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Move Sci > Shoulder Test 2 > Flashcards

Shoulder Test 2 Flashcards

1
Q

GH accounts for __% of shoulder motion

ST accounts for __%

A

GH:66%

ST:33%

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2
Q

How many degrees of freedom does the sternoclavicular joint have?

A

3

Elevation/depression
protraction/retraction
A/P rotation

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3
Q

Elevation and depression of the sternoclavicular joint occurs between the….

A

Disc and clavicle

remember elevation/depression happens more distally on the joint

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4
Q

Protraction and retraction of the sternoclavicular joint occurs between the….

A

Disc and manubrium

remember protraction retraction happens more proximally on the joint

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5
Q

Anterior posterior rotation of the sternoclavicular joint occurs between the….

A

Clavicle and the costal cartilage of 1st rib

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6
Q

The sternoclavicular joint consists of 2 synovial _____ joints

What are they?

A

Plane joints

Superior: between disc and medial clavicle

inferior: medial clavicle with manubrium and first costal cartilage

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7
Q

What is the purpose of the sternoclavicular disc?

A

Increases joint congruence and absorbs force

creates two seperate joint cavities and acts as pivot during motion

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8
Q

During elevation and depression of the sternoclavicular joint: the ______ rolls and glides on the _____

A

Clavicle on the disc

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9
Q

during protraction and retraction of the sternoclavicular joint, the ____________ roll and slide on the _________

A

Clavicle and disc on the manubrium

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10
Q

The anterior and posterior sternoclavicular ligament both limit ______

which is the primary?

A

Anterior/posterior translation

posterior ligament is the primary

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11
Q

What ligament limits elevation of lateral clavicle and counteracts force of SCM/sternohyoid muscle

A

costoclavicular ligament

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12
Q

What ligament resists excessive depression of clavicle and superior gliding of clavicle on manubrium

A

interclavicular ligament

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13
Q

What is normal SC elevation?

A

48

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14
Q

What is normal SC depression

A

15

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15
Q

What is normal SC protraction?

A

15-20

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16
Q

what is normal SC retraction?

A

30

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17
Q

What is normal posterior rotation of the SC?

Anterior?

A

Posterior: 50

Anterior: 10

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18
Q

During SC elevation: the lateral end of clavicle moves upward and the medial end rolls _______ and slides ______ on the sternum

A

rolls superiorly and slides inferiorly

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19
Q

During SC depression, the Lateral end of clavicle moves downward
Medial end of clavicle rolls _______ and slides ________

A

rolls inferiorly and slides superiorly

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20
Q

During SC protraction, the Lateral clavicle moves anteriorly in transverse plane
Medial clavicle roll and slide __________ on sternum

A

anteriorly

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21
Q

During SC retraction: Lateral clavicle moves posteriorly
Medial clavicle roll and slide ____________

A

posteriorly

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22
Q

During SC Elevation depression the roll and slide are ______

during SC protraction/retraction the roll and slide are _____

A

Opposite

Same

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23
Q

SC Joint Stability facts

A

Incongruent but stable link to axial skeleton

Degenerative changes uncommon

Disc and ligament structures help to dissipate forces

Represent 1-3% of joint dislocations in body
subluxations may be more frequent

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24
Q

What is the purpose of the AC joint?

A

Allows scapula to rotate during arm movement:

Increases UE motion

Positions glenoid beneath humeral head

Maximizes scapula contact to thorax

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25
Q

The lateral clavicle’s contact with the acromion is _____ in orientation and susceptible to ____ forces

A

Vertical

Shear forces

Note: This joint varys in congruence and configuration person to person, Variable disc at this joint that may or may not form

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26
Q

The AC joint has a ____ capsule and ____ ligaments

A

weak capsule

strong ligaments

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27
Q

What is the purpose of the superior AC and inferior AC ligament

A

resists opposing forces

inferior ligament is not as strong

Note: these are reinforced by the deltoids and traps

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28
Q

What are the two parts of the coracoclavicular ligament?

A

Conoid

Trapezoid

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29
Q

What is the purpose of the conoid ligament?

A

Resists inferior forces

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30
Q

What is the purpose of the trapezoid ligament

A

resist posterior translation

Note: trapezoid is in the front so it can resist clavicule moving back

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31
Q

What is the critical role of the coracoclavicular ligament (both parts combined)

A

couple posterior clavicle rotation and scapula **upward rotation **during arm elevation

32
Q

Internal and external rotation of the AC joint occurs at what axis?

How much normal motion?

A

vertical

Normally has 20-35 degrees

33
Q

Anterior or posterior tipping of the AC joint normally occurs in what plane?

How much motion does this normally have?

A

Oblique coronal axis

20-40

34
Q

Upward and downward rotation of the AC joint occurs in what axis?

how much motion?

A

Oblique AP axis

upward: 30
downward: 17

35
Q

What is the purpose of AC int/ext rotation?

Anterior/posterior tipping?

Up/down rotation?

A

Int/ext rotation- maintains scapular contact with curvature thorax

ant/post tipping- maintains scapular contact with verticle curvature of thorax

up/down rotation- tilts glenoid fossa up and down

36
Q

How is the AC joint most commonly injured?

A

Fall on shoulder with arm adducted or contact sports

  • not a very stable joint, subject to degenerative changes
37
Q

The scapulothoracic joint is dependent on…

A

movement at the AC and SC joints

38
Q

What is normal scapular position?

A

2 inches from midline between ribs 2 and 7

39
Q

How is the scapula normally oriented?

A

35-45 degrees internally rotated/protracted

tilted anteriorly 10-15 degrees

upwardly rotated 5-10 degrees

40
Q

How much upward rotation of the scap is required for arm elevation?

A

60

41
Q

Excessive ______ of the scapula causes winging

A

internal rotation

42
Q

Review this chart

A
43
Q

The GH joint has _ rotary and _ translatory degrees of freedom

A

3 and 3

44
Q

The humeral head normally faces…

A

Medially, superiorly, and posteriorly

45
Q

What is the normal angle of inclination and angle of torsion

A

inclination - 130-150

torsion- 30 posterior

46
Q

The glenoid labrum enhances the concavity by…

A

50%

47
Q

What 2 structures attach to the GH labrum?

A

Longhead of bicep tendon and GH ligaments

48
Q

The GH capsule tightens during…

how much distraction is normally possible?

A

Ext rotation + abd (90/90)

2.5cm

note: capsule has x2 the surface area of the humeral head

49
Q

What does the superior GH ligament resist?

A

Resists anterior and inferior translations of humeral head at 0 degrees abduction

50
Q

What is the function of the middle GH ligament?

A

Prevents all types of translation from 0-60 abduction

51
Q

What is the function of the inferior GH ligament?

A

3 components

Anterior- resists ant/inf translation

Posterior- resists post/inf translation

Axillary pouch- resists inf translation

52
Q

What ligament forms a tunnel for the longhead of bicep tendon to pass through?

A

Coracohumeral ligament

53
Q

what are the 2 parts of the coracohumeral ligament?

A

First band: coracoid to supraspinatus tendon + greater tubercle

Second band: coracoid to subscapularis + lesser tubercle

54
Q

What muscle can be impinged at the coracoacromial arch

A

supraspinatus

55
Q

What is inside of the subacromial space?

A

subacromial bursa, rotator cuff tendons, and tendon of long head of biceps

56
Q

What is the purpose of the coracoacromial arch

A

Protects subacromial structures and prevents superior dislocation of humerus

57
Q

What is normal flexion/extension and what axis does it occur in?

A

Coronal axis

120

50

58
Q

ABd limited when in neutral or medial rotation by _______,
________ is required for full Abd

A

greater tubercle

lateral rotation

59
Q

During GH elevation, the humeral head rolls ______ and slides __________

A

superiorly

inferiorly

60
Q

If arm is loaded (like you’re carrying something at your side), _________ contracts
May be more important that originally thought
↑ inferior subluxation with ↓ __________

A

supraspinatus

↑ inferior subluxation with ↓ rotator cuff function

61
Q

Deltoid requires synergistic help from ___________ to produce desired rotation of humeral head

A

rotator cuff

62
Q

Force vectors of middle deltoid: larger parallel (Fx) than perpendicular (Fy) component
Majority of force from deltoid from rest position causes humerus to translate __________

A

superiorly

63
Q

S.I.T.S perpendicular force component (Fy) causes some rotation of humerus but also compresses head into glenoid fossa
Parallel force component (Fx) offsets _________ force from deltoid by pulling humeral head _______

A

superior

inferior

64
Q

What muscle has the largest MA for abduction?

A

supraspinatus

65
Q

Can contribute to both flexion and abduction of shoulder

Helps to reinforce superior GH joint, centering the head and reducing vertical and anterior shear

May also tighten labrum

What muscle is this?

A

Longhead of biceps

66
Q

Joint reaction forces

A

All forces compress humeral head into glenoid fossa

Can reach 9-10x the weight of UE when arm is elevated

Greatest shear forces occur b/w 30-60˚ elevation

67
Q

What tendon is most susceptible to degenerate changes?

A

Supraspinatus tendon

painful arc 60-120

68
Q

Shoulder abduction requires SC _____, _______ and _____

A

protraction, elevation, and posterior roll

69
Q

shoulder adduction requires SC _____, _____, _____

A

retraction, depression, anterior roll back to neutral

70
Q

What is the overall ratio of scapulohumeral rhythm?

A

2:1

71
Q

Describe Scapulohumeral rhythm?

A

First 30- very little scapular movement

middle portion- 1:1 ratio

last portion: only GH motion

72
Q

What muscles upwardly rotate the scap

A

Trap and serratus anterior

73
Q

What happens at the SC/AC during 60 degrees of GH elevation

A

SC elevation -> Costoclavicular ligament becomes taut

AC posterior roll -> Conoid and trapezoid (coracoclavicular) ligaments and costoclavicular ligaments are taut and prevent more elevation

74
Q

What two delts work together for abduction?

A

ant and mid delt

Note: supraspinatus has larger MA than delt at less than 60 degrees of abduction

75
Q

Infraspinatus, teres minor, subscapularis
Activity is greater in _______ than abduction

A

flexion

76
Q

Rhomboids and levator scapulae do what?

A

Elevate and downwardly rotate scap

77
Q

What muscles can depress the scap?

A

Latissimus Dorsi- Adduction, extension, and medial rotation of humerus + Adduction and depression of scapula

Pectoralis Major Sternal Portion – depress GH and shoulder complex

Pectoralis Minor- Assists both by directly depressing scapula through attachment to coracoid process

Teres Major and Rhomboids- Strongly synergistic during adduction and depression of humerus

Levator Scapular- Downward rotation of the scapula

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