Week 3-4 Joints of the pectoral girdle & Glenohumeral (shoulder) joint Flashcards

1
Q

all type of joints and classification of the pectoral glide

A

sternoclavicular (SC) joint - synovial saddle joint (function as ball and socket joint) - atypical
acromioclavicular (AC) joint - synovial plane joint - atypical since wedge shaped and incomplete fibrocartilage disc
scapulothoracic joint - functional joint
glenohumeral (shoulder) joint - ball and socket joint

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2
Q

feature of clavicle

A

convex medial 2/3
concave lateral 1/3

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3
Q

clavicle - sternal (medial) end

A

sternal (articular) facet

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4
Q

clavicle - acromial (lateral) end

A

deltoid tubercle
acromial (articular) facet

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5
Q

bone and articular surfaces of sternoclavicular (SC) joint

A

sternum (clavicular notch)
clavicle (medial end)
1st costal cartilage (medial surface)

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6
Q

intra articular capsule of sternoclavicular (SC) joint

A

fibrocartilage

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7
Q

ligaments of sternoclavicular (SC) joint

A

anterior sternoclavicular - lay on capsule
posterior sternoclavicular - lay on capsule
interclavicular
costoclavicular - accessory ligament

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8
Q

movements of sternoclavicular (SC) joint

A

elevation/ depression
protraction/ retraction
posterior axial rotation

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9
Q

bone and articular surfaces of acromioclavicular (AC) joint

A

acromion (scapula)
clavicle (lateral end)

covered by fibrocartilage

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10
Q

intra-capsular disc of acromioclavicular (AC) joint

A

wedge shaped and incomplete fibrocartilaginous disc

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11
Q

ligaments of acromioclavicular (AC) joint

A

acromioclavicular - superior and inferior capsular thickenings
coracoclavicular - conoid & trapezoid

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12
Q

movements (stability) of acromioclavicular (AC) joint

A

3 degrees of freedom
passively - occurs with scapular movement
will adjust in any direction to allow scapular keep contact with chest wall

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13
Q

bone and articular surfaces of scapulothoracic joint

A

chest wall
body of scapula
serratus anterior acting as a disc

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14
Q

why scapulothoracic joint is a functional joint

A
  • no fibrous cartilaginous and synovial tissue
  • relies on muscles
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15
Q

resting position of the scapula on thorax - base of spine of scapula & inferior angle

A

base of spine of scapula - T3
inferior angle - T7

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16
Q

functions of scapulothoracic joint

A
  • scapular motion increases overall shoulder movement (keep humeral head in contact with glenoid fossa)
  • maintains scapulohumeral rhythm
  • movement relies of AC and SC joint movement
    .
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17
Q

movements of scapulothoracic joint

A

elevation/ depression
protraction/ retraction
upward/ downward rotation

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18
Q

bone and articular surfaces of glenohumeral (shoulder) joint

A

glenoid fossa of scapula
head of humerus (held by rotator cuff)

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19
Q

fibrous capsule and attachments of glenohumeral (shoulder) joint

A

fibrous capsule: loose cylindrical sleeve
attachments: margin of articular surfaces

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20
Q

reinforcements of glenohumeral (shoulder) joint

A

dynamic ligaments (distal attachment of the rotator tendons)

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21
Q

deficiencies of glenohumeral (shoulder) joint

A

top of bicipital groove
inferior to coracoid process

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22
Q

synovial membrane and communications with bursae

A

subscapular (communicating)
subacromial (non-communicating)

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23
Q

intrinsic, extrinsic and accessory ligaments of glenohumeral (shoulder) joint

A

intrinsic:
glenohumeral - superior, middle, inferior
transveral humeral

extrinsic: coracohumeral
accessory: coracoacromial

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24
Q

nerve supply of glenohumeral (shoulder) joint

A

suprascapular
subscapular
axillary
lateral pectoral
musculocutaneous

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25
Q

special structures of glenohumeral (shoulder) joint

A

glenoid labrum
long head of biceps tendon

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26
Q

movements of glenohumeral (shoulder) joint

A

flexion/ extension
abduction/ adduction
medial/ lateral rotation
circumduction

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27
Q

blood supply of glenohumeral (shoulder) joint

A

suprascapular vessels - above suprascapular notch
anterior circumflex humeral vessels - from axillary artery extend
posterior circumflex humeral vessels - from axillary artery extend

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28
Q

what structures help to support the superior aspect of the glenohumeral joint

A
  • coracohumeral ligament
  • long head of biceps brachii tendon
  • supraspinatus tendon
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29
Q

typically, the glenohumeral joint is prone to dislocation in which direction?

A

anterioinferiorly

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30
Q

what are the two muscles of scapular stabilization

A

serratus anterior and trapezius

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31
Q

scapulohumeral rhythm

A
  • scapula and humeral to achieve UL elevation
  • positioning glenoid fossa to serve UL function
  • contributes to enough length tension of muscles (eg: deltoid) to cross GH joint
  • loss of movement leads to shoulder dysfunction
  • 180 degrees elevation = 120 degrees GH: 60 degrees scapulothoracic (30 AC & 30 SC)
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32
Q

muscles that contributes downward rotation of the scapula

A

rhomboid major/ minor - retracts scapula
levator scapulae - elevates scapula
pectoralis minor - depress scapula, protracts scapula

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33
Q

muscles that contributes upward rotation of the scapula

A

trapezius (upper, middle, lower) - retracts scapula
serratus anterior - protracts scapula

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34
Q

muscles that contributes retraction of the scapula

A

trapezius (upper, middle, lower) - upward rot of scapula
rhomoids majoir/ minor - downward rot of scapula

35
Q

full abduction of GH joint needs to add some…

A

external rotation (but easy to dislocate)

36
Q

proximal and distal attachment of pectoralis major

A

proximal:
- clavicle head: anterior surface of medial half of clavicle
- sternocostal head: anterior surface of sternum, superior six costal cartilages, aponeurosis of external oblique muscles

distal:
lateral lip of intertubercular sulcus of humerus

37
Q

innveration of pectoralis major

A

lateral and medial pectoral nerves

38
Q

main action of pectoralis major

A
  • adducts and medially rotates humerus
  • draws scapula anteriorly and inferiorly
39
Q

proximal and distal attachment of pectoralis minor

A

proximal:
3rd - 5th ribs near costal cartilages

distal:
medial border and superior surface of coracoid process of scapula

40
Q

innervation of pectoralis minor

A

medial pectoral nerve

41
Q

main action of pectoralis minor

A
  • stabilise scapula by drawing it inferiorly and anteriorly against thoracic wall
42
Q

proximal and distal attachment of serratus anterior

A

proximal:
external surfaces of lateral parts of 1-8th ribs

distal:
anterior surface of medial border of scapula

43
Q

innervation of serratus anterior

A

long thoracic nerve

44
Q

main action of serratus anterior

A
  • protracts scapula and holds it against thoracic wall
  • rotates scapula
45
Q

proximal and distal attachment of trapezius

A

proximal:
- nuchal ligament
- spinous process of C7-T12 vertebrae
- medial third of superior nuchal line

distal:
lateral third of acromion, clavicle and spine of scapula

distal attachment of trapezius same as proximal attachment of deltoid

46
Q

innervation of trapezius

A

accessory nerve

47
Q

main action of trapezius

A

elevates, retracts, rotates scapula

48
Q

proximal and distal attachment of latissimus dorsi

A

proximal:
- last 3 ribs
- spinous process of T7-L5 vertebrae
- iliac crest

distal:
intertubercular sulcus of humerus

49
Q

innervation of latissimus dorsi

A

thoracodorsal nerve

50
Q

main action of latissimus dorsi

A

extends, adducts and medially rotates humerus at shoulder

51
Q

proximal and distal attachment of levator scapulae

A

proximal:
posterior tubercles of transverse process of C1-C4 vertebrae

distal:
medial border of scapula from superior angle to spine

52
Q

innervation of levator scapulae

A

dorsal scapular nerve, vental rami C3-C4

53
Q

main action of levator scapulae

A

elevates scapula medially

54
Q

proximal and distal attachment of rhomboid minor

A

proximal:
- nuchal ligament
- spinous process of C7-T1 vertebrae

didtal:
medial border of scapula at spine of scapula

55
Q

innervation of rhomboid minor

A

dorsal scapular nerve

56
Q

main action of rhomboid minor

A

fixes scapula to thoracic wall and retracts and rotates it to depress glenoid cavity

57
Q

proximal and distal attachment of rhomboid major

A

proximal:
spinous process of T2-T5 vertebrae

distal:
medial border of scapula below base of spine of scapula

58
Q

innervation of rhomboid major

A

dorsal scapular nerve

59
Q

main action of rhomboid major

A

fixes scapula to thoracic wall and retracts and rotates it to depress glenoid cavity

60
Q

proximal and distal attachment of deltoid

A

proximal:
lateral third of acromion, clavicle, spine of scapula

distal:
deltoid tuberosity of humerus

61
Q

innervation of deltoid

A

axillary nerve

62
Q

main action of deltoid

A

acromion: abducts arm
clavicle: flexes and medially rotates arm
spinal: extends and laterally rotates arm

63
Q

proximal and distal attachment of supraspinatus

A

proximal:
supraspinous fossa of scapula and deep fascia

distal:
superior facet of greater tubercle of humerus

64
Q

innervation of supraspinatus

A

suprascapular nerve

65
Q

main action of supraspinatus

A

initiates arm abduction, acts with rotator cuff muscles

66
Q

proximal and distal attachment of infraspinatus

A

proximal:
infraspinous fossa of scapula and deep fascia

distal:
middle facet of greater tubercle of humerus

67
Q

innervation of infraspinatus

A

suprascapular nerve

68
Q

main action of infraspinatus

A

lateral rotates arm

69
Q

proximal and distal attachment of teres minor

A

proximal:
middle part of lateral border of scapula

distal:
inferior facet of greater tubercle of humerus

70
Q

innervation of teres minor

A

axillary nerve

71
Q

main action of teres minor

A

lateral rotates arm

72
Q

proximal and distal attachment of teres major

A

proximal:
posterior surface of inferior angle of scapula

distal:
medial lip of intertubercular sulcus of humerus

73
Q

innervation of teres major

A

lower subscapular nerve

74
Q

main action of teres major

A

adducts and medially rotates arm

75
Q

proximal and distal attachment of subscapularis

A

proximal: subscapular fossa
distal: lesser tubercle of humerus

76
Q

innervation of subscapulaaris

A

lower and upper subscapular nerve

77
Q

main action of subscapularis

A

medially rotates arm

78
Q

what muscles are attached to intertubercular sulcus?

A

pectoralis major, latissimus dorsi, teres major

79
Q

what is scapular dyskinesis?
common causes?
muscles in resting position?

A

alternation of normal scapular kinematics

common causes:
- joints - AC instability, GH instability/ impingment
- muscles - lack of flexibility

muscles:
- tight pectoralis minor
- weak upper trapezius, levator scapulae, rhomboids

80
Q

positive dyskinesis test

A
  • wringing: prominence of medial border or inferior scapular angle
  • dysrhythmia: delayed/ premature motion, excessive or stuttering 結結巴巴的 motion of scapula during elevation
    .
81
Q

what is the space in deltoid (shoulder) region

A

quadrangular space

82
Q

borders and contents of deltoid (shoulder) region

border: superior, inferior, medial, lateral

A

borders:
superior: inferior border of teres minor
inferior: superior border of teres major
medial: long head of tricpes
lateral: surgical neck of humerus

contents:
axillary nerve
posterior circumflex humeral artery

83
Q

what is the space in scapular region

A

triangular space

84
Q

borders and content of scapular region

superior, inferior, lateral

A

borders:
superior: inferior border of teres minor
inferior: superior border of teres major
lateral: long head of triceps

content:
circumflex scapular artery