Shoulder

Question 1

What is the function of the anterior and posterior ligaments of the SCJ?

Answer 1

Checks anterior/posterior translation

Question 2

What motion does the costoclavicular ligament limit?

Answer 2

Elevation

Question 3

What motion does the costoclavicular ligament contribute to?

Answer 3

Inferior gliding of clavicle

Question 4

Is the acromioclavicular joint strong or weak?

Answer 4

Weak

Question 5

What motion does the superior ligament of the acromioclavicular joint check?

Answer 5

The distal clavicle from moving posteriorly

Question 6

What motion does the coracoclavicular ligament (conoid) resist?

Answer 6

Distal clavicular superior motion

Question 7

What motion does the coracoclavicular ligament (conoid) limit?

Answer 7

Upward rotation of the scapula

Question 8

What motion does the coracoclavicular ligament (conoid) assist in?

Answer 8

Posteriorly rotates the clavicle

Question 9

What is the signifigance of the coracoacromial ligament?

Answer 9

It is the roof of the GHJ and protects subacromial bursa and rotator cuff

Question 10

By how much does the labrum increase the depth of the GHJ?

Answer 10

50%

Question 11

Where is the GHJ loose?

Answer 11

Anteriorly and inferiorly

Question 12

Where is the GHJ tight?

Answer 12

Superiorly

Question 13

What does the superior GH ligament provide?

Answer 13

Anterior and inferior stability

Question 14

What does the middle GH ligament provide?

Answer 14

Anterior joint stability up to 60 degrees abduction

Question 15

What does a typical dislocation of GHJ look like?

Answer 15

Anterior and inferior

Question 16

What does the inferior GH ligament provide?

Answer 16

45 degrees abduction resists inferior translation
ER resists anterior translation
IR resists posterior translation

Question 17

What type of joint is the SCJ?

Answer 17

Saddle shape, plane synovial

Question 18

In the frontal plane, what is the arthokinematics for the SCJ?

Answer 18

Convex on concave

Question 19

How many degrees of elevation and depression does the SCJ perform?

Answer 19

Elevation-48 degrees

Depression-10 degrees

Question 20

In the transverse plane, what is the arthokinematics of the SCJ?

Answer 20

Concave on convex

Question 21

How many degrees of protraction and retraction does the SCJ perform?

Answer 21

Protraction-20 degrees

Retraction-30 degrees

Question 22

In the sagittal plane, how many degrees of posterior and anterior rotation does the SCJ perform?

Answer 22

Posterior rotation- 50 degrees

Anterior rotation- less than 10 degrees

Question 23

How many degrees of anterior/posterior tilting does the ACJ perform?

Answer 23

20-40 degrees

Question 24

How many degrees of upward/downward rotation does the ACJ perform?

Answer 24

30 degrees

Question 25

How many degrees of IR/ER does the ACJ perform?

Answer 25

30 degrees

Question 26

What is the orientation of the humeral head?

Answer 26

Medially, superiorly-130-150 degrees, and posteriorly- 30 degrees

Question 27

What is the arthokinematics of the GHJ?

Answer 27

Convex on concave

Question 28

What motion occurs with abduction of the GHJ?

Answer 28

External rotation; in scapular plane there is less ER

Question 29

What motion occurs with flexion of the GHJ?

Answer 29

Internal rotation

Question 30

What is the position of the scapulo-thoracic joint?

Answer 30

30-45 degrees in the coronal plane, 10-15 degrees anteriorly tilted, and 10 degrees upwardly rotated

Question 31

What motion occurs at the SCJ?

Answer 31

Elevation/depression and Protraction/retraction

Question 32

What motion occurs at the ACJ?

Answer 32

IR/ER and Anterior/Posterior tilting

Question 33

What is the signifigance of the scapulo-humeral rhythm?

Answer 33

To maintain optimal alignment of the glenoid and the humeral head, and increase the ROM available in elevation

Question 34

Describe scapulo-humeral rhythm in kinseiology terms.

Answer 34

Maintains optimal length-tension relationship for the scapulo-humeral muscles; minimizes active insufficiency

Question 35

What motions is scapulohumeral rhythm responsible for?

Answer 35

Elevation of the humerus, upward rotation of the scapula, posterior tilting of scapula; 2:1 ratio (GHJ:STJ)

Question 36

What muscles are the upward scapular rotators?

Answer 36

Upper trapezius, middle trapezius, lower trapezius, and serratus anterior

Question 37

What muscles are responsible for compression and joint stabilization?

Answer 37

Infraspinatus, teres minor, subscapularis, and supraspinatus

Question 38

What muscles perform glenohumeral elevation?

Answer 38

Supraspinatus-most active from 0-60 degrees of abduction | Deltoid is the prime elevator for flexion and assists in abduction after 15 degrees

Question 39

During early elevation, describe the moment arm of the deltoid.

Answer 39

The deltoid has a poor moment arm at this point

Question 40

During early elevation, describe the moment arm of the supraspinatus.

Answer 40

The supraspinatus has a longer moment arm

Question 41

When does the moment arm of the deltoid improve?

Answer 41

During mid range

Question 42

Which musle provides the greater abduction force?

Answer 42

Deltoid

Question 43

What motion does the deltoid cause during arm elevation?

Answer 43

Superior glide of the humerus; can cause impingement

Question 44

What motion does the rotator cuff cause during arm elevation?

Answer 44

Inferior glide

Question 45

What muscles are shoulder depressors in weight bearing?

Answer 45

Latissimus dorsi and pectoralis major

Question 46

What muscles prevents scapular IR?

Answer 46

Rhomboids

Question 47

What muscle cause scapular depression and abduction?

Answer 47

Pectoralis minor; can cause weakness of the rhomboids

Question 48

What does GIRD stand for?

Answer 48

Glenohumeral Internal Rotation Defecit

Question 49

How is GIRD defined?

Answer 49

A loss of IR of 20 degrees or more compared to contralateral side

Question 50

What can cause GIRD?

Answer 50

Shoulder overuse injuries, impingement, RTC tears, and SLAP tears

Question 51

How does GIRD effect the body?

Answer 51

Humeral retroversion, throwing causes ER torque, humeral head sits posteriorly on glenoid

Question 52

How many degrees of loss in total motion will classify as GIRD?

Answer 52

Greater than 5 degrees

Question 53

What are the causes of serratus anterior weakness?

Answer 53

Long thoracic nerve palsy, disuse, and scapular winging in flexion

Question 54

What causes upper trapezius weakness?

Answer 54

Spinal accessory nerve palsy (SNAP), posterior scapular flip, trapezius atrophy, depressed scapula, trapezius weakness, limited shoulder abduction

Question 55

What are the causes of upper trapezius overuse?

Answer 55

Decreases upward rotation of scapula and increase shoulder impingement

Question 56

How can we improve subluxation of the shoulder?

Answer 56

Work on posture