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the shoulder complex Flashcards

1
Q

4 joints of the shoulder complex

A

glenohumeral joint
sternoclavicular joint
acromioclavicular joint
scapulothoracic joint

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2
Q

how much shoulder ROM is contributed by the glenohumeral joint

A

2/3s

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3
Q

how much shoulder ROM is contributed by the scapulothoracic joint

A

1/3

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4
Q

upper thoracic rotation occurs ___(ipsi/contra)__ with shoulder elevation

A

ipsilateral

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5
Q

how many degrees of freedom occur at the SC joint (& what are they)?

A

3 DoF
elevation/depression
pro/retraction
anterior/posterior

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6
Q

where is the superior SC joint articulation

A

medial clavicle and disc

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7
Q

where is the inferior SC joint articulation

A

medial clavicle with manubrium and first costal cartilage

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8
Q

what are the 2 jobs of the SC joint disc

A

increase congruence
absorbs force

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9
Q

arthrokinematics of elevation/depression of SC joint

A

clavicle rolls and glides on disc

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10
Q

arthrokinematics of protraction/retraction of SC joint

A

sc disc + clavicle roll and slide on manubrium

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11
Q

costoclavicular ligament limits what motion (+ counteracts which 2 muscles)

A

limits elevation of lateral clavicle by counteracting SCM and sternohyoid muscles

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12
Q

what direction does the anterior and posterior fibers of the costoclavicular ligament run?

A

anterior: laterally
posterior: medially

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13
Q

interclavicular ligament

A

resists excessive depression of clavicle + superior gliding of clavicle on manubrium

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14
Q

what degree of ROM can SC joint elevate + depress?

A

48* elevation
15* depression

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15
Q

what degree of ROM can SC joint protraction/retraction?

A

15-20* pro
30* retraction

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16
Q

what degree of ROM can SC joint posteriorly + anteriorly rotate?

A

50* post
10* ant

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17
Q

how does the clavicle move in elevation (lat vs med ends)

A

lateral end moves up

medial end rolls superiorly + slides inferiorly on sternum

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18
Q

what type of synovial joint is the SC joint

A

saddle

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19
Q

how does the clavicle move in depression (lat vs med ends)

A

lateral end moves down

medial end rolls inferiorly + slides superiorly on sternum

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20
Q

how does the clavicle move in protraction (lat vs med ends)

A

lateral end moves anteriorly (transverse plane)

medial end rolls and slides anteriorly on sternum

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21
Q

how does the clavicle move in retraction (lat vs med ends)

A

lateral end moves posteriorly

medial end rolls and slides posteriorly on sternum

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22
Q

t/f: SC joint is commonly susceptible to degenerative changes

A

FALSE –> the AC joint is

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23
Q

how many degrees of freedom does the AC joint have (+ what movements)

A

3 DoF

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24
Q

what joint allows the scapula to rotate during arm movements

A

the AC joint!!

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25
what joint maximized the scapula's contact to the thorax
AC joint
26
what are the 3 possible orientations of the AC joint? which orientation is most susceptible to degeneration? which is most common?
mediolateral (most common) lateromedial vertical <-- most susceptible to shear forces
27
coracoclavicular ligament
firmly unites clavicle and scapula
28
conoid ligament
resists inferior forces
29
trapezoid ligament
resists posterior translation
30
couple ________ clavicle rotation and scapula _________ rotation during arm elevation
posterior upward
31
how many degrees of internal and external rotation does the AC joint have? which axis does it rotate around?
20-35* vertical axis
32
how many degrees of anterior and posterior tilting does the AC joint have? which axis does it tilt around?
20-40* oblique coronal axis
33
how many degrees of upward and downward rotation does the AC joint have? which axis does it rotate around?
up: 30* down: 17* oblique AP axis
34
how does the glenoid fossa move when the AC joint rotates up and down?
tilts the glenoid fossa up and down
35
2 most common MOIs of AC joint
contact sport collision falls on shoulder with arm ADducted
36
the scapulothoracic "joint" depends on the integrity and structure of which 2 joints?
SC and AC joints
37
where does the scapula rest in relation the the rib cage and the midline
2" away from midline on ribs 2-7
38
___ degrees of upward rotation is required for arm elevation
60
39
excessive internal rotation of the ST joint leads to....
scapular winging
40
how does the scapula move in shoulder flexion/abduction (3)
protraction elevation upward rotation
41
how does the SC joint move in shoulder flexion/abduction? (3)
1. protraction (rolls + slides anteriorly) 2. posterior rotation (inferior slide, superior roll @ disk) 3. elevation
42
how does the SC joint move in shoulder lowering/adduction? (3)
1. retraction (post roll, post glide) 2. depression 3. anterior rotation (sup slide, inf roll at disc)
43
how does the scapula move in shoulder lowering/adduction (3)
retraction depression downward rotation
44
how does the AC joint move in shoulder flexion/abduction (1)
upward rotation
45
how does the AC joint move in shoulder lowering/adduction (1)
downward rotation
46
what joint is the "premier example" of dynamic stabilization
ST joint
47
t/f: the humeral head is larger than the glenoid fossa
true
48
what is the angle of inclination range of the humeral head + shaft of humerus
130-150*
49
what is the angle of torsion in GH joint
30*
50
what % does the glenoid labrum increase glenoid fossa concavity
~50%
51
GH capsule is most susceptible to which direction of dislocation?
anterior!
52
superior GH ligament
resists anterior and inferior translations of humeral head (at 0* abduction)
53
middle GH ligament
prevents ANY translations of humeral head from 0-60* degrees abduction
54
interior GH ligament complex has 3 components: what are they and what motions do they resist?
anterior = prevents ant/inf translation (ABD/IR) posterior = prevents post/inf translation (ABD/IR) axillary pouch = prevents inf translation (ABD)
55
coracohumeral ligament
forms a tunnel for LH of biceps to pass through
56
where are the 2 bands of the coracohumeral ligament
first band: base of coracoid to edge of supraspinatus tendon + greater tubercle second band: base of coracoid into subscapularis and lesser tubercle
57
3 structures that form a "vault" over the humeral head
coracoid acromion coracoacromial ligament
58
subacromial space contains (3 main structures)
subacromial bursa rotator cuff tendons tendon of LHB
59
flexion + extension ROM of GH joint
120* flex 50* ext
60
ab/adduction ROM of GH joint
90-120*
61
what movement of the arm is required for full range abduction?
lateral rotation
62
in elevation, how does the GH slide and roll
humeral head slides inferiorly + rolls superiorly
63
which rotator cuff muscle is key in static stabilization of GH joint
supraspinatus
64
if supraspinatus is not turning on, what direction is the shoulder more susceptible to dislocate
inferiorly
65
what muscle is the prime mover for GH abduction
deltoid
66
deltoid requires synergistic help from which muscle group to rotate humeral head
rotator cuff
67
what muscle contributes for the first part of shoulder abduction
supraspinatus
68
what is SITS
supraspinatus infraspinatus teres minor subscapularis
69
which 2 rotator cuff muscles help with lateral rotation to clear the greater tub during UE elevation
infraspinatus teres minor
70
which muscle centers the head of the humerus and reduces vertical + anterior shear?
long head of biceps brachii
71
which ROM do the greatest shear forces occur?
between 30-60* elevation
72
which tendon in the GH joint is the most vulnerable to injury
supraspinatus (can tear or be impinged)
73
what age group is most susceptible to RCTs
60+ years
74
what ROM degree range causes the most pain in a person with a RCT
60-120*
75
scapulohumeral rhythm ST vs GH ROM
ST = 60* GH = 120*
76
scapulohumeral motion distributes motion between how many joints
4
77
t/f: scapulohumeral motion prevents active insufficiency as the scapula rotates up
true!! it helps maintain good length-tension of humeral muscles
78
how does the GH joint move in shoulder flexion/abduction
superior roll of humerus with inferior slide on glenoid
79
how does the GH joint move in shoulder lowering/adduction
inferior roll of humerus with superior slide on glenoid
80
what is the overall ratio of movement with GH:ST
2:1 GH:ST
81
what ROMs of scapulohumeral rhythm is primarily GH joint
0-60* 120-180*
82
what part of ROM in scapulohumeral rhythm is ST:GH 1:1
60-120*
83
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84
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85
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86
what muscles act as force couple to allow ST upward rotation
upper/lower trap + serratus anterior
87
which deltoid muscles work together for abduction of shoulder
anterior and middle delt
88
which part of the delt adds joint compression
posterior delt
89
length-tension depends on which joint's motions
ST joint
90
slide 49

movement science (6 decks)

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