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S3- Musculoskeletal > iRA/tRA- Shoulder Complex Anatomy and Kinematics Review > Flashcards

iRA/tRA- Shoulder Complex Anatomy and Kinematics Review Flashcards

1
Q

The scapula lies in a plane ___ degrees to the back, and __ degrees to the clavicle. It extends from the _nd to _th rib.

A
  • 30 degrees, 60 degrees

- 2nd and 7th

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2
Q

The superior angle of the scapula corresponds to T_ spinous process and the medial lip of the spine corresponds to T_ spinous process.

A
  • T1

- T3

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3
Q

What are the 3 morphologies of the acromion?

A
  • Type I: Flat
  • Type II: Curved
  • Type III: Hooked
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4
Q

Type __ acromion is a negative prognostic factor for conservative management, while Type __ acromion is a good prognostic indicator for conservative management.

A
  • Type III (hooked)

- Type I (flat)

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5
Q

What type of acromion has the greatest correlation with subacromial impingement syndrome?

A

Type III (hooked)

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6
Q

What are the 3 ligaments of the scapula?

A
  • Coracoacromial ligament
  • Superior Transverse Scapular ligament
  • Inferior Transverse Scapular ligament
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7
Q

The coracoacromial ligament is a strong triangular band with a ____________ deep to this to allow movement of deeper supraspinatus tendon.

A

subacromial bursa

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8
Q

The superior transverse scapular ligament completes the scapular ______ to make foramen.

A

notch

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9
Q

The inferior transverse scapular ligament arches over the _________ nerve.

A

suprascapular

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10
Q
  • What is the glenoid labrum?

- What does the glenoid labrum do?

A
  • Ring of fibrocartilage attached to the margin of the glenoid fossa.
  • Deepens the glenoid cavity for congruency of articular surfaces.
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11
Q

For the Glenohumeral Joint (GHJ), the head of the humerus faces superiorly, medially, and _________.

A

posteriorly

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12
Q

The angle of inclination of the GHJ is ____ degrees and ___ degrees of retroversion.

A
  • 135 degrees

- 30 degrees

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13
Q

The GHJ capsule is weakest where?

A

Over the anterior aspect of the capsule between the bands of the glenohumeral ligament.

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14
Q

What does the coraco-humeral ligament connect?

A

corocoid process to greater tuberosity

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15
Q
  • How many bands of the GH ligament are there?

- The GH ligament is taut in __ and slackened in __.

A
  • 3 (superior, middle, inferior)

- ER, IR

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16
Q

When we are positioned in 90 degrees of abduction there is a tightening of the ______ and ______ fibers of the GH ligament. The _______ GH ligament resists anterior and posterior humeral head translation by cupping the joint.

A
  • middle and inferior

- inferior

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17
Q

The scapulothoracic joint is a _____ joint between the scapula and thoracic wall.

A

false

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18
Q

The clavicle is ______ shaped (convex medial 2/3s, concave lateral 1/3). It transmits UE weight to ______.

A
  • sigmoid

- axial skeleton

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19
Q

How do females clavicles differ from males?

A

Shorter, thinner, less curved, smoother, acromial end lower than sternal end.

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20
Q

What are the 3 parts of the sternum?

A
  • Manubrium
  • Mesosternum (body)
  • Xiphoid process
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21
Q

The sternoclavicular (SC) joint is _______ shaped and is divided by a ________.

A
  • saddle

- meniscus

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22
Q

What are the articulating surfaces of the SC joint?

A
  • Sternum
  • Clavicle
  • Superior surface of 1st costal cartilage
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23
Q

What are the stabilizing ligaments of the SC joint?

A
  • Anterior SC joint
  • Posterior SC joint
  • Interclavicular ligament
  • Costoclavicular ligament
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24
Q

The SC joint has two axes. The first corresponds to the ________ sternocostal on _____ clavicular, allowing movement of the clavicle in the vertical plane. The second corresponds to the ________ sternocostal on _________ clavicular, allowing movement of the clavicle in the horizontal plane.

A
  • concave, convex

- convex, concave

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25
Q

The SC joint also undergoes axial rotation of ___ degrees.

A

30

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26
Q

The acromioclavicular joint is a _____ joint and is subject to dislocation, why?

A
  • plane

- absence of interlocking articular surfaces, weakness of ligaments

27
Q

The acromion has a slightly _______ surface facing _____________. The clavicular surface faces inferior, _________, and laterally.

A
  • convex, anteriomedially

- posteriorly

28
Q

What are 2 extra-articular ligaments that support the AC joint?

A
  • Conoid ligament

- Trapezoid ligament

29
Q

What is the resting position of the GHJ?

A

55 degrees abduction, 30 degrees horizontal adduction, slight ER

30
Q

What is the close-packed position of the GHJ?

A

Max abduction and ER

31
Q

What is the close-packed position of the SCJ?

A

Full elevation

32
Q

What is the close-packed position of the ACJ?

A

90 degrees abduction

33
Q

What are the boundaries of the quadrilateral space?

A
  • Teres major
  • Teres minor
  • Long head of triceps
  • Surgical neck of humerus
34
Q

What are the contents of the quadrilateral space?

A
  • Axillary nerve

- Posterior circumflex humeral artery

35
Q

What motions can close the quadrilateral space down?

A
  • Extension
  • Abduction
  • ER
36
Q

What is the rotator cuff interval?

A
  • Triangular portion of glenohumeral capsule that lies between the supraspinatus and subscapularis tendons.
  • Reinforced by superior glenohumeral and coracohumeral ligaments.
  • Adhesions in this area with adhesive capsulitis, causes anterior seating of humeral head.
37
Q

Adhesions in the rotator cuff interval with adhesive capsulitis causes ________ seating of the humeral head.

A

anterior

38
Q

The biceps pulley is a tendoligamentous sling formed by what structures?

A
  • Superior GH ligament
  • Coracohumeral ligament
  • Distal attachment of the subscapularis tendon
39
Q

What does the biceps pulley do?

A

Stabilizes the long head of the biceps in the bicipital groove.

40
Q

SHOULDER COMPLEX MUSCULATURE

A

SHOULDER COMPLEX MUSCULATURE

41
Q

What are the muscles of the rotator cuff?

A
  • Supraspinatus
  • Infraspinatus
  • Teres minor
  • Subscapularis
42
Q

The rotator cuff is the primary ___________ of the GH joint. It can provide _____ stability in response to external __________.

A
  • stabilizer
  • rapid
  • perturbation
43
Q

What are other muscles that act on the shoulder complex?

A
  • Teres Major
  • Deltoid
  • Trapezius
  • Biceps Brachii
  • Coracobrachialis
  • Pectoralis Major and Minor
  • Latissimus Dorsi
  • Rhomboid Major and Minor
  • Serratus Anterior
  • Levator Scapulae
  • Triceps Brachii
44
Q

KINEMATICS

A

KINEMATICS

45
Q

During elevation, what motions should occur at the scapula? What muscles are involved?

A
  • Upward rotation (upper trap, lower trap, serratus anterior)
  • Posterior tilting (serratus anterior)
  • Internal rotation
46
Q
  • There is a : ratio of GH:Scapular motion during shoulder abduction.
  • With shoulder abduction, we get a contralateral thoracic spine _____________.
A
  • 2:1

- lateral flexion

47
Q

Describe the 3 phases of shoulder abduction:

Phase I (0°-60°)

  • ________ and ___________
  • “Locking” at 90° from greater tuberosity impacting superior margin of glenoid; lateral ________ and __________ of the humerus to delay lock.

Phase II (60°-120°)

  • 60° rotation of scapula to orient glenoid superior and anterior, axial rotation of ___ and ____ joints
  • _________ (upper and lower) and _______________
  • Checked by _________________ and inferior ___________

Phase III (120°-180°)

  • Lateral flexion of _______
  • ________, ________, inferior ________, and _____________ elevate UE
A
  • deltoid and supraspinatus
  • rotation and flexion
  • AC and SC
  • trapezuis and serratus anterior
  • latissimus dorsi and inferior pec minor
  • T-spine
  • deltoid, supraspinatus, inferior trapezius, serratus anterior
48
Q

Describe the 3 phases of shoulder flexion:

A

1

49
Q

The rhomboids and possibly levator scap are innervated by the ___________ nerve at root C_.

A
  • dorsal scapular nerve

- C5

50
Q

The serratus anterior is innervated by the __________ nerve at root C_,C_, and C_*.

A
  • long thoracic

- C5, C6, and C7*

51
Q

The subclavius is innervated by the _____________ at root C_ and C_.

A
  • nerve to subclavius

- C5 and C6

52
Q

The supraspinatus and infraspinatus are innervated by the _________ nerve at root C_ and C_.

A
  • suprascapular

- C5 and C6

53
Q

The long thoracic nerve innervates the serratus anterior which is essential for what?

A

Keeping the scapula stable on the thorax (winged scapula)

54
Q

The pec major and pec minor are innervated by both the __________ nerve (C_, C_, C_) and ____________ nerve (C_, T_).

A
  • lateral pectoral nerve (C5, C6, C7)

- medial pectoral nerve (C8, T1)

55
Q

The upper subscapularis is innervated by the _____________ nerve at root C_ and C_.

A
  • upper subscapular nerve

- C5 and C6

56
Q

The lower subscapularis and teres major are innervated by the _____________ nerve at root C_ and C_.

A
  • lower subscapular nerve

- C5 and C6

57
Q

The latissimus dorsi is innervated by the ____________ nerve at root C_-C_.

A
  • thoracodorsal nerve

- C6-C8

58
Q

The deltoid and teres minor are innervated by the ________ nerve at root C_ and C_. The nerve also has a sensory distribution to where?

A
  • axillary nerve
  • C5 and C6
  • lateral proximal upper arm
59
Q

The triceps is innervated by the _______ nerve at root C_-T_. The nerve also has a sensory distribution to where?

A
  • radial nerve
  • C5-T1
  • posterior aspect of digits 1-3 and lateral half of digit 4
60
Q

The extensors of the wrist and long extensors of the fingers are innervated by the __________ nerve at root C_ and C_.

A
  • posterior interosseous nerve

- C7 and C8

61
Q

The coracobrachialis, biceps, and brachialis are innervated by the __________ nerve at root C_-C_. The nerve also has a sensory distribution to where?

A
  • musculocutaneous nerve
  • C5-C7
  • lateral cutaneous nerve of forearm
62
Q

The wrist flexors, thenar muscles, and radial lumbricals are innervated by the ________ nerve at root C_-T_. The nerve also has a sensory distribution to where?

A
  • median nereve
  • C6-T1
  • palmar lateral hand and digits 1-3 and radial 4th digit
63
Q

The ____________ nerve is a branch of the median nerve from roots C_ and C_ that innervates the pronator quadratus, FDP, and FPL.

A

-anterior interosseous nerve

64
Q

The FCU and FDP (medial hald) are innervated by the ________ nerve at root C_-T_. The nerve also has a sensory distribution to where?

A
  • ulnar nerve

- dorsal cutaneous branch (palmar digit 5 and medial half of digit 4)

S3- Musculoskeletal (27 decks)

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