Ch 16

Question 1

what is the only attachment site for the shoulder?

Answer 1

the SC joint

Question 2

plan of scapula

Answer 2

provides a more functional arc for motion than the cardinal sagittal or frontal planes

Question 3

what is the last growth plate to close

Answer 3

the medial clavicular epiphysis is the last growth plate to close at the age of 25.

Question 4

angle of inclination is what

Answer 4

is the relationship between the shaft of the humerus and the humeral head in the frontal plane normally 130 to 150 degrees.

Question 5

angle of torsion is what

Answer 5

is the relationship between the shaft of the humerus and the humeral head

Question 6

the AC joint

Answer 6

i sa plane synovial join allows a gliding articulation between the acriomion and the clavicle capable of 3 degrees of freedom of movement each around an oblique axis internal and external rotation and upward and downward rotation around an axis perpendicular to the plane of scapula anterior and posterior scapula tipping around the horizontal axis.

Supported by the ac ligament and the oraoclavicular ligament.

Question 7

external rotation in 0 degrees of abduction

Answer 7

ligaments limiting movement is: superior GH ligament coracohumeral ligament

Question 8

external rotation in 45 degrees of abduction

Answer 8

middle gh ligament, anterior band of the inferior Gh ligament

Question 9

external rotation in 90 degrees of abduction

Answer 9

posterior band of the inferior gh ligament

Question 10

internal rotation in 90 degrees of abduction `

Answer 10

superior gh ligament and the coracohumeral ligament

Question 11

inferior displacement in 90 degrees of abduction

Answer 11

inferior gh ligament

Question 12

subscapularis muscle

Answer 12

is the only member of the rotator cuff group that internally rotates the humerus

Question 13

what is the ratio between the gh and the scapulothoracic articulation

Answer 13

two to one ratio is found between GH elevation and upward scapula rotation.

Question 14

phases of the pitching motion

Answer 14

wind-up: gh neutral, low joint stresses elbow some degrees of flexion, concentric muscle contration muscular forces mostly generated by the lower extremity

cocking: 90 abduction, external rotation

acceleration 90 abduction moving to internal rotation

deceleration: 90 abduction internal rotation

follow through: horizontal abduction internal rotation decreasing abduction

Question 15

sprengle’s deformity

Answer 15

a congentitally undescended scapula, may occur on one scapula or both.

Question 16

what is the strength ratio of internal to external rotator

Answer 16

for oncentric contraction is 3:2 and for eccentric contraction os 3:4.

Question 17

what is the easies way to determine should rom

Answer 17

apley’s scratch test.

Question 18

apley’s scratch test has 3 components

Answer 18

flexion and extension, abduction and adduction, and internal and external rotation.

Question 19

sternoclavicular joint sprains

Answer 19

injuries usually occur from a longitudinal force being placed on the clavicle. this mechanism cmmonly occurs by folling on an outstretched arm or from a force bing placed on the lateral portion of the shoulder.

Question 20

posterior SC dislocation is ?

Answer 20

this is treated as a medical emmergency because of the potential to harm the sublavian arteries, esophagus, trachea, and veins.

Question 21

sternoclavicular joint injury

Answer 21

onset is acute, pain is limited to the sc joint area pain is increased with any should motion that causes motion at the sc joint, presure on the underlying neurovascular network can cause paresthesia.

inspection dislocation are marked by displacement of the clavicular head anterior superiorly or posteriorly. palpation obvious joint displacement is often felt. pain over the sc joint
AROM: increases pain with flexion and abduction
PROM increased pain with flex, abd and horizontal and
MMT: isometric testing should not be painful
stres testing should perform deformity

Question 22

acromioclavicular joint sprains

Answer 22

acute localized pain at the ac joint possibly including the upper trap and uper scaula. falling on a pint of the shoulder landing on the ac joint or FOOSH.
AROM: pain with elevation of the humerus and during protraction and retraction. MMT: decreased stregth and pain for all muscles attachments on the acromion or clavicle PROM: pain produced during elevation of the humerus increased pain with horizontal abduction

Question 23

acromioclavicular joint pathology

Answer 23

commonly referred to as a separated shoulder . rupture of these ligaments results in instability or dislocation of the joint therefor these rutures are more correctly reffered toas sprains

Question 24

piano key sign

Answer 24

is a bob of the clavicle vertically with the distal clavicle depressing and elevating with manual palpation indicting trauma to the coracolclavicluar ligament.

Question 25

bankart lesion

Answer 25

is a tear of the gh ligament avulsed from the labrum or from the portion of the labrum. this is a difficult thing to identify clinically.

Question 26

hill-sachs lesion

Answer 26

a defect in the posterior humeral head articular cartilage caused by impact of the humeral head on the glenoid fossa as the humerus attempt to relocate.

Question 27

reverse hill-sahs lesion

Answer 27

are lesions found on the anterior portion of the humeral head after a posterior dislocation

Question 28

impingement

Answer 28

if left untreated continued internal impingement forces magnified by throwing will result in a slap lesion.

Question 29

impingement syndrome

Answer 29

insidious, pain is beneath the acromion process and ratiating to the lateral arm patient may complain of popping and clicking depending on involvement of bursa and rotator cuff musculature.

Inspection: the shoulder may be postured for comort by holding the arm in slight abduction and avoiding overhead arm motions palpation: tendernes exists beneatht he ac and greater tuberosity

AROM: active abduction in an arc of motion
MMT: elevation in play of scapula and external rotation.
PROM: internal impingement: excesive external rotation limited internal rotation
special test: neer and hawkins are positive

Question 30

subacromial bursitis

Answer 30

chronic rotator cuff impingement or rotator tears lead to inflammation of the bursa

Question 31

SLAP lesions

Answer 31

are tears of the superior aspect of the gleniod lebrun that extend anteriorly and posteriorly to the biceps insertion.

Question 32

rotator cuff tendinopathy

Answer 32

insidious or acute pain deep in the shoulder beneath the acromion process. clicking during gh motions AROM: pain between 70 and 120, MMT: pain and or weakness with abduction internal rotation externa rotation and elevation PROM: ecreased pain compared to atom except in positions of impingement. Stress test done to rule out GH and AC laxity. joint play to assess for hyper or hypo mobility special test drop arm test impingement test may be positive.

Question 33

SLAP lesions exam findings

Answer 33

acutor or resulting from micro trauma pain in the anteroposterio portion of the shoulder landing on FOOSH, glenohumeral instability, overhead motions forward shoulder posture AROM: limited internal rotation and horizontal adduction MMT: pain with shoulder and elbow flexion, PROM: limited horizontal adduction limited internal rotation special tests: active compression test, anterior slide test, compression-rotation test

Question 34

ac join sprains

Answer 34

stabilize in the position that lessens pain