The Shoulder Flashcards
types of solid joints
fibrous and cartilaginous
fibrous joints composition
solid, limited movement
sutures, syndesmoses, composes
develop from cartilaginous (adults)
cartilaginous joint composition
synchondroses
symphyses
synovial joints
joint capsule
hyaline cartilage
some have articular disc
typically mobile
joint capsule is composed of
inner synovial membrane
outer fibrous capsule
3 functional classifications of joints
synarthrosis
amphiarthrosis
diarthrosis
amphiarthrosis
joints with little movement
synarthrosis
joints with no movement
diarthrosis
joints with lots of movement
i.e. synovial joints
nonaxial
joint with no axis of movement
uniaxial
joint with single axis of movement
biaxial
joint with 2 axes of movement
multiaxial
> 2 axes of movement
6 joints of the upper limb
acromioclavicular glenohumerol (shoulder) elbow radioulnar (proximal) radioulnar (distal) sternocalvicular
all are synovial, diarthrotic
acromioclavicular joint
articulating bones
acromion process of scapula, clavicle
acromioclavicular joint
structural type
synovial, plane
acromioclavicular joint
functional type and movements allowed
diarthrotic, gliding and rotation of scapula
scapula and humerus compose which joint
shoulder
shoulder joint structural type
synovial
ball and socket
movements allowed by shoulder joint
multiaxial, flexion, extension, abduction, adduction, circumduction, rotation of humerus/arm
elbow articulating bones
ulna and radius with humerus
elbow structural type
synovial
hinge
movements allowed by elbow
uniaxial
flexion , extension of forearm
what muscles groups are considered shoulder
axioappendicular
scapulohumeral
axioappendicular
connect axial skeleton to the upper limp
anterior structures of pectoral region
posterior structures of back
scapulohumeral muscles
connect scapula to humerus
bursae in the shoulder
fluid filled sacks
subacromial
sub deltoid
subcoracoid
subscapular
subacromial bursa
space between acromion and supraspinatus tendon
very fragile
sub deltoid bursa
between deltoid muscle and joint capsule
very large
subcoracoid bursa
between subscapularis muscle and coracoid process
may be fused with sub scapular bursa
which bursae can communicate with each other but not with synovial cavity?
subacromial
sub deltoid
subcoracoid
sub scapular bursa
between subscapularis muscle and joint capsule
communicates with synovial joint
function of clavicle (big picture)
bony link that holds the shoulder to the body
function of the capsule
pocked that provides stability
what is a bursa?
lubricating sac in synovial joint
what holds the shoulder in place?
rotator cuff muscles and tendons
describe the general function of the labrum
rim of the cartilage to which the capsule attaches
impingement syndrome
clinical syndrome which occurs when the tendons of the rotator cuff muscles become irritated and inflamed as they pass through the subacromial space, the passage beneath the acromion. This can result in pain, weakness and loss of movement at the shoulder
what tendon is involved in impingement syndrome
supraspinatus tendon
can involve subacromial (bursitis)
scapulohumeral musculature
attach the scapula to the humerus
move the humerus at the shoulder joint and contribute to the stabilization of this joint
innervated by brachial plexus
what muscles are scapula humeral
deltoid
theres major
rotator cuff muscles
what muscles make up the rotator cuff
subscapularis
supraspinatus
infraspinatus
teres minor
what innervates the deltoid?
axillary
what innervates the teres major?
lower subscapular nerve
what innervates the subscapuaris?
upper and lower sub scapular
what innervates the supraspinatus?
suprascapular
what innervates the infraspinatus?
suprascapular
what innervates the teres mior?
axillary
proximal attachment of the deltoid
lateral 1/3 of clavicle, acromion, and spine of scapula
distal attachment of the deltoid
deltoid tuberosity of humerus
attachment of the deltoid
flexes, medially rotates, abducts, extends, and laterally rotates humerus
innervation of the deltoid
axillary nerve
name the four parts of the deltoid
clavicular part
posterior part
spinal part
middle part
proximal attachment of the teres major
posterior surface of inferior angle of scapula
distal attachment of the teres major
medial lip of inter tubercular groove of humerus
actions of the teres major
adducts and medially rotates humerus
innervation of the teres major
lower sub scapular nerve
what part of the humerus does the subscapularis attach to?
lesser tubercle
which muscles rest on the greater tubercle of humerus
teres minor, infraspinatus, supraspinatus
proximal attachment of supraspinatus
supraspinous fossa of scapula
actions of supraspinatus
works with deltoid in abduction of humerus
acts with other rotator cuff muscles in stabilizing shoulder joint
distal attachment of supraspinatus
superior facet greater tubercle of humerus
innervation of supraspinatus
supra scapular nerve
proximal attachment of subscapularis
sub scapular fossa (anterior surface of scapula)
distal attachment of subscapularis
lesser tubercle of humerus
actions of subscapularis
medially routes and adducts humerus
helps hold humeral head into place
innervation of subscapularis
upper and lower sub scapular nerves
which muscle is the largest of the rotator cuff muscles
subscapularis
describe subscapularis injuries
isolated ones are rare
common sports injuries in pitchers (rotator cuff tendonitis)
can lead to bicipital tendon instability and biceps tendonitis
proximal attachment of infraspinatus
infraspinous fossa of scapula
distal attachment of infraspinatus
middle facet of greater tubercle of humerus
actions of infraspinatus
laterally rotates humerus
helps hold humeral head in place
innervation of infraspinatus
supra scapular nerve
proximal attachment of teres minor
middle part of lateral border of scapula
distal attachment of teres minor
inferior facet of greater tubercle of humerus
actions of teres minor
laterally rotates humerus
helps hold head in place
innervation of teres minor
axillary nerve
greater than 90 degree rotation of humerus causes
compression point for supraspinatus tendon causing rotator cuff injury
can tear in elderly
what are some activities that can cause injury to rotator cuff
repetitive overhead activities
tennis swimming pitching stacking boxes or stocking shelfs painting construction work
what are the 2 large arteries that have tributaries providing blood to shoulder and axillary regions?
subclavian and axillary artery
subclavian transitions to axillary just below clavicle then axillary translates to brachial
origin of subclavian artery
right: brachiocephalic trunk
left: aortic arch
where does subclavian artery arise? where does it divide?
posterior to sternoclavicular joint
at the anterior scalene muscle
3 divisions of subclavian artery at anterior scalene muscle
part 1 (medial to ASM) part 2 (posterior to ASM) part 3 (lateral to ASM)
thyrocervical arterial trunk divides into (4)
- transverse cervicle artery
- inferior thyroid artery
- ascending cervical artery
- supra scapular artery
transverse cervical artery divides into:
superficial and deep branches
may arise independently
deep branch of transverse cervical artery is AKA
dorsal scapular artery
cervicodorsal trunk
when superficial and deep branches of t.c.a. arise independently and form an arterial trunk
suprascapluar artery
travels independently from trunk along superspinatus muscle, travels with nerve
where does the subclavian artery become axillary artery?
lateral border of first rib
what is the blood supply of the pectoral region
axillary artery and its branches
what are the anastomosing arterial branches of the shoulder? (5)
- supra scapular artery
- dorsal scapular artery
- posterior intercostal arteries
- circumflex scapular artery
- thoracodorsal artery
4 named spaces of the shoulder
- triangle of auscultation
- quadrangular space
- triangular space
- triangular interval
these allow for innervation and blood supply to get in the region
triangle of auscultation borders
superiorly and medially by trapezius
inferiorly by latissimus dorsi
laterally by medial border of scapula
what passes through quadrangular space
axillary nerve and posterior circumflex humeral artery
quadrangular space border
above: teres minor
below: the teres major
medially: the long head of the triceps brachii
laterally: the surgical neck of the humerus
what passes through triangular space
circumflex scapular artery
what passes through triangular interval
deep brachial artery and radial nerve
what are the borders of the triangle interval
teres major - superior
long head of the triceps brachii - medial
borders of triangular space
Inferior: the superior border of the teres major;
Lateral: the long head of the triceps;
Superior: Teres minor or Subscapularis
