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MSK > Upper limb : Shoulder joint > Flashcards

Upper limb : Shoulder joint Flashcards

1
Q

what are the features of the scapula?

A
  • irregular bone.
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2
Q

what are the features of the humerus?

specifically what is the difference in anatomical vs surgical neck.

A
  • anatomical neck : site of attachment to capsule, site of epiphyseal plate.
  • surgical neck : between tubercles and shaft, and more fractures than anatomical neck.
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3
Q

what are some features of the clavicle?

A
  • sternal end articulates with manubrium of sternum towards midline of body : sternoclavicular joint.
  • acromial end articulates with acromion of scapula : acromioclavicular joint.
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4
Q

what are some features of the glenohumeral joint?

A
  • the shoulder joint is a synovial joint, with ball and socket design.
  • most mobile with wide range of movement over multiple planes.
  • least stable joint in body : most common dislocations.
  • articular surfaces head of humerus to glenoid fossa, 4:1 disproportional.
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5
Q

what is the significance of the glenoid labrum?

A
  • deepens glenoid fossa, with loose anterosuperior attachment and inferior firm attachment.
  • proprioceptive nerve endings ( perceiving movement ) found in GH ligaments and labrum so disruption leads to decrease in that.
  • site of GH ligament attachment.
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6
Q

what is responsible for the mobility of the shoulder joint?

A
  • shallow glenoid fossa.
  • disproportion of articular surface.
  • lax capsule : relaxed.
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7
Q

name some static stabilisers of the shoulder joint.

A
  • glenoid labrum.
  • joint capsule.
  • intracapsular ligaments.
  • extracapsular ligaments.
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8
Q

name some dynamic shoulder stabilisers.

A
  • rotator cuff muscles.

- other muscles : deltoid, corabrachialis, long head of biceps and triceps.

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9
Q

what are the features of the capsule at the shoulder?

A
  • attached to glenoid labrum, margining fossa and anatomical neck of humerus from other side.
  • medially dips to surgical neck.
  • tough but lax to allow movement.
  • small opening with synovial membrane.
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10
Q

what is the significance of the synovial membrane?

A
  • lines the capsule, intracapsular bone to articular cartilage, covers tendon of long head of bicep within joint cavity.
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11
Q

what are the intracapsular ligaments?

A
  • 3 glenohumeral ligaments : superior, middle or inferior glenohumeral ligament.
  • 3 fibrous band from glenoid labrum to humerus, reinforces capsule anteriorly.
  • can be seen from inside the capsule.
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12
Q

what are the extracapsular ligaments?

A
  • caracoacramial : caracoid to acromion.
  • carocohumeral : caracoid to anteior greater tubercule.
  • transverse HL : holds tendon of long biceps head in place when shoulder moves.
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13
Q

what is the caracoacromial arch?

A
  • structure comprises caracoid process, caracoacromial ligament and acromian process.
  • prevents superior dislocation of humerus.
  • IMPINGEMENT SYNDROME.
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14
Q

what muscles make up the rotator cuff? and whats the significance?

A
  • supraspinatus, infraspinatus, teres minor, subscapularis (dorsal unlike others).
  • important in contributing to stability as the cuff fuses with capsule and strengthens it holding humeral head in glenoid cavity.
  • subacromial bursa separates suprapinatus from caracoacromial arch.
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15
Q

what are the actions of the rotator cuff muscles?

A
  • supraspinatus : initiation and first 15 of abduction.
  • infraspinatus : lateral.external rotation of arm.
  • teres minor : lateral arm rotation.
  • sunscapularis : medial/ internal rotation.

*also stabilised by deltoid, long biceps head, long biceps head, caracobrachialis.

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16
Q

what are the significance of shoulder bursae?

A
  • subacromial bursa : facilitates supraspinatus tendon under coracoacromial arch and deltoid movement.
  • subscapula bursa : facilitates subscapularis tendon over scapula
17
Q

what does the aubacromial space contain?

A
  • subacromial bursa, supraspinatous tendon, capsule, tendon of long head of biceps.
18
Q

what nerves and arteries supply the shoulder joint?

A
  • nerves : axillary, suprascapular, lateral pectoral nerve from brachial plexus C5, C6.
  • blood : anterior circumflex humeral, posterior circumflex humeral, suprascapular artery.
19
Q

what muscles are responsible for shoulder abduction?

think in 0-15, 15-90 and 90-150 degrees

A

first 90 : across glenohumeral joint.

  • 0-15 : supraspinatus (suprascapular nerve)
  • 15-90 : deltoid central fibres (axillary nerve)

90-150 : across scapulothoracic joint.
- rotation of scapula trapezius (upper fibres) and serratus anterior.

20
Q

describe the deltoid muscle.

A
  • origin : anterior and upper at clavicle, acromion of scapula, spine of scapula.
  • insertion : deltoid tuberosity on lateral humerus.
  • nerve supply : axillary (C5, C6)
21
Q

what movements are the deltoid muscle a part of?

A
  • anterior fibres : flex and medially rotate arm and shoulder.
  • central and middle fibres : abduct arm from 15-90.
  • posterior fibres : extend and laterally rotates arm at shoulder.
22
Q

describe the features of the trapezius muscles.

A

origin : external occipital protuberance of skull, nuchal ligament, spinous processes of C7, T12.
insertion : clavicle, acromion, spine of scapula.
nerve : spinal accessory nerve, proprioceptive fibres from C3 and C4.

23
Q

what movements are the trapezius muscle a part of?

A
  • upper fibres : rotate acromion of scapula upwards during abduction of shoulder.
  • lower fibres : rotate medial spine of scapula downwards.
24
Q

describe the features and movements of the serratus anterior.

A

origin : lateral ribs of 1-8 / 1-9.
*fibres pass deep into scapula and insert into medial border.
nerve : long thoracic nerve (C5,6,7) prone to injury at mastectomy causing winging of scapula.

actions : protraction of scapula, scapula rotation during shoulder abduction from 90-150.

25
Q

what muscles are responsible for extension of shoulder?

A
  • posterior fibres of deltoid (axillary C5,6).
  • latissimus dorsi (thoracodorsal nerve C6,7,8).
  • teres major (lower subscapular nerve C5,6).
26
Q

describe the features of the latissumus dorsi.

A
  • origin : spinous processes of T6-T12, thoracolumbar fascia, illiac crest and 3 lower ribs.
  • insertion : intertubucular sulcus of humerus.

action : extends, adducts and medially rotates shoulder.

27
Q

describe the features of teres major.

A
  • origin : posteriot surface of inferior scapula angle.
  • insertion : medial lip of intertubecular groove humerus.
  • action : adducts, extends and medially rotates the shoulder.
28
Q

what muscles are responsible for shoulder flexion.

A
  • clavicular head of pectoralis major. : medial and lateral pectoral nerves.
  • anterior deltoid fibres : axillary.
  • carocabrachialis : musculocutaneos nerve.
  • biceps brachialis : musculacutaneous nerve.
29
Q

describe the features of pectoralis major.

A
  • origin : clavicular head, sternocostal head.
  • insertion : lateral lip of intertubercular sulcus.
  • actions : adducts shoulder, flexes shoulder, internally rotates shoulder.
30
Q

describe the features of the caracobrachialis.

A
  • origin : caracoid process of scapula.
  • insertion : medial humeral shaft.
  • nerve : musculocutaneous nerve.
  • action : weak flexor and adductor of shoulder.
31
Q

describe the features of biceps brachialis.

A
  • origin : long head from supraglenoid tubercule of scapula and short head from caracoid process.
  • insertion : radial tuberosirty via biceps tendon and deep fascia of forearm.
  • actions : weak contribution to shoulder flexion, strong supinator, flexor of elbow.
32
Q

what muscles are responsible for shoulder adduction?

A
  • pectoralis major.
  • latissimus dorsi.
  • teres major.
33
Q

what muscles are responsible for shoulder medial rotation?

A
  • sternocostal head of pectoralis major, suscapularis, teres major, latissimus dorsi.
34
Q

what muscles are responsible for shoulder external rotation?

A
  • infraspinatues : subscapular nerve.

- teres minor : axillary.

MSK (15 decks)

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