Shoulder test questions Flashcards
When are the coracohumeral ligaments and GH ligaments tight?
Adduction
Which ligaments in the GHJ (glenohumeral joint) restrain ER and ABD?
Coracohumeral ligaments & glenohumeral ligaments (superior, middle and inferior)
when is there more shoulder ER instability in the GHJ?
90 degrees of ABD
there is more instability here than at 0 degrees of ABD
How much depth does the labrum provide in the GHJ?
adds 50%
doubles the depth of the glenoid fossa
What is a Bankart lesion?
When the glenoid labrum is torn away from the glenoid fossa during G-H dislocation
(1)What does the labrum do and (2)what will happen if it is injured?
(1) acts as a valve with the humeral head that creates a seal against atmospheric pressure and limits excessive translation
(2) it will increase joint instability (because the seal was broken)
what is the origin and insertion of the superior glenohumeral ligament (SGHL)?
O: superior portion of labrum and base of coracoid process
I: superior aspect of humeral neck
At which position/s is the SGHL tight and relaxed?
Tight: full adduction with arm at side or with an inferior translation
Relaxed: during abduction
What is the origin and insertion of the middle glenohumeral ligament (MGHL)?
O: beneath the supraglenoid tubercle and anterior superior portion of the labrum
I: just medial to the lesser tuberosity
- it blends with the fibers of the subscapularis
What forces does the MGHL resist?
- Anterior directed force with arm in an adducted position up to approximately 45 degrees
- limits extreme ER with arm at side
- acts as a secondary stabilizer with anterior translation
What is the origin and insertion of the Inferior glenohumeral ligament complex (IGHLC)?
O: attached proximally along anterior inferior rim of glenoid fossa and to glenoid labrum
I: attaches distally at the anterior and posterior inferior margins of the anatomical neck of the humerus
(note!!! it has an anterior and posterior band)
Where is the location for the only articulation with the axial skeleton?
At the sternoclavicular joint
What can cause variation in the resting scapular position?
- Pain
- Muscle fatigue
- Compensation
- Poor posture
- Hand dominance
- Occupation
- Muscle tone
- Age
What is the function of the bursa ?
To reduce friction between tendons, muscles, ligaments and bones
What structures are all in the subacromial space?
- Suprispinatus
- Bursa
- Superior joint capsule
- Origin of long head of bicep brachii
Why is it hard to elevate the arm when the arm is in full internal rotation?
The greater tuberosity comes in contact with the acromion
What arthokinematics are lacking when you have impingement with abduction?
You have superior roll without inferior glide
During G-H elevation with external rotation, if the scapula is fixed how far can you abduct the arm?
You can only abduct the arm to 90 degrees
At the SC and AC joint how many degrees contribute to elevation and which is early and which is late?
- SC: 30 degrees early and nearly completed by 90 degrees
- AC: 15 degrees early and 15 degrees late after 135 degrees of ABD
When is the coracoclavicular ligament tight?
When the coracoid moves downward
- (NOTE!!!) it will pull on clavicle and cause clavicle to posterior rotate approximately 50 degrees
What is the painful arc?
- injury to the subacromial bursa or Suprispinatus tendon
- causes inflammation and swelling
At what degree does the painful arc start? (approximately)
100 degrees of abduction
