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Kinesiology Exam 1 > Shoulder joints > Flashcards

Shoulder joints Flashcards

1
Q

what is the shoulder complex

A

an ensemble of bones, joints and soft tissue that must function synchronously

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2
Q

what is the center of activity and has dual function

A

GH joint

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3
Q

what are the dual functions of the GH joint

A

stability and mobility

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4
Q

what is the function of the shoulder

A

mobilize the hand in space

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5
Q

what does the design of the shoulder allow

A

for a large ROM

but this mobility presents conflict

we also need stability

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6
Q

articulation of the sternoclavicular joint

A

sternal end of the clavicle w/ the notch formed by the manubrium of the sternum and first costal cartilage

very incongruent joint

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7
Q

how is the SC joint incongruent

A

the articular surface of the clavicle is thicker than the articular surface of the manubrium

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8
Q

what type of joint is the SC joint

A

plane joint w/ 3 degrees of freedom of motion

although the joint is a plane joint, the surfaces are saddle shaped

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9
Q

how does the clavicle present w/in the SC joint in the frontal plane

A

the clavicle is convex w/in the frontal plane

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10
Q

how does the manubrium present w/in the SC joint in the anterior/posterior direction

A

the manubrium is convex w/in the anterior/posterior direction

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11
Q

how does the clavicle present w/in the SC joint in the anterior/posterior direction

A

the clavicle is concave w/in the anterior and posterior direction

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12
Q

how does the manubrium present w/in the frontal plane of the SC joint

A

the manubrium is concave w/in the frontal plane

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13
Q

how’re the manubrium and clavicle separated w/in the SC joint

A

fibrocartilaginous disc

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14
Q

what’re the functions of the sternoclavicular disc

A
  1. increase the motion b/w the articular surfaces
  2. acts as a shock absorber for forces that are transmitted from the lateral end of the clavicle
  3. improves joint stabilization by increasing joint congruity
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15
Q

motions of the SC joint

A

elevation

depression

protraction

retraction

upward rotation

downward rotation

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16
Q

elevation and depression occur

A

in the frontal plane around the sagittal axis

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17
Q

approximately how much can the SC joint elevate

A

45 degrees

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18
Q

approximately how much can the SC joint depress

A

5-15 degrees

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19
Q

where does protraction and retraction occur for the SC joint

A

transverse plane around a superomedial to inferomedial oblique axis

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20
Q

what is retraction @ the SC accompanied by

A

elevation

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21
Q

what is protraction @ the SC joint accompanied by

A

depression

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22
Q

(SC joint) protraction is the movement of

A

the distal clavicle anteriorly

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23
Q

(SC joint) retraction is the movement of

A

the distal clavicle posteriorly

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24
Q

how much pro/retraction can the SC perform

A

15 degrees

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25
Q

is rotation a true degree of freedom

A

no

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26
Q

where does rotation occur @ the SC joint

A

longitudinal axis of the clavicle

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27
Q

how does rotation occur (SC)

A

w/ elevation of the arm and w/ scapular rotation

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28
Q

what is upward rotation (SC)

A

anterior edge of the clavicle moving upwards

also called posterior rotation

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29
Q

what is downward rotation

A

anterior edge of the clavicle moving downwards

also called anterior rotation

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30
Q

how much upward rotation can the clavicle do (SC joint)

A

30-45 degrees

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31
Q

how much downward rotation can the clavicle do (SC joint)

A

10 degrees

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32
Q

elevation arthrokinematics (SC joint)

A

a convex clavicle moving on a concave manubrium

the bone motion and roll are in the same direction (up)

glide is in the opposite direction (down)

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33
Q

depression arthrokinematics (SC joint)

A

a convex clavicle moving on a concave manubrium

the bone motion and roll are in the same direction (down)

glide is in the opposite direction (up)

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34
Q

protraction arthrokinematics (SC joint)

A

a concave clavicle moving on a convex manubrium

bone motion, roll and glide are in the same direction anteriorly

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35
Q

retraction arthrokinematics (SC joint)

A

a concave clavicle moving on a convex manubrium

bone motion, roll and glide are in the same direction posteriorly

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36
Q

rotation arthrokinematics (SC joint)

A

primarily a spin motion

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37
Q

3 ligaments of the SC joint

A

anterior & posterior sternoclavicular ligaments

interclavicular ligament

costoclavicular ligament

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38
Q

anterior and posterior sternoclavicular ligaments

A

reinforce the joint capsule

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39
Q

interclavicular ligament

A

runs b/w the 2 clavicles

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40
Q

costoclavicular ligament

A

runs from the first rib to the clavicle

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41
Q

function of the ligaments during protraction

A

limited by costoclavicular ligament, posterior sternoclavicular capsule and ligament and posterior fibers of interclavicular ligament

movement of protraction is anterior, so limitation is posterior

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42
Q

function of the ligaments during retraction

A

limited by anterior fibers of costoclavicular ligament, anterior sternoclavicular capsule and ligament

movement is posterior so thinks that limit it will be anterior

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43
Q

function of the ligaments during elevation

A

limited by tension in the costoclavicular ligament, anterior sternoclavicular capsule and ligament

movement is upwards, limited by inferior factors

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44
Q

function of ligaments during depression

A

limited by interclavicular ligament and the superior capsule

movement is downwards, limited by superior factors

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45
Q

what is the AC joint

A

the articulation b/w the acromial end of the clavicle and the scapula

very incongruent

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46
Q

what type of joint is the AC joint

A

plane synovial joint

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47
Q

how many degrees of freedom does the AC joint have

A

3

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48
Q

articular surface shape of the AC joint

A

will vary

usually a convex/flattened distal clavicle and a concave acromion

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49
Q

what separates the 2 articular surfaces

A

fibrocartilaginous disk

varies in size

50
Q

motions of the AC joint

A

rotation of the scap

winging of the scap

tilting/tipping of the scap

51
Q

rotation of the scapula (AC joint)

A

upward and downward rotation

allows for the glenoid to rotate upward and downward

most important movement of the AC joint

occurs around an anteroposterior axis (AP)

Rotation in the AC joint is IDENTICAL and synonymous to rotation in the scapulothoracic joint

52
Q

upward rotation of the scap (AC joint)

A

lateral rotation

ABD

53
Q

downward rotation of the scap (AC joint)

A

medial rotation

ADD

54
Q

winging of the scap (AC joint)

A

occurs around a vertical axis

describes the normal posterior movement of the vertebral border of the scapula (medial border moves away from the ribcage)

too much winging is not good

55
Q

why is winging considered a normal movement (AC joint)

A

we need winging in order to have normal function

it helps the scapula stay in contact with and move around the thorax since the thorax is curved

so, winging allows for the scapula to move around the horizontally curvature of the thorax

56
Q

tipping/tilting of the scapula (AC joint)

A

occurs around a frontal axis

visualized as the inferior angle of the scap moving posteriorly as the superior border of the scap moves anteriorly

57
Q

what does tipping/tilting allow of the scapula (AC joint)

A

to maintain contact with the ribcage

58
Q

what movements does tilting/tipping of the scap occur (AC joint)

A

elevation

depression

rotation of the clavicle

59
Q

how much tilting/tipping of the scap do we have (AC joint)

A

estimated to be about 30 degrees

60
Q

ligaments of AC joint

A

joint capsule

acromioclavicular ligaments

coracoclavicular ligaments

61
Q

joint capsule (AC joint)

A

fairly weak

cannot maintain the integrity of the joint w/o ligamentous reinforcement

62
Q

acromioclavicular ligaments

A

4 parts (anterior, posterior, inferior, superior)

63
Q

what part of the acromioclavicular ligaments is the strongest

A

superior part

b/c it is reinforced by the aponeurosis of the trapezoid and deltoid

64
Q

coracoclavicular ligaments

A

most important of the AC joint b/c it provides stability and mobility

2 parts (trapezoid and conoid)

not a direct anatomical part of the AC joint, but firmly attaches the clavicle to the scapula and provides stability

originate on the coracoid process and attach to the posterior edge of the clavicle

65
Q

claviscapular link/claviscapular joint

A

the firm attachment of the coracoclavicular ligaments of the clavicle and scapula

66
Q

most important function of the coracoclavicular ligaments

A

produce rotation of the clavicle that is necessary for full ROM in elevation of the upper extremity

67
Q

explain elevation of the UE, in regards to the coracoclavicular ligaments

A

as the UE elevates –> the scapula upwardly rotates

this causes the coracoid process to move inferiorly, which pulls the coracoclavicular ligaments downward since they originate on the coracoid process

since the coracoclavicular ligaments attach to the posterior edge of the clavicle, it pulls down on it, so the clavicle posteriorly rotates

the result of the UE elevating is that the clavicle posteriorly rotates due to the pull of the coracoclavicular ligaments (clavicular rotation)

68
Q

is the scapulothoracic joint a true anatomic joint

69
Q

what are the articulations of the scapulothoracic joint

A

articulation b/w the scapula w/ the thorax

70
Q

what are movements of the scap associated with at the scapulothoracic joint

A

motions of the SC joint and the AC joints

scapula –> clavicle (AC joint)

clavicle to the axial skeleton –> SC joint

71
Q

where does the scapula lie

A

the scapular plane

72
Q

what is the scapular plane

A

30-45 degrees in front of the coronal plane

73
Q

why is the scapular plane important

A

for special tests on the shoulder joint and inspecting it

74
Q

resting position of the scapula

A

reference point for scapular movement

on the posterior thorax

2 inches from the midline

lies b/w the 2nd and 7th ribs

75
Q

why is resting position important

A

if the scapula starts in a different position, it can end in a different position

this causes everything to be in a different position

b/c everything is connected

76
Q

are motions independent of each other?

A

no, although motions are described independently, they don’t happen alone at the SC and AC joints

motions tend to occur together at varying degrees

77
Q

elevation and depression of the scapulothoracic joint

A

translatory motion of the scap along the rib cage from the resting position

moving upward (elevation) and downward (depression)

estimated about 10-12 cm of motion

78
Q

ABD and ADD of the scapulothoracic joint

A

translatory movement of the scap as it moves towards the vertebral column or away from it

towards (ADD), away (ABD)

estimated about 15 cm of motion

79
Q

upward and downward rotation scapulothoracic joint

A

rotary motions of the scap that change the position of the glenoid fossa

ROTATION AT THE AC JOINT IS IDENTICAL TO ROTATIONS AT SCAPULOTHORACIC JOINT

80
Q

upward rotation at scapulothoracic joint

A

inferior angle of the scap moving away from the midline

81
Q

downward rotation at the scapulothoracic joint

A

inferior angle of the scap moving towards the midline

82
Q

what will motion in one area cause

A

motion in another area

83
Q

functions of the scapulothoracic joint

A
  1. to orient the glenoid for optimal contact w/ the moving arm
  2. Adds ROM to elevation of the arm
  3. provide a stable base for controlling and gliding of the humeral head
84
Q

ligaments of the scapulothoracic joint

A

superior transverse ligament

coracoacromial ligament

85
Q

superior transverse ligament

A

converts the suprascapular notch into a foramen

suprascapular N passes under the lig

suprascapular vessels run over the lig

86
Q

coracoacromial ligament

A

extends from the coracoid to the acromion

creates the subacromial space

87
Q

what contents are w/in the subacromial space

A

supraspinatus

bursa

can cause subacromial crowding

88
Q

what is subacromial crowding cause

A

impingement at the shoulder

89
Q

what is the glenohumeral joint

A

articulation b/w the large head of the humerus w/ the small glenoid fossa

90
Q

describe the humeral head and glenoid

A

humeral head is 2-3x larger than the glenoid

glenoid is very shallow

91
Q

describe the GH joint

A

very mobile, but can be stable

92
Q

is the GH joint congruent or incongruent

A

incongruent

may allow for increased mobility of the hand

93
Q

how is the articular surface of the glenoid enhanced

A

glenoid labrum

increases the depth of the fossa

increases stability

94
Q

what type of joint is the GH joint

A

ball and socket synovial

3 degrees of freedom

95
Q

concave/convex GH joint

A

glenoid is concave and the humeral head is convex

the humeral head moves on the glenoid

bone motion and roll in the same direction, glide in the opposite direction

96
Q

flexion of the GH joint

A

elevation

120 degrees

97
Q

why can’t the shoulder flex to 180 on its own

A

it needs the scapula thoracic relationship

this causes upward rotation of the scapula, which allows the shoulder to reach 180 degrees of flexion

98
Q

extension of GH joint

A

55-60 degrees

99
Q

flexion/extension GH joint

A

sagittal place around an x-axis

100
Q

abduction/adduction GH joint

A

frontal plane around a sagittal axis (y-axis)

101
Q

ABD GH joint

A

120 degrees

102
Q

what else happens during GH ABD

A

ER of the humeral head

prevents the greater tubercle from hitting acromion

someone won’t be able to ABD fully w/o ER

103
Q

IR/ER GH joint

A

transverse plane around a vertical axis (z-axis)

IR: 70 degrees

ER: 90 degrees

104
Q

arthrokinematics of GH joint

A

convex humeral head moving on a concave glenoid

bone motion and roll in the same direction

gliding in opposite direction

there is minimal translation or gliding of the humeral head on the glenoid

105
Q

arthrokinematics flexion GH

A

bone motion and roll –> superior and anterior

glide–> inferior and posterior

106
Q

arthrokinematics extension GH

A

bone motion and roll –> inferior and posterior

glide –> anterior

107
Q

arthrokinematics ABD GH

A

bone motion and roll –> superior

glide –> inferior

108
Q

arthrokinematics ADD GH

A

bone motion and roll –> inferior

glide –> superior

109
Q

arthrokinematics ER GH

A

bone motion and roll –> posterior

glide –> anterior

110
Q

arthrokinematics IR GH

A

bone motion and roll –> anterior

glide –> posterior

111
Q

ligaments of the GH joint

A

capsule

glenohumeral ligaments

coracohumeral ligament

112
Q

capsule GH

A

completely encircles the GH joint articulation

thickest in its superior and inferior extents (relatively loose and redundant)

laxity of the capsule is necessary for large excursion of joint surfaces

provides little stability w/o reinforcement from ligaments and muscles

113
Q

glenohumeral ligaments

A

reinforce the anterior capsule

3 parts (superior, middle, inferior)

form a “Z” on the anterior capsule

may assist in capsular thickening

all portions tighten with ER

injury to these ligaments decrease stability of the joint

114
Q

what portion is the strongest of the glenohumeral ligaments

A

inferior

primary structure that provides anterior stability for the GH joint

115
Q

how do the glenohumeral ligaments tighten with ER

A

help stabilize ER

gliding occurs anteriorly during ER

3 ligaments stop over-glide

116
Q

coracohumeral ligament

A

extend from base of coracoid to greater and lesser tuberosities

limit lateral rotation of the humerus

provides passive support of the arm against the force of gravity

117
Q

what are the primary stabilizers of the shoulder

118
Q

4 general structures that are main factors of stability of the GH joint

A
  1. articular
  2. labrum
  3. capsulolabrum complex
  4. rotator cuff
119
Q

articular GH stability

A

d/t shape and torsion of humeral head and mobility of the scap

design of the joint does add to some stability

120
Q

capsulolabrum complex

A

capsule and GH ligaments

121
Q

rotator cuff

A

dynamic stabilization

122
Q

what is necessary for full ROM

A

all different motions at all 4 shoulder joints

will combine to have smooth shoulder motion

scapulohumeral rhythm

Kinesiology Exam 1 (9 decks)

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