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Musculoskeletal (Milly's) > Shoulder Joint > Flashcards

Shoulder Joint Flashcards

1
Q

What are both the articulating surfaces of the glenohumeral joint covered in?

A

Hyaline cartilage

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2
Q

Where does the joint capsule of the shoulder extend to?

A

From the border of the glenoid fossa to the anatomical neck of the humerus

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3
Q

What kind of membrane lines the fibrous sheath of the joint capsule? What is the benefit of this?

A

Synovial membrane

Produces synovial fluid which reduced friction between articulating surfaces

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4
Q

How is friction reduced in the shoulder joint?

A

There are several synovial bursae

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5
Q

What is a synovial bursae?

A

Synovial fluid filled sac which acts as a cushion between tendons and other joint structures

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6
Q

Name the two clinically important bursae

A

Subacromial and subscapular

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7
Q

What does the subacromial bursae do?

A

Supports the deltoid and supraspinatus muscles

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8
Q

What does the subscapular bursae do?

A

Reduced wear and tear on subscapularis tendon during movement at the shoulder joint

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9
Q

Name the 3 ligaments of the shoulder joint

A

Glenohumeral ligaments (superior,middle, inferior)
Coracohumeral ligament
Transverse humeral ligament
Coracoacromial ligament

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10
Q

What are the attachments of the glenohumeral ligaments?

A

Run with the joint capsule from the joint capsule to the anatomical neck of the humerus

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11
Q

What is the action of the glenohumeral ligaments?

A

To stabilise the anterior aspect of the shoulder joint

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12
Q

What is the attachment of the coracohumeral ligament?

A

Attaches to the base of the coracoid process to the greater tubercle of the humerus

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13
Q

What is the action of the coracohumeral ligament?

A

Supports the superior part of the joint capsule

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14
Q

What are the attachments of the transverse humeral ligament?

A

Spans distance between the two tubercles of the humerus

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15
Q

What is the action of the transverse humeral ligament?

A

Hold the tendon of the long head of the bicep in the bicipital groove

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16
Q

What are the attachments of the coracoacromial ligament?

A

Runs between the acromion and the coracoid process of scapula (forms coraco-acromial arch)

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17
Q

What is the action of the coracoacromial ligament?

A

Prevents superior displacement of the humeral head

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18
Q

What is different about the coracoacromial ligament compared to the other 3 ligaments of the shoulder joint?

A

It is not a thickening of the joint capsule

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19
Q

What is the arterial blood supply to the shoulder joint?

A

Anterior and posterior circumflex humeral arteries

Suprascapular artery

20
Q

What is the innervation of the shoulder joint?

A

Supplied by the axillary, suprascapular and lateral pectoral nerves (derived from roots C5 and C6)

21
Q

What kind of injury would affect the innervation of the shoulder joint function?

A

An upper brachial plexus injury (Erb’s palsy)

22
Q

What muscles permit extension at the shoulder?

A

Posterior deltoid, latissimus dorsi and teres major

23
Q

What muscles permit flexion at the shoulder?

A

Bicep brachii, pectoralis major, anterior deltoid and coracobrachialis

24
Q

What muscles permit adduction at the shoulder?

A

Pectoralis major, latissimus dorsi, teres major

25
Q

What muscles permit abduction at the shoulder?

A

0-15 degrees- supraspinatus
15-90 degrees- middle deltoid fibres
90 + degrees - trapezoid and serratus anterior (rotate scapular)

26
Q

What muscles permit medial rotation at the shoulder?

A 
Subscapularis
Pectoralis major
Latissimus doris 
Teres major
Anterior deltoid
27
Q

What muscles permit lateral rotation at the shoulder?

A

Infraspinatus and teres minor

28
Q

What are the factors contributing to the mobility of the shoulder joint?

A
  • the fact that it is a ball and socket joint
  • the disproportionate size of articulating surfaces
  • laxity of joint capsule
29
Q

What are the factors that contribute to the stability of the shoulder joint?

A

Rotator cuff muscles
Glenoid labrum
Ligaments

30
Q

How are dislocation of the shoulder joint described?

A

By where the humeral head lies in relation to the infraglenoid tubercle

31
Q

What is the more common type of shoulder dislocation?

A

Anterior dislocation

32
Q

What is anterior dislocation usually caused by?

A

Excessive extension and lateral rotation of the humerus

Humeral head is forced anteriorly and inferiorly- into the weakest part of the joint capsule

33
Q

Which two nerves can be effected by dislocations?

A

Axillary and radial

34
Q

What does injury to the axillary nerve cause?

A

Paralysis of deltoid and loss of sensation over regimental badge area

35
Q

What does rotator cuff tendinitis do to the shoulder joint over time?

A

Causes degenerative changes in the subacromial bursa and subsequently the supraspinatus tendon- increased friction between structures

36
Q

What is a characteristic sign of rotator cuff tendonitis?

A

Painful arc pain in the middle of abduction (where affected area comes into contact with the acromion)

37
Q

Posterior shoulder dislocations are less common and can easily be missed clinically and on x-ray. But how could these sort of breaks occur?

A

Electric shock, seizures

38
Q

How would someone present clinically with a posterior shoulder dislocation?

A

They wouldn’t be able to externally rotate at the shoulder because it is fixed in internal rotation

39
Q

How would you fix a clavicle fracture? What are the risks of this?

A

Wires and surgery

Wires may break and cause damage elsewhere

40
Q

Name a common degenerative condition of the shoulder joint

A

Calcification tendonitis- calcium hydroxyapatite deposit- tendon turns to bone

41
Q

What is popeye muscle? How is it treated

A

When the long head of the bicep ruptures and causes a bulging in the arm.
This is just cosmetic there is no need for surgery

42
Q

How would someone with impingement of the shoulder joint present clinically?

A

Low painful arc (once arm is past 90 degrees its fine)

Tender over tuberosity

Hawkins test +ive

43
Q

How would you treat someone with impingement of the shoulder joint?

A

Steroids and physio

Or surgical decompression

44
Q

What complications may occur after anterior dislocation of the shoulder?

A

Damage to axillary nerve. Axillary nerve runs posteriorly to head of humerus so dislocation anteriorly will pull on the axillary nerve.

45
Q

How would examine a patient who had dislocated their shoulder to determine the integrity of the axillary nerve?

What would you not do and why?

A

Test for sensation at regimental badge area (where injections happen)

Test for motor function in acute trauma

Musculoskeletal (Milly's) (28 decks)

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