Shoulder

Question 2

What are the 4 joints of the shoulder

Answer 2

Glenohumeral, acromioclavicular, sternoclavicular, scapulothoracic

Question 3

Glenohumeral joint classification

Answer 3

Synovial, simple, unmodified

Question 4

Glenohumeral joint degrees of motion

Answer 4

3

Question 5

Glenohumeral joint line of reference

Answer 5

Transverse axis through the centre of the head of the humerus

Question 6

Glenohumeral joint flexion/extension osteokinematics

Answer 6

Pure spine about a transverse axis (through the centre of the head of the humerus) in a sagittal plane (from 35d ext to 55d flex). ROM = 90-110d flex, 60d ext.

Question 7

Glenohumeral joint abduction/adduction osteokinematics.

Answer 7

Pure swing about a sagittal axis in a frontal plane. ROM = 80-90d abduct.

Question 8

Glenohumeral joint IR/ER osteokinematics.

Answer 8

Pure swing until EOR about a vertical axis (superoinferior axis through the humerus) in a transverse plane. ROM = 70-90d IR, 60-100d ER.

Question 9

Do the arthrokinematics of the glenohumeral joint follow the concave/convex rule?

Answer 9

No, the path of the articular glide is influenced by regional capsular tension which imposes articular translation during movement. In the inner ranges = minimal capsular tension and translation, whilst outer range = increased capsular tension and translation.

Question 10

Glenohumeral joint arthrokinematics flexion

Answer 10

Spin mid range = no translation. Flex > 55d = slight anterior translation

Question 11

Glenohumeral joint arthrokinematics extension

Answer 11

Spin mid range = no translation. Extension beyong 35d = slight posterior translation

Question 12

Glenohumeral joint arthrokinematics abduction

Answer 12

First 30d = slight superior translation>30d = variable with no net translation. Inferior glide to allow space for supraspinatus tendon and subacromial bursa.

Question 13

Glenohumeral joint arthrokinematics IR

Answer 13

Slight anterior translationAccompanying posterior glide is still required

Question 14

Glenohumeral joint end feel

Answer 14

Capsular

Question 15

Glenohumeral joint resting position

Answer 15

30d flexion, 30d abduction, 30d IR

Question 16

Glenohumeral joint close packed position

Answer 16

Full abduction with ER

Question 17

AC joint classification

Answer 17

Synovial, complex (if disc present), planar (functionally acts as an unmodified ovoid)

Question 18

AC joint degrees of motion

Answer 18

3

Question 19

AC joint osteokinematics

Answer 19

Permits slight movements of the scapula, contributes to scapulohumeral rhythm. Primary motions = upward rotation and downward rotation.

Question 20

AC joint line of reference

Answer 20

Transverse axis through the acromion and clavicle.

Question 21

AC joint upward/downward rotation osteokinematics

Answer 21

Impure swing about a sagittal ais in a frontal plane. Upwards rotation = up to 30d Note: upward rotation of the AC joint occurs as the scapula swings upward and outward in relation to the lateral clavicle, during shoulder abduction or flexion. Downwards rotation returns the scapula back to it’s anatomical position, during shoulder adduction or extension.

Question 22

AC joint transverse plane osteokinematics

Answer 22

Impure swing about a vertical axis in a transfer plane. Note: these movements cause the medial border of the scapula to pivot away and towards the outer surface of the thorax.

Question 23

AC joint sagittal plane osteokinematics

Answer 23

Impure spin about a transverse axis in a sagittal plane. Note: these movements cause the inferior angle of the scapula to tilt away or towards the outer surface of the thorax.

Question 24

AC joint arthrokinematics

Answer 24

Slight interior, superior, anterior and posterior glides of the acromion on the clavicle occur during scapular, clavicle and arm movements.

Question 25

AC joint end feel

Answer 25

Capsular for all directions

Question 26

AC joint capsular pattern

Answer 26

Pain at extremes of range, no specific limitations of ROM

Question 27

AC joint resting position

Answer 27

Arm side by side with support under the elbow

Question 28

AC joint closed pack position

Answer 28

Full upward rotation of scapular during arm flexion, abduction or elevation

Question 29

Sternoclavicular joint classification

Answer 29

Synovial, complex (disc), unmodified sellar (but functionally acts as an unmodified ovoid due to the disc presence which allows a spin or axial rotation component).

Question 30

Sternoclavicular joint degrees of motion

Answer 30

3

Question 31

Sternoclavicular joint line of reference

Answer 31

Transverse axis along the length of the clavicle.Note: clavicular movements are described as moving on a stationary manubrum

Question 32

Sternoclavicular joint osteokinematics elevation/depression

Answer 32

Impure swing around a sagittal axis in a frontal plane

Question 33

Sternoclavicular joint osteokinematics protraction/retraction

Answer 33

Impure swing about a vertical axis in a transverse plane

Question 34

Sternoclavicular joint osteokinematics posterior/anterior axial rotation

Answer 34

Spin about a transverse axis in a sagittal plane

Question 35

Sternoclavicular joint arthrokinematics elevation/depression

Answer 35

Inferior/superior glide respectively of the clavicle on the manubrium

Question 36

Sternoclavicular joint arthrokinematics protraction/retraction

Answer 36

A posterior then anterior (protraction) or anterior then posterior (retraction) glide respectively of the clavicle on the disc then disc and clavicle at EOR

Question 37

Sternoclavicular joint anthrokinematics posterior/anterior axial rotation

Answer 37

Posterior or anterior spine respectively of the medial end of the clavicle on the lateral surface of the articular disc.

Question 38

Sternoclavicular joint arthrokinematics inspiration and expiration

Answer 38

Posterior or anterior clavicular rotation respectively

Question 39

Sternoclavicular joint end feel

Answer 39

capsular for all directions

Question 40

Sternoclavicular joint capsular pattern

Answer 40

pain at extreme ranges, loss of rotation components

Question 41

Sternoclavicular joint closed pack position

Answer 41

Full elevation and posterior axial rotation of the clavicle

Question 42

Sternoclavicular joint resting position

Answer 42

Arm by the side with support under the elbow

Question 43

What shape is the articular surface of the humerus

Answer 43

1/3 of a sphere, convex in all directions

Question 44

What shape is the articular surface of the glenoid cavity

Answer 44

Concave, greater curvature in AP direction

Question 45

What is the glenoid labrum made of

Answer 45

Fibro cartilage

Question 46

Name the ligaments of the AC joint

Answer 46

Corocoacromial, corococlavicular (conoid and trapezoid) and acromioclavicular

Question 47

What fibres are there of the GH ligament

Answer 47

Superior, middle, inferior and posterior glenohumeral

Question 48

What bursae is there at the GH joint

Answer 48

Subacromial, subscapular, subdeltoid

Question 49

Describe the articular surfaces of the sternoclavicular joint

Answer 49

Clavicle = convex vertically and slightly concave AP. Manubrium = approximately reciprocal curvature, however the articular disc completely divides the joint

Question 50

Describe the AC joint articular surfaces

Answer 50

Approximately planar, either surface may be slightly convex with the other concave. Sometimes there is an articular disc.

Question 51

Name the muscles which flex the shoulder

Answer 51

Ant. fibres of deltoid, biceps brachii, coracobrachialis, clavicular portion of pec. major

Question 52

Name the muscles which extend the shoulder

Answer 52

Sternal portion of pec. major, teres major, lat. dorsi, posterior fibres of deltoid, triceps brachii

Question 53

Name the muscles which internally rotate the shoulder

Answer 53

Anterior fibres of deltoid, pec major, subscap, teres major, lat. dorsi

Question 54

Name the muscles which abduct the shoulder

Answer 54

Middle fibres of deltoid, supraspinatus

Question 55

Name the muscles which adduct the shoulder

Answer 55

Pec. major, teres major, lat. dorsi, teres minor

Question 56

Name the muscles which externally rotate the shoulder

Answer 56

Posterior fibres of deltoid, infraspinatus, teres minor

Question 57

Name some of the nerves innervating the shoulder muscles

Answer 57

Axillary nerve, pectoral nerve, musculocutaneous nerve, subscapular nerve

Question 58

Name the muscles acting on the scapula

Answer 58

Serratus anterior, pectoralis minor, levator scapulae, trapezius, rhomboids major and minor

Question 59

Name the nerves which innervate the muscles acting on the scapula

Answer 59

Long thoracic nerve, dorsal scapular nerve, accessory nerve.