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Anatomy > Shoulder > Flashcards

Shoulder Flashcards

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
Q

Complications of biceps tendonitis

A
  • Sheath thickens, causing fibrosis, scarring, & adhesions
  • Compromises mobility of the muscle
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26
Q

Usually associated with primary shoulder pathologies

A
  • Impingement in subacromial space
  • RC tears
  • Coracoacromial ligament thickening
27
Q

Mechanism of bursitis

A

Overuse of RC muscles

28
Q

Most common shoulder bursa to get irritated

A

Subacromial

29
Q

Complications of subacromial bursitis

A

Impingement

30
Q

Mechanism of frozen shoulder

A
  • Inflammation (more cytokines and inflammatory cells)

- Leads to capsular fibrosis, where more collagen is deposited and normal collagenous remodelling is lost

31
Q

How to identify adhesive capsulitis

A

Articular surface loses smoothness, becomes red

32
Q

(mechanical) Consequence of shoulder impingement

A
  • Shoulder instability, excessive translation of the humeral head
  • Deltoid fire more
33
Q

Most common shoulder impingement

A

Supraspinatus + subacromial bursa

34
Q

Incidence of impingement

A

1/3 in lifetime

35
Q

Compensation with shoulder impingement

A
  • More superior translation of humeral head
  • Decreased rotator cuff activation/coactivation
  • More upper traps and deltoid activity
36
Q

Mechanism of anterior shoulder dislocation

A

Force + Abduction, extension, external rotation

37
Q

% of dislocations that are anterior

A

95-97%

38
Q

Complications of anterior shoulder dislocation

A

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
Q

% of posterior shoulder dislocations

A

2-5%

40
Q

Mechanism of post. shoulder dislocation

A

Force with adduction, flexion, and internal rotation

41
Q

Complications of post. shoulder dislocation

A
  • RC and lig tears

- Reverse bankart & hill sachs lesions

42
Q

% of sup./inf. shoulder dislocations

A

0.5%

43
Q

Mechanism for superior dislocation

A

Extreme superior force on adducted shoulder

44
Q

Mechanism for inferior dislocation

A
  • Forceful hyperabduction of the shoulder

- Direct axial loading on abducted shoulder

45
Q

Mechanism for AC joint dislocation

A
  • Lateral blow to arm in adduction

- Usually in sports, MVA, or falling on side of body

46
Q

Mechanism for clavicular #

A
  • Common in children
  • Direct impact
  • FOOSH
47
Q

Should also be examined in clavicular #

A
  • Neurovasculature

- Lungs

48
Q

Locations of clavicular #

A
  • Medial 1/3 5%
  • Middle 1/3 80%
  • Lateral 1/3 15%
49
Q

Neurogenic TOS

A
  • 85-95%

- Pain, numbness, weakness, paraesthesia

50
Q

Arterial TOS

A

Cold pale fingers, numbess, tingling, weakness

51
Q

Venous TOS

A

Fatigue, UL heaviness, swelling, bluish tone to skin of UL

52
Q

Areas of entrapment (TOS)

A
  • Interscalene triangle
  • Costoclavicular space
  • Pectoral triangle
53
Q

Interscalene triangle

A
  • 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
Q

Costoclavicular space

A
  • Medial 1/2 of clavicle, first rib, scapula

- Most likely structure to be compressed is the subclavian vein

55
Q

Pectoral triangle

A
  • 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
Q

Sensory innervation of radial nerve

A

Poserolateral arm and forearm, post thumb, 2nd, and 1/2 of 3rd figit

57
Q

Radial nerve entrapment

A
  • Motor (pierces supinator, deep)

- Sensory (superficial, sometimes pierces ECRB

58
Q

MSC nerve entrapment

A

Pierces coracobrachialis

59
Q

Sensory distribution of MSK nerve

A

Anterolateral forearm

60
Q

Ulnar nerve entrapment

A
  • Cubital tunnel
  • Between FDP and FDS
  • Guyon’s canal
61
Q

Sensory distribution of ulnar nerve

A
  • Anterior medial wrist and 5th digit + 1/2 of 4th

- Posterior wrist, digits 5,4, 1/2 of 3 (no tips)

62
Q

Median nerve entrapment

A
  • Carpal tunnel

- Pronator teres (rare, between ulnar and radial heads of PrT)

63
Q

Median nerve sensory distribution

A

Anterior hand (minus 5th, 1/2 4th, post. tips of 1,2,3

64
Q

Axillary nerve entrapment

A
  • Quadrangular space, or pst # of humerus

Anatomy (4 decks)

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