What is the difference between the glenohumeral joint and the shoulder girdle (describe scapulothoracic movement)? What are the normal movements of each?
- the glenohumeral joint is a ball and socket joint that is responsible for connecting the upper extremity to the trunk. It’s a combination of the humeral head and glenoid fossa of the scapula
- the shoulder girdle provides support to your shoulder region and allow for a large ROM
- scapulothoracic movement is the site of movement between the scapula (shoulder blade) and thorax (chest wall)
- normal movements: abduction, adduction, elevation, depression, upward rotation, downward rotation
Explain how the total motion of the shoulder is created (hint: scapulohumeral rhythm)
- the scapula rotated 1 degree for every 2-degree movement of the humerus
- the first 30 degrees of glenohumeral abduction does not incorporate the scapula motion
- 30-90 degrees, the scapula abducts and upwardly rotates 1 degree for every 2 degrees of humeral elevation
- above 90 degrees, the scapula and humerus move in 1:1 ratio
What is the primary function of the rotator cuff? Describe and locate the muscles that make up the rotator cuff
- function = stabilize the glenohumeral joint by compressing the humeral head against the glenoid
- location = surrounding the shoulder joint
- muscles = (S.I.T.S)
- supraspinatus
- infraspinatus
- Teres minor
- subscapularis
Explain the difference between a shoulder separation and a shoulder dislocation. Explain the most common mechanism of injury for each.
- shoulder separation = injury to the ligament between the shoulder blade and collarbone
- mechanism: a forceful blow to the tip of the shoulder
- shoulder dislocation = the humerus fully loses contact with the socket of the shoulder blade
- mechanism: forced abduction and external rotation
What is a step deformity?
visibly raised point of the shoulder where the collar bone and shoulder blade has separated due to a ligament tear
- different levels of the bones
what is the piano key sign and what injury would this indicate?
when the ulna protrudes and the forearm is demonstrated by depressing the ulnar head and it springs back into position
- wrist instability
What would be the immediate treatment for shoulder dislocation? What are common complications resulting from this type of injury?
- immediate treatment: refer to physician for reduction and x-rays, NEVER push back yourself
- common complications:
- recurrence
- tearing of muscles, ligaments, or tendons
- nerve or blood vessel damage around shoulder joint
What is the brachial plexus? What is its significance?
a network of nerves in the shoulder that carries movement and sensory signals from the spinal cord to the arms and hands
What is a stinger (or burner)?
a sudden burning pain or numbness in the at, often accompanied by weakness of the upper arm or shoulder muscles after an injury
List the three most common mechanisms of injury to the shoulder? Provide a sport-specific example of each. How can we help prevent each from happening?
mechanisms:
- direct trauma - ex: dislocation when getting tackled in football
- indirect trauma- ex: overhead pressing with too heavy of a weight
- throwing-type motions- ex: softball player with shoulder pain after pitching for her whole softball career
prevention:
- have an adecquate warm up
- monitor the athlete for overtraining/overload
- listen for warning signs
What are the three (3) articulations at the elbow joint?
- humero-radial joint
- radio-ulnar joint
- humero-ulnar joint
What are the parts of the humerus (specific anatomy) that articulates with each of the two other bones?
- trochlea
- capitulum
What are the main ligaments in the elbow? Where would you find the two major bursae?
ligaments:
- medial collateral ligament
- lateral collateral ligament
- ulnar collateral ligament
two major bursae:
- bicipital bursa = biceps brachii
- olecranon bursa = tip of the elbow
What is the carrying angle? What is the normal range for males? Females?
carrying angle: angled formed by the long axis of humerus and midline of the forearm, larger angles are considered abnormal
normal ranges:
- females = 13-16 degrees
- males = 11-14 degrees
. List the two (2) most common mechanisms of injury to the elbow? Provide a sport specific example of each. How can we help to prevent each from happening?
mechanism:
- direct/indirect trauma- ex: falling while biking and landing on your arm/ trying to do a clean with too much weight and causing dislocation
- chronic repetitive throwing- ex: tennis elbow
prevention:
- monitor amount of activity
- encourage different sport movements
- rest
Discuss common fractures of the elbow and forearm. What would the immediate treatment be?
fractures:
- humerus
- supracondylar fracture
- radial head
- 4 classes (mason)
- olecranon process (ulna)
- coronoid process fracture
- medial epiphyseal plate
treatment:
- refer to GP for x-ray
What ligament is always ruptured with an elbow dislocation? What is the most common direction for the dislocation to occur?
ligament: lateral ulnar collateral ligament (LUCL)
most common direction: axial compression
What are the medical names for little league elbow? Discuss the cause of little league elbow. What conditions would be included in a little league elbow?
medical name: medial epicondyle apophysitis
cause: excessive throwing in young athletes (valgus stress)
conditions:
- tendonitis/ tendinosis
- medial humeral growth plate
- avulsion fracture
Which carpal bone would you find in the anatomical snuff box? Why is this bone particularly significant to the athletic trainer?
carpal bone: scaphoid
significant because it is important for motion and stability in the wrist joint
In the anatomical position, the radius is on what side of the wrist? Are the radius and ulna parallel or crossed in this position?
- lateral forearm right side
- parallel
. Describe the carpal tunnel. What structures create the tunnel? What structures run through the tunnel? What happens when the structures running through the tunnel get irritated? Why is this significant to the athletic trainer?
- carpal tunnel: narrow passageway surrounded by bones and ligaments on the palm side of your hand
- structures: arched carpal bones and carpal ligaments
- when the median nerve is compressed, numbness, tingling, and weakness in the arm and hand may occur
- good for AT to know so they do not overwork the athlete and is able to avoid pain
What rule should you enforce regarding wearing rings while playing sports?
do not wear rings during activity
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Module 1: introduction/terminology30
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Module 2: Functional Anatomy- Terminology29
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Module 3: Risk Management36
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Module 4: functional movement16
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Module 5: soft tissue response35
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HOPS25
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module 9: lower extremity- worksheet26
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final18
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module 6: Injury assessment and emergency response - worksheet10
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shoulder joint complex7
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upper arm, elbow, forearm5
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wrist, hand, and fingers5
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ankle5
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hip and thigh8
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lower leg and foot4
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upper extremity worksheet22
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hip/thigh review sheet16
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knee/lower leg review sheet18
