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Kines Exam 3 > Shoulder Joint > Flashcards

Shoulder Joint Flashcards

1
Q

function of shoulder

A

position the UE (hand) for function

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2
Q

shoulder is more dependent on ________ than on ________ for integrity

A

muscle;

joint structures;

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3
Q

mobility to permit UE function but at a cost

A

most likely joint of UE to dislocate

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4
Q

scapulothoracic joint is not a true anatomical joint because

A

there is no fibrous union
no capsule

it is still considered a joint tho

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5
Q

supra-acromial

A

coracoacromial arch & the head of the humerus

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6
Q

movement of the Scapulothroacic joint is associated with movement of ______ & ________

A

Acromioclavicular & sternoclavicular

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7
Q

common lever of the shoulder

A

clavicle

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8
Q

scapulothoracic joint

A
  • is not a true anatomical joint

- associated with acromioclavicular & sternoclavicular

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9
Q

common link of the scapothoracic joint

A

clavicle

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10
Q

functions of the scapulothoracic joint

A
  • maintain optimal position of glenoid fossa
  • incr functional ROM of upper extremity
  • provides a stable base for upper extremity function
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11
Q

scapulothoracic joint primary motions

A

elevation/depression – translatory
(this is an up & down motion – i.e. shrug shoulders)

abduction/adduction (protraction/retraction) – translatory

upward/downward mobility – rotary

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12
Q

scapulothoracic joint secondary motions

A

tipping & winging

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13
Q

winging (scapulothoracic secondary motion)

A

rotation about vertical axis (vertebral axis comes away)

caused by weak serratus anterior

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14
Q

tipping (scapulothoracic secondary motion)

A

rotation about medial-lateral axis

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15
Q

scapulothoracic joint – function of secondary motion

A

maintain proximity of scapula on thorax

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16
Q

stabilization of scapulothoracic joint

A

muscles & atmospheric pressure

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17
Q

when you have _____ movement there will be _____ movement

A

scapula;
clavical

and vice versa

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18
Q

structural attachment between the axial & appendicular skeleton

A

sternoclavicular joint

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19
Q

anterior & posterior sternoclavicular ligaments check:

A

anterior & posterior motion of clavicle

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20
Q

costoclavicular ligament

A

primary stabilizer

  • site of AOR for elevation/depression & protraction/retraction
  • checks elevation & superior glide of clavicle
  • movement is limited upward
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21
Q

interclavicular ligament checks

A

checks depression & downward glide

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22
Q

sternoclavicular elevation ROM

A

45 deg

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23
Q

sternoclavicular depression ROM

A

15 deg

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24
Q

sternoclavicular protraction ROM

A

15 deg

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25
Q

sternoclavicular retraction ROM

A

15 deg

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26
Q

rotation ROM

A

30 - 45 deg

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27
Q

arthrokinematics sternoclavicular joint

A

rotation posteriorly

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28
Q

sternoclavicular joint disk

A
  • increases joint surface congruency
  • acts as a hinge/pivot point
  • absorbs forces from appendicular skeleton (extremities)
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29
Q

depending on the motion the sternoclavicular joint disk will be stuck on either the ______ or _______

A

manubrium;
clavicle

then the bone without the disk will move on that

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30
Q

acromioclavicular joint is _____ lateral clavicle on _____ acromion

A

convex;

concave

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31
Q

acromioclavicular joint allows for increased

A

increased scapular motion

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32
Q

acromioclavicular joint allows for adjustment of the

A

scapula outside of the initial planes of motion

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33
Q

acromioclavicular joint transmits:

A

forces from the scapula to the clavicle

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34
Q

acromioclavicular joint anatomy

A

fibrocartilage disk that degenerates with time

weak capsule

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35
Q

superior & inferior acromioclavicular ligaments

A
  • check horizontal movements

- relatively weak

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36
Q

coracoclavicular ligaments - medial

A

conoid

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37
Q

coracoclavicular ligament - lateral

A

trapezoid

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38
Q

coracoclavicular ligament checks

A

primarily superior dislocation of the clavicle * important

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39
Q

coracoclavicular ligament

A

limits & assists scapula movement

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40
Q

acromioclavicular joint

A

susceptible to trauma (dislocation) & degenerative changes

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41
Q

acromioclavicular separation

A

tearing of the coracoclavicular ligament

–> this lets the clavicle go up and then the Acromioclavicular ligament tears

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42
Q

labrum

A

(at glenohumeral)

  • redundant fold of dense fibrous connective tissue continuous with capsule
  • increase joint congruency
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43
Q

capsule of glenhumeral joint

A
  • taut superiorly
  • loose anteriorly < inferiorly
  • risk of dislocation: anterior > inferior > posterior > superior
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44
Q

greatest risk of dislocation (GH joint capsule)

A

anterior capsule of glenohumeral joint

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45
Q

least risk of dislocation (GH joint capsule)

A

superior capsule of GH joint

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46
Q

GH joint ligaments

A

thickening of anterior capsule

3 ligaments – superior, middle, inferior

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47
Q

GH joint ligaments - all tighten with _______ and ______ of humeral head – although not ___________

A

ER;
anterior translation;
overly strong

48
Q

Coracohumeral ligament location

A

coracoid process –> blends with superior capsule & supraspinatus tendon –> greater tubercle

49
Q

Coracohumeral ligament checks

A

checks external rotation and inferior translation of humeral head

50
Q

bursa of GH joint

A

subacromial – can be 2 distinct bursa (subacromial & sub deltoid)
–> common site of pain

51
Q

function of bursa

A

prevent friction at tendon

52
Q

bursitis

A

synovial filled sac (bursa) is swollen

53
Q

coracoacromial (suprahumeral arch)

A
  • osteoligamentus ceiling of GH joint
  • subacromial bursa lies between it and the humeral head
  • region of pain secondary to impingement
54
Q

coracoacromial (suprahumeral arch) prevents

A

the humeral head from dislocating superiorly

55
Q

angle of inclination (GH joint)

A
  • frontal plane
  • occurs between long axis of shaft & humeral head
  • norm= 130 - 150
56
Q

glenoid fossa faces

A

anteriorly and inferiorly

57
Q

humeral head faces

A

medially, superiorly, & posteriorly

58
Q

angle of torsion (GH joint)

A
  • transverse plane
  • between humeral condyles & humeral head
  • NORM: 30 deg posteriorly
59
Q

how many degrees of freedom of osteokinematics of glenohumeral joint?

A

3 DOF

60
Q

flexion/extension of GH joint

A

100-150 deg

61
Q

abduction of GH joint ROM

A

60 deg medially rotated

62
Q

adduction of GH joint ROM

A

90 - 135 deg

63
Q

internal rotation of GH joint ROM

A

50 deg adducted

64
Q

external rotation of GH joint ROM

A

120 deg (abducted to 90)

65
Q

scaption of GH joint ROM

A

90 - 120 deg (scaption = elevation in plane of scapula)

66
Q

never get pure spin of GH joint due to

arthrokinematics

A

non-congruence

67
Q

GH joint arthrokinematics

A
  • non-congruent causes never a pure spin
  • associated with gliding & rolling
  • follows convex & concave rule
68
Q

around the labrum is ______ congruency

A

increased

69
Q

moving concave and whole structure moves in _____

A

same direction (stabile convex)

70
Q

stable concave and structure moves in

A

opposite direction (moving convex)

71
Q

arm at side (dependent position) is

A

the superior joint capsule & coracohumeral ligament

–> keeps joint in approximation when in normal rest state

72
Q

supraspinatus becomes active with:

A

heavier loads

73
Q

muscle function of dynamic stabilization – GH joint

A
  • move the humerus
  • provide intra-articular gliding
  • maintain apposition of joint (good approximation because of strong muscles and support)
74
Q

dynamic stabilization – abduction

A

deltoid & supraspinatus

75
Q

dynamic stabilization – flexion

A

anterior deltoid (mainly translatory)

76
Q

unopposed deltoid activity

A
  • impaction of the humeral head in the coracoacromial arch

- rotator cuff is the opposing force (specifically: infraspinatus, subscapularis, trees minor)

77
Q

Rotator cuff muscles

A

supraspinatus, infraspinatus, teres minor & subscapularis

  • blends w/ and reinforces joint capsule
78
Q

infraspinatus, subscapularis & Teres minor synergists with ________ to allow for _______

A

deltoid;
elevation

ROTATOR CUFF FUNCTION

79
Q

ROTATOR CUFF FUNCTION – forces both ____ & ______

A

rotary & compressive
(dynamic stability)

ROTATOR CUFF FUNCTION

80
Q

teres minor & infraspinatus _________ rotate the humerus to clear the ________ during ________

A

externally;
greater tubercle;
elevation

ROTATOR CUFF FUNCTION

81
Q

compressive component of supraspinatus

A

stabilizes GH joint

ROTATOR CUFF FUNCTION

82
Q

supraspinatus is a _____ translator force

A

superior

ROTATOR CUFF FUNCTION

83
Q

rotary component of supraspinatus

A

significant abductor

ROTATOR CUFF FUNCTION

84
Q

predispositions to dislocations at the rotator cuff

A
  • anterior tilt of glenoid fossa
  • excessive retrotorsion
  • weakened rotator cuff
85
Q

biceps tendon (@ rotator cuff)

A

supraglenoid tubercle –> ulna

  • long head reinforces the anterior glenohumeral joint
  • wearing of bicipital tendon sheath transverse humeral ligament
  • poorly vascularized
86
Q

scapulohumeral rhythm

A

180 deg = 120 glenhumeral joint movement + 60 deg scapulothoracic joint

87
Q

ratio of scapulohumeral ryhthm

A

Glenohumeral:Scapulothoracic = 2:1
over the entire range

for every 2 degrees of GH you get 1 deg of scapula movement

88
Q

Scapulohumeral rhythm for pre-phase/setting:

Inconsistent amount of scapula movement causes

A

proximal stability for distal mobility

89
Q

Scapulohumeral rhythm pre-phase/setting:

G-H movement

A

60 degrees flexion and
30 degrees abduction

TOTAL= 30 - 60 degrees all G-H motion

90
Q

Scapulohumeral rhythm: phase I & Scapulothoracic motion

muscle movement

A

Trapezius (upper & lower) & serratus anterior (upper & lower) contract

91
Q

Scapulohumeral rhythm: phase I & Scapulothoracic motion

ligament movement

A

coracoclavicular ligament tightens locks AC joint

because the AC joint is locked down the scapula & clavicle can move together

92
Q

Scapulohumeral rhythm: phase I & Scapulothoracic motion

clavicle motion

A

clavicle elevates about 30 degrees through sternoclavicular joint

93
Q

Scapulohumeral rhythm: phase I & Scapulothoracic motion

scapula movement

A

tipping & 10 degrees of winging

The scapula and clavicle move together because the AC joint is locked down

94
Q

Scapulohumeral rhythm: phase II & acromioclavicular motion

ligament motion

A
  • costoclavicular ligament tightens
  • the taut costoclavicular ligament pulls down on the coracoid
  • this pulls the conoid tubercle of the clavicle down
95
Q

Scapulohumeral rhythm: phase II & acromioclavicular motion

movement of the clavicle

A

rotation of clavicle on long axis

96
Q

Scapulohumeral rhythm: phase II & acromioclavicular motion

movement of the scapula

A

rotation of the scapula on axis through acromioclavicular joint

20 degrees tipping & 40 degrees winging

97
Q

scapulohumeral rhythm summary 0 to 90 degrees incr

A

60 deg glenohumeral, 30 degrees scapulothoracic about sternoclavicular joint

98
Q

scapulohumeral rhythm summary 90 to 180 degrees incr

A

60 deg glenohumeral, 30 degrees scapulothoracic about acromioclavicular joint

99
Q

The significance of sternoclavicular and acromioclavicular motion

A

for clavicle to rotate about its longitudinal axis

100
Q

Scapulohumeral rhythm function

A
  • distribute large ROM between 2 joints, less compromise of stability
  • maintain optimal position of glenoid fossa
  • maintain optimal length-tension relationship for muscles
101
Q

Deltoid

A
  • middle deltoid abducts
  • maintenance of optimal length-tension is dependent on scapula motion
  • Rotator cuff (oblique - infraspinatus, subscapularis, trees minor): combines with deltoid to form a force couple
102
Q

Supraspinatus motions

A
  • Major abductor and flexor (prepares glenohumeral joint for shoulder flexion) - during abduction pulls humerus head into shoulder joint
  • begins glenohumeral joint through full ROM without deltoid
103
Q

Supraspinatus functions

A
  • Primary mover for abuction and flexion
  • Compresses G-H joint
  • Steers humeral head vertically
104
Q

Infraspinatus & teres minor

A

external rotation

- compresses & stabilizes

105
Q

subscapularis

A

internal rotation

- compresses and stabilizes

106
Q

Two force couples - muscle function

A
  • upper segments of traps and serratus anterior along with levator scapula
  • lower segments of traps and serratus anterior
107
Q

force couples

A

pull in different directions but produce the same movement

108
Q

downward rotation of shoulder (force couples)

A
  • pec minor = pull down
  • levator scapulae = pull up
  • latissimus dorsi = pull down
109
Q

upward rotation of shoulder (force couples)

A
  • lower traps = pull down
  • upper traps = pull up
  • serratus anterior = pulls up from forward
110
Q

function of latissimus dorsi

A
  • adduction, medial rotation, extension of humerus
  • adduction and depression of scapula
  • seated push ups & crutch walking (holds scap down in place when you push your body upward)
111
Q

function of pectorals major

A
  • clavicular head - flex glenohumeral joint

- sternal portion parallels the latissimus to depress the shoulder complex

112
Q

function of pectorals minor

A
  • depress and rotates scapula downward
113
Q

function of trees major

A
  • adduction, medial rotation, extension of humerus

latts helper~~

114
Q

Total elevation in pre-phase G-H joint

A

30 - 60 degrees

115
Q

Total elevation in phase I

A
  • 30 degrees of S-T rotation & clavicular elevation

- 30 degrees of G-H movement

116
Q

total elevation in phase II

A
  • 30 degrees of S-T rotation & AOR through AC joint

- 30 to 60 degrees of G-H joint movement

117
Q

Total elevation of the shoulder joint

A

180 degrees

Kines Exam 3 (5 decks)

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