Shoulder Ligaments and Structures

Question 1

Sternoclavicular joint type

Answer 1

Synovial ball and socket joint

clavicular head w/ clavicular notch of manubrium

Question 2

Sternoclavicular disk

- 3 functions

Answer 2

Fibrocartilage, from superior head of clavicle to lateral inferior clavicular notch

1. Increase congruence
2. Decrease compressional stress
3. Prevents superior translation of clavicle head

Question 3

Anterior and posterior sternoclavicular ligaments

Answer 3

capsular

1. limit anterior and posterior mvt of clavicle head

Question 4

Interclavicular ligament

Answer 4

Capsular, Between clavicular heads, also binds to manubrium

1. Prevents lateral translation of clavicle

Question 5

Costoclavicular ligament

Answer 5

Extrinsic, from inferior medial clavicle to costal cartilage and 1st costal bone
1. Prevents superior translation of clavicle head

Question 6

Acromioclavicular joint

- Type and function

Answer 6

Synovial gliding joint, planar

1. Increases ROM of scapulae

Question 7

Superior and inferior acromioclavicular ligament

Answer 7

Capsular

1. Prevent superior translation of clavicle

Question 8

Coracoclavicular ligament

Answer 8

Extrinsic, from coracoid tubercle of clavicle to coracoid process of scapula
2 parts- trapezoid most lateral, conoid (twisting) more medial
1. Prevent superior translation of clavicle

Question 9

Shoulder separation definition

Answer 9

Luxation/subluxation of acromioclavicular joint

Lateral blow to shoulder forces lateral clavicle upward

Question 10

The acromioclavicular joint is most important for which movement?

Answer 10

Elevation/depression of scapula
(Upward rotation of clavicle but no rotation of scapula, not possible if fused)
- AC joint increases ROM in all planes

Question 11

Post/ant tilt ROM

Answer 11

Anatomical position is almost as posteriorly tilted as possible (inf angle resting on thorax)
- Ant tilt- 30-35º, inferior angle moves off thorax

Question 12

Scapular movements in sagittal, frontal, transverse planes

Answer 12

Sagittal: ant/post tip
Frontal: elevation/depression, up/down rotation (AoR med inf scapular spine)
Transverse: protract/retract, axis longitudinal through SC joint

Question 13

Glenoid Labrum

Answer 13

1. Increase congruency

2. Decrease stress by increasing SA

Question 14

Axillary recess- definition, significance

Answer 14

Inferiorly sagging part of GH joint capsule

Weakest part, MOI for subluxations

Question 15

Coracohumeral Ligament

3 fx

Answer 15

From coracoid process to greater and lesser tuberosities (2 bands, crosses bicipital groove)

1. Limits inferior translation
2. Limits Adduction
3. Helps protect biceps tendon

Question 16

Coracoacromial Ligament

Answer 16

Coracoid process to acromion
Extrinsic, forms roof of coracoacromial arch
1. Limits superior mvt humerus

Question 17

Glenohumeral ligaments (3 parts)

Answer 17

Capsular, all anterior
Superior: ER, post translation, Adduction
Middle: ER
Inferior: ER, Ant translation, ABDuction

Question 18

Transverse ligament of humerus

Answer 18

Crosses bicipital groove

1. Supports bicipital tendon

Question 19

Scapulohumeral Rhythm in ABD

Answer 19

Total ROM 160-180, approximately 2:1 mvts
90º pure GH ABD
60º Scapular up rotation
30º additional ROM with external rotation
(clears greater tubercle, provides articular surface)

Question 20

Scapulohumeral coupled motions

Answer 20

• GH flexion + elevation, slight post tip
• Horiz ABD + retraction
• ABD + up rotation, elevation
  And vice versa

Question 21

Supraspinatus and subacromial bursa

Answer 21

Bursitis damages supraspinatus muscle & tendon, impingement

Question 22

Rotator Cuff tear MOI

Answer 22

Usually supraspinatus tendon calcifies under pressure
Evulsion- tendon rupture, tear
Subacromial bursitis can impinge it
Common with overhead work

Question 23

Superior transverse scapular ligament

Answer 23

From superior angle to base of coracoid process, spans scapular notch

• suprascapular artery passes above
• suprascapular nerve passes below/through notch