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Anatomy > Shoulder > Flashcards

Shoulder Flashcards

(64 cards)

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1
Q

Joints of the shoulder complex

A
  • GH
  • AC
  • SC
  • Scapulo-thoracic
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2
Q

Weight transmission through UE

A

1) through humerus
2) through GH
3) through AC to strong SC

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3
Q

Ligaments of the SC joint

A
  • Anterior (covers whole front)
  • Interclavicular (covers top)
  • Costoclavicular (underneath, connects to first rib)
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4
Q

Degrees of freedom in the shoulder

A

3 rotation degrees of freedome

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5
Q

Scap mvmt at 90 ABD

A

30 (60 arm) 2:1

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6
Q

Scap mvmt at 180 ABD

A

65 (115 arm) ~3:1

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7
Q

Prime movers of the scap when arm is elevated

A

Trapezius and SA

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8
Q

Nerve for traps

A

Accessory CN11

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9
Q

Nerve for SA

A

LTN

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10
Q

Ligaments of the GH jount

A
  • Coracohumeral (bicep long head goes through)

- Superior/middle/inferior GH ligs

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11
Q

Only GH lig with a posterior side

A

Inferior GH lig

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12
Q

Bicep long head runs through this GH lig

A

Coracohumeral lig

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13
Q

Function of superior GHL

A
  • Limits anterior and inferior translation

- Bridges gap between supraspinatus and subscap tendons

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14
Q

Function of middle GHL

A

Limits anterior translation in abduction

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15
Q

GH lig absent in ~30% of peeps

A

Middle GHL

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16
Q

Function of inferior GHL

A
  • Has 2-3 bands (including axillary pouch
  • Limits antero/postero-inferior
  • Espescially in abduction
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17
Q

Labrum extends fossa depth by ____%

A

50%

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18
Q

GH fossa points _____ regularly, to provide _____ stability

A

Upwards, inferior

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19
Q

Where the GH is more taut/lax

A

Taut: superiorly, or inferiorly at full ROM
Lax: inferior

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20
Q

Where most of the dynamic GH stabilizers are

A

Posteriorly (all except subscap, kinda supraspinatus)

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21
Q

Function of the cuff during arm elevation

A
  • Pull head of humerus towards glenoid fossa

- Provide inferior translation - limiting superior translation (shear)

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22
Q

Most vulnerable RC muscle

A
  • Supraspinatus

- Tearing or calcification that can lead to impingement

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23
Q

Inflammation of shoulder can impact

A
  • Capsule/ligs
  • Tendons
  • Bursa
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24
Q

Bicep tendonitis

A

Most commonly the long head. Repetitive attraction in friction triggers inflammation leading to swelling, further mechanical irritation

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25
Complications of biceps tendonitis
- Sheath thickens, causing fibrosis, scarring, & adhesions - Compromises mobility of the muscle
26
Usually associated with primary shoulder pathologies
- Impingement in subacromial space - RC tears - Coracoacromial ligament thickening
27
Mechanism of bursitis
Overuse of RC muscles
28
Most common shoulder bursa to get irritated
Subacromial
29
Complications of subacromial bursitis
Impingement
30
Mechanism of frozen shoulder
- Inflammation (more cytokines and inflammatory cells) | - Leads to capsular fibrosis, where more collagen is deposited and normal collagenous remodelling is lost
31
How to identify adhesive capsulitis
Articular surface loses smoothness, becomes red
32
(mechanical) Consequence of shoulder impingement
- Shoulder instability, excessive translation of the humeral head - Deltoid fire more
33
Most common shoulder impingement
Supraspinatus + subacromial bursa
34
Incidence of impingement
1/3 in lifetime
35
Compensation with shoulder impingement
- More superior translation of humeral head - Decreased rotator cuff activation/coactivation - More upper traps and deltoid activity
36
Mechanism of anterior shoulder dislocation
Force + Abduction, extension, external rotation
37
% of dislocations that are anterior
95-97%
38
Complications of anterior shoulder dislocation
Hill-Sachs Lesion - osteochondral indentation on humeral head due to pressing up on glenoid ridge Bankart lesion - Tear in glenod - Can be fibrous or bony
39
% of posterior shoulder dislocations
2-5%
40
Mechanism of post. shoulder dislocation
Force with adduction, flexion, and internal rotation
41
Complications of post. shoulder dislocation
- RC and lig tears | - Reverse bankart & hill sachs lesions
42
% of sup./inf. shoulder dislocations
0.5%
43
Mechanism for superior dislocation
Extreme superior force on adducted shoulder
44
Mechanism for inferior dislocation
- Forceful hyperabduction of the shoulder | - Direct axial loading on abducted shoulder
45
Mechanism for AC joint dislocation
- Lateral blow to arm in adduction | - Usually in sports, MVA, or falling on side of body
46
Mechanism for clavicular #
- Common in children - Direct impact - FOOSH
47
Should also be examined in clavicular #
- Neurovasculature | - Lungs
48
Locations of clavicular #
- Medial 1/3 5% - Middle 1/3 80% - Lateral 1/3 15%
49
Neurogenic TOS
- 85-95% | - Pain, numbness, weakness, paraesthesia
50
Arterial TOS
Cold pale fingers, numbess, tingling, weakness
51
Venous TOS
Fatigue, UL heaviness, swelling, bluish tone to skin of UL
52
Areas of entrapment (TOS)
- Interscalene triangle - Costoclavicular space - Pectoral triangle
53
Interscalene triangle
- Ant + mid scalene, superior border of 1st ribe - Subclavian vein runs anterior, not trapped - Only brachial plexus and subclavian artery - Can also be due to cervical rib
54
Costoclavicular space
- Medial 1/2 of clavicle, first rib, scapula | - Most likely structure to be compressed is the subclavian vein
55
Pectoral triangle
- Coracoid process, ribs, pec min - Commonly neurovascular structures compressed here - Any inflammation/hypertrophy/posture of pec min can cause this. - Aggravated with arm elevated
56
Sensory innervation of radial nerve
Poserolateral arm and forearm, post thumb, 2nd, and 1/2 of 3rd figit
57
Radial nerve entrapment
- Motor (pierces supinator, deep) | - Sensory (superficial, sometimes pierces ECRB
58
MSC nerve entrapment
Pierces coracobrachialis
59
Sensory distribution of MSK nerve
Anterolateral forearm
60
Ulnar nerve entrapment
- Cubital tunnel - Between FDP and FDS - Guyon's canal
61
Sensory distribution of ulnar nerve
- Anterior medial wrist and 5th digit + 1/2 of 4th | - Posterior wrist, digits 5,4, 1/2 of 3 (no tips)
62
Median nerve entrapment
- Carpal tunnel | - Pronator teres (rare, between ulnar and radial heads of PrT)
63
Median nerve sensory distribution
Anterior hand (minus 5th, 1/2 4th, post. tips of 1,2,3
64
Axillary nerve entrapment
- Quadrangular space, or pst # of humerus

Anatomy (4 decks)

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