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NPTE-MSK Review > Shoulder Review > Flashcards

Shoulder Review Flashcards

1
Q

The shoulder girdle has only ____ boney attachment to the axial skeleton. The ______ articulates with the sternum.

A

> 1 boney attachment

>The clavicle articulates with the sternum

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2
Q

4 joints of the shoulder girdle

A

Synovial Joints:
1. GHJ, ACJ, SCJ
Functional Articulations:
1. Scapulothoracic

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3
Q

GHJ

A

incongruous, ball & socket triaxial joint w/a lax capsule. Supported by tendons of the rotator cuff, the glenohumeral ligaments, and the coracohumeral ligament.

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4
Q

Arthrokinematics of GHJ

A

Convex humeral head roll/slide opposite of concave glenoid fossa

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5
Q

Anatomical location of the glenoid fossa

A

Anterior, lateral, & upward

purpose: provide some stability to GHJ

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6
Q

Anatomical purpose of the glenoid labrum

A

Deepen the glenoid fossa to provide greater congruity and to serve as an attachment site for the capsule

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7
Q

GHJ Arthrokinematics: Flexion

A

Spin

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8
Q

GHJ Arthrokinematics: Extensin

A

Spin

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9
Q

GHJ Arthrokinematics: Horizontal ADD

A

Convex humeral head rolls Anterior/ Slide Posterior

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10
Q

GHJ Arthrokinematics: Horizontal ABD

A

Convex humeral head rolls Posterior/ Slide Anterior

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11
Q

GHJ Arthrokinematics: IR @ 0 degrees ABD

A

Convex humeral head rolls Anterior/ Slide Posterior

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12
Q

GHJ Arthrokinematics: ER @ 0 degrees ABD

A

Convex humeral head rolls Posterior/ Slide Anterior

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13
Q

GHJ Arthrokinematics: ADD

A

Convex humeral head rolls Inferior/ Slide Superior

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14
Q

GHJ Arthrokinematics: ABD

A

Convex humeral head rolls Superior/ Slide Inferior

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15
Q

Static Stability of GHJ

A

The structural relationship between boney anatomy, ligaments, and glenoid labrum

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16
Q

Dynamic Stability of GHJ

A

The tendons of the RTC blend with the ligaments and glenoid labrum at their sites of attachment > when muscles contract they provide stability by tightening the static restraints.

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17
Q

In addition, the ______ and the ______ reinforce the capsule with their attachments and provide superior and inferior shoulder joint support respectively.

A
  1. Long head of the bicep

2. Triceps Brachii

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18
Q

The long head of the bicep

A

Provides stabilization against humeral elevation & contributes to anterior stability of the GHJ by resisting torsional forces when the shoulder is ABD and ER.

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19
Q

Static Stabilizers of the Scapula

A
  1. Cohesive forces of the subscapular bursa
  2. SC and AC joint ligaments
  3. Scapulothoracic Fascia
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20
Q

Dynamic Stabilizers of the Scapula

A
  1. Upper, middle, and lower traps
  2. Serratus Anterior
  3. Levator Scap
  4. Rhomboids
21
Q

Static Stabilizers of the GHJ (with arm in dependent position)

A
  1. Super capsule, superior GH ligament, & Coracohumeral ligament
  2. Adhesive properties of synovial fluid & negative joint pressure
  3. Slight upward inclination of glenoid improves congruence
22
Q

Dynamic Stabilizers of the GHJ

A
  1. RTC
  2. Deltoid
  3. Long head of biceps brachii
  4. Pectoralis major
  5. Lats
  6. Teres major
23
Q

The weak capsule of hte ACJ is reinforced with _____ and ______.

A
  1. Superior and inferior AC ligaments
24
Q

Stability of the ACJ

A

The AC ligaments are supported by strong coracoclavicular ligament

No muscles directly cross the joint for dynamic support

25
Q

Arthrokinematics for ACJ Retraction

A

Clavicle Rolls Posterior & slides Anterior

26
Q

Arthrokinematics for ACJ Protraction

A

Clavicle rolls anterior & slides posterior

27
Q

SCJ

A

Incongruent, triaxial, saddle-shaped joint with a disk.

28
Q

Stability of SCJ

A

Supported by anterior & posterior SC ligaments & the interclavicular/costoclavicular ligaments. No muscles directly cross the joint for dynamic stability.

29
Q

True or False

Rotation of the clavicle occurs as an accessory motion when the humerus is elevated above the horizontal position & the scapula has to rotate; it cannot occur in an isolated voluntary motion.

A

True

30
Q

SCJ Arthrokinematics: Protraction

A

Concave clavicle rolls and slides anterior

31
Q

SCJ Arthrokinematics: Retraction

A

Concave clavicle rolls and slides posterior

32
Q

SCJ Arthrokinematics: Elevation

A

Convex clavicle rolls superior/medial & slides inferior/lateral

33
Q

SCJ Arthrokinematics: Depression

A

Convex clavicle rolls inferior/lateral & slides superior/medial

34
Q

Upward & downward rotation of the STA

A

Upward rotation, posterior tilting, & ER of the scapula are component motions that must occur with full shoulder elevation

35
Q

IR/ER of the scapula

A

When the medial border of the scapula lifts away from (wings) or approximates the rib cage.

36
Q

Anterior tilting of the scapula

A

Occurs in conjunction with internal rotation and extension of the humerus when reaching the hand behind the back

37
Q

Postural Relationship

A

In a dependent position, the scapula is stabilized through a balance of forces. The weight of the humerus creates a downward rotation, contraction, and forward tilting moment on the scapula. These moments are balanced by the support of the upper traps, serratus anterior, rhomboids, and middle traps.

38
Q

Subacromial Space

A

Made up of the coracoacromial arch, overlies the subacromial/subdeltoid bursa, the supraspinatus tendon, and a portion of the muscle.

39
Q

Function of subacromial space

A

Allow for & participated in normal shoulder function

40
Q

Compromise of subacromial space

A

It could be caused by faulty muscle function, postural relationships, faulty joint mechanics, injury to the soft tissue in the region, or structural anomalies of the acromion that can lead to impingement syndromes.

41
Q

Scapulohumeral Rhythm

A

2:1 (glenohumeral motion: Scapular rotation)

42
Q

The function of scapulohumeral rhythm

A

Research shows that during humeral elevation, the synchronous motion of the scapula allows the muscles to move the humerus to maintain an effective length-tension relationship throughout the activity and helps maintain congruence between the humeral head and fossa while decreasing shear forces.

43
Q

Clavicular elevation & rotation with humeral motion

A

The first 30 degrees of upward rotation of the scapula occurs with elevation of the clavicle in the SCJ. As the coracoclavicular ligament becomes taut, the clavicle rotates 38 degrees to 55 degrees about its longitudinal axis, which creates an elevation @ the acromial end. This allows for an extra 30 degrees @ the ACJ.

44
Q

External Rotation of the humerus with elevation

A

During elevation of the arm, the humerus ER; this allows for the greater tubercle of the humerus to clear the coracoacromial arch. A weak infraspinatus and/or trees minor could result in an impingement of the soft tissues in the subacromial space leading to pain, inflammation and eventually loss of motion.

45
Q

Deltoid/Supraspinatus vs. Infraspinatus/Teres minor/subscap

A
  1. The deltoid works to cause an upward translation of the humerus.
  2. The supraspinatus is significant in stabilizing, compressing and a slight upward translation effect on the humerus during arm elevation working with the deltoid during humeral elevation.
  3. The infraspinatus, teres minor, and subscap produce a stabilizing compression and downward translation of the humerus in the glenoid.

The combined motions of all 5 muscles produce a balance in forces that elevate the humerus and control the humeral head. Interruption of the coordinated function of these mechanisms may lead to tissue microtrauma and shoulder complex dysfunction.

46
Q

Nerve Disorders in the Shoulder: Brachial Plexus in TOS

A

Common sites for compression:

  1. Scalene triangle
  2. Costoclavicular space
  3. Under the Coracoid Process
  4. Pectoralis minor muscle
47
Q

Nerve Disorders in the Shoulder: Suprascapular nerve in Suprascapular notch

A

This injury occurs from direct compression or from nerve stretch, such as when carrying heavy book bags over the shoulder.

48
Q

Nerve Disorders in the Shoulder: Radial Nerve in the Axilla

A

Compression occurs from continual pressure, such as when leaning on axillary crutches.

NPTE-MSK Review (1 decks)

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