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Fall Semester FS Exam 1 > Shoulder Complex > Flashcards

Shoulder Complex Flashcards

1
Q

the shoulder girdle is made up of

A

sternum, scapula, and rib cage

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2
Q

shoulder joint is made up of

A

glenohumeral joint (GHJ)

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3
Q

name the true joints of the shoulder complex

A

AC, SC, GH

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4
Q

scapulothoracic joint

A

not a true joint

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5
Q

name the 3 cavities of the scapula

A
  1. supraspinus fossa
  2. infraspinous fossa
  3. subscapular fossa: located anterior and inferior to the glenohumeral cavity
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6
Q

The steroclavicular joint is made up of

A

sternum, clavicle, and superior aspect of first costal cartilage

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7
Q

Disc of SC joint

A

made of fibrocartilage: disc can regenerate and can withstand tensile forces

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8
Q

function of disc of SCJ

A

improves contact btwn sternum and clavicle and increases shock absorption. also prevents SCJ dislocation in the medial direction (prevents clavicle from riding on top of manubrium) (along with costoclavicular ligament)

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9
Q

attachments of disc

A

superior: clavicle and interclavicular ligament
inferior: cartilage of first rib

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10
Q

motion at the SCJ is ___

A

angular

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11
Q

Elevation/depression plane/axis?

A

frontal plane, sagittal axis

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12
Q

degrees of elvation and depression

A 
elevation = 45
depression = 15
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13
Q

during elevation/depression clavicle is ___ and manubrium is ____

A 
clavicle = convex
manubrium = concave
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14
Q

protraction/retraction plane and axis

A

transverse plane, vertical axis

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15
Q

degrees of pro/retraction

A

15

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16
Q

during pro/retraction, clavicle is ___ and manubrium is ____

A 
clavicle = concave
manubrium = convex
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17
Q

rotation (up/down) plane and axis

A

sagittal plane, longitudinal (ML) axis

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18
Q

degrees of claviclular rotation

A 
up = 30-45
down = back to neutral
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19
Q

If impact occurs direclty along the long axis of the clavicle, where is the damage?

A

at SC joint. disc and CC ligament won’t help to prevent injury. excessive medial force tears the disc from it’s atachment on the first rib

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20
Q

if force is perpendicular or at an angle to the clavicle (towards rib cage), where is the damage?

A

the first rib becomes the fulcrum and the clavicle will break at the point of impact with the first rib. usually middle 1/3 of clavicle

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21
Q

The AC joint is which type of joint?

A

gliding joint with flat articular surfaces

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22
Q

AC joint (concave/convex parts)

A 
acromion = concave
clavicle = convex
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23
Q

AC joint is made up of

A

clavicle, acromion, intraarticular meniscus (not always present) – meniscus acts as a wedge

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24
Q

highest palpable part of shoulder area?

A

ACJ

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25
Q

supporting structures of AC joint

A
  • weak capsule
  • AC ligaments inferiorly and superiorly
  • coracoclavicular ligament (main support for ACJ)
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26
Q

function of AC ligaments

A

provide horizontal joint stability for anterior displacment and posterior glide

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27
Q

function of coracoclavicular ligament

A

connects clavicle to scapula
provides horizontal stability
prevents superior dislocation of clavicle on acromion

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28
Q

two parts and functions of coracoclavicular ligament

A
  1. trapezoid: prevents medial displacement of acromion under clavicle
  2. coniod
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29
Q

which joint has more motion: AC or SC?

A

SCJ

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30
Q

what has to happen for the acromion to move beneath the clavicle and cause dislocation?

A

coracoclavicular ligament has to be damaged. doesn’t happen often.

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31
Q

main support ligament of AC joint?

A

coracoclavicular ligament

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32
Q

Where does dislocation occur more frequently? ACJ or SCJ?

A

SCJ

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33
Q

Rotation (up/down) of AC joint

A

frontal plan, AP axis
25 degrees upward
concave acromion on convex clavicle

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34
Q

protraction (winging) and retraction of ACJ

A

transverse plane, vertical axis

35 degrees

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35
Q

elevation (tipping) of ACJ

A

sagittal plane, ml axis

20 degrees forward

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36
Q

Purpose/function of scapulothoracic mechanism/joint (not a true joint)

A

serves as a moving platform for proper arthrokinematics of the GHJ while maintaining dynamic stability

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37
Q

scapulothoracic joint includes

A

scapula (clavicle) and rib cage

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38
Q

stabilizing factors of the scapulothoracic joint

A

clavicle, atomospheric pressure, and active and passive muscle tension

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39
Q

notes on scapulothoracic joint

A
  • negative pressure present between anterioer surface of scpula and the rib cage
  • scapulothoracic mechanism refers to the motion between the scapula and the rib cage
  • takes into account AC and SC joints, like a sum of the two joints
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40
Q

rotation (up/down) of SCTHOR joint (scapulothoracic)

A

up = 60
down = 10
combo of glide and spin

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41
Q

abduction (protraction) and adduction (retraction) of scthor joint

A

abd = 13-15 cm
add = 3-5 cm
glide on rib cage

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42
Q

elevation/depression of scthorac joint

A

elevation = 40-45
depression = 10-15
translation on a curvilinear path

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43
Q

define tipping of scapula

A

inferior angle moves away from rib cage

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44
Q

what is the limiting factor for depression of the scapulothoracic joint?

A

1st rib ?

45
Q

name the 6 primary shoulder girdle muscles

A

trap, levator scap, rhomboids, SA, pec minor, subclavius

46
Q

goal of 6 primary shoulder girdle muscles

A

move the GH joint and provide stability

47
Q

function of subclavius

A

depresses the clavicle towards the first rib

48
Q

four muscles that elevate the scapula

A
  1. trap upper fibers
  2. levator scap
  3. rhomboid minor
  4. rhomboid major
49
Q

five muscles that do scapular depression

A
  1. trap lower fibers
  2. lower fibers of SA
  3. pec minor
  4. lat dorsi
  5. lower fibers of pec major
    (gravity!)
50
Q

how do the lat and pec major produce scapular depression?

A

because of their attachment on the humerus

51
Q

muscles that produce abudction of the scapula

A

pec major, pec minor, SA

52
Q

muscles that produce adduction of the scapula

A

trap, rhomboid major and minor

53
Q

muscles that produce upward scapular rotation

A

upper and lower fibers of trap
upper and lower fibers of SA
(axis of rotation is below the spine of the scapula)

54
Q

muscles that produce downward rotation of the scapula

A
  1. levator scap
  2. rhomboid minor
  3. rhomboid major
  4. Pec minor
    (gravity!)
55
Q

glenohumeral joint is which type of joint?

A

ball and socket (3 DF)

56
Q

the GH capsule is tight in which direction and loose in which 2 directions?

A 
tight = superiorly
loose = anterior and inferiorly (and posteriorly??)
57
Q

is there a posterior GH ligament?

A

no, only superior, middle and inferior

58
Q

which ligament forms the roof of the arch?

A

coracoacromial ligament (reinforces capsule superiorly)

59
Q

the majority of stability for the GHJ comes from what?

A

soft tissue - muscle, ligament, capsule

60
Q

T/F translation occurs within the glenoid cavity and can cause labral tears and impingement

A

true

61
Q

the posterior aspect of the capsule is surrounded by what?

A

teres minor, supraspinatus, infraspinatus (no ligaments)

62
Q

location of supraspinatus

A

between head of humerus and acromion

63
Q

facts about the labrum

A

labrum is a continuation of the articular cartilage, but has more fibrous cartilage than the articulr cartilage does. Labrum fibers are circumferential making it better for protection

64
Q

9 primary shoulder joint muscles

A
  1. deltoid
  2. supraspinatus
  3. pec major
  4. coracobrachialis
  5. lat dorsi
  6. teres major
  7. rotator cuff msucles
  8. biceps
  9. tricpes
65
Q

name the rotator cuff muscles

A

supraspinatus
infraspinatus
teres minor
subscapularis

66
Q

attachment of subscapularis

A

lesser tubercle

67
Q

attachment of supraspinatus

A

greater tubercle

68
Q

when does the teres major do scapular rotation?

A

only when the humerus is fixed and cannot move

69
Q

teres major

A

helps lat. both do adduction, IR, extension

70
Q

two muscles that produce arm abduction

A

deltoid and supraspinatus

71
Q

muscles producing arm adduction (4)

A

lat dorsi, pec major upper and lower fibers, teres major, coracobrachialis

72
Q

strongest adductor?

A

Latissimus dorsi because of size and large MA

73
Q

muscles producing arm flexion (4)

A

pec major upper and lower fibers, anterior fibers of deltoid, coracobrachialis, bicpes

74
Q

muscles producing arm extension (5)

A

latissimus dorsi, pec major upper and lower fibers, posterior fibers of deltoid, long head of triceps, teres major

75
Q

how can the pec major produces flexion and extension?

A

prodces extension when arm is in a flexed position

76
Q

pec major functions

A

adduction, flexion, extension, IR

77
Q

muscles that produce IR

A

lat dorsi, pec major upper and lower fibers, anterior fibers of deltoid, teres major, subscapularis

78
Q

msucles that produce ER

A

posterior fibers of deltoid, infraspinatus, teres minor

79
Q

what makes up the coracoacromial arch?

A

acromion, coracoacromial ligament, and coracoid process

80
Q

coracoacromial arch role

A

forms the roof over the glenoid fossa and humeral head. role is to limit superior translation of the GHJ

81
Q

which ligament holds the long head of the biceps tendon in the intertebercular groove?

A

transverse humeral ligament

82
Q

supraspinatus is located between which 2 ligaments?

A

coracoacromial and coracohumeral

83
Q

define humeral retroversion

A

the orientation of the humeral head with respect to the medial and lateral epicondyles

84
Q

normal retroversio nangle

A

30-40 defgrees (head points slightly posterior)
larger angle = more ER
smaller angle = less ER, more IR

85
Q

define force couple

A

two forces that are equal but opposite in direction that produce rotation

86
Q

3 muscles involved in force couple (revolving door example)

A

upper trap, lower trap, SA
force in oppsite directions, torque in same direction
force couple = agonist muscles

87
Q

examples of force couples

A
  • deltoid and supraspinatus

- lat dorsi and teres major

88
Q

can single joint muscles work by themselves?

A

no, require scapular stabilization by one or more other muscles. ex: for deltoid to do abduction, SA has to control scapula so that the motion is effective

89
Q

scapulohumeral rhythm - ratio?

A

2:1 ratio

GHJ moves 2 degrees for every 1 degree of scapular motion

90
Q

phase 1 of SCH rhythm

A

1st 30 degrees of abduction comes from the GHJ

91
Q

phase 2 of SCH rhythm

A

from 30-90 degrees, we get an additional 30 degrees from GHJ and 30 degrees from SCJ.

92
Q

when does the 2:1 ratio occur?

A

during phase 2 of SCH rhythm

93
Q

phase 3 of SCH rhythm

A

90 to 180 degrees. additional 50-60 degrees from GHJ, 30 degrees from ACJ, no more from SCJ

94
Q

when is the SCJ active during scapulohumeral rhythm?

A

phase 2 (contributes 30 degrees of motion from 30-90 degree position of abduction)

95
Q

when does the ACJ move?

A

doesn’t start moving until phase 3, at 90 degrees horizontal abduction. from 90 to 180 degrees = phase 3

96
Q

what motions occur at the SCJ during abduction?

A

first elevation and then posterior rotation

97
Q

what ligament limits motion and causes posterior rotation of the clavicle during the late stages of abduction?

A

coracoclavicular ligament

98
Q

superior rolling of the GH joint is directed by which muscle?

A

supraspinatus

99
Q

when superior rolling occurs, sliding occurs in which direction?

A

inferior. this maintains the head of the humerus away from the coracoacromial arch

100
Q

Arthrokinematics of GHJ

A

when the humeral head rolls up, the supraspinatus pulls medially and down. the more the head rolls up, the more the vertical force of the supraspinatus pushes the head down with respect to the scapula.

101
Q

if your supraspinatus is weak, what occurs with regards to arthrokinematics of GHJ?

A

force is more medial and the head of the humerus goes farther up, causing impingemnt

102
Q

Role of bursa

A

decrease friction forces

103
Q

largest bursa?

A

subdeltoid. actually 3 separate bursa (subdeltoid, subacromial, and subcorocoid)
3 are separated by a thin synovial membrane

104
Q

location of subscapularis bursa

A

between subscapularis tendon and neck of scapula

105
Q

location of infraspinatus bursa

A

between infraspinatus tendon and joint capsule

106
Q

the deltoid tries to create subluxation by pulling the humerus up and the scapula down. which muscles counteract this and how?

A

subscapularis, teres minor, and infraspinatus coutneract this by creating a downward force on the humerus to prevent subluxation

107
Q

JRF at GHJ

A
  • arthrokinematics of humerus abudction is spinning of the humerus on a fixed center of rotation
  • imbalanced forces = superior gliding
  • center of pressure is whithin the glenoid fossa
108
Q

What occurs if the SA is paralyzed?

A

downward rotation of scapula occurs - results in glenoid cavity becoming vertical - higher tension then needed to prevent downwards subluxation

109
Q

GHJ selected specific factors

A

Requirement for extreme mobility
avoid subluxatio ndue to gravity
avoid upward subluxation of humerus
need to exceed ball and socket range

Fall Semester FS Exam 1 (1 decks)

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