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Movement Science > The Shoulder > Flashcards

The Shoulder Flashcards

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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
Q

What is a major cause of subacromial impingement? Why?

A

Lack of posterior tilting - if the scapula can’t lean backwards to get bones out of the way = impingement

26
Q

What are the articulations of the GHJ?

How does it sit?

A

Humeral head to glenoid fossa
Slightly medial, superior & posterior in scapular plane
Only 1/3 of humeral head in fossa

27
Q

What is the main function of the GHJ?

A

Mobility over stability - mostly soft tissue stabilization

28
Q

Glenoid clock

A

12 superior, 6 inferior, 9 posterior, 3 anterior

29
Q

Other than ligaments, what are the passive restraints of the GHJ?

A
  1. Bony congruency
  2. Glenoid labrum
  3. Joint capsule
  4. Negative pressure seal - acts as a suction cup to improve stability
30
Q

Main job of the glenoid labrum in the GHJ? What does injury cause?

A

Provides depth to encompass 50% of GHJ
Stronger inferior attachment with weaker superior attachment
Injuries = shoulder instability due to excessive translation & pain

31
Q

What is the main job of the joint capsule in the GHJ?

A

Laxity to allow for motion
2x the surface area of the humeral head
Becomes taut in various positions to improve stability

32
Q

What are ligaments make up the passive stabilizers of the GH joint?

A

Superior, Middle & Inferior Gelnohumeral ligament

Coracohumeral ligament

33
Q

Where is SGHL attached? What is it’s main job?

A

Anteriosuperior labrum to lesser tuberosity

  1. Main restraint for inferior translation in resting & adduction
  2. Assists with preventing A/P displacement
34
Q

Where is MGHL attached? What is it’s main job?

A

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
Q

What ligament is not always present in the GHJ?

A

MGHL

36
Q

Where is IGHL attached? What are it’s main segments? What are their main jobs?

A

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
Q

Where is Cocacohumeral lig attached? What is it’s main job?

A

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
Q

What are the dynamic stabilizers of the GHJ? What do they do?

A
  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
Q

What doesn’t the rotator cuff cover?

A

the inferior aspect of capsule or rotator interval

40
Q

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

A

3: Abd/Add, Flex/Ext, IR/ER

41
Q

Kinematics and Degrees GHJ:

Abduction/Adduction

A

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
Q

Kinematics and Degrees GHJ:

Flexion/Ext

A

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
Q

Kinematics and Degrees GHJ:

IR/ER

A

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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