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Movement Science Exam 2 > The Shoulder Complex > Flashcards

The Shoulder Complex Flashcards

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1
Q

Which joint is responsible for 2/3rd of shoulder motion?

A

Glenohumeral joint

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2
Q

What joint is responsible for 1/3rd of shoulder motion?

A

Scapulothoracic joint

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3
Q

What is the normal range of motion of elevation for the shoulder complex? How many degrees does the glenohumeral contribute? What about the scapulothoracic joint?

A

180º
120º
60º

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4
Q

What bones make up the shoulder complex?

A

Clavicle
Scapula
Humerus

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5
Q

Which 4 joints make up the shoulder complex?

A

Glenohumeral Joint
Sternoclavicular Joint
Acromioclavicular Joint
Scapulothoracic Joint

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6
Q

What other motion is needed in order for shoulder elevation to occur? (Ipsilateral/contralateral) (cervical/thoracic/lumbar) (flexion/extension/sidebending/rotation)

A

Ipsilateral thoracic rotation

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7
Q

What is the only structure that connects the axial skeleton to the shoulder?

A

Sternoclavicular joint

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8
Q

How many degrees of freedom does the sternoclavicular joint have? What are those motions?

A

3 DoF
Elevation/Depression
Protraction/Retraction
Anterior/Posterior Rotation

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9
Q

Between which 2 structures will elevation and depression of the sternoclavicular joint take place? (Disc/clavicle/manubrium/1st rib costocartilage)

A

Disc and Clavicle

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10
Q

Between which 2 structures will protraction and retraction of the sternoclavicular joint take place? (Disc/clavicle/manubrium/1st rib costocartilage)

A

Disc and Manubrium

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11
Q

Between which 2 structures will anterior and posterior rotation of the sternoclavicular joint take place?
(Disc/clavicle/manubrium/1st rib costocartilage)

A

Clavicle and 1st rib costocartilage

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12
Q

Where is the articulation of the superior joint of the sternoclavicular joint?

A

Medial clavicle and disc

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13
Q

Where is the articulation of the inferior joint of the sternoclavicular joint?

A

Medial clavicle with manubrium and first costal cartilage

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14
Q

What happens at the SC joint during elevation and depression? (Relating to the clavicle and disc)

A

Clavicle rolls and glides on disc

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15
Q

What happens at the SC joint during protraction and retraction? (Relating to the disc, clavicle, and manubrium)

A

The disc and clavicle roll and slide on the manubrium

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16
Q

Which 4 ligaments surround the SC joint?

A

Anterior Ligament
Posterior Ligament
Costoclavicular Ligament
Interclavicular Ligament

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17
Q

What motion does the anterior ligament in the SCJ limit?

A

Anterior/Posterior translation (posterior is the primary limiter)

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18
Q

What motion does the posterior ligament in the SCJ limit?

A

Anterior/Posterior translation (posterior ligament is the primary limiter)

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19
Q

What motion does the costoclavicular ligament in the SCJ limit?

A

Elevation of lateral clavicle
Counteracts superior pull of SCM and Sternohyoid muscles

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20
Q

Which fibers of the costoclavicular ligaments run laterally?

A

Anterior fibers

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21
Q

Which fibers of the costoclavicular ligaments run medially?

A

Posterior fibers

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22
Q

What motion does the interclavicular ligament in the SCJ limit?

A

Excessive depression of clavicle
Superior gliding of clavicle on manubrium

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23
Q

What structures does the interclavicular ligament protect?

A

Subclavian artery and brachial plexus

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24
Q

How many degrees of elevation does the SCJ allow?

A

48º

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25
Q

How many degrees of depression does the SCJ allow?

A

15º

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26
Q

How many degrees of protraction does the SCJ allow?

A

15-20º

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27
Q

How many degrees of retraction does the SCJ allow?

A

30º

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28
Q

How many degrees of posterior rotation does the SCJ allow?

A

50º

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29
Q

How many degrees of anterior rotation does the SCJ allow?

A

10º

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30
Q

What happens to the medial end of the clavicle on the sternum during elevation? (Referring to rolling and sliding)

A

Rolls superiorly and slides inferiorly

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31
Q

What happens to the medial end of the clavicle on the sternum during depression? (Referring to rolling and sliding)

A

Rolls inferiorly and slides superiorly

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32
Q

What happens on the medial end of the clavicle on the sternum during protraction? (Referring to rolling and sliding)

A

Rolls and slides anteriorly

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33
Q

What happens on the medial end of the clavicle on the sternum during retraction? (Referring to rolling and sliding)

A

Rolls and slides posteriorly

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34
Q

What happens on the medial end of the clavicle on the sternum during posterior rotation? (Referring to the surface of the clavicle)

A

Inferior surface faces anteriorly

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35
Q

What happens on the medial end of the clavicle on the sternum during anterior rotation? (Referring to the surface of the clavicle)

A

Inferior surface returns to neutral (or more posteriorly)

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36
Q

What two structures does the ACJ attach?

A

Scapula and lateral clavicle

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37
Q

How many DoF does the ACJ have? What are they?

A

3
Internal/External Rotation
Anterior/Posterior Tilting
Upward/Downward Rotation

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38
Q

How many degrees of internal and external rotation does the ACJ allow?

A

20-35

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39
Q

How many degrees of anterior and posterior tilting does the ACJ allow?

A

20-40º

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40
Q

How many degrees of upward rotation does the ACJ allow?

A

30º

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41
Q

How many degrees of downward rotation does the ACJ allow?

A

17º

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42
Q

True or False: The AC capsule is a strong capsule

A

False; weak

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43
Q

How many AC ligaments are there? What are their names?

A

3 (4 if counting the coracoclavicular one as 2)
Superior AC
Inferior AC
Coracoclavicular (Made up of considerable ligament and trapezoid ligament)

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44
Q

What motions does the superior AC resist?

A

Opposing forces

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45
Q

What motions does the inferior AC resist?

A

Opposing forces (Not as strong as the superior AC)

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46
Q

What does the coracoclavicular ligament do?

A

Firmly unite the clavicle and scapula

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47
Q

What motions does the conoid ligament resist?

A

Resists inferior forces

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48
Q

What motions does the trapezoid ligament resist?

A

Resists posterior translation

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49
Q

What is the critical role of the coracoclavicular ligament?

A

Couple posterior clavicle rotation and scapula upward rotation during arm elevation

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50
Q

What is the most common way to injure the ACJ?

A

By engaging in contact sports or falling on shoulder with arm adducted

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51
Q

Which of the following is a functional joint rather than a true joint?

A

Scapulothoracic joint

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52
Q

For the scapulothoracic joint to move, which other joints must move as well?

A

AC, SC, or both

53
Q

Where does the scapula naturally rest?

A

Scapula rests 2 inches from midline between ribs 2-7

54
Q

In resting position, which way is the scapula shifted (protracted or retracted) and by how many degrees?

A

Internally rotated (protracted)
35-45º

55
Q

In resting position, which way is the scapula tilted (anteriorly or posteriorly) and by how many degrees?

A

Tilted anteriorly
10-15º

56
Q

In resting position, which way is the scapula rotated (upwardly or downwardly) and by how many degrees?

A

Upwardly rotated
5-10º

57
Q

What are the rotary motions of the STJ?

A

Upward/Downward Rotation
Internal/External Rotation
Anterior/Posterior Tilting

58
Q

What are the translatory motions of the SCJ?

A

Elevation/Depression
Protraction/Retraction (Abduction/Adduction)

59
Q

How many degrees of upward rotation are required for arm elevation?

A

60º

60
Q

In the STJ, what does excessive internal rotation cause?

A

Scapular winging

61
Q

Which shoulder joint is the premier example of dynamic stabilization?

A

ST Joint

62
Q

What kind of synovial joint it’s the GHJ?

A

Ball and Socket

63
Q

How many degrees of freedom does the GHJ have?

A

3 rotary and 3 translatory

64
Q

Size wise, how does the humeral head differ from the glenoid fossa?

A

The humeral head is larger than the glenoid fossa

65
Q

The glenoid fossa can be retroverted or anteverted. What does this mean?

A

It is the bony orientation of the glenoid fossa. If the glenoid fossa is retroverted, that means that it is facing posteriorly. If it is anteverted, that means that it is facing anteriorly

66
Q

Which way does the humeral head face, which relation to the glenoid fossa?

A

Head faces medially, superiorly, and posteriorly

67
Q

What is the angle of inclination of the humeral head?

A

130-150º

68
Q

What is the angle of torsion of the humeral head, and where direction does it face?

A

30º
Posteriorly

69
Q

What does the glenoid labrum do to the glenoid fossa?

A

The glenoid labrum enhances the fossa concavity by about ~50%

70
Q

What are all 5 functions of the glenoid labrum?

A
  1. Enhance fossa concavity
  2. Resist humeral head translations
  3. Protect bony edges of fossa
  4. Minimize GHJ friction
  5. Dissipate joint contact forces
71
Q

How do you tighten the GH capsule?

A

Abduction + Lateral Rotation (External rotation)

72
Q

For which tendon does the glenoid labrum serve as an attachment site?

A

Tendon of the long head of bicep

73
Q

How much distraction of the GHJ is possible in the loose packed position?

A

2.5 cm

74
Q

Which direction is the GH capsule most commonly dislocated?

A

Anteriorly

75
Q

How many ligaments are there in the GHJ, and what are they?

A

4
Superior GH Ligament
Middle GH Ligament
Inferior GH Ligament Complex
Coracohumeral ligament

76
Q

How many ligaments is the inferior GH ligament complex composed of, and what are their names?

A

Anterior
Posterior
Axillary Pouch

77
Q

What structure does the superior GH ligament help to form?

A

Rotator Cuff Interval

78
Q

What motions does the superior GH ligament resist?

A

Resists anterior and inferior translations of the humeral head at 0º abduction

79
Q

What motions does the middle GH ligament resist?

A

Prevents ANY translation of the humeral head from 0-60º of abduction

80
Q

What motions does the anterior portion of the inferior GH ligament complex resist?

A

Resists anterior and inferior translation after 60º of abduction

81
Q

What motions does the posterior portion of the inferior GH ligament complex resist?

A

Resists posterior and inferior translation after 60º of abduction

82
Q

What motions does the axillary pouch portion of the inferior GH ligament complex resist?

A

Resists inferior translation after 60º of abduction

83
Q

What do the two bands of the coracohumeral ligament form?

A

They form a tunnel for long head of biceps to pass through

84
Q

Where is the first band of the coracohumeral ligament located?

A

Base of coracoid to edge of supraspinatus tendon and greater tubercle

85
Q

Where is the second band of the coracohumeral ligament located?

A

Base of coracoid into subscapularis and lesser tubercle

86
Q

What structures form the coracoacromial arch?

A

Coracoid, acromion, and coracoacromial ligament

87
Q

What structures are contained in the subacromial space?

A

Subacromial bursa, rotator cuff tendons, tendon of long head of biceps

88
Q

What is the function of the coracoacromial arch?

A

To protect subacromial structures, and prevent superior dislocation of the humerus

89
Q

What can be a result of a type 3 coracoacromical arch?

A

Increased susceptibility to impingement

90
Q

What can be a result of a type 4 coracoacromical arch?

A

Increased susceptibility to superior dislocation

91
Q

How much flexion does the GHJ allow?

A

120°

92
Q

How much extension does the GHJ allow?

A

50°

93
Q

In what axis does GH flexion and extension occur?

A

Coronal

94
Q

In what axis does GH medial and rotation occur?

A

Long axis

95
Q

In what axis does GH abduction and adduction occur?

A

Anterioposterior axis

96
Q

How much Abduction/Adduction does the GHJ allow?

A

90-120º

97
Q

What motion of the GHJ is limited when in a certain position? And what is it limited by?

A

Abduction is limited when in neutral or medial rotation
Limited by the greater tubercle

98
Q

In order for full abduction of the GHJ to occur, what following motion must also occur in the GHJ?

A

Lateral rotation

99
Q

What can a tight capsule around the GHJ cause?

A

It could cause shifting of the humeral head during motion, or limit motion

100
Q

What passive forces counteract the effects of gravity on the arm?

A

Rotator interval capsule
Capsular vacuum creates negative pressure
Lower glenoid + labrum tilt slightly upward
Passive tension of supraspinatus

101
Q

Which muscle in the shoulder is “always on,” and what happens if it turns off?

A

The supraspinatus is always on. If it turns off, inferior subluxation occurs, which in turn reduces rotator cuff function

102
Q

Which muscles are the prime movers for abduction in the GHJ?

A

Middle deltoid and supraspinatus

103
Q

Which muscle is a prime mover for flexion in the GHJ?

A

Anterior deltoid

104
Q

Which is a larger force vector of the middle deltoid? Parallel (Fx) or Perpendicualr (Fy)

A

Parallel (Fx)

105
Q

The majority of force from the deltoid from resting position causes which directional translation in the humerus?

A

Superior

106
Q

In order for the deltoid to produce desired rotation of the humeral head, which other synergistic muscles must activate?

A

Rotator cuff muscles

107
Q

Name the 4 rotator cuff muscles

A

Supraspinatus
Infraspinatus
Teres minor
Subscapualris

SITSub

108
Q

What is a dynamic stabilization function of the rotator cuff muscles, mainly the ITSub?

A

Compressing the head of the humerus into the glenoid fossa

109
Q

The parallel force component (Fx) of the rotator cuff muscles offsets _______ translatory force from deltoid by pulling humeral head ______

A

Superiorly; Inferiorly

110
Q

Which 2 rotator cuff muscles help with lateral rotation to clear the greater tubercle?

A

Infraspinatus
Teres minor

111
Q

How does the long head of the biceps dynamically stabilize the GH?

A

Reinforces the GHJ by centering the head and reducing vertical and anterior shear
Also tightens labrum

112
Q

At what angles is the greatest shear forces on the GHJ?

A

30-60º of elevation

113
Q

Which tendon is the most vulnerable for degeneration or dysfunction in the GHJ?

A

Supraspinatus tendon

114
Q

At which angles would you expect pain to be produced if there is degeneration of the supraspinatus tendon?

A

60-120º (the painful arch)

115
Q

What are the main functions of scapulohumeral motion?

A

Distribute forces between the 4 joints, permitting more ROM with more stability

Maintains glenoid fossa in optimal position for humeral head -> decreases shear forces

Maintains good length-tension of humeral muscles preventing active insufficiency as scapula rotates up

116
Q

How much abduction of the GH occurs before the ST kicks in?

A

30º

117
Q

How much flexion of the GH occurs before the ST kicks in?

A

60º

118
Q

Which 2 muscles kick in during clavicular elevation to upwardly rotate the scapula?

A

Trapezius and serratus anterior

119
Q

Which ligament becomes taut during clavicular elevation?

A

Costoclavicular ligament

120
Q

Which ligaments become taut during clavicular posterior rotation and work to prevent more elevation?

A

Coracoclavicular ligaments (conoid and trapezoid)
Costoclavicular ligaments

121
Q

Which muscles work together to achieve elevation of the shoulder?

A

Deltoid
SITSub
Trapezius
Serratus Anterior
Rhomboids
Levator Scapulae

122
Q

Which muscles work together to achieve depression of the shoulder?

A

Latissimus Dorsi
Pectoralis Major
Pectoralis Minor
Teres Major
Rhomboids
Levator Scapulae
Lower Trapezius

123
Q

Which muscle has a constant MA through ROM, larger than deltoid for the first 60 degrees of abduction?

A

Supraspinatus

124
Q

Which muscles’ activity in the shoulder is greater in flexion than in abduction when it comes to elevation of the shoulder?

A

ITSub

NOT SUPRA

125
Q

Which muscles work together in order to elevate and downwardly rotate the scapula?

A

Rhomboids and Levator scapulae

126
Q

Which muscles can eccentrically stabilize during upward rotation?

A

Rhomboids and Levator scapulae

127
Q

Which portion of the pec major depresses the GH and shoulder complex?

A

Sternal portion

128
Q

How does the pec minor work in depression of the shoulder?

A

Assists by directly depressing scapula through attachment to coracoid process

129
Q

Which two muscles are strong synergists during adduction and depression of the humerus?

A

Teres major and rhomboids

Movement Science Exam 2 (2 decks)

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