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Functional Anatomy > Week 10 > Flashcards

Week 10 Flashcards

1
Q

four joints of the shoulder complex

A

Sternoclavicular
acromioclavicular
glenohumeral
scapulothoracic

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2
Q

Articulations involved in the shoulder complex

A 
sternum
clavicle
ribs
scapula 
humerus
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3
Q

What stabilises the sternoclavicular joint

A

anterior and posterior sternoclavicular ligaments
interclavicular ligaments
costoclavicular
articular disc
sternothyroid, sternohyoid, subclavius muscles

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4
Q

What is the primary purpose of the sternoclavicular joint

A

position scapula optimally to receive head of humerus

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5
Q

What stabilises the AC joint

A

Superior and inferior AC joint capsular ligaments
coracoclavicular ligament
articular disc
deltoid and upper traps

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6
Q

Role of the AC joint

A

Optimally align scapula against the thorax

add to scapula motion

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7
Q

Primary motions of the AC joint

A

upward and downward rotation

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8
Q

Secondary motions of the AC joint

A

horizontal & sagittal plan adjustments

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9
Q

Why is the AC joint inherently susceptible

A

sloped joint

high probability of large shear force

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10
Q

Joint sprains of the AC joint GI-III

A

Gr I = damage to capsule & acromioclav lig
Gr II = rupture acromioclav & damage to coracoclav lig
Gr III = rupture acromioclav & coracoclavic ligs

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11
Q

GH Type of joint

A

Multiaxial synovial ball and socket joint

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12
Q

How much of the humeral head does the glenoid fossa articular surface cover

A

1/3

fit offers little to no stability
mobility favoured over stability

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13
Q

What stabilises the GH joint

A 
Joint capsule & capsular ligaments
coracohumeral ligament
glenoid labrum
rotator cuff muscles
long head of biceps
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14
Q

What are the 4 glenohumeral joint ligaments

A

superior glenohumeral ligament
middle glenohumeral ligament
coracohumeral ligament
inferior glenohumeralligament

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15
Q

Function of the superior glenohumeral ligament

A

restrainsinferior & AP translation of humeral head

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16
Q

Function of the middle glenohumeral ligament

A

provides anterior GH stability (esp 60 degree abd)

Limits extreme ER

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17
Q

Function of coracohumeral ligament

A

Taut in add

restrains inf translation + ER of HOH

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18
Q

what are the three parts of inferior glenohumeral ligament

A

3 Parts - ant band pos band and auxillary pouch

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19
Q

What is the function of the axillary pouch

A

taut at 90 degrees

acts as a sling supporting humeral head to resist inferior & AP translation

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20
Q

What is the role of the posterior band

A

taut at 90 degrees abd and EOR IR

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21
Q

Role of the anterior band of the inferior glenohumeral ligament

A

strongest and thickest part of capsule
taut at 90 degrees abd and EOR ER
primary ligamentous restraint of ant translation of HOH
-both in neutral and abducted

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22
Q

What stresses the anterior band

A

activities involving abduction and ER
e.g. the cocking phase of a baseball pitch
repetition of movement can stretch and tear the anterior band

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23
Q

what does the glenoid labrum do

A

increases fossa depth by 50%

improves stability by increasing contact with HOH

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24
Q

What causes anterior-inferior labral tear

A

rapidly anteriorly translating HOH

25
Q

What does SLAP stand for

A

Superior labral tear

26
Q

What causes a superior labral tear

A

large and/or repetitive forces produced by LH biceps

Limits ability of LH biceps to restrain HOH anterior translation

27
Q

what does the coracoacromial arch comprise of

A

coracoacromial ligament and acromion space

- function roof of GH joint

28
Q

what is the subacromial space

A

space between arch & HOH

29
Q

What does the axillary nerve innervate

A

deltoid and teres minor

30
Q

What does the thoracodorsal nerve innervate

A

latissimus dorsi

31
Q

What does the upper subscapular nerve innervate

A

subscapularis upper fibres

32
Q

What does the lower subscapularis innervate

A

subscapularis lower fibres and teres minor

33
Q

What does the lateral pectoral nerve innervate

A

pectoralis major, occ pectoralis minor

34
Q

What does the middle pectoral nerve innervate

A

pectoralis major (sternocostal head) , pectoralis minor

35
Q

What does the suprascapular nerve innervate

A

Supraspinatus and infraspinatus

36
Q

What does the subclavian nerve innervate

A

subclavius

37
Q

What does the dorsal scapular nerve innervate

A

rhomboid major and minor, levator scapulae

38
Q

What does the long thoracic nerve innervate

A

Serratus anterior

39
Q

6 steps of full abduction of the shoulder

A
  1. scapulohumeral rhythm 2:1 - 120 degrees GH abduction + 60 degrees ST upward rotation
  2. 60 degrees upward rotation of scapula - simultaneous SC joint elevation + AC joint upward rotation
  3. clavicle retracts at SC joints
  4. Scapula posteriorly tilts and externally rotates
  5. clavicle posterior rotates about its axis
    6 GH joint externally rotates
    – allows greater tubercle to pass posterior to acromion process
  • -supraspinatus contracts to ull superior capsule taut
  • -Auxillary pouch stretches to form sling for HO inferiorly
40
Q

Role of Rotator cuff

A

provide structural reinforcement
regulate dynamic joint stability
actively control arthrokinematics

41
Q

LH biceps brachii role

A

reinforces capsule rotator interval
restricts ant translation of HOH
Thoughts to resist superior migration of HOH

42
Q

ST elevators

A

upper traps
levator scapulae
rhomboids

43
Q

ST depressors

A

lower traps
lats
pec minor
subclavius

44
Q

ST protractor

A

serratus ant

45
Q

ST retractors

A

middle traps
lower traps
rhomboids

46
Q

ST upward rotators

A

Serratus ant

upper and lower traps

47
Q

ST downward rotators

A

rhomboids

pec minor

48
Q

What is throwers paradox

A

shoulder must be mobile enough to throw but stable enough to prevent injury

49
Q

Injury risks of baseball pitchers

A

labrum vulnerable to injury
- LH biceps

ER at risk when shoulder decelerates

50
Q

Stages of baseball pitch

A 
-knee up (wind up)
knee up - foot contact (stride) 
Foot contact - Max ER (arm cocking)
Max ER - Release (Arm acceleration)
Release - Max IR (Arm deceleraton)
Max internal rotation - (follow through)
51
Q

What is the wind up

A

initial movement to max knee lift of stride leg
greatest activity = upper traps , serr ant, ant delt

low RC activity
forces and torques low

52
Q

What is the stride phase

A

From end of balance to ground contact of lead foot

  • dramatic increase in shoulder muscle activity
    • incl deltoids, suprasp, infrap SA & upper traps

Scapula rotates up, elevates + retracts
Shoulder abducts, ER +horiz abd

53
Q

Stride phase

A

supraspin highest activity
- abduct shoulder
compress and stabilise GH joint

Deltoid high activity

54
Q

Arm cocking phase

A

lead foot contact to max shoulder ER

55
Q

arm acceleration

A

Max sh ER to ball release

56
Q

Phase 1 throwing rehab program

A 
decrease pain and inflamm
Normal ROM
prevent muscle atrophy
Dynamic stability
Control functional stress/strain ( stop throwing

Exercises & modalities
-ice, mobes, STT
flexibility and stretching
`

57
Q

Phase 2 Throwing rehab

A 
control flexibility 
progress strength
restore muscle balance
enhance dynamic stability
core and LL strength
58
Q

Phase 3 throwing rehab program

A

aggressive stretching
progress neuromuscular control and proprioception
improve strength power and endurance
initiate light throwing

59
Q

phase 4`

A

progress to throwing program
return to competitive throwing
continue strength and flexibility drills

Functional Anatomy (13 decks)

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