1) Sternum

2) clavicle

3) humerus

4) scapula

1st rib articulates with both the manubrium and the body of the sternum.

True or false

False

1st rib articulates with just the manubrium

The anterior surface of the Clavicle....

Medially is ______ and laterally______?

Upper: supraspinatus

Middle: infraspinatus

Lower: teres minor

2nd rib

T3

7th rib

1) type I - flat

2) type II - curved

3) type III - hooked

Scapulothracic Joint properties

(4)

1) functional joint

2) the base on which the humerus moves

3) stabiity is derived from 17 muscles

4) contributes to force absorption and production

1) elevation: UT, levator, rhomboid

2) depression: LT, lower portion of Serratus

3) Retraction: Trap, rhomboids

4) Protraction: serratus Anterior

5) Upward rotation: Serratus anterior, UT, LT

6) Downward Rotation: Rhomboids, levator

If a pt. has FHRS posture they will be expected to  have the ability to raise their hands over their head.

True or false

1) force absorbtion

2) increase the surface area of the joint

1) joint capsule

2) anterior sternoclavicular ligament

3) posterior sternoclavicular ligament

4) costoclavicular ligament

5) interclavicular ligament

At the SC joint....

Elevation/ depression occurs in what plane and around what axis?

protraction/Retraction?

clavicular rotation?

1) parallel to the frontal plane, A-P axis

2) Parallel to the horizontal plane, S-I axis

3) rotation occurs around the longitudinal axis

Elevation:45 degrees

Depression: 10 degrees

1) Acromioclavicular ligament

2) Coracoclaviclavicular ligament

3) articular disc

1)Fibrous Capsule

2) GH ligaments

3) Coracohumeral Ligament

4)capsular reinforcement by rotator cuff

5) Glenoid Labrum

6) Static Stabilizing forces

Superior GH Ligament

1) comes from where

2) inserts

3)taught in what positions

1) supraglenoid tubercle

2) anatomic neck

3) adduction, inferior and posterior humeral translation

Middle GH ligament

1) origin

2) insertion

3) taught in what positions

1) anterior rim of the glenoid fossa

2) Anterior capsule

3) anterior translation and ER

Inferior GH ligament

Origin 

insertion

name the 3 distinct pouches

fibers are tight during what movements?

1) anterior-inferior rim of the glenoid fossa and adjacent labrum

2) anterior-inferior and posterior-inferior margins of the anatomic neck

3) anterior band, posterior band, axillary pouch

4) all bands are tight during abd

Anterior: abd/ER

posterior: abd/ IR

1st: Education on avoiding re injury, modalities as necessary, ROM and gentle stretching

2nd: isometrics, consider friction massage and joint mobs. address instability

3rd: friction massage, increase focus on strengthening, NM contral joint play.

PT surgion comunications for RC tear

Size and type of tear

number of tears

location of tear

integrity of tissue/blood supply

type of deltoid resection

Rehab protocol RC tear

1) 0-3 wks

2) 3-6 wks

3) 6-12 wks

4) 12 wks - 6 mo

1) PROM/ scapular stab

2) AAROM, rotor cuff stab, NM re-ed, postural training.

3) AROM and PRE below 90 degrees

4) functional training

Coracohumeral Ligament

Origin

insertion

when is it taught

1) lateral borader of coracoid process

2) anterior side of the greater tubercle

3) Extreme ER, flexion, and extension. Also inferior translation

What reinforces the anterior capsule?

posterior capsule?

superior capsule?

anteior capsule: subscapularis

posterior capsule: infraspinatus and teres minor

superior capsule: supraspinatus

zone I starts at 12 o'clock

zone II starts at 3 o'clock

zone III starts at 6 o'clock 

zone IV starts at 9 o'clock

Named while looking at a lateral view of the labrum.

What are the static forces that hold the humerus in place? (3)

1) compressive force due to the inclination of the the glenoid

2) tension in the superior capsular structures

3) normally intra articular pressure in the joint

bankhart lesion

What is affected?

Where is the tear?

Labrum

zone II (3-6 o'clock)

SLAP lesion

Cause?

Torn by what?

1) FOOSH, throwing sports, volleyball, tennis

2) the biceps tendon

Arthrokinamatics of the GH joint roll and glide

Axis of rotation

1) Flexion/extension

2) Abduction

3) adduction

4) ER

5) IR

1) M-L axis spin of the humerus(slight inferior and posterior glide)

2) A-P axis roll superior glide inferior 

3) A-P axis roll inferior glide superior

4) S-I axis posterior roll anterior glide

5) S-I axis anterior roll posterior glide

Coracoacromial arch function

(2)

1) serves as the roof of the glenohumeral joint

2) protects the supraspinatus

subacromial space contains what?

(4)

1) supraspinatus muscle tendon

2) subacromial bursa

3) long head of the biceps

4) portions of the superior capsule

1)posture

2) osteophyte formation

3) AC joint Degeneration

4) hypertrophy of the coracoacromial ligament

5) inflammation of the subacromial bursa

Humeral protectors

1) what muscles

2) how do you test them

3) purpose

1) Supraspinatus, infraspinatus, teres minor, subscapularis, long head of biceps

2) subscap: push off

infra: 45 degrees of internal rotation

teres: neutral

biceps: decelorator of the humerus

3) work together to oppose the upward pull of the deltoid and hold the humerus in the glenoid

Scapular pivoters

1) muscles involved

2) purpose

1) Levator, UT, LT, rhomboid major, Rhomboid minor

2)pairs concentrially or eccentrically to rotate the scapula

Humeral Positioners

1)muscles/ innervation

Deltoid - 3 heads/C5-6 

Pec Major/C5-6

Lat dorsi/ C6-8

Humeral positioners force couples

1) abduction

2) forward flexion above 90

3) forward flexion below 90

1) Delt/ RC

2) Ut/ upper serratus

3)LT/ lower serratus

Scapulohumeral Rhythm 

Capsular innervation/location of pain referal

1) anterioinferior

2) sup & post capsule

3) superioanterior

1) Axillary N/deltoid & teres Minor

2) supra scpular N./ supraspinatus & inferaspinatus

3)lateral pectoral N./pec major

dorsal scapular Nerve 

1) innervates

2) damage causes what

1)LS & rhomboids

2) loss of retraction and downward rotation

1) in between middle and anterior scalenes

2) between clavicle and 1st rib

3) pec minor and upper ribs

humeroulnar joint

humeroradial joint

proximal radioulnar joint

Medial collateral ligament

Anterior bundle 

1) resists what motion

2) origin

3) insertion

4) when is it taught

1)Valgus at the elbow

2) medial epicondyle

3) coronoid 

4) full extension

UCL posterior bundle

1) origin

2) insertion

3) taught in what position

1) medial epicondyle

2) olecranon process

3) extreme elbow flexion

The transverse bundle of the UCL provides the most stability for the elbow joint.

true or false

False

it is contained fully on the ulna and provides no stability.

lateral epicondyle, blends with annular ligament

Lateral epicondyle, supinator crest

-5 - 145

30-130

C5-7

Biceps brachii

coracobrachialis

brachialis

Radial nerve

1) nerve root levels

2) pathway

1)C5-T1

2) travels through radial groove of the humerus emerges from the lateral side of the distal humerus

Ulnar Nerve

1) nerve root levels

2) nerve pathway

1) C8-T1

2) posterior to the medial epicondyle