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Gross Anatomy > Shoulder Joints > Flashcards

Shoulder Joints Flashcards

1
Q

What type of joint is the sternoclavicular?

A

Saddle: convex medial clavicle fits snuggly on manubrium

Has a fibrocartilagenous disc separating the articulating surfaces of the bones to deepen articulation

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2
Q

Ligaments of the sternoclavicular?

(3)

A

Sternoclavicular: bind clavicle –> manubrium both ant and posteriorly

Interclavicular: bind the medial ends of the right and left clavicles together sup to manubium

Costoclavicular: binds clavicle to first rib

*key ligament in inverse mvmt of shoulder/clavicle*

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3
Q

Dislocations of the sternoclavicular?

A

not common, posterior can result in traume bc it pushes on brachiocephalic veins

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4
Q

Innervation of sternoclavicular

(2)

A
  1. nerve to the subclavius
  2. supraclavicular nerve (C3-C4 cervical plexus)
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5
Q

Blood supply of sternoclavicular (2)

A
  1. Suprascapular: comes off of thyrocervical trunk, runs superior, hits laterally
  2. interal thoracic: comes posterior to joint

(branches of subclavian)

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6
Q

Acromialclavicular joint type?

A

planar: gliding and sliding

btw acromion and the lateral end of the clavicle

some movement, main function is to bind the clavicle to the scapula to support the weight of the upper limb and keep the humerus suspended to the side without a lot of energy in the form of muscle contraction

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7
Q

Ligaments of acromioclavicular joint (2)

A
  1. acromioclaicular ligament: clavicle –> acromion
  2. coracoacromial: coracoid process –> acromion. has 2 parts
    1. conoid: cone shaped
    2. trapezoid: flatter
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8
Q

Shoulder Separation

A

In the acromialclavicular joint, tearing of the coracoclavicular ligaments and/or the acromialclavicular ligaments. Weight of upper limb pulls scap and acromion downward

result: clavicle overrides the acromion

different degrees of tearing, greater tears, greater separation (can see on the skin)

if the coraccoligaments stay in tact, there is no prominence seen from the skin, if it gets torn, there is prominance and the clavicle protrudes in front of the acriomion

*hard to immobilize, need to use a sling*

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9
Q

Innervation of the acromialclavicular ligament (2)

A
  1. suprascapular nerve: posterior section
  2. lateral pectoral nerve: anterior section
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10
Q

Blood supply to amromiallavicular (2)

A
  1. suprascapular artery
  2. thoaracoacromial artery: 4 branches–> CAPD
    * clavicular and acromional coming to this joint
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11
Q

Glenohumeral (shoulder) joint

A

most mobile in the human body.

Ball and socket synovial: between humeral head and the glenoid fossa.

Fibrous capsule attaches from glenoid cavity to the anatomical neck of the humerus and surrounds joint

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12
Q

Ligaments of shoulder joint (4)

A
  1. coracoacromial
  2. coracohumeral
  3. transverse humeral
  4. glenohumeral
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13
Q

Coracoacromial ligament

A

coracoid process –> acromion, sits above the joint

*prevents upward displacement of the head of the humerus

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14
Q

Coracohumeral ligament

A

coracocoid–> lesser tuberosity of humerus

strengthens sup portion of the capsule, resists excessive abduction

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15
Q

Transverse Humeral Ligament

A

between greater and lesser tubercle, holds the tendon of the long head of the triceps in the bicipital groove running over it

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16
Q

Glenohumeral Ligaments

(3 parts)

A
  • surround the joint capsule the most closely.
  • all attach from the upper margin of the glenoid cavity and labrum and strengthen the anterior portion of the capsule
  1. superior: over humeral head to a depression above lesser tuberosity
  2. middle: in front of humerus to lower lesser tuberosity.

*partially in the back too, most common area of dislocation and weakest anteriorly

  1. inferior: goes to lower part of the anatomical neck. Key stabilizer of the anterior shoulder, weakness leads to anterior glenohumeral instability
17
Q

Glenoid Labrum

A

rim of fibrocartilage attaching to the outer rim of the glenoid fossa.

Superior attachment includes supraglenoid tubercle and the origin of the tendon of the long head of the biceps

helps deepen the articulation between the head of the humerus and the glenoid fossa of the scap (added cup shape), provides stability, greater mobility

*tears are associated with glenohumeral dislocations

18
Q

Capsule of the shoulder joint

A

very thin and lax.

  1. attaches to glenoid beyond labrum and anatomical neck.
  2. strengthened by muscles of the shoulder (SITS+long head of biceps)
19
Q

Bursa of the shoulder joint (5)

A

Like partially filled water balloons

  1. subscapular: btw muscle and neck of scap, communicates w/ shoulder joint
  2. subacromial/subdeltoid: inf to acromion extending distally, superficial to supraspinatous, doesnt communiate w/ joint
  3. smaller bursa associated with tendons in the area
  4. one btw coracoid and the capsule
  5. one on upper surface of acromion
20
Q

Innervation of the shoulder joint (4)

A
  1. Suprascapular: also goes to acromioclavicular
  2. Axillary: behind the neck of the humerus
  3. Lateral pectoral: run anteriorly
  4. Post cord of brachial plexus: branches directly off, small
21
Q

Blood supply to shoulder joint (3)

A
  1. anterior humeral circumflex
  2. posterior humeral cx: both wrap around the head
  3. suprascapular: provides less blood supply than others
22
Q

Passive Stability of the shoulder joint

A

Most moveable joint in the body, leads to a lot of instability

Passive stability: those factors that keep the joint stable when its at rest and not in motion, not actively contracting to keep the joint in place

  • trap: postural, keeps shoulder joint in a retracted and upwarldly rotated position. damage to trap marked by drooping of the shoulder in ipsilateral side
  • deltoid: prevents dislocation by gravity
  • ligaments: esp. inf glenohumeral coracohumeral, and labrum
  • long head of the biceps: keeps top portion of humeus applied to the scap
23
Q

Active stability of the shoulder joint

A

structures that stabilize the joint when motion occurs

rotator cuff muscles: arise from scap and insert into proximal humerus. Rotate the humerus, major active stability

keep head of the humerus applied directly to glenoid fossa and also pull it downward. Counteract the tendency of the head of the humerus to move up toward the acromion

24
Q

Movements of the shoulder joint

A

mvmt of scap:

  1. elevation
  2. protraction
  3. upward rotation
  4. scapulohumeral rhythm: 120 degree of abduction coming from glenohumeral, 60 from scapular upward rotation

mvmt of glenohumeral:

  1. flex/ext
  2. ab/adduction
  3. medial/lateral rotation
25
Q

Shoulder impingement

A

overuse injury: repetitive mvmts causes fatigue in roator cuff muscles

full abduction makes the shoulder unstable bc there is minimal contact between articulating bones during this motion

ITS action is to prevent the humerus from riding up and pressing the supraspinatous between the acromion and gr8er tubercle

supraspinatus most likely to tear because the lowers ITS muscles get fatigued, push the head up, and tear the muscle

primary symptom is pain post to and below acromion

26
Q

Tests for shoulder impingement

A
  1. painful arc: pain present from 60-120 degrees of full abduction
  2. can tests: should be able to hold can upright at shoulder level and resist downward forces without it hurting, but when they turn the can to empty it and resist forces, it should be painful

shows supraspinatous impingement

27
Q

Shoulder dislocation

A

head of humeus displaced from glenoid cavity

  • 95-98% of the time: anterior, can see a buldge in the shoulder
  • 2-4% of the time: posterior, no buldge, can go awhile before it is diagnosed
  • 1% inferior: arm stuck in abduction, caused by blunt force trauma during adbuction
28
Q

openings in the capsule of the shoulder joint

A
  1. between greater and lesser tubercles to allow passage of the long head of biceps thru joint
  2. below and anterior to coracoid process, allows joint to communicate with subscap bursa
  3. sometimes one posteriorly btw joint and a bursa under an infraspinous tendon

Gross Anatomy (18 decks)

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