Shoulder

Question 1

scaption

Answer 1

elevation of the glenohumeral joint in the plane of the scapula

Question 2

glenohumeral joint

Answer 2

a true synovial-lined diathrodial joint

Question 3

glenoid fossa

Answer 3

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

Question 4

labrum

Answer 4

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

Question 5

scapula

Answer 5

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

Question 6

acromion morphology

Answer 6

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

Question 7

coracoid process

Answer 7

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

Question 8

greater tuberosity

Answer 8

attachment for supraspinatus, infraspinatus, and teres minor

Question 9

lesser tuberosity

Answer 9

attachment for subscapularis

Question 10

Z ligaments

Answer 10

aka glenohumeral ligaments

superior, middle, and inferior

Question 11

Superior glenohumeral ligament

Answer 11

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

Question 12

middle glemohumeral ligament

Answer 12

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

Question 13

inferior glenohumeral ligament

Answer 13

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

Question 14

coracohumeral ligament

Answer 14

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

Question 15

Subacromial space

Answer 15

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

Question 16

Impingement syndrome

Answer 16

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

Question 17

Clinical Findings of Impingement Syndrome

Answer 17

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

Question 18

subacromial bursa

Answer 18

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

Question 19

Erb’s Palsy

Answer 19

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

Question 20

Klumpke’s Palsy

Answer 20

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

Question 21

Shoulder complex vascularization

Answer 21

thoracoacromial, suprahumeral, and subscapular arteries

Question 22

Close packed position of the glenohumeral Joint

Answer 22

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

Question 23

Open packed position of the glenohumeral joint

Answer 23

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

Question 24

acromioclavicular joint

Answer 24

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

Question 25

coracoclavicular ligaments

Answer 25

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

Question 26

AC joint innervation

Answer 26

suprascapular, lateral pectoral, and axillary nerves

Question 27

AC joint blood supply

Answer 27

suprascapular and thoracoacromial arteries

Question 28

Scapulothoracic joint

Answer 28

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

Question 29

sternoclavicular joint close packed position

Answer 29

maximum arm elevation and protraction

Question 30

sternoclavicular joint open packed position

Answer 30

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

Question 31

sternoclavicular joint ligaments

Answer 31

anterior and posterior sternoclavicular ligaments interclavicular ligament costoclavicular ligament

Question 32

Tietze's syndrome

Answer 32

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

Question 33

scapular pivoters

Answer 33

trapezius, serratus anterior, levator scapulae, and rhomboids

Question 34

humeral propellers

Answer 34

latissimus dorsi, pectoralis major and minor

Question 35

humeral positioners

Answer 35

all three parts of deltoid

Question 36

shouder protectors

Answer 36

rotator cuff muscles, biceps

Question 37

scapulohumeral rhythm

Answer 37

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

Question 38

Frozen shoulder

Answer 38

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

Question 39

Herpes Zoster

Answer 39

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

Question 40

Anterior GH dislocation

Answer 40

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

Question 41

Sprengels Deformity

Answer 41

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

Question 42

scapular winging

Answer 42

paralysis of serratus anterior due to long thoracic nerve damage

Question 43

Scheuermann's Disease

Answer 43

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

Question 44

Scoliosis

Answer 44

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

Question 45

Muscles prone to tightness

Answer 45

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

Question 46

Muscles prone to inactivity or lengthening

Answer 46

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

Question 47

shoulder flexion

Answer 47

180 degrees

Question 48

shoulder extension

Answer 48

60 degrees

Question 49

shoulder abduction

Answer 49

180 degrees

Question 50

shoulder adduction

Answer 50

50 degrees

Question 51

shoulder external rotation

Answer 51

90 degrees

Question 52

shoulder internal rotation

Answer 52

70 degrees