Kines I final > Shoulder > Flashcards

Shoulder Flashcards

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1
Q

3 joints of shoulder

A

Glenohumeral
Sternoclavicular
Acromioclavicular

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2
Q

in flexion/abduction, how much do the scapula and GH joint contribute

A

scapula 1/3

GH joint 2/3

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3
Q

What kind of joint is sternoclavicular?

A

synovial plane

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4
Q

SC disk- upper attachment

A
  • considered part of manubrium

- in elevation and depression, medial clavicle ROLLS AND GLIDES on stationary disk

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5
Q

SC disk- lower attachment

A
  • part of clavicle

- in protraction and retraction, SC disk and medial clavicle ROLL and SLIDE on manubrial facet

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6
Q

Functions of SC discs

A
  1. stability
  2. increase joint congruence
  3. absorbs forces transmitted from lateral to medial
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7
Q

What does SC disc limit

A

medial movement of clavicle

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8
Q

What ligaments comprise the joint capsule

A 
Sternoclavicular ligament (anterior and posterior)
Costoclavicular ligament (anterior and posterior)
Interclavicular ligament
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9
Q

What is the function of the sternoclavicular ligament?

A

reinforces joint capsule

limit A/P translation of medial clavicle

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10
Q

Bilaminar costoclavicular ligament function

A
  • limit elevation of lateral clavicle

- help inferior glide of medial clavicle

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11
Q

interclavicular ligament

A
  • limits excessive depression of lateral clavicle

- aids in superior glide of medial clavicle

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12
Q

SC joint motions

A

elevation/depression
protraction/retraction
anterior/posterior rotation

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13
Q

SC joint elevation and depression slide arthrokinematics

A

elevation- superior roll, inferior glide

depression- inferior roll, superior glide

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14
Q

SC joint elevation depression ROM

A

Elevation:

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15
Q

SC joint protraction/retraction arthrokinematics

A

protraction: anterior slide
retraction: posterior slide

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16
Q

concave/convex of protraction retraction of SC joint

A

concave: clavicle
convex: manubrium

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17
Q

SC joint protraction retraction ROM

A

protraction: 15-20º
retraction: >30º

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18
Q

SC joint anterior posterior rotation (spin) between what surfaces

A

saddle shape surface of medial clavicle and manubriocostal facet

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19
Q

anterior posterior rotation of SC joint motion

A

it can posterior rotate but it’s anterior rotation is just coming back to normal (it’s pretty limited)

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20
Q

SC joint anterior posterior rotation ROM

A

Anterior rotation:

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21
Q

SC joint and stress (degeneration)

A
  • SC joint does NOT undergo a lot of degenerative change like other shoulder joints
  • SC disc and Costclavicular ligament minimize stress
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22
Q

AC joint type

A

synovial plane

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23
Q

AC joint functions

A
  1. to allow scapula to rotate in 3D during arm movement so UE motion is increased
  2. allows transmission of forces from UE to clavicle
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24
Q

is the AC joint capsule weak or strong?

A

Weak. cannot maintain integrity without reinforcement of ligaments

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25
ligaments of AC joint are...
- superior and inferior Acromioclavicular ligament | - coracoclavicular ligament
26
what does the superior acromioclavicular ligament limit
limits movement caused by anterior forces
27
is superior AC ligament stronger or weaker than inferior AC ligament?
stronger
28
what reinforces fibers of superior AC ligament
aponeurotic fibers of traps and delts
29
function of coracoclavicular ligament
1. unites clavicle and scapula 2. provides most of the joints superior and inferior stability 3. protect tendon of RTC
30
describe the medial part of the coracoclavicular ligament
- conoid | - provides restraint to translatory movement by superior directed forces to distal clavicle
31
describe the lateral part of the coracoclavicular
- trapezoid | - provides more restraint that the conoid to translatory movement caused by posterior directed forces.
32
what do both portions (conoid and trapezoid) do together?
- limit upward rotation of scapula | - prevent medial displacement of scapula (esp trapezoid)
33
what are the motions that occur at the AC joint?
internal/external rotation anterior/posterior tilting upward/downward rotation
34
AC joint internal external rotation ROM
I and E comibined: 30º
35
Anterior/posterior tilting of AC joint ROM
anterior and posterior combined 20-40º
36
upward and downward rotation of AC joint ROM
available ROM 30º
37
AC joint and stress
yes, susceptible to trauma and degenerative stress
38
Scapulothoracic (ST) joint closed pack position
abduction | ER
39
motions of the scapula
``` upward and downward rotation- primary scapular motion elevation and depression- SC jt protraction and retraction- SC jt Internal and external rotation- AC jt Anterior and Posterior tilting- AC jt ```
40
Glenohumeral joint type
ball and socket
41
what is the angle of inclination (GH joint)
- axis through humeral head and neck in relation to longitudinal shaft of humerus - (between 130º and 150º: typically 135º)
42
angle of torsion (GH joint)
- axis through humeral head and neck in relation to an axis through humeral condyles - usually 30º
43
Function of the labrum
1. attachment for biceps long head 2. resists translation of humeral head 3. reduces joint friction 4. enhances depth by 50% 5. protects bony edge of labrum
44
What makes up the GH capsule?
superior GH ligament middle GH ligament inferior GH ligament complex
45
what does the superior GH ligament do? when is it active
- contributes most to anterior and inferior joint stability | - at 0º abduction
46
what does the middle GH ligament do? when is it active?
- contributes mainly to anterior joint stability - absent in 30% people - at 0-60º abduction
47
what does IGHLC do? when is it active?
- has 3 parts: anterior, posterior ligaments with axillary pouch in between. - anterior ligament limits anterior translation at ER - posterior ligament limits posterior translation at IR - with at least 45º abduction, IGHLC resists inferior humeral head translation.
48
Coraacoacromial arch limits what
inferior translation of humeral head
49
what does Band 1 and Band 2 of coracoacromial ligament doe
Band 1: inserts onto supraspinatus and greater tubercle; joint superior GH ligament Band 2: inserts onto subscapularis and lesser tubercle both form tunnel for LONG head of biceps
50
what is repetitive impingement?
inflammation, fibrosis, thickening of soft tissues; | further reducing subacromial space during arm elevation
51
most important bursae of shoulder complex? function?
- subacromial and subdeltoid bursae | - reduces friction to permit smooth gliding
52
GH motions and ROM
Flexion (120º) and Extension (50º) Abduction and Adduction Medial and Lateral rotation (90º-120º)
53
Scapulohumeral Rhythm
- elevation of humerus - upward rotation of scapula - posterior tilt of scapula - 2:1 ration (GHJ:STJ)
54
upward scapular rotators?
Upper, Middle, Lower trap | SA
55
What muscles make up rotator cuffs (RTC)?
Supraspinatus Infrapsinatus Teres minor Subscapularis
56
What do RTC cause at the joint?
compression and joint stabilization
57
What happens at glenohumeral elevation?
supraospinatus is most active 0-60 (initiates elevation) | deltoid is prime elvator for flexion, assist abduction AFTER 15 degrees.
58
describe what happens with the deltoid and supraspinatus during arm elevation (MA of deltoid and supraspinatus, deltoid force)
- deltoid has small MA during early elevation - supraspinatus has longer MA during early elevation - deltoid MA improves in mid range (gets longer) - deltoid provides greater abduction force tha nsupraspinatus Overall: deltoid is good abductor after 15 degrees. Deltoid MA increases so it becomes stronger to abduct amr.
59
Describe the deltoid and the rotator cuff during arm elevation?
- deltoid causes superior glide of humerus (lead to impingement bw humerus and acromion) - RTC causes inferior glide Overall: deltoid has superior pull; RTC has inferior pull
60
Shoulder depressors in WB
lats | pec major
61
if teres major is weak, what happens to scapula?
wings out
62
what is the antagonis of the teres major? what is it's function
- rhomboids | - Rhomboids need to stabilize the scap so it prevents IR to keep the scapula in good position so it doesn't fly off.
63
scapular depression and abduction muscle
pec minor
64
What is GIRD?
Gleohumeral IR Deficit | - loss of IR of 20 degrees or more compared to other side
65
How can you get GIRD
- shoulder overuse injury - impingement - RTC tears - SLAP tears
66
what does GIRD cause (torsion) and why
Humeral retroversion because after years of throwing constantly, the shaft of the humerus begins to rotate, so humeral heads sits posteriorly on glenoid.
67
serratus anterior weakness causes and what does it cause?
causes: long thoracic nerve palsy and disuse | will cause: scapular winging IN FLEXION
68
Upper trapezius weakness- causes and what does it cause
causes: Spinal accessory nerve palsy (SNAP) | will cause: scapular flip, trap atrophy, depressed scap, trap weakeness, limited shoulder abduction
69
how to tell if it's serratus weakness or trapezius weakness
if scap wings in Abduction= upper traps Flexion= SA
70
what can cause RTC weakness?
``` tear suprascalular n pinch C5-C6 radiculopathy bursitis CVA disuse ```
71
what is hemiplegic shoulder?
when joint is sublaxed (not even sitting in glenoid fix posture first then muscles (supraspinatus, delts)
72
resting position of scap
UR 5-10 AT 10-15 ARot 35-45
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