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Locomotor > The shoulder > Flashcards

The shoulder Flashcards

1
Q

what does the region of the shoulder include

A

The pectoral, scapular, and lateral supraclavicular regions

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2
Q

what is the pectoral girdle made out of

A
  • the calvicle and the scapula
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3
Q

what does the humorous articular with

A
  • Humorous articulates with the scapula so that the shoulder regions is connected to the pectoral girdle
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4
Q

what is the pectoral girdle

A
  • Pectoral (shoulder) girdle is a bony ring, it is a moveable and flexible region
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5
Q

describe the structure of the pectoral girdle

A
  • Incomplete posteriorly because the scapula doesn’t articulate bone to bone with the vertebral column, it is attached by muscles to the vertebral column
  • scapula acts as a muscle attachement points
  • Formed by the scapulae (posteriorly) and clavicles (anteriorly)
  • Completed anteriorly by the manubrium of the sternum
  • clavicle overlies the first rib
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6
Q

where does the clavicle articular with the sternum

A
  • articulates anteriorly and forms the sternoclavicular joint
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7
Q

why can you palpitate along the clavicle

A
  • because no muscles cross it anteriorly
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8
Q

what causes protractor and retraction in the pectoral girdle

A

the muscle attached between the scapula and vertebral column

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9
Q

describe the structure of the scapula

A
  • Clavicle (collar bone) connects the upper limb to the manubrium via sternoclavicular joint
  • acromioclavicular joint, articulation with acromion of scapula and the clavicle
  • the acromioclavicular joint keeps arm away from thorax, giving maximum freedom of movement
  • s curve that acts as a spring in the clavicle – this means that it can be more flexible and absorb shock
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10
Q

what does the S shape curve in the clavicle do

A
  • it increases its resilience
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11
Q

how are fractures caused in the clavicle

A
  • direct or indirect force
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12
Q

describe what the fracture looks like

A

-medial part points upwards whereas lateral part points onwards creating a tent of the skin
this happens because..
– The Weight of arm drags lateral fragment inferiorly.
– And the Action of sternocleidomastoid pulls medial fragment superiorly

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13
Q

describe the promotion of breakages that are clavicles

A

– 2-5% of adult fractures

– Most frequently fractured bone n childhood – sometimes happens during birth

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14
Q

what does the clavicle protect

A

Brachial plexus
Major underlying vessels
Apex of lung

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15
Q

what is the scapula

A

Triangular flat bone on posterolateral aspect of thorax,

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16
Q

what ribs does the scapula overlie

A

2nd to 7th rib

- this is the physiological scapulothroacic joint

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17
Q

what is the scapula an attachment site for

A

Attachment site for many shoulder/pectoral girdle muscles

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18
Q

describe the structure of the scapula

A

spine’ ridge on posterior side separates supraspinous fossa and infraspinous fossa
- Lateral end of spine of scapula - acromion,

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19
Q

what are the muscles that act on the scapula

A
  • trapizieous acts on the scapula
  • Trapizieus acts on the scapula
  • Levator scapulae – lifts the scapula – it attaches to the top and lifts it
  • Triceps brachii – one head attaches to the scapula
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20
Q

what is the humorous

A
  • it is the largest bone in the body
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21
Q

what does the humorous articular with

A
  • Articulates with scapula at glenohumeral joint and radius and ulna at elbow joint
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22
Q

describe the sternoclavicular joint

A
  • Clavicle and manubrium of the sternum and 1st costal cartilage
  • Strength due to strong ligaments
  • Only articulation between upper limb and axial skeleton
23
Q

what does the interarticular disc do int he sternoclavicular joint

A

– fibrocartilage that fits into the joint – this acts as packing and a shock absorber – make certain that the joint surfaces are closer together to prevent movement

24
Q

describe the structure of the acromioclavicular joint

A

– Between Acromion and clavicle
– located 2-3 cm from ‘point of the shoulder’
– No muscles cross AC joint
– Muscles moving scapula move AC joint – when the scapula moves the AC joint moves

25
Q

what is stronger the sternoclavicular joint or the acromioclavicualr joint

A

– Not as strong as sternoclavicular, interarticular disc is not as large as the one in the sternoclavicular joint

26
Q

describe how the acromioclavicular can dislocate

A

– the clavicle is intact but just separated, the clavicle moves up due to the sternocleimastoid, and gravity moves the shoulder and the scapula down

27
Q 
what muscles cause ... movement in the scapula 
1. elevation 
2 depression 
3 protection 
4 retraction 
5 upward rotation 
6 downward rotation
A 
Elevation
- Trapezius (descending)
Depression
- Gravity 
Protraction
- Serratus anterior
- Pectoralis minor
Retraction
- Trapezius (middle)
Upward rotation
- Trapezius (descending)
- Serratus anterior (inferior)
Downward rotation
- Latissimus dorsi
28
Q

what does the glenoid cavity articular with

A

head to the humorous

29
Q

describe the structure of the glenoid cavity

A

– Shallow glenoid cavity deepened by ring of fibrocartilage - ‘glenoid labrum – it helps to hold the head of the humerous against the shallow depression of the glenoid cavity’ – it is a slight depression in the glenoid region in the scapula, the head of the humerous is about 4 times bigger then the glenoid cavity
– Fibrous joint capsule loose and baggy – increases the range of movement

30
Q

why is there a large freedom of movement in the glenohumeral joint

A

– Due to loose articular capsule,
– large humeral head compared to shallow/small glenoid cavity – this prevents any bone restrictions that limit the head of the humorous from moving

31
Q

what movements can the glenohumeral joint do

A

– flexion-extension
– abduction-adduction
– medial and lateral rotation
– circumduction (combination flexion, extension, abduction and adduction)

32
Q

what are the chief flexors in the glenohumeral joint

A

Chief flexors
Pectoralis major (clavicular part)
Deltoid (anterior part) - comes from the clavicle, goes round the arcomin onto the scapula spine
- Coracobrachialis assisted by biceps brachii which stabilises the joint

33
Q

what are the chief extensors in the glenohumeral joint

A

Chief extensors
Latissimus dorsi - attaches to the humerous and the vertebrae
Deltoid (posterior fibres)
- Teres major - Long head of triceps brachii helps stabilise the joint

34
Q

what are the chief abductors in the glenohumeral joint

A

chief abductor
Deltoid (all parts but especially central fibres)
Solely active 110-180o of abduction
Supraspinatus does 1st 10o of abduction
Active and works with deltoid 10- 110o of abduction

35
Q

describe how the physiological scapulotheraicic joint works

A
  • the head of the humerus uses all the available articular space when it moves to 90 degrees, the supraspinatus and deltoid help it do this abduction
  • up to 30 degrees the scapula is in a position of stability
  • beyond 30 degrees scapula rotates upwards to reposition glenoid fossa - serratus anterior and trapezius help it do this
  • there is a 2:1 ratio over the 180 degree of shoulder abduction, 120 degrees occurs at the glenohumeral joint and 60 degrees occurs at the scapualthroacic joint
36
Q

what is the 2:1 ratio of shoulder abduction

A
  • there is a 2:1 ratio over the 180 degree of shoulder abduction, 120 degrees occurs at the glenohumeral joint and 60 degrees occurs at the scapualthroacic joint
37
Q

what are the chief adductors

A

Pectoralis major
Latissimus dorsi

Gravity is prime mover

38
Q

what is the chief medial rotator

A

Subscapularis

39
Q

what is the chief lateral rotator

A

Infraspinatus

40
Q

what are rotator cuff muscles

A
  • Group of 4 muscles that surround the scapula and attach to the head of the humerous
41
Q

what are movements that are combined often

A
  • abduction and external rotation

- adduction and internal rotation

42
Q

what are the 4 muscles that stabilise the glenohumeral joint

A
  • Supraspinatus – abductor - goes to the greater tuberosity
  • Infraspinatus- goes into the greater tuberisocity
  • Teres minor – goes into the greater tuberiosicty
  • Subscapularis – goes into the lesser tuberosicty
43
Q

what do the glenohumeral joints do

A
  • Form musculotendinous cuff around glenohumeral joint blending with articular capsule
  • Tonic contraction holds relatively large humeral head in shallow glenoid cavity
44
Q

where do glenohumeral joints attach

A
  • 3 attach to greater tuberosity of humerus

- 1 attaches to lesser tuberosity of humerus

45
Q

what are bursae

A
  • Protect tendons
  • Bursae act as cushions and reduce friction in order to protect tendons
  • they are normally filed with fluid
46
Q

where is the bursae

A
  • They are underneath the acromin and can protect the supraspinatus tendon
47
Q

what causes pain on abduction of the arm

A
  • Subacromial bursa inflammation (bursitis) causes pain on abduction of arm
48
Q

what is the most common glenohumeral joint dislocation

A
  • anterior dislocation
49
Q

why when you dislocate the glenohumeral joint is it weaker

A

Glenoid labrum may be stripped from anterior aspect of glenoid cavity, making joint weaker

50
Q

how does dislocation of the glenohumeral joint dislocate

A
  • Glenohumeral joint fully abducted tilts head of humerus inferiorly onto weaker part of joint
  • Strong flexor and adductor muscles pull humeral head anteriorly
  • this causes the humerus to go into the weaker part of the join where there is not muscle there
  • the rounded profile of the shoulder is lost and gravity pulls the humorous inferiorly
51
Q

what is the problem with a glenohumeral dislocation

A

Axillary nerve can be compressed or damaged completely as it is near the inferior part of the glenohueral joint

52
Q

what are the consequences of the axillary nerve being damaged

A

– Deltoid
• Impaired abduction – can no longer do abduction
– Loss of sensation over “regimental badge
– Long term dmage is that the deltoid atrophies and waste end up with a really weak shoulder

53
Q

what does the axillary nerve innervate

A

the deltoid muscle

Locomotor (22 decks)

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