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Orthopedic Diagnosis > Shoulder > Flashcards

Flashcards in Shoulder Deck (52):
1

scaption

elevation of the glenohumeral joint in the plane of the scapula

2

glenohumeral joint

a true synovial-lined diathrodial joint

3

glenoid fossa

flat, but made 50% deeper by a ring of fibrocartilage called the labrum

4

labrum

a ring of fibrocartilage that makes the glenoid fossa 50% deeper
forms part of the articular surface of the glenohumeral joint
attached to the margin of the glenoid cavity and the joint capsule and contributes to joint stability

5

scapula

the base of the glenohumeral joint
lies on the thoracic cage at 30 deg to the frontal plane, 3 deg superior to he transverse plane, and 20 deg forward in the sagittal plane

6

acromion morphology

flat
slightly convex
hooked (predisposes the shoulder to a rotator cuff injury)

7

coracoid process

acts as a lever for the pec major muscle to help stabilize the scapula
coracobrachialis and short head of the biceps originate here

8

greater tuberosity

attachment for supraspinatus, infraspinatus, and teres minor

9

lesser tuberosity

attachment for subscapularis

10

Z ligaments

aka glenohumeral ligaments
superior, middle, and inferior

11

Superior glenohumeral ligament

limits external rotation and inferior translation of the humeral head with the arm at the side

12

middle glemohumeral ligament

limits external rotation and anterior translaiton of the humeral head with the arm in 0 and 45 deg of abduction

13

inferior glenohumeral ligament

consists of an anterior band, posterior band, and axillary pouch with varying functions

14

coracohumeral ligament

consists of two bands that join near the acromion and prevents AC joint separation

15

Subacromial space

contains the long head of the biceps tendon, supraspinatus, and upper margins of subscapularis and infraspinatus, subdeltoid and subacromial bursae
narrowest between 60 and 120 deg of scaption

16

Impingement syndrome

pain in the subacromial space when the humerus is elevated or internally rotated
supraspinatus tendon and bursa become entrapped between the acromion and greater tuberosity
once the supraspinatus tendon is disrupted there will often be further impingement and irritation which can lead to biceps tendonitis and further rupture
thought to precipitate attritional changes in the rotator cuff leading to a tear

17

Clinical Findings of Impingement Syndrome

pain will often become worse at night as the subacromial bursa becomes hyperemic after use

18

subacromial bursa

one of the largest bursae in the body
provides two smooth serosal layers, one adhered to the overlying deltoid and the other to the rotator cuff beneath

19

Erb's Palsy

aka erb-duchenne paralysis
upper brachial plexus injury from forceful depression of the shoulder
patient presents with internally rotated and adducted shoulder (waiter's tip position)
biceps reflex is lost and there is muscle wasting; some elbow and hand motion may be present

20

Klumpke's Palsy

aka Klumpke-Dejerine Paralysis
Lower brachial plexus injury from forceful pulling of the upper arm
impairment of wrist flexion and movements of the intrinsic muscles of the hand

21

Shoulder complex vascularization

thoracoacromial, suprahumeral, and subscapular arteries

22

Close packed position of the glenohumeral Joint

90 deg of abduction and full external rotation; or full abduction and external rotation

23

Open packed position of the glenohumeral joint

55 deg of semiabduction and 30 deg of horizontal adduction without internal or external rotation

24

acromioclavicular joint

diarthrodial joint formed by acromion and lateral end of the clavicle
serves as the main articulation suspending the upper extremity from the trunk and is the joint about which the scapula moves

25

coracoclavicular ligaments

conoid and trapezoid
mainly provide vertical stability, with control of superior and anterior translation as well as anterior axial rotation

26

AC joint innervation

suprascapular, lateral pectoral, and axillary nerves

27

AC joint blood supply

suprascapular and thoracoacromial arteries

28

Scapulothoracic joint

functionally a joint, but lacks characteristics of a true synovial joint
plays a significant role in all motions of the shoulder complex

29

sternoclavicular joint close packed position

maximum arm elevation and protraction

30

sternoclavicular joint open packed position

yet to be determined but likely when the arm is by the side

31

sternoclavicular joint ligaments

anterior and posterior sternoclavicular ligaments
interclavicular ligament
costoclavicular ligament

32

Tietze's syndrome

aka costochondritis
etiology unknown, pain and swelling of one or more costocartilages, overlying skin is reddened, swelling may persist for months

33

scapular pivoters

trapezius, serratus anterior, levator scapulae, and rhomboids

34

humeral propellers

latissimus dorsi, pectoralis major and minor

35

humeral positioners

all three parts of deltoid

36

shouder protectors

rotator cuff muscles, biceps

37

scapulohumeral rhythm

the combination and synchronization of motions between the scapula and humerus during arm elevation
2:1 ratio between motion at GH joint and scapula, respectively

38

Frozen shoulder

adhesive capsulitis
inflammation of the synovial layers causing an outpouring of secretion exudate leading to formation of adhesions
no GH movement
progressive motion limitation and concomitant muscle atrophy

39

Herpes Zoster

aka shingles
chicken pox related, severe neuralgic pain, unilateral clear crops of vesicles along the course of a cutaneous nerve

40

Anterior GH dislocation

most common
95% recurrence after initial event
squaring off appearance of the shoulder

41

Sprengels Deformity

congenital, develops prior to the third month of skeletal development
partially undescended shoulder
2:1 female predominance

42

scapular winging

paralysis of serratus anterior due to long thoracic nerve damage

43

Scheuermann's Disease

aka juvenile kyphosis
at least three continuous segments are wedges more than 5 deg
slight male predominance
etiology unknown

44

Scoliosis

60-80% women
lateral curvature of the thoracic spine with vertebral body rotation

45

Muscles prone to tightness

upper trap
levator scapulae
pec major and minor
upper cervical extensors
scm
scalenes
teres major and minor

46

Muscles prone to inactivity or lengthening

lower and middle trap
rhomboids
serratus anterior
deep neck flexors
subscapularis
spuraspinatus
infraspinatus

47

shoulder flexion

180 degrees

48

shoulder extension

60 degrees

49

shoulder abduction

180 degrees

50

shoulder adduction

50 degrees

51

shoulder external rotation

90 degrees

52

shoulder internal rotation

70 degrees