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Flashcards in 15 - Shoulder Joint Deck (63)
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1

Label the following diagram.

2

What are the three different joints of the scapula?

- Glenohumeral (shoulder)

- Acromioclavicular

- Scapulothoracic

3

What muscles insert and originate from the scapula coracoid process?

Insert: Pec minor and coracobrachialis 

 

Origin: Short head biceps brachii

4

What are the important bony landmarks of the lateral surface of the scapula?

- Glenoid fossa: head of humerus articulates here with glenoid lavbrum 

 

- Supraglenoid tubercle: site of origin of long head of biceps

 

- Infraglenoid tubercle: site of origin of long head triceps

5

Where is the anatomical neck of the humerus?

Between the head of the humerus and the tubercles

6

Label the different bony landmarks of the humerus.

7

How do fractured scapulas occur and what is the best way to treat them?

- Rare

- Severe chest trauma, e.g high speed road collisions, crushing injuries

- Tone of muscles surrounding holds fragments in place whilst healing occurs so no fixation needed

8

Label this AP x-ray of the shoulder joint.

9

What factors are responsible for the mobility and stability of the shoulder joint?

Mobility: (makes unstable) 

- Shallow glenoid fossa

- Lax capsule

- Disproportion of articular surfaces

 

Stability:

- Muscles of rotator and others

- Ligaments

- Capsule

10

What is the function of the clavicle and where does it attach to?

- Attach upper limb to trunk as part of shoulder girdle

- Protect underlying neurovascular to upper limb 

- Transmit force from upper limb to axial skeleton

11

Label the important bony landmarks of the clavicle and state what each end articulates with.

- Long S bone 

- Medial aspect convex anteriorly, lateral is concave 

12

What is the coracoclavicular ligament?

TWO PARTS - suspending weight of upper limb from clavicle

- Conoid tubercle: conoid ligament, medial coracoclavicular ligament

 

- Trapezoid line:  trapezoid ligament, lateral coracoclavicular ligament

13

What muscles and ligaments originate or insert onto the clavicle?

- Deltoid 

- Trapezius 

- Subclavis 

- Pec maior 

- Sternocleidomastoid 

- Sternohyoid

14

What type of joint is the acromioclavicular joint and what makes it atypical?

- Plane type synovial 

- Palpated 2-3cm medially from tip of shoulder

- Articular surface lined with fibrocartilage not hyaline

- Joint cavity partially divided by articular fibrocartilage disc

15

Where is the joint capsule of the acromioclavicular joint?

- Loose fibrous layer that gives rise to articular disc 

- Lined internally by synovial membrane 

- Posterior aspect of joint reinforced by trapezius fibres

16

What are the ligaments of the acromioclavicular joint?

Intrinsic: Acromioclavicular ligament superiorly 

 

Extrinsic: Conoid and trapezoid ligament

17

What movement occurs at the acromioclavicular joint?

- Small degree of axial rotation and anteroposterior movement

- Passive movement as no muscles cross it

18

What type of joint is the sternoclavicular joint?

- Saddle type synovial 

- Manubrium of sternum, clavicle and upper medial first costal cartilage

-Only attachment of upper limb to skeleton so strong

- Fibrocartilage lining not hyaline and articular disc

19

Why is there an articular disc in the sternoclavicular joint?

Allows clavicle and manubrium to slide over each other more freeling allowing rotation in 3 axes rather than 2 like a normal saddle

20

What are the possible movements of the shoulder that require the sternoclavicular joint to move too?

- Elevation of shoulder joint (e.g shrugging shoulders or abducting arm over 90)

- Depression of shoulders

- Protraction/Retraction of shoulder

- Rotation (e.g arm over head)

21

Label this diagram of the proximal humerus and state what passes through the intertubercular sulcus?

- Tendon of the long head of biceps brachii 

- Edges of the groove are know as the lips and different muscles insert onto them, see on diagram

 

A LADY BETWEEN TWO MAJORS

22

What is the danger of fracturing the surgical neck of the humerus?

- Blund trauma to shoulder from falling on outstretched hand

- Axillary nerve and circumflex humeral vessels in close proximity 

- Nerve damage results in paralysis of deltoid and teres minor so hard to abduct limb. Will also have loss of sensation of regimental badge area over deltoid

23

What is being pointed to here on the humerus and what is it the landmark for?

- Radial groove

- Radial nerve and profunda brachii artery lie in this groove 

24

What muscles attach to the humeral shaft and where?

Posteriorly: Lateral and medial head of triceps, with spiral groove between 

Anteriorly: Corachobrachialis, deltoid, brachioradialis, brachialis

25

What defines whether a muscle is intrinsic or extrinsic in the shoulder?

Extrinsic: Originate from torso and insert onto bones of shoulder (humerus, clavicle, scapula) 

 

Intrinsic: Originate from scapula and/or clavicle and insert onto the humerus

26

What are the extrinsic muscles of the shoulder?

All on back of the trunk and organised into two layers

27

What are the superficial extrinsic muscles of the shoulder, their innervation, their origin/insertion and their actions?

28

What are the deep extrinsic muscles of the shoulder, their innervation, their origin/insertion and their actions?

29

How do you test the trapezius muscle?

Ask patient to shrug shoulders whilst you push down on them

30

What are the intrinsic muscles of the shoulder? (scapulohumeral group)

- 4 rotator cuff muscles 

- Deltoid 

- Teres Major