8 - Intro to Shoulder Complex

Question 1

What joints make up the shoulder complex?

Answer 1

Glenohumeral Joint
Acromioclavicular Joint
Sternoclavicular joint
Sapulothoracic complex

Question 2

True or false the GH joint is designed for mobility over stability?

Answer 2

True

Question 3

How many degrees of freedom does the GH joint have?

Answer 3

3

Question 4

What type of joint is it?

Answer 4

Synovial and Unmodified ovoid

Question 5

What fraction of the humeral head articulates with the glenoid fossa?

Answer 5

1/3

Question 6

What deepens the glenoid fossa?

Answer 6

The glenoid labrum

Question 7

What action gets pure spin at the GH joint?

Answer 7

Flexion/extension

Question 8

What action would give you superior roll plus inferior glide at the GH joint?

Answer 8

Abduction

Question 9

What action would give you inferior roll plus superior glide at the GH joint?

Answer 9

Adduction

Question 10

What action would give you anterior roll plus posterior glide?

Answer 10

Medial/Internal Rotation

Question 11

What action would give you posterior roll plus anterior glide at the GH joint

Answer 11

Lateral/External Rotation

Question 12

In what order would you start to lose the following movements. Internal rotation, external rotation and abduction

Answer 12

ER then abduction then IR

Question 13

What is the function of the coracohumeral ligament?

Answer 13

To limit ER below 60 degees abduction
Works with the superior glenohumeral ligament
Provides restraint for flex/ext
Is a tunnel for the biceps

Question 14

What is the function of the superior glenohumeral ligament?

Answer 14

Limits inferior translation in the adducted arm
Limits ER from 0-45 degrees abduction
Put on stretch with biceps during throwing

Question 15

What is the function of the middle glenohumeral ligament?

Answer 15

Anterior stability at 45 degrees abduction
Anterior stability at 90 degrees abduction
Inferior stability in adduction and ER

Question 16

What is the function of the inferior glenohumeral ligament?

Answer 16

Primary restraint to all movements anterior, posterior and inferior with the arm abducted beyond 45 degrees

Question 17

How does the supraspinatus contribute to dynamic stability?

Answer 17

It facilitates GH compression maximally between 45 and 90 degrees and is gone at 150 degrees

Question 18

How do infraspinatus and teres minor contribute to dynamic stability?

Answer 18

They are humeral head depressors. They allow supraspinatus to compress and prevent subacromial compression
They are also external/lateral rotators and eccentrically decelerate internal/medial rotation

Question 19

How does subscapularis contribute to dynamic stability?

Answer 19

It is active in all movements of the humerus that require compression and depression
Acts eccentrically to decelerate external rotation

Question 20

How does the long head of biceps contribue to GH joint dynamic stability?

Answer 20

It increases GH compression with supraspinatus
Applies longitudinal compressive force during deceleration activities
It increases anterior stability in abduction/external rotation by resisting translational stress

Question 21

What is the primary force couple of scapular lateral rotation?

Answer 21

Upper fibers of traps and seratus anterior

Question 22

How does the UFT and serratus anterior force couple work?

Answer 22

UFT pull the spine of the scapula up and serratus anterior pulls the medial border and inferior angle laterally
This is all in the initial stages of shoulder flexion (0-90 degrees)

Question 23

What muscle helps with lateral rotation of the scapula after 90 degrees of shoulder flexion?

Answer 23

The lower fibers of traps

Question 24

In terms of location of pain where is it typically felt when there is a shoulder dysfunction?

Answer 24

On the lateral aspect of the upper arm (common around the deltoid insertion)

Question 25

Where would acromioclavicular pain be felt?

Answer 25

On the anterior aspect of the upper arm

Question 26

Where is C-spine pain typically felt?

Answer 26

neck, upper shoulder and scapula

Question 27

What does the ending "itis" mean?

Answer 27

Inflammation

Question 28

What does the ending "opathy" mean?

Answer 28

any pathology

Question 29

What does the ending "osis" mean?

Answer 29

degenerative over time

Question 30

True or false: acromioclavicular pain is evident above 90 degrees abduction?

Answer 30

True

Question 31

In what age range are you most likely to see frozen shoulder/ adhesive capsulitis?

Answer 31

45-60

Question 32

In what age population are you most likely to see rotator cuff degeneration?

Answer 32

40-60

Question 33

In what age are you most likely to see or suspect a chondrosarcoma

Answer 33

30+

Question 34

In what age range are you likely to see or suspect calcium deposition?

Answer 34

20-40

Question 35

In what population are you likely to suspect GH instability?

Answer 35

15-20

Question 36

If someone gets relief with placing their hands on their head what type of pain might it indicate?

Answer 36

Nerve root pain

Question 37

If someone's arm is fixed in a forward flexion and slight abduction position what might you suspect?

Answer 37

Anterior GH dislocation

Question 38

If someone's arm is fixed in an internal rotation and abduction position what might you suspect?

Answer 38

Posterior GH dislocation

Question 39

What are some indicators od nerve injury?

Answer 39

History of weakness, numbness or paresthesia | Positive test findings when testing the muscle supplied by the nerve

Question 40

What organs can refer pain to the shoulder/upper arm area?

Answer 40

Liver Gallbladder (inferior angle on R side) Heart (left anterior upper arm) Diaphragm (upper traps, referral to C3-4 dermatome)

Question 41

What could be some sources of static scapula winging?

Answer 41

Weak muscles (LFT) or having another muscle be tight (peck minor) Paralyzed SA Damage to Long Thoracic Nerve Instability of medial border to remain against chest wall

Question 42

What is a sulcus sign?

Answer 42

A divit or sulcus in the shoulder which could indicate an anterior or inferior dislocation or just having general laxity at the shoulder

Question 43

What does a step deformity indicate?

Answer 43

AC sprain | The traps pull up and the weight of the arm pulls downward giving a step down look

Question 44

What is the painful arc of shoulder movement?

Answer 44

Occurs between 60-120 degrees when the bursa gets impinged under the aromian