down on the humerus, the roughened area is called the what?
Deltoid tuberosity, where the deltoid attaches
52
What is superficial to the Deltoid Tuberosity?
Subdeltoid Bursa where the deltoid actually attaches
53
Posterior aspect of the humerus running Medial to Lateral what is that groove called?
Musculospiral groove or Radial Groove
54
What runs in the musculospiral groove or radial groove?
Radial Nerve and deep brachial artery
55
What attaches just above the musculospiral/radial groove?
Lateral head of the triceps brachii attaches on the shaft of the humerus
56
What attaches just below the musculospiral/radial groove?
Medial head of the triceps brachii attaches on the shaft of the humerus
57
What is the widest portion of the distal humerus called?
Epicondyles, Medial and Lateral epicondyle
58
What resembles a spool of thread on the medial humerus?
Trochlea
59
What are the condyles function on the humerus?
articulating surfaces for ulna and radius
60
What is the bulbus spherical condyle on the lateral humerus is what?
Capitulum
61
On the humerus where is the olecronon fossa located?
in between the Capitulum and Trochlea on the posterior aspect
62
What goes into the Olecronon Fossa when you elbow extend?
Olecranon process of the Ulna
63
What is just superior to the Capitulum, an indentation
Radial Fossa
64
When you flex your elbow what fits into the Radial fossa?
The radial head
65
When you flex your elbow what fits into the Coranoid fossa?
The coranoid process of the ulna
66
What is the most superior and posterior aspect of the ulna called?
Olecranon process
67
What is the concavity of the anterior aspect of the ulna called?
Trochlear notch, where the humerus' Trochlea fits into
68
What is just lateral and inferior to the trochlear notch?
Radial notch, where the head of the radius fits into
69
What is just distal of the Ulnar head?
Ulnar styloid process
70
What is the larger bulbous bump of your wrist medially?
Ulnar head
71
Is the Radial head superior or inferior?
Superior/proximal
72
What is the concavity at the head of the radius called?
Fovea
73
What is the thin inferior to the head of the radius called?
neck of the radius
74
What is the large bulbous portion inferior to the neck of the radius called?
Radial tuberosity
75
What inserts to the radial tuberosity?
insertion point for Biceps brachii
76
Which bone the most lateral bone in the forearm?
Radius
77
When you pronate and supinate which forearm bone moves?
The radius bone moves around the ulnar
78
What bones does all pronation and supination muscles attach to ?
Radius
79
On the Ulnar what is just inferior to the Trochlear notch?
Ulnar tuberosity
80
What muscles attaches to the Ulnar tuberosity?
Brachialis
81
What movement does the Brachialis produce?
Neither bc its not attached to the radius
82
What movement does the biceps brachii produce?
Supination of the forearm
83
What is the most distal portion of the radius, the projection?
Radial styloid process
84
What is the medial indentation of the radius called?
Ulnar notch
85
What fits into the Ulnar notch of the radius?
Ulnar head
86
The most inferior surface of the radius is for what?
Carpal articulation
87
Which two carpal bones will the Distal articulating surface of the radius articulate with?
Scaphoid and Lunate
88
What is the physical difference between posterior and anterior surface of the distal radius?
Anterior and concaved and flat where as the posterior portion is pointing out
89
What is the point of distal posterior of the radius called?
Dorsal tubercle or Lister's Tubercle of the radius
90
What is relationship between a muscle to the Lister's Tubercle or Dorsal tubercle?
Extensor Pollicus longus will loop around it and change direction
91
What are the eight carpal bones?
some lovers try positions that they cant handle
| scaphoid lunate triquestrum pisiform trapezium trapezoid capitate hamate
92
How are the 8 carpal bones ordered?
Proximal row and Distal row
93
What is the most proximal and lateral carpal bone and in the anatomical snuff box
Scaphoid
94
What are the two carpal bones that articulate with the radius?
Scaphoid and Lunate
95
Which proximal row carpal bone isn't actually in it but sticks out and floats alone?
Pisiform
96
What sort of bone is Pisiform carpal?
sysmoid bone or aka floating bone
97
Which carpal is just inferior to the ulnar
Triquetrum
98
Which carpal is most lateral and distal?
Trapezium
99
What does the Trapezium align with and articulate with?
Articulates with the 1st digit (Thumb)
100
What does the Trapezoid align with and articulate with?
2nd digit (Index)
101
What does the Capitate align with and articulate with?
3rd digit
102
What is Capitate AKA?
"Key Stone" carpal bone
103
What is on the anterior aspect of the Hamate bone?
Hook of Hamate
104
Hook of hamate + Pisiform is what?
Guyon's Canal
105
What does the Hamate align with and articulate with?
4th and 5th metacarpal
106
What is just distal to the Carpal bones?
Metacarpal bones
107
What are the three parts of the Metacarpals?
Head, Shaft, Base
108
What is on the distal portion of the Metacarpals? and what's its shape?
the head which is convex
109
What part of the metacarpal articulates with the carpal and whats its shape?
concaved base
110
How many Metacarpal are there?
5
111
How many Phalanges are there?
14
112
what's the shape of the phalanges' head and base?
base is concaved and head is convexed
113
What are the three phalange called?
distal, middle, proximal phalanges
114
Whats the different between digits 2,3,4,5 vs digit 1
digits 2,3,4,5 have three segments: distal, middle, proximal
| digit 1 has only 2 segment: distal and proximal
115
At the level of the head of 1st metacarpal what is located there?
2 sesmoid bones known as the sesmoid bones of the thumb
116
What is located in between the sesmoid bones of the thumb
The long tendon of Flexor pollicus longus
117
What tendon is the sesmoid bones of the thumb inbedded in?
tendon of Flexor pollicus brevis
118
What is the only attachment of the UE to the axial skeleton?
Sternoclavicular Joint
119
What kind of joint is Sternoclavicular Joint?
Synovial Saddle Joint
120
What sort of disc is in the Sternoclavicular Joint?
FIbrocartilagenous disc
121
what is the function o fthe fibrocartilagenous disc in the sternoclavicular joint?
increases congruency (increase contact points of each surfaces aka fills in the gaps formed when saddle joint moves) and enhance joint movement
122
How many DOF does sternoclavicular joint have? and name them.
Three
1- elevation/depression
2- protraction/retraction
3- posterior/anterior
123
What is sternoclavicular joint anterior rotation and posterior rotation?
posterior rotation is the movement of the clavicle at only the end ROM of shoulder elevation
anterior rotation is the resting position after posterior rotation
124
Name the shoulder elevation movements.
Shoulder abd
Scaption
Shoulder flexion
125
If you can't posteriorly rotate the clavicle what other motion is now limited?
full shoulder elevation
126
Is the sternoclavicular joint easily injured?
no. very strong due to many strong ligaments
127
What are the ligaments located anterior and posteriorly on the SC joint?
two Anterior and two Posterior SC joint
128
What movements does the Anterior and Posterior SC Joint prevent?
excessive anterior and posterior movement of the sternal end of the clavicle
129
What sits on top of the two Anterior/Posterior SC Joint?
one Interclavicular ligament
130
What movement does the Interclavicular ligament
Excessive superior movement of the sternal end of the clavicle
131
What bone is just Inferior to the clavicle?
1st rib
132
What ligament attaches from the 1st rib to the clavicle in the SC joint medially?
costoclavicular ligament
133
what movement does the costoclavicular ligament
excessive elevation of the sternal end of the clavicle
134
What kind of joint is the acromioclavicular joint?
Plane synovial joint - two flat surfaces gliding against each other
135
What union is the AC joint?
acromion end of the clavicle and the acromion process of the scapular
136
How many DOF does AC joint have?
Three
1- Anterior/Posterior tipping
2- Upward/Downward rotation
3- Internal/External rotation
137
Why does the scapular move or rotate anteriorly when you shrug your shoulder
Due to the contour of the thorax, as it follows the contour up it tips anteriorly it will also come back posteriorly when coming back down
138
Whats the size of the fibrocartilage disc in the AC joint?
small
139
How many ligaments are there in AC joint?
three
140
What are the AC Joint ligaments?
Superior AC ligament
Inferior AC ligament
Coracoclavicular ligament
141
Which AC joint ligaments are weak and most likely to be ruptured?
Superior and Inferior AC ligament
142
What is the sprain to the AC Joint called?
shoulder seperation
143
What is the stronger AC joint called?
Coracoclavicular ligament
144
What is the coracoclavicular ligament composed of?
lateral trapezoid ligament and medial conoid ligament
145
What is the mechanical/physical property of conoid ligament during rest, shoulder elevation, and end range of shoulder elevation?
The conoid ligament is cone in shape due to a wound/spiral nature of the ligament. It is bent in half while the arm/shoulder is at rest to the side. During shoulder elevation the conoid ligament is straight and taut. To allow for the far end range the wound/spiral ligament unwinds a bit to allow for the complete ROM and draws the clavicle into POSTERIOR ROTATION
146
What type of joint is the glenohumeral Joint?
Synovial Ball and Socket
147
what are the 3 DOF
Flexion/Extension
Abduction/Adduction
Internal/External Rotation
148
What is the GH joint DOF combined called?
Circumflexion
149
What is unique of the GH Joint?
the Most mobile and least stable in the human body, joint wise. due to the 3:1 ratio
150
In the GH Joint there is an attachment site what is it called?
Glenoid Labrum
151
What attaches to the Glenod Labrum?
Attachment for Long head of biceps and joint capsule
152
What surrounds all synovial joint like GH joint?
Joint capsule
153
What is the relationship between Glenoid Labrum and Joint Capsule?
They blend in together.
154
What happens when there is a tear in the joint capsule or Glenoid Labrum of the GH Joint?
Since within the Joint capsule there is a negative pressure, a tear in the blended in capsule or glenoid labrum will result in loss of vacuum therefore loss of stability
155
What are the four aspects of the GH joint capsule?
superior, inferior, middle, posterior
156
what is unique about the GH joint capsules inferiorly?
AKA redundancies which are fold-like which allows for further movement and ability to elevate the arm
157
What it is called when the inferior aspect of the GH joint capsule or redundancy is compromised?
Frozen shoulder or adhesive capsulitis
158
What motions are restricted by the Superior, Middle, Inferior GH ligaments?
Superior- prevents humeral head dipping/inferiorly
Middle- prevents humeral head going anteriorly
Inferior- prevents inferior and anterior movement
159
What is the Foramen of Weitbrecht? and what's its function?
Foramen found in between the Superior and Middle GH ligament. Allows for the GH dislocation (anteriorly)!!! bad GH dislocation. highly unstable
160
How is GH Joint stabilized?
Dynamic stabilization by the muscles around it
161
What is the function joint of the shoulder girdle?
Scapulo-thoracic Joint
162
Where is the Scapulo-thoracic Joint and what is its function?
Articulation between the Flat scapula and round thoracic cage. allows for appropriate muscle contraction to maintain joint congruency to prevent winging
163
What are the motions occuring at the ST Joint?
Elevation/Depression
Protraction/Retraction
Upward/Downward Rotation
164
Where is the motions of ST Joint oriented around?
the Glenoid Fossa
165
Why is all the UE stability provided by the ST joint important?
it is the proximal stability to allow for good distal stable motions of the UE example of shoveling snow on ice and on solid ground
166
What are the Three muscles related to the ST joint DURING SCAP UPWARD ROTATION and what are their roles?
All of these must concommited contract
- Upper Trap
- Lower Trap- prevents scap elevation
- Serratus Anterior- protract scap and maintain medial border to prevent winging
167
What is the loss of contact of the Scapula and Thorax called?
Scapular winging
168
What is the movement of the scapula and in what plane during: reach across the body?
protract in the direction the hand will be placed on the transverse plane
169
What is the movement of the scapula and in what plane during: shoulder elevation?
upward rotation with the glenoid fossa upward in the coronal plane
170
What is the movement of the scapula and in what plane during: reach down?
downward rotation with the glenoid fossa pointing down in the coronal plane
171
If you dont have full scapular upward rotation what else is limited?
shoulder elevation
172
What region of the spine and motion is important for shoulder elevation by the Rhomboids
Functional Thoraxic extension
173
What are the other two ligaments of the shoulder?
1- Coracoacromial ligament
| 2- Transverse humeral ligament
174
Which ligament forms a root for the GH joint? and its junction
Coracoacromial ligament
| prevents anterior movement therefore prevents impingement
175
What is the Transverse humeral ligament's function?
holds the long head of the biceps in the bicipital groove
176
What are the four muscles of the Rotator cuff?
Infraspinatus
Supraspinatus
Subscapularis
Teres minor
177
What happens when the Supraspinatus is injured or torn?
Can't initiate the abduction of the shoulder, the arm will remain on the side of the body.
178
When does the Deltoid start to kick in for shoulder abduction?
30-40 degrees
179
Where does the Supraspinatus attach to the greater tubercle of the humerus?
Most anterior facet of the greater tubercle after diving under the acromion process
180
Where does the Infraspinatus attach to the greater tubercle of the humerus?
Most lateral facet of the greater tubercle after diving under the acromion process
181
Where does the Teres Minor attach to the greater tubercle of the humerus?
The most posterior and inferior aspect of the greater tubercle
182
What innervates supraspinatus/infraspinatus?
suprascapular nerve
183
what inneravates teres minor?
axillary nerve
184
what innervates the subscapularis?
upper and lower subscapular nerve
185
How does the subscapularis attach to the humerus and where on it?
Attaches to the lesser tubercle without diving the acromion process
186
What motion does Infraspinatus do?
ER when the arm is by the side *best ER compared to miny Teres minor
187
What motion does Teres minor do?
ER when the arm is abducted to 90 degrees *pitchers exercise*
188
What motion does Subscapularis do?
IR when the arm is at the side
189
what rotator cuff muscle is synergist with deltoid?
supraspinatus
190
IF ER is limited which muscle would you say is tight?
Subscapularis
191
Rotator cuff provides dynamic stability for what joint?
GH joint
192
Since the Deltoid brings up the humeral head superiorly it can cause impingement what muscles pulls the humeral head inferiorly? they centralize the humeral head
Infraspinatus, Teres minor, Subscapularis
193
Infraspinatus, Teres minor, and Subscapularis prevents the elevation of humeral head from impingement of what 4 structures?
1- Acoracoarcomial arch
2- acromion process
3- supraspiantus tendon
4- subacromial bursa
194
What innervates Trapezius?
Spinal accessory nerve
195
When all upper, middle, and lower trapezius contract what motion occurs to the scapula?
upward rotation
196
When Rhomboid major and minor contract what motion occurs to the scapula?
retraction and downward rotation
197
When levator scapular retracts what motion occurs to the scapula?
medially elevates and downward rotation
198
Serratus Anterior retracts what motion occurs to the scapula?
Protraction of the scapular
199
Pectoralis Minor attaches to the scapular on the corocoid process retracts what motion occurs to the scapula?
protracts, downward rotation, and depress
200
What are the attachments of Pectoralis Minor and scapula?
deep to the Pectoralis major attaches corocoid process to rib 3-5 innervated by Medial and Lateral pectoral nerve
201
Highly kyphotic posture could assume they have tight what muscles in the shoulder region?
Pectoralis Minor
202
Teres Major attaches from the Inferior angle of the scapula to what?
Medial lip of the bicipical groove or crest of the lesser tubercle of the humerus
203
What does the Teres major have the same attachment and actions with?
Latissimus dorsi
204
Biceps brachii has two heads, the long head and short head. which is lateral and medial and what are they attachments?
Long head is lateral that attaches on supraglenoid tubercle
| Short head is medial attaches to the corocoid process
205
What are the two distal attachments of biceps brachii?
The tendonis and more lateral attaches to the radial tuberosity
The medial attachments are known as bicipital apeneurosis, blends with the fascia of the forearm
206
How does the biceps get involved with the shoulder?
The superior aspect of the biceps it goes over the shoulder muscles
207
Biceps brachii does what three actions
shoulder flexion, elbow flexion, and supination
208
What are the attachments of the three heads of triceps brachii?
Long head- just inferior to the glenoid fossa aka infraglenoid tuberacle
Lateral head- just superior to the musculospiral groove proximal lateral 1/3 of the humerus
Medial head- medial and distal 2/3 inferior to the musculospiral groove of the humerus
209
How is the Medial head of the humerus found?
Just deep to the long head therefore its hard to find
210
What triceps attach to the actual bone of the humerus
The Medial head of the triceps brachii bc the long head of the triceps don't actually attach to the humerus bone it hands out over the medial head.
211
Where do all three heads of the triceps converge?
The centralized triceps tendon and blends in to the olecranon process of the ulna.
212
What sits just above the olecranon process of the ulna where the triceps tendon converged?
Olecranon bursa
213
Triceps brachii retracts what motion occurs to the scapula?
extension of the shoulder
214
How is triceps elbow extension interfered with other UE movements ?
Unrelated by other UE motions such as pronation, neutral, or supinated bc its not attached to the Radius.
215
What are the attachments of Coracobrachialis?
Coracoid process to the medial proximal 1/3 of the humerus. Innervated by the musculocutaneous nerve
216
coracobrachilais retracts what motion occurs to the scapula?
shoulder flexion when the arms on the side. Adduction or horizontal adduction
217
How many heads does deltoid have?
Anterior, middle, and posterior head
218
what sort of fiber orientation is the deltoid muscle?
convergent muscle
219
What does anterior head of deltoid do?
shoulder flexion, internal rotation, and horizontal adduction
220
What does posterior head of deltoid do?
shoulder extension, external rotation, and horizontal abduction
221
Abduction of the coronal plane which deltoid heads are firing?
All three middle, anterior, posterior. If posterior is weak or not working the abduction will leave coronal plane and vier to the anteriorly and vice versa
222
What are the attachments of Pectoralis Major?
Body of the sternum and sternocostal cartilages ribs 2-6, and medial 1/3 of the clavicle and attaches to the crest of the greater tubercle aka lateral lip of the bicipital groove
223
pectoralis major retracts what motion occurs to the shoulder?
internal rotation, adduction, and horizontal adduction
224
what innervates the pectoralis major?
medial and lateral pectoral nerve
225
Clavicular head of the pec major contracts then what happens?
When the arm is already extended, it allows for shoulder flexion up and across. Most used during the first initiation
226
Sternocostal head of the pec major contracts then what happens?
pull the arm down to shoulder extension
