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Movement Science > The Shoulder > Flashcards

The Shoulder Flashcards

1
Q

What’s the difference between static/ dynamic stabilizers?

A 
Static = ligament & capsule
Dynamic = muscles
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2
Q

What’s the link between mobility & stability?

Clinical implications?

A

the more mobile, the less stable it is

Excessive mobility can lead to injury

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3
Q

What are the 4 boney articulations of the shoulder complex?

A 
SCJ = sternoclavicular joint
ACJ = acromioclavicular joint
GH = glenoid humeral joint 
STJ = scapulo-throacic joint
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4
Q

What links the apendicular and axial skeleton?

A

the SCJ

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5
Q

What are the articulations of the SCJ?

A

medial clavicular end, sterno clavicular facet, superior border of first rib cartilage

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6
Q

3 Main jobs of the SCJ

A
  1. Strut to staiblize the shoulder
  2. Provide protection to underlying structures - heart, lungs, arteries, brachial plexus, etc.
  3. Prevention inferior migration of shoulder girdle
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7
Q

What provides static stabilization of the SCJ?

A

Anterior/posterior SC ligaments
Costoclavicular ligaments - Ant + Post
Interclavicular ligament
Articular Disc

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8
Q

What is abnormal about the articular disc of the SCJ?

Possible reason for this?

A

It doesn’t degeneration like other joints - we really need protection in that area so the body knows not to break it down (or something like that)

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9
Q

If an individual were to damage their clavicle what would give first: bone or ligaments? Why?

A

Bone would give first - clavicular break - because protection is so important ligaments are extra strong

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10
Q

What provides dynamic stabilization of the SCJ?

A
  1. SCM
  2. sternothyroid
  3. sternohyoid
  4. subclavius m.
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11
Q

How many DOF does the SCJ have? What are they?

A

3 DOF
Elevation/Depression
Protraction/Retraction
Rotation

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12
Q

Kinematics & Degrees of DOF of SCJ

: Elevation/Depression

A

convex clavicle on concave sternum
elevation = superior roll, inferior slide
depression = inferior roll, superior slide

30-40 deg elevation/ 10 deg depression

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13
Q

Kinematics & Degrees of DOF of SCJ

: Protraction/ Retraction

A

*concave clavicle on convex sternum on transverse diameter_
protraction = anterior roll, anterior slide
retraction = posterior roll, posterior slide

15-30 deg of each

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14
Q

What limits movement at SCJ during protraction?

A
  1. Posterior bundle of costoclavicular lig
  2. Posterior capsule ligaments
  3. Scapular muscles
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15
Q

Kinematics & Degrees of DOF of SCJ

When does SCJ rotation occur?

A

During abduction & flexion (jumping jack motion)
= Posterior Rotation - spin of sternal end of clavicle on disc
–> opposite on way down

25-30°

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16
Q

Define longitudinal diameter in relation to the SCJ

A

FIND A GOOD ANSWER FOR THIS

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17
Q

What are the articulations of ACJ?

A

lateral end of clavicle & acromion

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18
Q

What type of joint is SCJ? How many DOF?

A

Gliding/plane joint with articular disc & synovial capsule
3 DOF

19
Q

What is the main job of ACJ?

A
  1. Attachment for scapular movement on the clavicle
  2. Handles high contact motion
  3. Can be a boney restriction for overhead movement
20
Q

What is a main difference between ACJ & SCJ?

A

ACJ is less mobile & experiences more arthritic changes than SCJ (bc it’s a smaller joint with greater forces)

21
Q

What are the dynamic stabilizers of the ACJ?

A

Upper trap & Deltoid

22
Q

What are the static (passive) stabilizers of the ACJ?

A

Coracoclavicular lig - conoid & trapezoid

Acromioclavicular lig

23
Q

What are the DOF of ACJ?

A
  1. Upward/downward rot - inferior border away from/toward midline
  2. IR/ER - medial border away from/toward thorax
  3. Ant/post tilting - spine of scap towards/away from thorax
24
Q

What position the scapula usually sit in resting? During elevation?

A

Resting: 60° IR, 8.4° Ant tilt, 2.5° Upward Rot
Elevation: +8 IR, +19 Post tilt, +11 Upward Rot

25
What is a major cause of subacromial impingement? Why?
Lack of posterior tilting - if the scapula can't lean backwards to get bones out of the way = impingement
26
What are the articulations of the GHJ? | How does it sit?
Humeral head to glenoid fossa Slightly medial, superior & posterior in scapular plane Only 1/3 of humeral head in fossa
27
What is the main function of the GHJ?
Mobility over stability - mostly soft tissue stabilization
28
Glenoid clock
12 superior, 6 inferior, 9 posterior, 3 anterior
29
Other than ligaments, what are the passive restraints of the GHJ?
1. Bony congruency 2. Glenoid labrum 3. Joint capsule 4. Negative pressure seal - acts as a suction cup to improve stability
30
Main job of the glenoid labrum in the GHJ? What does injury cause?
Provides depth to encompass 50% of GHJ Stronger inferior attachment with weaker superior attachment Injuries = shoulder instability due to excessive translation & pain
31
What is the main job of the joint capsule in the GHJ?
Laxity to allow for motion 2x the surface area of the humeral head Becomes taut in various positions to improve stability
32
What are ligaments make up the passive stabilizers of the GH joint?
Superior, Middle & Inferior Gelnohumeral ligament | Coracohumeral ligament
33
Where is SGHL attached? What is it's main job?
Anteriosuperior labrum to lesser tuberosity 1. Main restraint for inferior translation in resting & adduction 2. Assists with preventing A/P displacement
34
Where is MGHL attached? What is it's main job?
inferior to SGHL.. 1-3 o'clock (R shoulder) to more lateral on lesser tuberosity 1. Prevents anterior translation, esp. at 45-60° abduction 2. Limits ER
35
What ligament is not always present in the GHJ?
MGHL
36
Where is IGHL attached? What are it's main segments? What are their main jobs?
Inferior aspect of labrum to the anatomic neck of humerus Main: Stabilizes arm in 90° abduction 3 components: 1. Anterior band = Resists anterior translation; taut with abduction & ER 2. Posterior = Resists posterior translation; taut with abduction & IR 3. Axillary pouch = Resists inferior translation, helps resist AP translation; taut with 90° abduction
37
Where is Cocacohumeral lig attached? What is it's main job?
Lateral side of base of coracoid --> anatomic neck of humerus; anterior to SGHL 1. Reinforces superior capsule 2. Restrains inferior translation & ER of humerus
38
What are the dynamic stabilizers of the GHJ? What do they do?
1. Rotator cuff - blends with capsule for mechanical stability, compresses, stabilizes & centralizes head in fossa during movement 2. Long head of biceps tendon - closes the rotator interval providing ant. reinforcement against dislocation; resists ant translation & superior migration dep on position 3. Deltoid
39
What doesn't the rotator cuff cover?
the inferior aspect of capsule or rotator interval
40
How many DOF does the GHJ have? What are they?
3: Abd/Add, Flex/Ext, IR/ER
41
Kinematics and Degrees GHJ: | Abduction/Adduction
*Convex on Concave* Abd = Superior roll with inferior slide = 120° Must occur with ER to clear acromion - need inferior capsular mobility Add = inferior roll, superior slide
42
Kinematics and Degrees GHJ: | Flexion/Ext
Spinning motion around M-L axis Extreme flexion = tension of posterior capsule can cause anterior translation of humerus 120° Flexion 65° active Ext, 80° passive
43
Kinematics and Degrees GHJ: | IR/ER
*Convex on Concave* IR = Anterior roll, posterior slide ER = Posterior roll, anterior slide 70-85° IR 90° ER if arm is at 90° abduct = primarily a spin

Movement Science (1 decks)

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