Week 8 Masterclass Flashcards
What are the 4 joints in the shoulder
Glenohumeral
Acromioclavicular
Sternoclavicular
Scapulathoracic
During elevation, how does the clavicle move
Rolls and moves inferiorly on the sternum
During depression, how does the clavicle move
Rolls and moves superiorly on the sternum
During retraction, how does the clavicle move
Rolls and moves posteriorly on the sternum
During shoulder flexion, how does the scapula move
Scapula posteriorly tilts
During shoulder extension, how does the scapula move
Scapula anteriorly tilts
During shoulder abduction, how does the head of humerus move
Slides inferiorly due to pressure from the rotator cuff
During shoulder adduction, how does the head of humerus move
Slides superiorly
During ext and ER, how does the head of humerus move
slides anteriorly
During flex and IR, how does the head of humerus move
Slides posteriorly
How does the humerus and scapula work together to extend the glenohumeral joint
Humeral head slides anteriorly
Scapula tilts anteriorly
What muscle keeps the head of the humerus compressed onto the glenod
Supraspinatus
What is the role of the supraspinatus in the glenohumeral joint
keeps the head of the humerus compressed onto the glenod
What would happen if the supraspinatus tears
The head of the humerus will rise during and as there is no force keeping it down
What muscles in the rotator cuff ER and abd
Supraspinatus
What muscles in the rotator cuff ER and add
Infraspinatus and Teres minor
What muscles in the rotator cuff IR
Subscapularis
What is scapulohumeral rhythm
2 degrees of abd = 1 deg of scapula upward rotation
If the humerus is abducted at 40deg, how much upward rotation is seen in the scapula
20 degrees
What is winging of the scapula
The scapular rises too early (scapula doesn’t rise in the first 30deg of abd)
In a relaxed stance, how should the clavicle sit
relatively level from the sternum to shoulder
What does it mean if someones clavicle is sloped downwards
Excessive activation of levator scapulae and rhomboids
What does it mean is someones clavicle is sloped upwards
Excessive activation of upper traps
In upward rotation of the scapula, what are the 3 muscles that assist in the movement
Upper Traps
serratus anterior
Lower part of traps
In downward rotation of the scapula, what are the 3 muscles and actions that assist in the movement
Levator Scapulae
Rhomboids
Pectoralis Minor
What causes SLAP lesions in the shoulder
Repetitive rotation e.g swimming, tennis etc.
Shoulder pain prognosis
Not particularly favourable. Only 40-60% will recover within 12 months
What type of shoulder injury are people under 40 more likely to present with
Glenohumeral instability
What type of shoulder injury are older people more likely to present with
Reduced space in the subacromial space
If someone hears a pop when moving their arm overhead and now struggles to abd, what is likely the injury
Proximal bicep tendon tear (long head)
In someone who has frozen shoulder, how might they move
Cant move glenohumeral joint, only scapula. To abd arm they shift their entire body
Is frozen shoulder a muscular or structural injury? what does this mean for PROM and AROM
Structural
PROM = AROM
What age demographic of people are more likely to have frozen shoulder? Why?
45+
Increased inflammatory markers
What causes frozen shoulder
Inflammation and thickening of ligaments and capsule
Impairments of frozen shoulder
Decreased abd and ER ROM
Night pain
If someone is suspected to have frozen shoulder, why should they get an x-ray
To rule out OA
What type/grade of AC joint injury would have a step deformity present
Type 3
Type 1-2 AC joint injury prognosis
4-6 weeks
When should an AC joint is sent for Xray and what is being searched for
When there is a step deformity (type 3) and used to rule out clavicle fracture
When should surgery be used to treat AC joint injury
If AC joint is type 3 (step deformity) it should be suggested
Type 4+ surgery is required
Is surgery beneficial for AC joint injury
Yes and no. It is likely that they will not 100% restore function after conservative treatment or surgery
What is a SLAP tear in the shoulder
Bicep tendon tears labrum
What does SLAP stand for in the shoulder complex
Superior
Labral tear from
Anterior to
Posterior
MOI Slap tear
Trauma: Fall onto the point of the shoulder or fall onto an outstretched arm with shoulder adducted or flexed
Insidious: Excessive superior translation of the humeral head on the glenoid rim due to insufficient control by the rotator cuff muscles during repetitive overhead activities (e.g tennis serve, swimming, water polo)
Differential diagnosis between AC sprain and SLAP tear
Step deformity in AC joint
Pain location (deep in the shoulder vs pain on palpation)
Pain in overhead movements (SLAP)
