Functional and clinical anatomy of the shoulder Flashcards

(37 cards)

1
Q

What are the 3 bones which make up the shoulder?

A
  1. Clavicle
  2. Humerus
  3. Scapula
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2
Q

What are the different regions of the proximal humerus?

A
  1. Head
  2. Anatomical neck
  3. Surgical neck
  4. Greater tubercle
  5. Inter-tubercular groove
  6. Lesser tubercle
  7. Deltoid tuberosity
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3
Q

What is the anatomical neck of the humerus?

A

The anatomical neck is where the proximal large globular head of the humerus meets the shaft

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4
Q

What is the functional importance of the anatomical neck?

A

The epiphysis is located here and so this is where growth occurs

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5
Q

What is the surgical neck of the humerus?

A

The most narrow part of the humerus

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6
Q

What is the clinical relevance of the surgical neck of the humerus?

A

Stresses are accumulated here when we fall and fractures are likely in this region, hence the name ‘surgical neck’

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7
Q

Which tendon passes through the inter-tubercular groove and where does this tendon insert?

A
  • Biceps long-head tendon

- Inserts onto the glenoid

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8
Q

What is the glenoid?

A

It is a shallow socket in the shoulder blade

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9
Q

Where does the humeral head rest?

A

In the glenoid

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10
Q

What is the labrum?

A

Soft fibro-cartilagenous ring that sits around the glenoid cavity

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11
Q

What is the role of the labrum?

A

It surrounds the glenoid (socket) and helps to stabilise the joint by deepening the socket

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12
Q

What is the importance of the deltoid tuberosity?

A

This is where the deltoid muscle inserts

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13
Q

What is sergeant’s stripes loss of sensation?

A

Surgical neck fracture impacts the axillary nerve which winds around the surgical neck and provides sensation over the shoulder tip (where the sergeant’s stripes would normally be)
- So there is loss of sensation and motor activity to the shoulder tip!

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14
Q

What are the coracoclavicular ligaments?

A

The trapezoid ligament (lateral)

The conoid ligament

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15
Q

What is the role of the coracoclavicular ligaments?

A

Connect the scapula to the trunk via the clavicle

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16
Q

Route of the coracoclavicular ligaments?

A

From the coracoid process to the clavicle

17
Q

How does the clavicle connect to the acromion of the scapula?

A

Via the acromioclavicular joint and the coracoacromial ligament

18
Q

What is the coracoacromial ligament?

A

The coracoacromial ligament is a strong triangular ligament between the coracoid process and the acromion

19
Q

What is the function of the coracoacromial ligament?

A

The function of the coracoclavicular ligament is to allow complex shoulder movement without separation of the scapula from the clavicle

20
Q

How does the shoulder attach to the body?

A

Via the clavicle

21
Q

The humerus attaches to the scapula, but how do the humerus and scapula connect to the main trunk?

A

Through the acromioclavicular joint and the sternoclavicular joint

22
Q

What are the most common movements of the shoulder-clavicle motion?

A
  1. Around the vertical axis: facing the glenoid anteriorly

2. Around the horizontal axis: facing the glenoid more supero-laterally

23
Q

What makes the shoulder joint unstable?

A

The glenoid cavity is very small compared to the area of the humeral head (ball)
- Ball = 4 x socket area

24
Q

How is the shoulder joint stabilised? Give specific examples

A

By ligaments which sit over the joint capsule, they deepen and support the joint superiorly, making up for the difference in area between ball and socket

  • Glenohumeral ligaments
  • Coracohumeral ligament
  • Coracoacromial ligament
25
What is the clinical relevance of the labrum?
We can suffer from labral tears which is often the cause for shoulder dislocations
26
What are the two different groups of muscles around the shoulder?
- Intrinsic vs extrinsic | - Those which connect the humerus to the scapula and those which connect the scapulo-humeral complex to the trunk
27
What are the different intrinsic muscles of the shoulder?
1. Deltoid 2. Teres major 3. Rotator cuff (teres minor, subscapularis, supraspinatous & infraspinatous)
28
What are the extrinsic muscles of the shoulder?
Superficial: trapezius, latissimus dorsi Deep: levator scapulae, rhomboids
29
What are the different muscles of the rotator cuff?
1. Supraspinatous 2. Infraspinatous 3. Subscapularis 4. Teres minor
30
Role of the rotator cuff muscles?
Control the position of the head in relation to the glenoid cavity - Maintain function of the joint during all its movements
31
Different shoulder movements?
1. Flexion 2. Extension 3. (internal) Medial rotation 4. (external) Lateral rotation 5. ABduction 6. ADDuction
32
What is a bursa?
Fluid filled bag which allows movement of the muscle and tendon in relative to the bone = MASSIVELY REDUCING FRICTION
33
Where are bursae found?
Between the supraspinatous muscle, tendon and acromial process (between skin and bone)
34
Clinical relevance of bursae?
Can become inflamed (SUPRASPINATOUS BURSITIS) making it difficult to abduct the arm = 'PAINFUL ARC' of abduction
35
What is the 'painful arc' of abduction? Explain how the arc of pain associates with structures found in the shoulder
When abducting the arm starts at a specific point and ends at a particular angle in the arc Posteriorly: - 45-60 degrees = glenohumeral painful arc - 170-180 degrees = acromioclavicular painful arc Anteriorly: - 60-120 degrees = subacromial painful arc
36
Give another cause of the painful arc of abduction?
Inflammation of the tendon rather than the bursa = SUPRASPINATOUS TENDINITIS
37
What is shoulder dislocation?
When the humeral head slips out of the glenoid fossa - When dislocation occurs, the short muscles around the shoulder (teres major, minor and infraspinatus) go into spasm and pull the humeral head medially