Anatomy Shoulder

Question 1

Name the four RTC tendons

Answer 1

Subscapularis lesser tubercle

Supraspinatus, infraspinatus and teres minor on greater tubercle

Question 2

Describe the motions the RTC have on the humerus

Answer 2

Subscap, Infraspinatus and Teres minor prevent superior migration
Subscap prevents anterior migration
Infraspinatus and teres minor prevent posterior migration; subscap prevents posterior migration at 90 degrees flexion

Question 3

Shoulder Resting position, CPP, capsular pattern

Answer 3

RP: 55 deg abduction; 30 deg HAD
CPP: full elevation and LR
Capsular pattern: LAM

Question 4

Shoulder innervation

Answer 4

Lateral pectoral nerve
Axillary nerve
Posterior cord of brachial plexus
Suprascapular nerve

Question 5

Superior Glenohumeral Ligament

Answer 5

Provides INFERIOR STABILITY with arm at side and with adduction
Limits ER up to 45 degrees abduction

Question 6

Middle Glenohumeral Ligament

Answer 6

Prevents anterior translation in adduction

Limits LR from 45-90 degrees abduction

Question 7

Inferior Glenohumeral Ligament

Answer 7

Supports humeral head > 90 degrees abduction; limiting inferior translation (anterior band tightens with LR; posterior band tightens with MR)
Excessive LR stretches anterior band, leading to GH jt laxity

Question 8

Coracohumeral ligament

Answer 8

• Tightens with frozen shoulder
• Primary restraint of long head of bicep
• Contributes to inferior stability of GH joint during adduction (PREVENTS CAUDAL DISLOCATION)
• Limits LR < 60 degrees abduction

Question 9

Coracoacromial Ligament

Answer 9

Forms arch over humeral head
Blocks superior translation
Associated with RTC pathology

Question 10

Transverse humeral ligament

Answer 10

holds biceps tendon (long head) within groove

Question 11

Rotator Interval

Answer 11

• Subscapularis
• Supraspinatus
• Superior glenohumeral ligament
• coracohumeral ligament
• Limits inferior translation and ER with arm adducted
• Limits posterior translation with arm flexed, adducted and IR

Question 12

AC joint
Resting Position
Closed Packed Position
Capsular Pattern

Answer 12

RP: arm at side
CPP: 90 degrees abduction
CP: pain at extreme ranges esp HAD and full elevation

Question 13

AC joint Innervation

Answer 13

Lateral Pectoral Nerve

Suprascapular Nerve

Question 14

Ligaments of AC joint

Answer 14

Acromioclavicular ligament (first ligament injured; constraint for posterior displacement and resists horizontal movement)
Coracoclavicular ligament (controls vertical stability - conoid and trapezoid)

Question 15

Conoid and Trapezoid ligaments

Answer 15

Conoid constrains anterior and superior rotation

Trapezoid ligament constrains horizontal and vertical displacement when clavicle moves in axial compression

Question 16

Step Deformity

Answer 16

CC and AC ligaments torn when seen at rest; accentuated with patient HAD arm or MR and bring hand up back as high as possible
Distal end of clavicle lying superior to acromion process

Question 17

Sternoclavicular Joint
Resting position
Capsular Pattern
Closed Packed Position

Answer 17

RP: arm at side
CPP: full elevation and protraction
CP: pain at extreme ROM especially HAD and full elevation

Question 18

SC joint innervation

Answer 18

Anterior supraclavicular

Nerve to subclavius

Question 19

SC joint ligaments

Answer 19

Sternoclavicular (posterior capsular ligament provides primary restraint)
Interclavicular ligament (resists inferior translation of clavicle)
Costoclavicular (main ligament maintaining integrity of joint)