Shoulder Anatomy

Question 1

The scapula lies in a plane ___ to the back and ___ to the clavicle

Answer 1

30, 60

Question 2

What type of acromion morphology is a good prognostic indicator for conservative management?

Answer 2

Type 1 Flat

Question 3

What type of acromion morphology increases the likelihood of impingement on subscapular lig, bursa?

Answer 3

Type 2: curved

Question 4

What type of acromion morphology is a negative prognostic indicator for conservative management and the greatest correlation with subacromial impingement syndrome?

Answer 4

Type 3: Hooked

Question 5

The subacromial bursa deep to this ligament allows movement of deeper supraspinatus tendon?

Answer 5

Coracoacromial Ligament

Question 6

This ligament completes scapular notch to make foramen?

Answer 6

superior transverse scapular ligament

Question 7

This ligament a arches over suprascapular nerve (entering infraspinous fossa)?

Answer 7

inferior transverse scapular ligament

Question 8

What the the ring of fibrocartilage attached to the margin of the glenoid cavity that deepens the cavity for increased congruence?

Answer 8

glenoid labrum

Question 9

What is the angle of inclination of the humeral head?

Answer 9

135

Question 10

What is the retroversion of the humeral head?

Answer 10

30

Question 11

The gh joint stabilizer that travels from coracoid process to greater tuberosity?

Answer 11

coraco-humeral ligament

Question 12

The 3 bands of the GH ligament (superior, middle, and inferior) are ____ in ER and ___ in IR

Answer 12

i. Taut in ER

ii. Slackened in IR

Question 13

When shoulder positioned in 90 deg abduction, describe effect on middle and inferior fibers of GH ligament.

Answer 13

1. Tightening of the middle and inferior fibers of the GH ligament

Question 14

When shoulder positioned in 90 deg abduction, describe what the inferior GH ligament will resist.

Answer 14

2. Inferior GH ligament resists anterior and posterior humeral head translation

Question 15

T/F The Scaoulothoracic Joint is a false joint between the scapula and thoracic wall

Answer 15

True

Question 16

What are the 4 stabilizers of the SC joint?

Answer 16

anterior SC ligament, Posterior SC ligament, interclavicular ligament, costoclavicular ligament

Question 17

Describe arthrokinematics of the sc joint in the vertical plane.

Answer 17

Convex clavicle moving on concave sternocostal

Question 18

Describe arthrokinematics of the sc joint in the horizontal plane.

Answer 18

concave clavicle moving on convex sternocostal

Question 19

Why is the AC joint subject to dislocation?

Answer 19

i. Absence of interlocking articular surfaces

ii. Weakness of ligaments

Question 20

What are the 2 extra-articular ligaments supporting the AC joint?

Answer 20

i. Conoid ligament

ii. Trapezoid ligament

Question 21

What is the open pack position of the GH joint?

Answer 21

55 abd
30 hor add
slight ER

Question 22

What are the boundaries of the quadrilateral space?

Answer 22

i. Teres major
ii. Teres minor
iii. Long head of triceps
iv. Surgical neck of humerus

Question 23

What are the contents of the quadrilateral space?

Answer 23

i. The axillary nerve

ii. Posterior circumflex humeral artery

Question 24

What three motions will close the quadrilateral space?

Answer 24

Extension, abduction, ER closes space

Question 25

The rotator cuff interval lies between what tendons?

Answer 25

lies between the supraspinatus and subscapularis tendons

Question 26

The rotator cuff interval is reinforced by what ligaments?

Answer 26

Reinforced by superior glenohumeral and coracohumeral ligaments

Question 27

Adhesions in The rotator cuff interval causes the humeral head to sit in which direction?

Answer 27

Anteriorly

Question 28

The biceps pulley is a Tendoligamentous sling formed by what 3 aspects?

Answer 28

i. Superior glenohumeral ligament ii. Coracohumeral ligament iii. Distal attachment of the subscapularis tendon

Question 29

What stabilizes the long head of the biceps in the bicipital groove (tearing can lead to instability)?

Answer 29

The biceps pulley

Question 30

Because the GH has (1) a great degree of movement, (2) has little bony congruency, and (3) has poor elasticity of capsule, what provides rapid stability in response to external perturbation?

Answer 30

Rotator cuff

Question 31

What 3 muscles upwardly rotates the scapula?

Answer 31

Upper Trap, Lower Trap, Serratus Anterior

Question 32

What muscles posteriorly tips the scapula?

Answer 32

serratus anterior

Question 33

When the shoulder abd, the contralateral thoracic spine will move into what position during phase 3 of abduction (120-180)

Answer 33

lateral flexion

Question 34

Phase 1 of shoulder of abd (0-60 deg) uses these muscles mostly?

Answer 34

Deltoid & supraspinatus

Question 35

Because of the Locking” at 90 deg from greater tuberosity impacting superior margin of glenoid, what motions occur?

Answer 35

lateral rotation and flexion of the humerus to delay lock

Question 36

Phase 2 of shoulder abduction (60-120) uses these muscles mostly?

Answer 36

Trapezius (upper – upward rotation, lower - posterior tilting) and serratus anterior

Question 37

What muscles will check phase 2 (60-120) of shoulder abduction?

Answer 37

Checked by latissimus dorsi and inferior pec major

Question 38

Phase 3 of shoulder abduction (120-180) uses these muscles mostly?

Answer 38

Deltoid, supraspinatus, inferior trapezius, serratus anterior elevate UE

Question 39

Phase 1 of shoulder flexion (0-50) uses what muscles?

Answer 39

Anterior deltoid, coracobrachialis, and superior clavicular fibers of the pec major initiate shoulder flexion

Question 40

Phase 1 of shoulder flexion (0-50) is checked by what tension from what muscles?

Answer 40

teres major and minor, infraspinatus, and coracohumeral ligament

Question 41

Phase 2 of shoulder flexion (60-120) uses what muscles?

Answer 41

Trapezius and serratus anterior

Question 42

Phase 2 of shoulder flexion (60-120) is checked by what tension from what muscles?

Answer 42

latissimus dorsi and inferior pec major

Question 43

During phase 2 of shoulder flexion (60-120), the scapular rotates to 60 to do what?

Answer 43

orient glenoid superior & anterior

Question 44

Phase 3 of shoulder flexion (120-180) uses what muscles?

Answer 44

Deltoid, supraspinatus, inferior trapezius, serratus anterior elevate UE

Question 45

Check for what nerve with proximal humeral fractures?

Answer 45

Axillary nerve