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4b shoulder joint Flashcards

(85 cards)

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1
Q

What type of joint is shoulder joint ?

A

ball & socket synovial joint

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2
Q

what gives the shoulder joint a wide range of movement at the cost of instability ?

A

head of humerus is much larger than the glenoid fossa (glenoid cavity )

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3
Q

shoulder joint has a ….. range of movements

A

wide

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4
Q

shoulder joint is most mobile and least stable meaning what ?

A

most mobile = has greatest range of all the joints

least stable = most commonly dislocated joint

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5
Q

acromion = palpable …

A

bony shelf above shoulder

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6
Q

caracoid process = palpable …

A

below the lateral clavicle

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7
Q

What are the close anatomical landmarks to where some of the rotator cuff muscles attach to ?

A

lesser and greater tubercles

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8
Q

Regional tenderness in the intertubercular (bicipital) groove indicates what ?

A

biceps tendon inflammation

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9
Q

Head of humerus attaches to what of the scapula ?

A

glenoid cavity

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10
Q

what is the shoulder joint also known as ?

A

glenohumeral joint

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11
Q

what is glenohumeral joint lined by ?

A

hyaline cartilage

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12
Q

what is glenoid cavity deepened by ? It is the fibrocartilaginous tissue within the glenoid cavity

A

glenoid labrum

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13
Q

Shoulder joint is inherently unstable what is this due to ?

A
  • shallow glenoid cavity
  • disproportion of articular surfaces
  • multiplanar movements
  • lax capsule (great mobility is permitted)
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14
Q

Stability of shoulder joint is achieved in 4 ways , which are what ?

A
  1. capsule
  2. ligaments (extracapsular + intracapsular)
  3. muscles of the rotator cuff
  4. other muscles
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15
Q

Shoulder capsule is attached to what ?

A
  • glenoid labrum & margins of glenoid cavity
  • anatomical neck of humerus
  • bridges intertubercular groove & dips down medially to surgical neck
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16
Q

In the shoulder joint what allows full abduction ?

A

bridges intertubercular groove & dips down medially to surgical neck

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17
Q

what does it mean by shoulder capsule bridges intertubercular groove ?

A

shoulder capsule attaches around area on humerus bone where tendon of long head of biceps muscle runs - help stabilise biceps tendon as it passes through the groove

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18
Q

[remove when content known] what does it mean by shoulder capsule dips down medially to the surgical neck ?

A

surgical neck is below the head of the humerus bone, arrangement of capsule dips allows for greater looseness in capsule particularly when fully abducted because abduction involves a significant amount of rotation and movement in the shoulder joint

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19
Q

Shoulder capsule is ..1.. but ..2… enough to allow movement

A
  1. tough
  2. lax (loose)
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20
Q

small opening anteriorly in shoulder capsule allows communication between where ?

A

synovial shoulder joint and subscapular bursa

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21
Q

1.

What is the purpose of the synovial membrane ?

A

line capsule and lines bone within capsule up to edge of articulating surfaces

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22
Q

Tendon of what muscles lies within the joint cavity ?

A

long head of biceps

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23
Q

What does the tendon acquire as it enters joint ?

A

tubular sleeve of synovium which surrounds the tendon up to its insertion on scapula

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24
Q

what does the gap in the capsule allow ?

A

synovium and joint cavity to be continuous with subscapular bursa

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25
what are the 4 extracapsular ligaments ?
* coracoacromial * coracohumeral * coracoclavicular * transverse humeral
26
location of coracoacromial ligament [most important ligament!]
between acromion and coracoid process
27
location of coracohumeral ligament
base of coracoid process to anterior part of greater tubercle
28
location of transverse humeral ligament
holds tendon of long head of biceps in place during shoulder movement
29
How can coracoclavicular ligament be torn ?
from AC joint dislocation
30
3 glenohumeral ligaments that are intracapsular ligaments
* superior * middle * inferior
31
Where do intrascapular ligaments extend between ?
glenoid labrum and humerus
32
what reinforces the capsule anteriorly ?
parts of fibrous capsule - can only be seen from inside the capsule
33
coracoacromial arch is formed by ?
coracoacromial ligament + acromion + coracoid process
34
What kind of structure is coracoacromial arch ?
strong bony and ligamentous
35
coracoacromial arch : 1. overlies .... 2. prevents... 3. clinically important in ...
1. humeral head 2. upper displacement 3. in painful Arc syndrome
36
What are the rotator cuff muscles ?
collective name given to 4 muscles closely associated with the shoulder joint
37
Name the rotator cuff muscles
SITS * Supraspinatus * Infraspinatus * teres minor * subscapularis
38
What are the most important structures that give stability to the joint ?
rotator cuff muscles
39
In rotator cuff muscles: * tendons ...1... to form a cuff * cuff fuses with ..2... and ...3.. it * ..4... in muscles holds humeral head close to ....5... cavity * supraspinatus tendon is separated from CAA (coracoacromial) by .....6...
1. blend 2. capsule 3. strengthens 4. tone 5. glenoid 6. subacromial bursa
40
Action of rotator cuff muscle: supraspinatus
initiation and first 15 degrees of abduction
41
Action of rotator cuff muscle: infraspinatus
lateral rotation of arm
42
Action of rotator cuff muscle: teres minor
lateral rotation of arm/ weak adductor
43
Action of rotator cuff muscle: subscapularis
medial rotation of arm
44
Nerve involved with supraspinatus
suprascapular nerve (C5,6)
45
Nerve involved with infraspinatus
suprascapular nerve (C5,6)
46
Nerve involved with teres minor
axillary nerve (C5,6)
47
Nerve involved with subscapularis
upper and lower subscapular nerve
48
What are the other muscles that act on the shoulder joint to stabilise it ?
1. deltoid 2. long head of biceps 3. long head of triceps
49
where does long head of biceps attach to ?
supraglenoid tubercle
50
where does long head of triceps attach to ?
infraglenoid tubercle
51
Which muscle can bring about all shoulder movements except adduction ?
deltoid
52
What does deltoid attach to ?
* lateral clavicle * acromion * scapula spine * humerus
53
What are the 6 pectoral girdle muscles ?
* trapezius * latissimus dorsi * levator scapulae * rhomboid minor & major * teres major
54
Function of trapezius muscle ?
elevates, retracts and depresses the scapula
55
Function of latissimus dorsi ?
extends, adducts and medially rotates humerus can raise the trunk to the arm e.g. dips. climbing
56
function of levator scapulae ?
elevates & rotates scapula
57
function of rhomboid minor & major
retract & fix position of scapula
58
function of teres major
adduction & medial rotation of humerus
59
What does subacromial bursa facilitate movement of ?
* supraspinatus tendon under CAA (coracoarcomial arch) * deltoid muscle over the shoulder joint capsule and greater tubercle of humerus
60
What is subacromial bursitis ?
inflammation of the subacromial bursa
61
What does subacromial bursitis cause ?
pain on adbuction of arm between 50 - 130 degrees 'painful arc' syndrome
62
what does subscapular bursa facilitate movement of ?
subscapularis tendon over scapula
63
subscapular bursa communicates with what ?
joint cavity
64
...?.. anterior protract scapula (reaching out) & holds it close to the thoracic wall
? = serratus anterior
65
Where does the serratus anterior attach to ?
ribs 1-8 and medial scapula border
66
Dislocation of glenohumeral joint is typically what ?
inferior & anterior
67
Dislocation of glenohumeral joint is clinically defined how ? why ?
as anterior dislocation -> humeral head locating anteriorly (pull of powerful adductors)
68
dislocation of glenohumeral joint is usually caused by ?
trauma on a fully abducted arm
69
humeral head comes to lie below what ?
coracoid process
70
capsule and rotator cuff may tear = poor healing leading to what ?
recurrent dislocation
71
anterior dislocation : * loss of ..1.. contour of shoulder -> appears ..2... * head of humerus lies ....3.. below ....4... process * arm supported by other hand (very ...5...)
1. round 2. square 3. anteriorly 4. coracoid 5. painful
72
when is axiallary nerve injured ?
* in dislocation * or fracture of surgical neck of humerus
73
2 main results of axillary nerve damage
* loss of sensation in 'regimental badge area' * motor function loss
74
The regimental badge area is an area over ....1.... & supplied by ..2... nerve (C ....3...)
1. central part of deltoid 2. axillary 3. C5, 6
75
Why is important to not test motor function loss as a result of axillary nerve damage ?
could cause incredible pain, more damage
76
what does it mean by motor loss as a result of axillary nerve damage ?
loss of deltoid muscle (no abduction of arm)
77
Problem of 'painful arc' syndrome
supraspinatus tendon rubbing under CAA (Coracoacromial Arch)
78
'Painful arc' syndrome leads to 3 things which are what ?
* Subacromial Bursitis (+/- calcification) * Supraspinatus Tendonitis (+/- calcification) * Degeneration and rupture of tendons
79
4 risk factors for painful arc syndrome
* reptitive overuse * ageing * avascularity of supraspinatus tendon * slight differences in anatomy = may increase chances of impingement (compression of soft tissue)
80
Example of repetitive overuse as a risk factor for painful arc syndrome
* Sports (racquet sports, climbing, swimming) * Work involving overhead use of arms
81
Why is agening a risk factor for painful arc syndrome ?
degenerative changes in tendons
82
causes of painful arc syndrome
irritation and inflammation of the supraspinatus tendon/subacromial bursa
83
Pain during when in painful arc syndrome ?
60-120 degrees of abduction arc
84
Why do symptoms of painful arc syndrome (pain during 60-120 degrees of abduction arc) happen ?
impingement (compression of soft tissue) of inflamed rotator cuff tendons, or inflamed subacromial bursa (between acromion and head of humerus)
85
Whcih ligaments can be ruptured by AC (acromioclavicular) joint dislocation ?
coracoclavicular ligaments

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