Which way does the humeral head face?
- A) medial, posterior, superior
- B) medial, anterior, superior
- C) medial, posterior, inferior
- D) medial, anterior, inferior
A) Medial, Posterior, Superior
What is the purpose of the glenoid labrum in the shoulder joint?
Deepen the fossa, Create a negative intraarticular vacuum, and assist with stability
The Superior Glenohumeral Ligament restrains what motion in the shoulder?
The Middle Glenohumeral Ligament restrains what motion in the shoulder?
Anterior translation and External rotation
The Inferior Glenohumeral Ligament restrains what motion in the shoulder?
Anterior and posterior translation
The medial border of the scapula should be approximately how far from the vertebral column at rest?
Approximately 5 cm
Which ligament in the Sternoclavicular Joint if damaged results in the greatest amount of instability?
Posterior Sternoclavicular Ligament
The Conoid Ligament resists what motion in the shoulder complex?
Clavicle elevation and protraction
The Trapezoid Ligament resists what motion in the shoulder complex?
Compression of the Acromioclavicular Joint
Explain the general concept of the Deltoid-Rotator Cuff Force Couple.
The superior directed force of the deltoid is counteracted by the inferior and medially directed force creasted by the infraspinatus, sbuscapularis, and teres minor.
*The supraspinatus provides a direct compression force into the humeral head*
What force couple is provided the main rotation of the scapula during elevation of the arm below 90degrees.
Upper Trapezius and Levator Scapula
What force couple provides the primary upward rotation when the arm is elevated above 90degrees?
Serratus Anterior and Lower Trapezius
*Serratus Anterior is found to be impaired in patients with impingement.*
How should you position the patient to help define the peri-scapular muscles while assessing for muscle atrophy?
Have patient place their hands on their hips (iliac crest).
Describe the Kibler Scapular Slide Test as is assesses scapula dyskinesia.
Measure the distance from the Thoracic Spinous Process to the Inferior angle of the scapula with the arm first positioned at neutral and elevated at 90deg.
*Difference > 1.5cm is considered abnormal*
An Inferior Angle Scapular Dysfunction as described by Kibler is most commonly seen in what shoulder diagnosis?
Rotator Cuff Impingement
(Anterior tipping of the scapula)
A Medial Border Scapular Dysfunction as described by Kibler is most commonly seen in what shoulder diagnosis?
Glenhumeral joint instability
A Superior Scapular Dysfunction as described by Kibler is most commonly seen in what shoulder diagnosis?
Rotator Cuff weakness and fource couple imbalances?
How do you perform the Scapular Assistance Test (SAT) to assess for scapula dyskinesia?
Therapist stands behind the patient and helps guide the scapula as the pt actively elevates the arm.
*Positive = ROM increase or pain decreases
How do you perform the Scapular Retraction Test (SRT) to assess for scapula dyskinesia?
Therapist manually retracts the scapula while the patient actively internally and externally rotates the arm at 90deg of abduction.
*Positive = Increased ROM or decreased pain
**Often seen in posterior impingement and RTC pathology
How do you perform the "Flip Sign" Test and what does a positive test indicate?
Resist arm external rotation at the side.
*Positive = medial border comes off the thorax
**Indicates need to work on serratus anterior and trapezius force couple.
According to EMG studies, which position of the arm activates the Supraspinatus the best?
Champagne Toast Position
Arm abducted 30deg, Slight ER, Flexion 30deg