the shoulder complex Flashcards
what bones make up the shoulder complex?
humerus
scapula
clavicle
what joint connects the shoulder to the axial skeleton?
sternoclavicular joint
what is the primary mechanism that serves for securing the shoulder girdle to the rest of the body?
suspensory muscles
what are the three anatomical joints that make up the shoulder complex?
sternoclavicular joint
acromioclavicular joint
glenohumeral joint
what is the functional joint that makes up the shoulder complex?
scapulothoracic joint
what is particular about the scapulothoracic joint?
its not a true joint, it has no boney articulation between the scapula and thoracic cage, movement produced is that of the scapula gliding on the thoracic cage
what articulates in the GH joint?
the small glenoid fossa with the head of the humerus
what is the GH joint often referred to as?
the shoulder joint
what motions can be accomplished by the sternoclavicular joint?
elevation/depression
protraction/retraction
anterior/posterior rotation of the clavicle
what type of mvmt occurs at the acromioclavicular joint?
minimal movement but will participate in elevation and depression, protraction/retraction
anterior/posterior rotation of the clavicle
what enhances the glenoid fossa?
the glenoid labrum
what has the GH joint sacrified to serve the mobility needs to the hand?
sacrified congruency
what mvmts can be accomplished by the GH joint?
flexion/extension
add/abd
IR/ER
What is the GH joint susceptible to?
degenerative changes and dernagement
what are the shoulder muscles responsible for?
F/E
ABD/ADD
ER/IR
What is the Scapulothoracic motion a part of?
part of a true closed chian with SC and AC joints thus movement of ST will result in motion of AC and/or SC joint
what type of motion occurs at the ST joint?
Elevation/depression
protraction/retraction
up/down rotation
what motion occurs to keep the scapula relatively flushed with the curved rib cage?
smaller motion of the medial/lateral rotation and anterior/posterior tipping of the ST joint
scapular muscles are responsible for what types of mvmts?
Elevation/depression
protraction/retraction
up/down rotation
what is the general AROM/PROM of flexion in the shoulder?
160-180 degrees
what is the general AROM/PROM of extension in the shoulder?
50-60
what is the general AROM/PROM of ABD in the shoulder?
180
what is the general AROM/PROM of IR in the shoulder?
60-100
what is the general AROM/PROM of ER in the shoulder?
80-90 degrees
what is the normal end feel in the shoulder during Flexion, extension, ABD, IR/ER
capsular
what muscles make up the rotator cuff? what is their main function?
supraspinatus
infraspinatus
teres minor
subscapularis
what is the main function of the rotator cuff muscles? how is it accomplished?
serve as dynamic stabilizers to the GH joint by compressing the head of the humerus into the glenoid fossa
creates an inferior translator pull to offset the superior pull of the deltoid during abd (infra, teres and sub)
creates a superior force against gravity with ABD (supraspinatus)
would the GH joint be able to account for the full ROM of the shoulder by itself?
no, its the coordinated function of the shoulder complex that allows it to achieve the greatest ROM,
what helps provide the remaining ROM to the GH joint?
the ST joint via the AC and SC joints during upwards rotation of the scapular induced by the trapezius and serratus anterior
what is the ST rhythm?
the concomitant GH and ST motion
summerize in 3 points the main effect of the combined Scapulohumeral motion
- the motion is distributed between GH and ST joints
- it maintains the glenoid fossa in an optimal position to recieve the head of the humerus, increasing joint congruency while decreasing shear forces
- permits musscles acting on the humerus to maintain good length-tension relation while minimizing of preventing active insufficency of GH muscles
what are some orthopedics capsular patterns?
arthritis
frozen shoulder
what are some orthopedics non-capsular patterns?
impingement bursitis tendinitis/muscle labrum AC OR SC pathology nerve dislocation/subluxation fracture of humerus or clavicle ligament sprains hyper/hypomobility scapulothoracic dysfunction
what are some common shoulder conditions that may occur post stroke?
subluxation
spasticity
frozen shoulder
impringement
why is the elbow complex designed to serve?
serve the hand
what is the main function of the elbow complex?
provide mobility of the hand in space by shortening/lengthening the UE
what bones make up the elbow complex?
humerus
radius
ulna
what are the total joints that make up the elbow complex? where are they located?
- humeroulnar (elbow)
- humeroradial (elbow)
- proximal radioulnar joint (wrist)
- distal radioulnar joint (elbow)
whta is the funtion of the humeroulnar and humeroradial joint?
allows for flexion and extension
what links the proximal and distal radioulnar joint?
interosseous membrane
thus functions as a single joint
what is the main motion accomplished by the radioulnar joint?
pronation/supination
how many muscles cross the elbow complex? where do they act on?
15 muscles
some acti on the shoulder other on the wrist
what is the effect of having muscles linking the shoulder, elbow and wrist together?
allows to enhance the function o the hand
how many muscles are directly associated with the elbow joint, what are they, what is their function?
flexors (3): brachialis, biceps brachii and brachioradialis
extensors (2): triceps and anconeus
how many muscles are associated with the radioulnar joint? what is their function
supination (2): supinator, biceps brachi
pronation (2): pronator teres, pronator quadratus
what is the normal AROM for flexion of the elbow complex? what happens in not supinated
135-145 degrees
if not supinated the AROM will decrease
what is the normal PROM for flexion of the elbow complex?
150-160 degrees
what is the normal end feel of the elbow complex during flexion?
soft tissue approximation
what is the normal AROM/PROM for extension of the elbow complex? what may be possible?
0 degrees
possible to have cases of hyperextension
what is the joint end feel in the case of extension of the elbow?
bony
what is the normal AROM/PROM for pronation of the elbow complex with elbow at 90 degrees?
75 degrees
what is the joint end feel in the case of pronation/supination of the elbow?
capsular
what is the normal AROM/PROM for supination of the elbow complex with elbow at 90 degrees?
80 degrees
what is the normal carrying angle in men? in women?
men: 5 degrees
women: 10-15 degrees
what is cubitus valgus?
increased carrying angle
what is cubitus varus?
decreased carrying angle
what is the functional ROM for flexion for the elbow?
~100 degrees
what is the function ROM for pronation for the elbow?
~50 degrees
what is the function ROM for supination for the elbow?
~55 degrees
what are some common conditions that occur at the elbow?
-lateral epicondulitis
-medial epicondylitis
olecranon bursitis
ulnar collateral ligament sprains
dislocations
fracture
cubital tunnel syndrom
arthritis
muscle sprains
what joint forms the wrist complex?
- radiocarpal joint
- midcarpal joint
whta joint located between the radius/TFCC proximally and scaphoid, lunate and triquetrum distally?
radiocarpal joint
where is the midcarpal joint located?
between the proximal row composed of the scaphoid, lunate and triquetrum and the distal row made up of the trapezium, trapezoid, capitate and hamate.
what is the normal AROM/PROM for flexion of the wrist?
80 degrees
what is the normal end feel of the wrist?
capsular
what is the normal AROM/PROM for extension of the wrist?
70 degrees
what is the normal AROM/PROM for radial deviation of the wrist?
20 degrees
what is the normal AROM/PROM for ulnar deviation of the wrist?
35 degrees
what are the primary muscles involved in flexion of the wrist?
palmaris longus
flexor carpi radialus
flexor carpi ulnaris
what are the muscles involved with flexion of the wrist?
Palmaris longus Flexor carpi radialis Flexor carpi ulnaris Flexors digitorum superficialis Flexors digitorum profundus Flexor pollicis longus
what are the primary muscles involved in extension of the wrist?
Extensor carpi radialis longus and brevis Extensor carpi ulnaris
what are the muscles involved with extension of the wrist?
Extensor carpi radialis longus and brevis Extensor carpi ulnaris
Extensor digitorum communis
Extensor indicis
Extensor digiti minimi
Extensor pollicus longus Extensor pollicus brevis Abductor pollicus longus
what muscles are involved in RD of the wrist?
Extensor carpi radialis longus and brevis Extensor pollicis longus and brevis
Flexor carpi radialis
Abductor pollicis longus
what muscles are involved in UD of the wrist?
extensor carpi ulnaris
flexor carpi ulnaris
what are the two most important functions of the wrist? why?
extension and UD as they are needed to grab objects
what is the functional ROM for flexion of the wrist?
55 degrees
what is the functional ROM for extension of the wrist?
60 degrees
what is the functional ROM for UD of the wrist?
35 degrees
what is the functional ROM for RD of the wrist?
17 degrees
what are some common hand conditions?
sprains and strains carpal tunnel syndrome de quervain syndrome osteoarthritis of the thumb and fingers tendon repair rehab fracture of radius or ulna scaphoid fracture boxer’s fracture radioculopathy dislocations nerve impingement
what is tenis elbow?
lateral epicondylitis
what is golfer’s elbow?
medial epicondylitis